Are Stomach Ulcers Caused by Stress?

For decades, conventional wisdom held that stomach ulcers developed as the result of stress and spicy foods. Even Alfred Nobel, the man who established the Nobel Prize, once said, “Worry is the stomach’s worst poison.”

In fact, two scientists who discovered a link between stomach ulcers and bacteria had a trouble convincing the medical community of their findings until one researcher did something drastic.

About Your Stomach and Gastric Ulcers

A stomach ulcer is an open sore on the lining of your stomach. Also known as peptic ulcers, stomach ulcers are common. Nearly 15 million people in the United States have been diagnosed with stomach ulcers, according to the Centers for Disease Control and Prevention (CDC).

The stomach is an important part of the digestive tract, responsible for mixing food with digestive juices. Glands in the stomach produce acids and enzymes that help break down food, while powerful stomach muscles churn the food with these juices.

The stomach is a hollow organ, somewhat like a bag with a lining. It consists of several layers of tissue:

• Mucosa – the stomach’s inner lining, where gastric ulcers develop
• Submucosa – situated below the mucosa; contains connective tissue, blood vessels, nerve cells, and lymph vessels
• Muscularis externa – layers of muscles that contract and relax to break down food
• Serosa – the outermost layer that wraps around the stomach

Stomach ulcers affect the gastric mucosa, which is the innermost layer of tissue inside the stomach. As its name suggests, the gastric mucosa is always covered in mucus, a slippery goo that protects the delicate tissue inside the stomach.

Ulcers develop when something erodes the protective gastric mucosa and begins to attack the tissues below. Erosion eventually causes open sores; stomach acid can continually irritate the sores to cause symptoms and further damage. Left untreated, stomach ulcers can cause internal bleeding and other serious complications. They can even wear a hole completely through the stomach wall.

2 Scientists Discover Bacterial Cause of Stomach Ulcers – and Nobody Believed Them

Australian Dr. Robin Warren was working as a pathologist at Royal Perth Hospital, where he routinely looked at and evaluated specimens collected during biopsies. During the early 1980s, he began to notice colonies of an unknown strain of bacteria living in the lower part of the stomach in about half of all patients who had their stomachs biopsies. What’s more, the scientist noticed signs of inflammation were always present in the gastric mucosa near the bacteria.

A young clinical fellow, Barry Marshall, became interested in Warren’s findings. The two scientists began studying biopsies from 100 patients and eventually cultured (grew) the previously unknown strain of bacteria, later named Helicobacter pylori (H. pylori). The organism was present in nearly every patient who had inflammation or a stomach ulcer.

Based on their findings, Warren and Marshall proposed that H. pylori, not stress, was the underlying cause of stomach ulcers. The medical community was not so convinced, though.

At the time, doctors routinely prescribed medications to reduce acid production in the gut. This worked, at least for a little while, because H. pylori thrives in acidic environments, such as the stomach. Antacids do not kill bacteria, though, so the stomach ulcers would return after the patient stopped taking the medication.

Warren and Marshall wanted to prove that patients could only be cured of stomach ulcers by eliminating the H. pylori bacteria, but they faced many obstacles. They could not experiment on lab mice because H. pylori only affects primates, for example, and they were prohibited from experimenting on people.

Without other options, Marshall did the unthinkable: he stirred some H. pylori biopsied from a patient’s gut into a broth and drank it.

He began to feel the symptoms of the precursor to a stomach ulcer, gastritis, a few days later. He returned to his lab, where he performed a biopsy of his own stomach and cultured H. pylori, thereby proving that the bacterium was the underlying cause of stomach ulcers.

In 1982, Warren and Marshall proved that eliminating the H. pylori bacterium is the only way to cure stomach ulcers. In 2005, they won a Nobel Prize – ironic, considering the pair of scientists disproved one of Nobel’s famous sayings about worry being the cause of stomach problems.

Today, doctors prescribe antibiotics to treat stomach ulcers.

Diagnosing and Treating Stomach Ulcers

Doctors use a number of tests to diagnose stomach ulcers. Diagnosis usually begins with an evaluation and blood tests for H. pylori. Imaging can include an upper GI/endoscopy that allows doctors to view the stomach and other digestive organs. The radiologist performing the study may take biopsies of tissues for laboratory testing.

For more information about stomach ulcers and stress, or to have an H. pylori test, consult with your doctor.