For years, many people believed that eating spicy food, skipping meals, or dealing with stress was the primary cause of stomach ulcers. While these factors may worsen symptoms, medical experts say they are not the root cause.

Stomach ulcers, also known as gastric ulcers, are open sores that develop on the lining of the stomach. When they occur in the upper part of the small intestine, they are called duodenal ulcers. Together, they are known as peptic ulcers.

The real causes of stomach ulcers

1. Helicobacter pylori (H. pylori) infection

The leading cause of stomach ulcers is infection with a bacterium called Helicobacter pylori (H. pylori). This common bacteria weakens the protective mucus lining of the stomach, allowing stomach acid to damage the tissue beneath it.

Many people carry H. pylori without knowing it, but in some individuals, the infection leads to ulcers and other digestive problems.

2. Long-term use of painkillers

Frequent use of non-steroidal anti-inflammatory drugs (NSAIDs) such as:

Ibuprofen
Aspirin
Naproxen
Diclofenac

can reduce the stomach’s natural protective lining, increasing the risk of ulcers, especially among older adults and people who take these medications regularly.

Can stress or spicy foods cause ulcers?

Not directly.

Although stress and spicy foods can irritate an existing ulcer and make symptoms feel worse, they do not cause ulcers on their own.

However, chronic stress may affect digestion and delay healing, while spicy meals can trigger pain in people who already have ulcers.

Common symptoms

Symptoms of stomach ulcers vary from person to person but often include:

Burning pain in the upper abdomen
Bloating
Heartburn
Nausea
Feeling full quickly
Burping frequently
Loss of appetite
Unexplained weight loss

In severe cases, ulcers may cause:

Vomiting blood
Black or tarry stools
Severe abdominal pain
Dizziness or fainting due to internal bleeding

These symptoms require immediate medical attention.

Who is most at risk?

Your risk of developing an ulcer increases if you:

Have an H. pylori infection
Frequently use NSAID painkillers
Smoke cigarettes
Drink excessive alcohol
Are over 60 years old
Have a family history of ulcers

How are stomach ulcers treated?

Treatment depends on the underlying cause.

If H. pylori is responsible, doctors usually prescribe:

Antibiotics to eliminate the bacteria
Proton pump inhibitors (PPIs) to reduce stomach acid
Medicines that protect the stomach lining

If painkillers are the cause, a doctor may recommend stopping or changing the medication and prescribing acid-reducing drugs to allow the ulcer to heal.

Most ulcers heal completely within several weeks when treated properly.

How to prevent stomach ulcers

You can lower your risk by:

Washing your hands regularly to reduce the spread of H. pylori
Taking painkillers only as directed
Avoiding smoking
Limiting alcohol intake
Eating a balanced diet rich in fruits, vegetables and whole grains
Seeking medical advice if persistent stomach pain develops

The bottom line

Stomach ulcers are far more likely to be caused by H. pylori infection or long-term use of certain painkillers than by spicy foods or stress. Recognising the symptoms early and seeking prompt medical treatment can prevent serious complications and lead to a full recovery. If you experience persistent stomach pain or notice warning signs such as vomiting blood or black stools, consult a healthcare professional immediately.