For decades, the idea that stress or eating spicy food leads to a burning hole in the stomach—a peptic ulcer—was common knowledge. However, modern medical science has largely debunked this long-held belief.

While stress can certainly impact your well-being, the root causes of peptic ulcers are far more specific.

What Exactly Are Peptic Ulcers?

Peptic ulcers are open sores that develop on the inner lining of the stomach, the upper part of the small intestine (duodenum), or sometimes the esophagus.

They form when the protective mucous layer of the digestive tract is eroded, allowing stomach acid and digestive juices to eat away at the underlying tissue.

• An ulcer in the stomach is called a gastric ulcer.
• An ulcer in the duodenum is called a duodenal ulcer.

The most common symptom is a burning or gnawing abdominal pain, often felt between the breastbone and the belly button, which can sometimes worsen after eating (gastric ulcer) or improve with eating but wake a person at night (duodenal ulcer).

The Real Causes of Peptic Ulcers

Contrary to popular belief, peptic ulcers are rarely a result of stress alone. The vast majority of ulcers are caused by two primary factors:

1. Infection with Helicobacter pylori Bacteria: This is the most common cause. The pylori bacterium lives in the mucous lining of the stomach and small intestine. It can cause inflammation and weaken the protective lining, making it susceptible to damage from stomach acid.
2. Regular Use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Medications like aspirin, ibuprofen, and naproxen sodium, when taken regularly or in high doses, can irritate and inflame the lining of the digestive tract, increasing the risk of ulcer formation.

Less common causes include other infections, severe illness or injury, and rare conditions that cause overproduction of stomach acid.

Peptic Ulcer Myths and Facts

The link between a high-stress lifestyle and peptic ulcers is one of the most persistent medical myths. Understanding the facts is crucial for proper prevention and treatment.

Myth	Fact
Stress Causes Ulcers	FALSE. Stress does not cause an ulcer, as the primary causes are pylori infection or NSAID use.
Spicy Food Causes Ulcers	FALSE. Diet does not cause ulcers. However, spicy or acidic foods and alcohol can aggravate an existing ulcer and worsen symptoms.
Milk Heals Ulcers	FALSE. Milk may provide temporary relief by coating the stomach and neutralizing acid, but it is not a cure. The relief is short-lived, and milk can even stimulate more acid production.
Stress Worsens Ulcer Symptoms	FALSE. Diet does not cause ulcers. However, spicy or acidic foods, and alcohol can aggravate an existing ulcer and worsen symptoms.

Conclusion

While the image of a stressed-out executive developing a stomach ulcer is a cultural trope, the science is clear: stress does not cause peptic ulcers. The real culprits are the pylori bacteria and the long-term, high-dose use of certain pain relievers like NSAIDs.

Stress and diet are important to manage because they can significantly worsen the symptoms of an existing ulcer, but treating the underlying cause—the infection or medication use—is necessary for healing.

Dr. Kailash Mishra
Director & Gastroenterologist Consultant
Prime Gastro Liver Clinic