Does stress really cause ulcers?

Even around the end of the 20th century, medical experts were convinced that stress was the main cause of ulcers, before spicy food, smoking and heavy drinking. Although research findings have since cast a serious doubt on this, public opinion still seems to favour this theory.

Peptic ulcer is a break in the lining of the stomach, the first part of the small intestine or occasionally the lower oesophagus. According to Great Discoveries in Medicine, peptic ulcer had the lifetime prevalence rate of 10% in the 20th century.

Before the 1980’s, even medical experts were convinced that ulcers were mainly caused by stress. Smoking and eating spicy food were thought to be secondary risk factors, suggests 50 Great Myths of Popular Psychology. This belief was probably based on the observation that whenever we’re stressed, our stomachs contract. However, Barry Marshall and Robin Warren’s Nobel Prize-winning research illustrated that this illness has strong links to bacteria called H. pylori (Helicobacter pylori).

In 1979 two Australian pathologists, Robin Warren and Barry Marshall, noticed that many (about 80%) of their gastric ulcer patients had a mysterious bacteria clinging to the tissues of their biopsy specimens. They theorized that these bacteria (the H. Pylori) had something to do with ulcers, but they were not taken seriously by the medical community.

In order to prove their theory, Barry Marshall designed a dangerous experiment. He drank a brew containing billions of H. Pylori bacteria to show that they are the main cause of ulcers. As he recalled in an interview:

“So what I thought would happen – I thought it would take hold and I would have no symptoms and be perfectly well for a few years and ultimately get an ulcer. So I was surprised when after a week I developed bad breath, and everyone in the family was complaining about me, and then all my laboratory friends put me in my own private lab and I had nobody else in there, it was so bad, and I started having vomiting attacks every morning, which was very, very weird, and I noticed there was no acid in the vomit. So weird things were happening at that point”.

However, Marschall ultimately didn’t get a stomach ulcer, so he couldn’t decisively prove the link between H. Pylori and ulcers. The proof emerged when researchers along the globe reported that their ulcer patients showed improvement after the H. Pylori infection was treated with antibiotics.

With all of this being said, many people (like Marshall himself) don’t get ulcers even after getting H. Pylori infections. This would indicate that there are other factors that lead to the development of ulcers, and stress could be one of them. It seems clear, however, that stress isn’t the main cause of this illness.



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