Why Does Stress Cause Gastritis and Stomach Ulcers?

The connection between stress and stomach problems is well known. We have all experienced it at some point or another. It can vary from a little indigestion to a dull ache or even chronic stomach problems when we are stressed.  However, there is sometimes confusion about whether stress causes these stomach problems or not.

In fact, there is even more confusion about what stress means in the context of related esophagus (gullet), stomach, and intestinal problems. With regards to gastritis, the term stress gastritis is probably the most misunderstood type of stomach problem by the average person. Are we talking about stresses in life that are associated with financial worry and relationship disruptions? Or are we talking about the strain on the body as a result of a major illness?

What stress causes stomach problems?

Stress in life can worsen gastritis, flare up stomach ulcers, and exacerbate related stomach problems. It does not cause these stomach problems. However, stress from illness can cause stomach problems like gastritis and ulcers. It is therefore important to differentiate between these types of stress.

Stress in Life

The term stress is often used loosely to refer to any period of inconvenience, tension and discomfort in our lives. In these instances we are referring to mental or emotional stress which may be brought about by worry, anxiety, grief and anxiety. The collective term for these mental and emotional strains is psychological stress. In other cases it may be due to continuous and strenuous physical activity and refers to physical stress, although many of us prefer to use the word strain.

It is, however, important to consider lifestyle changes in light of psychological stress and physical strain. Overuse of medication, excessive alcohol consumption, heavy cigarette smoking, and irregular meal times are events that arise when we are stressed. It is this behavior that can possibly cause stress cause gastritis and ulcers, but not the psychological stress or physical strain itself.

Stress with Illness

However, there is another form of stress that impacts on the body. This is stress that accompanies severe and debilitating conditions where the patient is in a period of critical care. It may be seen with :

• Debilitating illness
• Extensive burns
• Major surgery
• Severe trauma
• Mechanical ventilation
• Multi-organ failure

Often these types of stresses accompanies hospitalization and without proper management death is possible. Stress with debilitating illness causes stress gastritis, more correctly known as stress-induced gastritis, and stress ulcer syndrome.

How does stress causes gastritis and ulcers?

When dealing with symptoms of stress-induced gastritis, treatment options focus on managing the underlying stress and addressing the gastric inflammation. Lifestyle modifications, such as stress reduction techniques and dietary changes, play a crucial role in alleviating these symptoms. In more severe cases of acute gastritis, medications or other medical interventions may be recommended to ease the inflammation and promote healing of the stomach lining.

A Healthy Stomach Prevents Gastritis and Ulcers

A healthy stomach has a mucus barrier that prevents the stomach acid within it from making contact with the stomach wall tissue. Thousands of mucus cells and glands in the stomach wall are constantly producing mucus to protect the inner lining of the stomach wall. In gastritis, stomach ulcers and related problems, it is this mucus barrier that is somehow compromised. The causative factor may injure and inflame the stomach wall to some extent. However, it is the stomach acid that causes more severe damage of the stomach wall.  Sometimes the mucus barrier may be normal but the stomach acid is copious or highly acidic and the mucus barrier cannot cope.

Lifestyle, Illness, Medication and Infection

Any mechanism that can cause one of the following may lead to stress cause gastritis and stomach ulcers:

1. either increases the quantity of acid or its acidity, and/or
2. decreases the mucus barrier.

It is largely caused by these factors related to lifestyle, medication use, illness and infection.

• Alcohol and recreational drugs like cocaine
• NSAIDs (non-steroidal anti-inflammatory drugs)
• Certain antibiotics
• Cigarette smoking
• Helicobacter pylori (H.pylori) infection
• Depletion of mucus barrier and host defences with illness

What types of stomach problems occur with stress?

Inflammation of the stomach lining, known as gastritis, can manifest in various forms, with acute gastritis being one type. Stress-induced gastritis is a specific subset of gastritis that occurs due to increased stress levels and can lead to uncomfortable symptoms such as stomach pain and a feeling of fullness. While these symptoms can be distressing, it’s essential to recognize that they are not directly linked to stomach cancer, which is a separate and more serious condition.

Stomach Injury and Ulcers from Stress

Gastritis is a condition where the stomach wall is inflamed. It can be erosive or non-erosive. This means that the stomach wall can be severely inflamed, but the lining has not been damaged in non-erosive gastritis. When the stomach wall is worn down and ‘eaten’ away, tiny ulcers and erosions form in the stomach wall. This is erosive stress cause gastritis. The ulcers that arise are commonly referred to as gastric ulcers or stomach ulcers.

The stomach is unlikely to be affected in isolation. Often the first part of the small intestine (duodenum) and lower part of the esophagus (gullet) are also affected. Therefore the term peptic ulcer disease is used to collectively refer to ulcers in the esophagus, stomach and duodenum. In fact, duodenal ulcers are more common than stomach ulcers.

How is stress gastritis and stress ulcers treated?

It is important to consult a healthcare professional to determine the appropriate treatment of stress-induced gastritis and to rule out any more serious underlying conditions like stomach cancer. By taking proactive steps to manage stress and addressing the type of gastritis involved, individuals can often find relief from symptoms like stomach pain and regain their stomach health.

Medical Treatment

Stress-induced gastritis and stress ulcers are treated medically with :

• Antacids to neutralize stomach acid when highly acidic or in excess.
• Proton pump inhibitors and H2-blockers to reduce stomach acid secretion.
• Antibiotics for H.pylori eradication when infection is present.

Treating Stress

Although stress-induced gastritis and stress ulcers require decisive medical intervention, these stomach problems, when associated with psychological stress, can be managed without medication in the long term. It should first be treated medically, and then the focus should be on preventing a recurrence. Stress management is the key. Lifestyle changes that arise with psychological stress need to be identified as possible contributors to stomach problems and stopped. For example, alcohol and NSAIDs must be used in moderation and not as a means to ease stress.

Dr. Hannah Cohen

She is a dedicated gastroenterologist, guides individuals to optimal digestive health. Her expertise ensures individuals enjoy a balanced and comfortable digestive system, contributing to overall well-being and vitality.