Does Stress Cause Stomach Ulcers?

A wealth of research from over the years demonstrates a strong connection between mind and body, which is why many mental health conditions can have physical manifestations as well. Stress in particular can have a variety of effects on the body over both the short- and long-term. See below for an overview of these, plus an examination of stomach ulcers in particular and whether stress can cause them.

Potential health effects of chronic stress

That’s because the body automatically instigates a number of physiological processes—known as the “fight-or-flight” response—when you feel stressed to prepare you to handle a threat. These processes include an increase in epinephrine and cortisol levels, which cause higher blood pressure, a faster heart rate, and more rapid breathing. If you’re highly stressed much of the time, these processes continue for longer than they’re meant to, keeping you in a constant state of high alert that can cause health problems.

According to an article by Yale Medicine, people who experience chronic stress may be at a higher risk for mental and physical health conditions such as:

• Hypertension
• Type II diabetes
• Arthritis
• Obesity
• Heart disease
• Metabolic syndrome
• Substance use issues (drugs and alcohol)
• Behavioral addictions (internet, food, gambling)
• Mood disorders like depression
• Anxiety disorders

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Ulcers aren’t commonly found on lists of the most common stress-related health problems, but is it possible for stress to cause them? We’ll explore research on the topic below.

What are ulcers?

An ulcer is a sore that is slow to heal, or that eventually heals but returns. Ulcers can appear virtually anywhere on the skin or even 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 stomach or peptic ulcers. They can damage the layer that safeguards your stomach from the acids inside of it, causing a significant amount of pain. They can hurt or burn when you move, or they may throb even when you’re sitting still. 

Can stress cause ulcers?

Can stress cause ulcers? The short answer is thought to be no, not on their own, but that stress may contribute to their formation and can also make them more difficult to heal. Peptic ulcers are typically caused by H. pylori bacterial infections or taking NSAIDs (non-steroidal anti-inflammatory drugs). In the past, researchers concluded that stress alone does not cause ulcers, but more recent studies suggest that there may still be a link between the two. 

Researchers have discovered that neural pathways between the brain and stomach mean that mental and emotional states can influence the gut environment. In other words, stress experienced in the brain could potentially encourage the growth of H. pylori bacteria in the stomach—especially if you’re already prone to an overgrowth of this ulcer-causing bacteria. In other words, stress could make you more vulnerable to developing an ulcer from other causes. Other risk factors for developing an ulcer include:

• Smoking
• Drug use
• Excessive alcohol consumption
• Excessive use of NSAIDs or aspirin 
• Hypertension
• Obesity
• Advanced age

How ulcers are diagnosed and treated

Since you can’t see any external signs of a stomach ulcer, you’ll typically need to meet with your doctor for a diagnosis. They may ask about your symptoms, health history, and lifestyle, and they might conduct an upper endoscopy test as well—which involves passing a tiny camera into your digestive tract to identify possible ulcers. 

Treatment depends on the severity of your ulcers, their cause, and any concurrent medical conditions you may have. It could range from over-the-counter antacids to antibiotics or other prescription medication. Your doctor will also likely recommend taking care to avoid or limit activities that can worsen an ulcer, some of which include smoking, drinking alcohol, eating spicy foods, and experiencing high stress levels. Note that ulcers can lead to serious complications if left untreated, so it’s usually important to meet with your doctor if you believe you may have one.

Tips for reducing stress levels

While there doesn’t appear to be a direct, causal relationship between stress and ulcers, reducing stress may help you avoid various gut issues and can help you heal existing ulcers. Of course, pinpointing the main causes of your stress and addressing them is typically the first step, but we can’t always change jobs, solve relationship problems, or eliminate other common sources of stress so easily. That’s when stress-reduction and stress-management techniques like the following can be helpful.

Get physically active

There’s extensive research pointing toward the power of physical activity for helping with a variety of different mental and physical health concerns—and high stress is one of them. According to the Anxiety & Depression Association of America, getting regular physical exercise can help “decrease overall levels of tension” in addition to elevating and stabilizing mood, improving sleep quality, and boosting self-esteem. Even five minutes of aerobic exercise, the article reports, can “stimulate anti-anxiety effects”. That’s why regularly engaging in the recommended amount of exercise can help you manage stress overall, and going for a walk or a jog when you start to feel your stress levels rising may make it possible for you to stay calm.

Try meditation

Meditation is the practice of cultivating a nonjudgmental awareness of the present moment. It originated as an ancient spiritual and religious practice in India and is now also practiced by religious and nonreligious people around the world. A key reason for this is that research suggests that meditation can offer a variety of mental and physical health benefits—and helping reduce stress is one of these. As a 2021 study reports, mindfulness-based meditation in particular may “significantly decrease stress”. There are many ways to learn how to meditate, from apps to in-person classes to free online videos.

Set healthy boundaries

Sometimes, ending up in situations that aren’t comfortable for you can cause stress. That’s why learning to set and enforce healthy boundaries can be helpful. For example, if you’re overextended already and someone invites you to an event or asks for a favor that you simply don’t have the bandwidth for, turning them down can assist you in avoiding a spike in stress levels. Or, if a friend or partner wants to vent to you about something that’s bothering them, kindly but firmly telling them when you’re not emotionally up for listening can contribute to safeguarding your calm, too.

Speak with a therapist

Whether you’re worried about it exacerbating an ulcer or contributing to other health issues, learning to manage stress can be an important part of improving your overall well-being. If you’re having trouble managing stress levels in your life, you may find it helpful to speak with a therapist. They can provide you a safe, nonjudgmental space where you can express and process your emotions, and they can offer you coping techniques you can use to better manage stress levels in your life. If a mental health condition like an anxiety disorder is causing additional challenges in this area, they can help you address those symptoms as well. 

Many people who experience high-stress levels have busy schedules and may find it difficult to attend regular, in-person sessions with a therapist. In cases like these, online therapy may represent a more convenient, available option. With a virtual therapy platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or online chat to address the challenges you may be facing. Research suggests that there’s “no difference in effectiveness” between in-person and online therapy, so you can generally feel confident in choosing whichever option works for you.