Why Does Stress Cause Gastritis and Stomach Ulcers?

There connection between stress and stomach problems is well known. We have all experienced it at some time or the other. 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 is associated with financial worry and relationship disruptions? Or are we talking about the strain on the body as a result of 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 with 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 with psychological stress and physical strain. Overuse of medication and excessive alcohol consumption, heavy cigarette smoking and irregular meal times are events that arise when we are stress. It is this behavior that can possibly 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?

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 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?

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 forms in the stomach wall. This is erosive 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?

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 needs 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.

7 thoughts on “Why Does Stress Cause Gastritis and Stomach Ulcers?

  • January 24, 2015 at 10:29 am

    Can someone going through stress without realising it for my case I will be going to a new workplace…in one week time. And I am getting excited and at the same time, having the sense of what is going to be like feeling as the days draws near? Is this stress? I am not sure I am stress. However, the body is giving out sign such as gastric pain, headache etc

  • May 15, 2015 at 11:13 pm

    I have just been through a rough time with my elderly parents and My stomach is completely messed up from stress. I have an anxiety problem anyway and this has magnified it. I am thinking I have gastritis…get a bloated
    Stomach and a burning like its inflamed, Am taking Pepzin
    GI and sucralfate before meals.
    Any suggestions?

  • March 6, 2016 at 2:53 am

    I did an upper endoscopy which revealed gastritis. Biopsy result found no bacteria so the cause was stress and anxiety.

    Eat small meals throughout the day, reduce stress and don’t worry about it.

    Doc said stomach should heal in 6 wks

  • June 12, 2016 at 4:09 am

    Nancy – you are mirroring what is going on in my life. My stomach is such a mess – My doctor actually said that my parents are killing me 🙁 God the pain i have at my ribcage is just unbearable….This is a year later for you and I hope things have improved

  • October 11, 2016 at 3:26 pm

    I’ve been dealing with this for a year now. Had an endoscopy last January and found gastritis and small hiatal hernia about 2 cm. I took pantoprazole 40 mg a day and carafate 1g 4 times a day before meal. I still have flare ups. Whenever i’m stopping the meds it’s a bad acid rebound, i tried to switch meds pepcid 2 x a day. Still won’t heal. It’s affecting my life and my family. 🙁

  • January 18, 2017 at 4:24 am

    I am a healthy, fit, 61 year old woman. I have always had crooked teeth and after braces at 55, which didn’t help, I finally decided that I now wanted a brilliant smile. I had severe dental treatment. First cleaning and scaling, followed immediately by bleaching. NEVER do this again! It was the most painfull experience. The cleaning and scaling irritates the gums and than the bleaching liquid goes in. Excruciating!! One week later I had the preparation for 6 veneers and 4 crowns. I was so nerveus that my stomach was all screwed up and I was shaking. When they took of the temporary crowns and veneers, it was even worse. There was so much cracking and hammering that I was terrified my teeth would brake. Again the stress and screwed up stomach. With the placement of the new teeth, the process took 3 hours of extreme stress. A week later an infection developped above the new crown and I had an apicoectomy, Stress again. 5 days after this I had the first stage of an implant done, say no more!!! The result now is abrilliant smile but also a completely overstressed stomach with the most severe type of acidity all day. My gastro docter, who is amazing, did an ultrasound and noticed a thickning of the wall at the end of my stomach and the top of the duodenal intestine. Her question immediately was, did you undergo something very stressfull? I explained my dental works and she told me that this has caused it. She put me on Lanzor and Nexium for a month. I hope it will heal as it is very painfull with loads of acidity and heavyness or fullness sensation of the stomach. Has anybody experienced something similar and found another remedy to speed up the process?

  • February 23, 2017 at 2:44 am

    Pam — This is what I did —

    reducing your dosage of pantoprazole and taper it off. One week 20 mg, second week use every other day, third week ever 3 days nd so on.. then stop it. At the same time I took Enzymatic Theray DGL (chew 2 before meals) 3 times a day and one at night, before going to bed. Took Enzymatic Therapy Acid Ease 3 times a day 2 with food. Will take 2 months. Once out of PPI continue DGL and Acid Ease Enzymes.

    Change your diet to bland diet. No cofee, tea, alcohol, spicy food, acidi food. Eat soft foods.


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