Is it true that stress can cause stomach ulcers?

It is a widely known statement that all diseases from nerves, including stomach ulcers, are attributed to a stressful nature. It is believed that if you get too nervous, you can get this disease. We decided to check whether stress and overwork can cause illness.

The fact that the main cause of stomach ulcers is stress is written by such media as "Komsomolskaya Pravda" (“Ulcer: The Other Side of Stress”), "Arguments and Facts" (Stomach ulcer - from stress), edition "Pravda.ru" (“Ulcer is a disease of the nerves”). Similar information can be meet on websites numerous clinics, and sites selling various probiotic dietary supplements are completely categorical in their statements: “any psycho-emotional shock negatively affects the body’s defenses, and the gastrointestinal tract takes the first blow.”

Gastric ulcer (GUD) is a fairly common disease. By calculations scientists, about 4% of the world's population already suffers from it, and in some countries, such as the USA, up to 8%. By calculations According to the Russian Gastroenterological Association, from 11% to 14% of men and from 8% to 11% of women will encounter this pathology throughout their lives. Speaking scientific In other words, gastric ulcer is a “chronic relapsing disease that occurs with alternating periods of exacerbation and remission, the leading manifestation of which is the formation of a defect (ulcer) in the wall of the stomach and duodenum.” For the patient, this involves the following symptoms: pain of various types in the stomach with a predominance of “hungry” pain, heartburn, sour belching, nausea and vomiting, weight loss. The most informative diagnostic method is esophagogastroduodenoscopy, or, as it is more commonly called, gastroscopy, which consists of examining the gastric mucosa with an endoscope inserted through the mouth or nose.

The relationship between stress and gastrointestinal ulcers suggested Hans Selye. He exposed rats to various adverse effects: trauma, exhaustion, poisoning with adrenaline, atropine, morphine and formaldehyde. Noticing ulcers in the stomachs of animals at autopsy, in a 1936 article by Selye put forward hypothesis about the neurogenic etiology of peptic ulcer. This theory became dominant for decades. 

However, in 1979, Australian pathologist Robin Warren cultivated in an artificial environment and studied the bacterium Helicobacter pylori. Together with clinical microbiology professor Barry Marshall, he noted in 1983 that the microorganism was capable of neutralizing stomach acid and causing gastritis and ulcers. Scientists have hypothesized that this particular pathogen is responsible for the occurrence of ulcerative disease. However, the scientific community was not ready to abandon the neurogenic theory in favor of the bacterial one. Then Barry Marshall accepted radical decision and drank the contents of a Petri dish with a culture of Helicobacter pylori, and a few days later, using an endoscopic examination, he demonstrated to his doubting colleagues the classic clinical picture of a peptic ulcer in his own stomach. The disease was cured by taking antibiotics to which the bacterium was sensitive. In 2005, Robin Warren and Barry Marshall received Nobel Prize in Physiology or Medicine for his discovery of the bacterial nature of stomach ulcers.

According to the latest research, more than 50% of people in the world have this bacterium in their digestive tract. In some countries (Ethiopia, Nigeria, Mexico, Bangladesh, Egypt, Libya) this figure exceeds 90%. In Russia, the number of infected people ranges from 70% to 85%. However, the mere fact of infection does not mean the immediate onset of the disease. Microorganism Maybe exist in the gastrointestinal tract for a long time without causing symptoms, since the gastric mucosa has sufficient protective potential to prevent the corrosive action of pepsin and hydrochloric acid, which are part of the gastric juice. The most important provoking factor becomes taking nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, diclofenac, etc.). Also disrupt the functioning of the gastric mucosa and provoke peptic ulcers Maybe smoking, but scientists did not find a connection between moderate alcohol consumption and the occurrence of peptic ulcers. Household stress, fatigue, overexertion, burnout at work or family quarrels are also not among the provoking factors of ulcerative disease. The third most important factor counts genetic predisposition, and some of the genes responsible for an increased risk of peptic ulcer disease are also associated with the development of major depressive disorder. This may explain the cases of coincidence of poor emotional state and disturbances in the gastrointestinal tract.

However, in the speech of medical workers it is possible meet such a term missing from the ICD as “stress” or “shock ulcer”. This concept refers to an acute ulcerative process in the stomach and/or duodenum, resulting from severe trauma (serious accident, burn of a large percentage of the body, etc.) or extensive surgery. The cause of the ulcer in this case becomes the release of substances that radically narrow the walls of blood vessels and cause, in fact, ischemia of the gastrointestinal tract. This is an uncommon, but well-known complication to surgeons and traumatologists that occurs already in the hospital, so doctors who are aware of the risks prevent shock ulcers. It is important to note that shock or stress in this case does not mean everyday stress caused by a conflict at work or an ordinary quarrel, but a life-threatening state of the body.

Thus, peptic ulcer of the stomach and duodenum is a disease of bacteriological nature that occurs in people infected with a certain microorganism, mainly under the additional influence of unfavorable factors, such as taking anti-inflammatory drugs and smoking. Quarrels, conflicts, worries about deadlines, burnout at work and everyday stress cannot in themselves cause stomach ulcers. However, genes associated with susceptibility to major depressive disorder also code for greater susceptibility to the bacterium Helicobacter pylori.

Not true

What do our verdicts mean?

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