Does Stress Cause Stomach Ulcers?

Updated December 30, 2022by BetterHelp Editorial Team

A major concern of people who live with stress is that chronic worry and anxiety will cause a gastric or stomach ulcer. Typically, the main causes of stomach ulcers have been attributed to bacterial infections, smoking, and using non-steroid anti-inflammatory drugs (NSAIDs). However, recent research has indicated that there are other factors (such as anxiety, depression, and stress) that promote and impede the healing of these ulcers. This article explores how stress may increase your risk for developing a stomach ulcer and offers you healthy strategies to manage stress to reduce this risk. 

Are You Concerned That Stress Is Affecting Your Health?

What Are Ulcers?

An ulcer is a sore that is slow to heal or that eventually heals but returns. Ulcers can appear anywhere on the skin or inside the body, including within the gastrointestinal tract. Open sores that develop on the lining of the stomach or small intestine are referred to as . These sores can damage the layer that protects your stomach from the acids inside of it and cause a significant amount of pain. People also may develop ulcers externally for several reasons, including from compression injury to skin layers or bed sores.  

What Do They Feel Like?

Ulcers, whether on the inside or outside of the body, can be quite painful. They can hurt or burn whenever you move, or they may throb or emit a pulsing sensation even when you are sitting still. There are over-the-counter pain medications that you can take that might help with the problem, or if you they are severe, then you might need to get stronger prescription medication from a healthcare provider.

What Do Ulcers Look Like?

Ulcers that are outside the body are the only ones that are going to be visible to you. Their appearance varies. They might resemble red splotches that ooze. They might also look like darkened or swollen patches of skin that are similar to severe bruising. If you have what you think might be an ulcer, then your healthcare provider can confirm or deny that suspicion. If you tend to get them, then on subsequent occasions you will probably be able to identify one by yourself that has appeared on your body. 

Stomach ulcers are like external ones; however, you are unable to see them. If you are concerned you have a stomach ulcer, make an appointment with your healthcare provider. They will typically diagnose your ulcer after asking about your symptoms and taking your medical history following by an upper endoscopy test. This test involves taking a tiny camera that is passed through your digestive tract to identify possible ulcers. 

What Are Some of The Causes of Ulcers?

Some people seem to be more prone toward getting ulcers than others. They can be caused by injuries, infections, and certain diseases. Often, you will sustain an injury, and then an ulcer will form there because of a blood flow problem. The site will not be able to heal on its own and you will need to seek treatment.

If the ulcer is on the outside of your body, like on one of your legs, for instance, then it might be there because of a history of blood clots. If your legs frequently swell, then you are more prone to getting them. Osteoarthritis can cause them, and those individuals with varicose veins also have a higher tendency to suffer from them.


Bedsores are another form of ulcer that is also referred to as a pressure ulcer. A bedsore typically occurs in people who are bedridden or who regularly use a wheelchair. They are caused by prolonged pressure or friction and often occur where the bone protrudes. This pressure causes blood flow problems which in turn leads to an ulcer developing. At first, they look like off-color skin, but if not promptly treated, they can turn into large, open wounds.  Patients who are in the hospital recovering for extended periods are at a high risk for developing them if they are not closely monitored. This is why coma patients get moved to different positions throughout the day to keep them from getting bedsores.

Peptic Ulcers

Peptic ulcers are acid-induced lesions found in the stomach and duodenum (the first section of the small intestine connected to the stomach). These ulcers are typically caused by H. pylori bacterial infections, taking NSAIDs (non-steroidal anti-inflammatory drugs), and, rarely, from physical stress induced from surgical procedures. Over-the-counter acid suppressing medications and practicing care when taking NSAIDs may lower your risk for developing a peptic ulcer and improve symptoms. 

Can Stress Cause Stomach Or Peptic Ulcers?

In the past, it was concluded that stress alone does not cause ulcers. However, current research is revealing that while excessive stress will not cause ulcers, there is a link between the two. Scientists have discovered that there are neural pathways that connect the brain to the stomach that influence its environment. These studies show that stress pathways – the microbiome-gut-brain axis- influence the microbiome of the gastrointestinal system and may encourage the growth of H pylori bacteria in the stomach. While stress may play a role in making the stomach more vulnerable to developing ulcers, there are other known factors that increase your risk for peptic or stomach ulcers, including:

  • Smoking

  • Excessive alcohol consumption

  • Hypertension

  • Excessive NSAID or aspirin use

  • Obesity

  • Advanced age

  • Drug use

Of all these risk factors, excessive alcohol use is considered the most powerful influence in causing a peptic ulcer, or recurring peptic ulcers. Stress and eating spicy foods can exacerbate your condition if you have ulcers already. If you eat a blander diet, then your ulcers should heal faster. If you can reduce stress in your life, then you may also heal promptly. 

How Can You Reduce the Stress in Your Life?

While stress and ulcers are not necessarily directly related, at least not to the extent that one causes the other, reducing anxiety and stress in your life can have a beneficial effect on your gut.

Decreasing stress in your life means first recognizing what is causing you to be worried of anxious. Whether at work or in your personal life, you may notice that the anxious or stressful feelings are building within you. When you have those moments, stop and try to identify the situation, person, or environment that may be causing your stress. You may be able to pinpoint which stressors cause you extra anxiety by journaling about your day and when you feel the stress arise. 

Stress Caused by Your Job or Family 

If you have noticed that your job is the cause of your stress, you may consider finding a new job. However, this may not be possible. If this is the case, you can examine your job and your company to see where you can decrease some stress. Maybe you excel at certain areas of your job but there are parts of it that cause you severe stress. Consider talking to your supervisor or human resources manager to look for possible solutions. Maybe you are taking home more stress from work than is necessary. You may struggle with recognizing what is causing your stress at work, or you need help with setting boundaries. Consider meeting with a therapist to help you identify stressors and establish boundaries.  

Your family may be causing you extra stress and it may not be possible for you to step away for enough time to resolve these issues. If you are convinced that your family is the primary source of stress in your life, then consider setting up a time to communicate with them about the way that they are making you feel. Try to frame it in a fashion that does not sound accusatory. Instead, emphasize that there is something that they are doing that is causing you distress and work together to come up with a plan to resolve these issues. 

Are You Concerned That Stress Is Affecting Your Health?

What Happens If Peptic Ulcers Are Left Untreated?

If you do have peptic ulcers and you do not take steps to treat them, serious complications can occur. Internal bleeding can take place from the site of the ulcer which may lead to anemia (caused by low iron) from the loss of blood. An infection can also take place if the lining of the stomach or small intestine is completely eaten through by an ulcer. A serious infection of the abdominal cavity called peritonitis can also occur. If left untreated for an extended period, this infection can become serious and even life-threatening. 

Do You Feel Like Stress Is Exacerbating A Health Condition?

If you feel like stress is causing serious health conditions to occur for you, then you should seek out the aid of a healthcare provider and counselor. A healthcare provider can help you treat the ulcer and a therapist can help you with some of the stress prevention discussed in the above post. Your healthcare provide can give you a recommendation for a local therapist or you can try online therapy. A growing body of evidence is revealing that online therapy is an effective option for mental health treatment. A study published in the peer-reviewed research Journal of Clinical Psychology examined information from a large number of online counseling trials. This study found that overall attitudes between both counselors and participants were as positive as with in-person counseling. Furthermore, people who use online therapy do so in the comfort of their own home and have a diverse pool of therapists to choose from. 

With BetterHelp, you will be matched with a licensed therapist who can help you find better ways to cope with stress. You are not limited to video or phone sessions; you can also exchange messages on their platform (like email) or you can set-up live chat sessions. If you are concerned that stress is affecting the quality of your life or want support from a professional licensed therapist, reach out for a therapist today. 

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