Are stomach ulcers caused by stress and spicy foods?

For many years, both the public and medical doctors believed that stomach ulcers were triggered by eating spicy foods, or by extreme stress.  This was mostly based on anecdotal evidence, not any legitimate research.

Hot, spicy foods were an obvious culprit – after all, people often complained of stomach pain after consuming such dishes.  Spicy foods can indeed irritate existing ulcers, but no food can cause an ulcer.

Stress often feels like it’s “eating you up inside” and can likewise exacerbate symptoms by causing excess stomach acid secretion, but stress doesn’t cause an ulcer to form.

In the 1970s, Tagamet, an acid blocker prescribed for stomach ulcer treatment, reached $3 billion in sales.  Similar drugs reached $8 billion in sales during the following decade.  None of these medications worked very well and did nothing to cure existing ulcers.

Barry Marshall, (now Professor of Clinical Microbiology at the University of Western Australia), and his colleague Robin Warren developed a theory, with confirming experiments, in the 1980s implicating the H. pylori bacteria in peptic ulcer formation.  The medical establishment was quite slow in accepting this hypothesis, as it was widely believed that H. pylori could not survive in the stomach’s acidic environment.  In fact, H. Pylori excretes special enzymes that protect it from harsh stomach acids.  This enables it to breach the mucosal stomach lining and irritate the cells underneath.  Mr. Marshall and Mr. Warren were ultimately awarded the Nobel Prize in Physiology or Medicine in 2005 for their discoveries.

Since ulcers are now known to be the consequence of a bacterial infection, they are treated with antibiotics and eventually do heal.  A small portion of stomach ulcers are caused by overuse of NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) such as Advil and Motrin because they weaken the stomach lining.  In these cases, treatment generally consists of discontinuing use of the drug.