ZocdocAnswersCan stress cause ulcers?

Question

Can stress cause ulcers?

I've heard totally contradictory answers about this question, and I'd like for it to be settled, once and for all: does stress cause ulcers or not? I know bateria has a role, but I don't understand that either - isn't our stomach full of bacteria?

Answer

All good questions. The fact is that intestinal ulcers are complicated and often there are multiple factors that come together to facilitate their creation. The first factor that is needed for an ulcer to develop is a disruption in the protective layer of the stomach. This can happen because of an infection of the bacterial H. Pylori, or because of the use of anti-inflammatory drubs such as ibuprofen. Second, there must be acid production which can eat away at the lining of the stomach once the protective layer has been disrupted. Stress, especially prolonged stress, can have an effect on stomach acid production. While this alone can cause ulcers in some cases, most of the time the bacterial infection or use of anti-inflammatory drugs in the stomach is required. To answer your second question, under normal circumstances, the stomach should not have bacteria. In fact one of the major roles of stomach acid is the killing of bacteria before they can reach the small intestine. Stomach ulcers are not something to be taken lightly. If you are experiencing stomach pain that is worsened or relieved with food, or black tarry stools, you should be evaluated by your primary care physician (family doctor or internal medicine doctor), right away.

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