In recent years, stress is the order of the day, and stress dominates discussions across personal, professional and medical forums. Stress is known to trigger various ailments and we have already covered this in an earlier article last month.
A common perception among people is that stress can cause ulcers. We will examine the truth behind these perceptions.
What is an Ulcer?
An ulcer is said to occur when some tissues in the organs of the digestive tract, such as mouth, tongue, oesophagus, stomach and intestines become affected. The affected areas develop a hole, or a sore, or a painful inflammation, and cause bleeding if left untreated.
Types of Ulcers
Starting from the entrance of the digestive canal and moving downstream, ulcers can be divided into 3 types:
A. Mouth ulcers: The patient suffers from painful sores on the lips, tongue, inside of the cheeks and gums. Mouth ulcers should not be ignored if they are severe or recurring, as those may be symptoms of mouth cancer.
B. Physical Stress ulcers: These ulcers are found in the upper digestive tract which includes the oesophagus and stomach. As the name indicates, this kind of an ulcer is caused when the person has previously undergone or is currently undergoing severe physical stress due to any of the below reasons.
a. Trauma to the brain or body due to falls, fractures or accidents
b. A serious long-term illness such as cancer in any part of the body
c. Surgical procedures that are long, complex, painful and involve a long recuperation time
d. Serious burns of any nature, and from any cause
e. Gastrointestinal bleeding for various reasons
f. A stay in the ICU due to life-threatening conditions
C. Peptic Ulcers: This is found in the stomach and upper part of the small intestine. While some people list duodenal ulcer as a separate type, most doctors combine it with Peptic ulcers.
Symptoms of Ulcers
• Mouth ulcers: The patient displays sores which are painful to the touch or causes a burning sensation when the person consumes hot, cold and spicy food or beverages.
• Stress and Peptic ulcers: The patient suffers from heartburn, burning sensation, weight loss, loss of appetite and nausea.
Risk Factors for Ulcers
Let us examine the risk factors and bust a few myths.
a. Spicy food: Spicy food is said to increase secretion of stomach acids which is a contributing factor for stomach ulcers. However, new research indicates that this association may be wrong.
b. Unhealthy Lifestyle: Again, unhealthy lifestyle per se cannot cause ulcers. However, the lack of proper sleep or exercise combined with an unhealthy diet can trigger various ailments which in turn cause Physical Stress Ulcers.
c. Mental stress: There is very little evidence to support that mental stress can cause ulcers. In 2015-16, a joint study was conducted by Government Health agencies in the US and Denmark to study the various risk factors for ulcers. People who perceived that their lives were very stressful as well as people who claimed low levels of stress in their lives were chosen for this study.
As per the study, participants with a high, self-perceived stress level had a 2.2-fold higher risk of being treated for peptic ulcers in 33 months time following their interview, as compared to participants with a lower level of stress. The cumulative incidence of treatment was approximately 1.2% for those with a higher stress level and 0.4% for those with a lower level of stress.
If mental stress is not a strong risk factor, what is the connection between stress and ulcers? Stress in general reduces one’s immunity to disease. This makes the person vulnerable to several ailments which in turn can cause Physical Stress Ulcers.
d. Bacterial infection: Scientists are of the consensus that bacterial infection is one of the 2 primary causes for ulcers, the other being certain medication as explained below. In 1980s, the bacteria Helicobacter pylori (H pylori) was identified as the main culprit behind ulcers. It is also known to trigger gastritis inflammation. Again, some people with H pylori in their bodies are more vulnerable than others. Further, the bacterium can stay in the body for long before triggering ulcers. The heartening fact is that treatment for H pylori is simple and lasts a few weeks.
e. Certain medications: Certain non-steroidal, anti-inflammatory drugs (NSAIDs) are known to trigger ulcers for sure. This includes Aspirin, Motrin, Advil, Aleve, Ibuprofen and naproxen. Stopping or restricting the use will reduce the ulcer condition.
Contrary to perceptions, stress cannot trigger ulcers; however, managing stress is important for overall well-being which helps eliminates other risk factors which actually contribute to ulcers.