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The Cause of Ulcers May Surprise You


Stress, spicy foods and smoking were once thought to cause ulcers. Now we know that most ulcers are actually caused by bacteria, and helpful treatments are available. Read on to learn more about ulcers.


What is a peptic ulcer?

An ulcer is a painful sore in the wall of the stomach or small intestine. The most common symptom of an ulcer is a burning pain in the stomach.

Who gets ulcers?

About one in 10 people will get an ulcer at some point in their lives.

  • Ulcers in the stomach mostly occur in people over age 60. They are more common in women than in men.
  • Ulcers in the small intestine usually occur between the ages of 30 and 50. They are more common in men than in women.

What causes ulcers?

A healthy stomach has a balance of mucus and acid. But if you have too much harmful acid in your stomach and not enough mucus, you may develop an ulcer.  

Doctors used to think that ulcers were caused by spicy food, alcohol, cigarettes and stress. Research now shows that:

  • Most ulcers come from an infection of the Helicobacter pylori (H. pylori) bacteria. H. pylori is a common bacteria that is easy to come in contact with. Note that not everyone with H. pylori will develop an ulcer.
  • Some ulcers come from regularly taking certain medicines, such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDs).
  • Stress, smoking and drinking alcohol do not cause ulcers but may make your symptoms worse.

How are ulcers treated?                     

Ulcers are sores that need to heal. Your doctor will treat your ulcer based on what’s causing it. If it is caused by H.pylori bacteria, you may need to take antibiotics and acid-reducing medicines. If the ulcer is caused by a certain drug, you may need to stop taking that drug.

Either way, you can reduce pain and heal faster by reducing the amount of stomach acid you have. Some ways to reduce stomach acid are to:

  • Quit smoking, or cut back. The nicotine in cigarettes increases stomach acid and slows down the healing process.
  • Drink less alcohol. The more alcohol you drink, the more stomach acid you will make. Moderate drinking means no more than two standard drinks on any one day. Weekly, this means up to 14 drinks for men or nine drinks for women. Learn more about standard drink sizes here.
  • Avoid aspirin and NSAIDs. People may take NSAIDs for inflammation, fever or pain caused by headaches and arthritis.
  • Eat your meals slowly in a setting where you will not feel stressed.

Manage ulcers with proper nutrition

Eating well may help your ulcer heal more quickly and may help the stomach make less acid. Here are some tips for healthy eating:

  • Follow Canada’s Food Guide.
  • Enjoy a wide variety of foods. Choose whole grains, vegetables, fruit, low fat milk products, fish, meat and alternatives such as beans and lentils.
  • Eat foods that contain soluble fibre. A diet that’s high in soluble fibre may prevent ulcers from coming back. Foods with soluble fibre include: lentils, beans, oats, barley, peanut butter, nuts, and some vegetables and fruit.  
  • Some people feel that coffee makes their ulcer worse. If it bothers you or increases your ulcer pain, drink less coffee.
  • You do not have to eat a bland or boring diet, but some people do find that spicy food and citrus fruit make their ulcer feel worse. Spicy foods include dishes prepared with chilies, cayenne, black pepper or hot peppers. Citrus fruit are oranges, lemons and grapefruits. You can avoid these foods if they cause any pain. If these foods don’t cause any symptoms, you can continue to eat them.

The bottom line

Ulcers may be painful, but can be treated quickly. The first step is to find out the cause of the ulcer. Next, follow your doctor’s advice to treat the pain, and remember that smoking and drinking alcohol may make your ulcer worse. Choose foods that are rich in fibre - from delicious whole grains, vegetables, beans and nuts - and your ulcer may not come back to bother you again.  

If you have a peptic ulcer and would like to ask a Registered Dietitian a question, call 1-877-510-510-2 or send an email here.

For more information:

Eating Guidelines for Peptic Ulcers

Copyright © Dietitians of Canada 2015. All rights reserved.

Dietitians of Canada acknowledges the financial support of EatRight Ontario by the Ontario government. The views expressed do not necessarily reflect those of the Province.