Stress Is Back

People who face serious life stress are more likely to develop a peptic ulcer over the next 15 years.

By Richard Firshein, published on May 1, 1999 - last reviewed on April 25, 2005

For years, doctors believed that ulcers were psychosomatic, caused
by stress. But then researchers discovered a hardy, virulent
little bacterium known as Helicobacter priori. Able to survive and even
thrive in stomach acid, this bacterium is so damaging it has been given
Class 1 carcinogen status since it's known to be a direct precursor of
certain stomach cancers. This led scientists to believe that it caused

The discovery of H. priori was revolutionary. Doctors began to
treat ulcers with antibiotics. A combination of ampicillin and
metronidrazole (Flagyl), two common drugs, seemed to work best, and
individuals who had been suffering for years with agonizing ulcer pain
suddenly became well. Talk about a swing of the pendulum: a shocked
medical community concluded that all ulcers were caused by infection. The
search for a psychological root was abandoned.

End of story? Not quite. Eight out of 10 people infected with H.
priori never get ulcers. As an article in the Journal of the American
Medical Association points out, studies show that people who face serious
life stress are more likely to develop a peptic ulcer over the next 15
years. Research reported in the Archives of Internal Medicine followed
4500 subjects and found that the incidence of ulcers in those who felt
they were stressed was almost twice as great as in those who were
stress-free. In addition, the incidence of ulcers seems to rise after
national disasters. A review of medical records from 61 hospitals,
published in the American Journal of Gastroenterology, found that the
Hanshin-Awaji earthquake in Japan was followed by a marked increase in
bleeding gastric ulcers.

It's clear to me that the true origin of ulcers lies both in the
mind and the body. As a physician, I can see that stress plays a huge
role in all my patients' illnesses. I see flare-ups of asthma,
hypertension and diabetes during periods of stress. When approaching
treatment of any illness, I try to suggest nutritional and lifestyle
changes, and when necessary, medicines, to help both mood and

For example, a 54-year-old woman recently sought my help. She'd
suffered from ulcers for many years, and her doctor had given her
multiple courses of antibiotic therapy. The drugs had always helped, but
only temporarily; the ulcers always returned. Nobody had asked about her
levels of anxiety, but when I inquired, she admitted that she'd just
gotten out of a long and difficult marriage and was now a single mother
with financial problems. Stress had been her constant companion for

I suggested a program of meditation and biofeedback to help her
relax. I also prescribed a course of natural supplements, among them DGL
(deglycyrrhizinated licorice), a licorice extract that helps heal the
lining of the stomach, and aloe, another healing agent which soothes
inflammation. That, along with a final course of antibiotics, alleviated
her stress and quieted her inflamed gut. She hasn't suffered from an
ulcer in over a year.

To understand any disease, we need to realize that illnesses almost
always stem from multiple causes. Psychological factors should never be
overlooked when treating disease, and the immune and nervous systems
should be examined together. That's why I'm glad that stress is back at
least where ulcers are concerned.