¿El estrés causa úlceras? Es hora de obtener los hechos

Digestivo

por Muhannad Al Hanayneh, MD

julio8,2025

If you’re one of the nearly four million Americans affected by stomach ulcers, you know how painful and disruptive they can be. A common question you might even be asking yourself is: Does stress cause ulcers?

While stress affects your body in many ways, it does not directly cause ulcers. However, stress may worsen symptoms or slow healing.

Let’s take a look at the facts.

What causes ulcers?

An ulcer is a sore or break in the lining of the digestive tract. Stomach ulcers fall under gastrointestinal ulcers, which can also occur in the esophagus, small intestine, or colon.

The two main causes of stomach ulcers are:

  • Infection by Helicobacter pylori (H. pylori): This bacterium damages the stomach’s protective lining, allowing acid to cause ulcers. H. pylori is highly common, but only about 10-15% of infected individuals develop ulcers. Recent treatment includes combination antibiotic therapies, but antibiotic resistance is an emerging challenge.
  • Prolonged use of NSAIDs: Over-the-counter pain relievers like ibuprofen, naproxen and aspirin can damage the stomach lining, especially if used long-term or combined with H. pylori infection. It’s recommended to limit NSAID use and consult a doctor for alternatives if you have an increased risk of ulcers.

Other less common causes include acid hypersecretory conditions such as Zollinger-Ellison syndrome (ZES) and chronic digestive diseases like Crohn’s disease.

What are the symptoms of a stomach ulcer?

These painful lesions that develop in the lining of your stomach can significantly impact your daily life and require proper medical attention. Recognizing the warning signs early is crucial for preventing serious complications and getting appropriate treatment:

  • Persistent, nagging stomach pain that may worsen after eating
  • Bloating, heartburn or nausea
  • Black, tarry stools (indicating possible bleeding)
  • Vomiting blood or coffee-ground-like material (a sign of serious bleeding)

If you experience these symptoms, seek medical attention promptly to avoid complications like bleeding or perforation.

Stomach ulcer diagnosis

Doctors diagnose ulcers using an endoscopy, a procedure involving a thin, flexible camera tube inserted while you are sedated. This allows direct visualization of ulcers and biopsy sampling to check for H. pylori or rule out cancer.

Other tests include breath or stool tests to detect H. pylori infection.

Ulcer treatment helps with early intervention

Si las úlceras no se tratan, pueden continuar dañando el estómago y provocar una perforación (o agujero) en el revestimiento.

Ulcers are usually just found in the innermost layer of the gastrointestinal system, called the mucosa. However, when it starts eroding deeper, it can create a hole in the entire wall of the stomach. This will require emergency surgery to fix.

For most stomach ulcers, you can treat them conservatively with the following medical and lifestyle approaches:

Over the counter (OTC) medications

  1. Proton Pump Inhibitors (PPIs): These are the most effective medications for reducing stomach acid production and promoting ulcer healing. PPIs work by blocking the enzyme responsible for acid secretion in the stomach lining, allowing ulcers to heal and reducing pain.
  1. Antibiotics (if H. pylori infection is present): If testing confirms H. pylori, a combination of antibiotics is prescribed to eradicate the bacteria, usually alongside a PPI.

Lifestyle and dietary changes

There are rarer causes of stomach ulcers that can lead to reoccurring problems. This can happen, for example, if your stomach produces too much acid or if you’re living with a chronic digestive condition like Crohn’s disease. But for the most common types of ulcers, adjusting your lifestyle and treating the infection will heal them. Some changes might include:

  • Quitting smoking, as smoking impairs healing and increases acid production.
  • Pain medication awareness, which involves avoiding NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen, aspirin, and naproxen, which can worsen ulcers. Use acetaminophen for pain relief instead. NSAIDs can be used sparingly for no longer than 2 weeks at a time.

The bottom line: Does stress cause ulcers?

While stress does not directly cause stomach ulcers, it can affect your overall digestive health by slowing healing and increasing symptom severity. Managing stress and following your healthcare provider’s recommendations can improve recovery.

If you experience persistent stomach pain or signs of bleeding, consult your doctor immediately for diagnosis and treatment.

Concerned about your risk for ulcers and other digestive disorders? Take our gut health quiz or book an appointment with a gastroenterologist near you.

Sobre el Autor

El Dr. Al Hanayneh es gastroenterólogo del personal médico de Clínica de especialidades Baylor Scott & White - Marble Falls. Anteriormente, fue profesor asistente en la sucursal de la Universidad de Texas en Galveston, donde enseñó a becarios, residentes y estudiantes.

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