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Stomach ulcers are open sores that develop on the lining of the stomach or upper part of the small intestine.
They are often associated with diet, particularly spicy or acidic foods, but this is one of the most persistent misconceptions about their cause.
While food can aggravate symptoms and slow healing, it rarely causes ulcers on its own. In reality, most ulcers result from a combination of infections, medication overuse, lifestyle habits, and even genetic predisposition.
Stomach Ulcer Causes Not Related to Food
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Understanding these deeper causes is essential for prevention, early diagnosis, and effective treatment. Here's a breakdown of the key factors beyond food that contribute to ulcers.
1. Painkillers
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin, and diclofenac are widely used to relieve pain, inflammation, and fever.
However, regular or high-dose use of these medications significantly increases the risk of ulcers. NSAIDs work by blocking enzymes known as COX-1 and COX-2, which are involved in inflammation and pain signalling.
A man holding the stomach in pain from ulcers
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Unfortunately, COX-1 also helps protect the stomach lining by promoting the production of mucus and regulating acid.
By blocking COX-1, NSAIDs reduce the stomach’s natural defences, making it more vulnerable to damage from stomach acid.
People with chronic pain conditions who rely on these medications for daily relief are especially at risk. Prolonged NSAID use can also delay healing of existing ulcers or cause them to bleed.
Doctors often recommend using the lowest effective dose and pairing NSAIDs with acid-suppressing drugs like proton pump inhibitors (PPIs) when long-term use is necessary.
2. Stress
Stress doesn’t directly cause stomach ulcers, but it has a powerful impact on their development, symptoms, and healing process.
When a person experiences chronic stress, the body produces more cortisol and adrenaline, which can increase stomach acid production and reduce blood flow to the stomach lining.
Stress can lead to development of stomach ulcers
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This imbalance weakens the natural barrier that protects the stomach from its own acid.
In some cases, extreme physical stress, such as surgery, burns, or major illness, can trigger what are known as stress ulcers. These are more common in hospital settings, particularly in intensive care units.
While managing stress may not eliminate ulcers, it can greatly support recovery and reduce flare-ups.
Stress-reducing techniques like mindfulness, regular exercise, and therapy can make a noticeable difference in how symptoms are experienced and managed.
3. Smoking
Smoking is a significant risk factor for developing stomach ulcers and complicates their treatment.
The nicotine in cigarettes stimulates acid production while simultaneously reducing the secretion of bicarbonate, a natural substance that neutralises stomach acid.
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Smoking is among the causes of stomach ulcers
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Smoking also restricts blood flow to the stomach lining, slowing down the body’s ability to heal damaged tissue.
In people infected with H. pylori, smoking interferes with the effectiveness of antibiotics and increases the likelihood of treatment failure.
Smokers are also more likely to experience ulcer complications such as perforation or bleeding. Despite the well-known risks of smoking to the lungs and heart, its impact on the digestive system is often overlooked.
Quitting smoking is one of the most effective ways to improve ulcer healing, reduce the risk of recurrence, and enhance overall gut health.
4. Alcohol
Alcohol, particularly when consumed in large amounts or over a long period, is harmful to the stomach lining.
It increases acid production and erodes the protective mucous layer that lines the stomach. Once that layer is compromised, acid can damage the stomach wall and contribute to ulcer formation.
Even moderate drinking can worsen symptoms in people who already have ulcers or gastritis. Moreover, alcohol interferes with the absorption and effectiveness of ulcer medications, particularly antibiotics and acid-reducing drugs.
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Alcohol intake can cause stomach ulcers
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The risk is compounded when alcohol use is combined with smoking or NSAIDs. While occasional or light drinking may not cause ulcers in everyone, heavy alcohol use is clearly linked to greater risk and delayed recovery.
For individuals with ulcers, reducing or eliminating alcohol consumption is a key step towards healing and symptom control.
5. Genetics
There is evidence to suggest that ulcers can run in families, although not in the same direct way as genetic disorders.
A family history of peptic ulcers may indicate a genetic predisposition to overproduce stomach acid or to be more susceptible to H. pylori infection.
Inherited traits may also affect how well a person’s stomach lining repairs itself or how sensitive they are to the effects of NSAIDs.
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Stomach ulcers(HSTV)
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In many families, environmental factors also play a role such as shared dietary habits, use of over-the-counter medications, or exposure to similar stress levels.
While having a family history doesn’t guarantee someone will develop ulcers, it does increase their risk.
People with this background should be especially cautious about other contributing factors and may benefit from early screening and preventive care if symptoms arise.
6. Underlying health conditions
In some cases, ulcers are not isolated conditions but symptoms of broader health problems.
One rare but notable cause is Zollinger-Ellison syndrome, a disorder in which tumours called gastrinomas form in the pancreas or duodenum.
These tumours cause the stomach to produce excessive amounts of acid, leading to severe and recurrent ulcers.
Other health conditions such as liver cirrhosis, chronic kidney disease, and respiratory disorders like COPD have also been linked to increased ulcer risk.
These conditions can impair blood circulation, reduce the effectiveness of the stomach’s protective lining, or increase the body’s stress load. In such cases, treating the underlying condition is just as important as managing the ulcer itself.
A comprehensive medical evaluation is often needed when ulcers don’t respond to standard treatment or when they appear in people without common risk factors.
It’s not just about what you eat
While certain foods can irritate the stomach and intensify ulcer symptoms, they are rarely the root cause of the problem.
Most stomach ulcers are caused by an infection with H. pylori, long-term use of NSAIDs, smoking, excessive alcohol use, chronic stress, and certain health conditions.
Food in a refrigirator
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Genetic factors and lifestyle habits can further influence one’s risk. Focusing only on food ignores the deeper causes and may delay appropriate treatment.
Anyone experiencing persistent stomach pain, bloating, or nausea should seek medical advice for proper diagnosis.
Early intervention, combined with lifestyle changes and medication, can lead to complete healing and prevent serious complications. Understanding the full picture empowers people to take better control of their health, from the inside out.