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Bruce Springsteen’s Tour Stopper: What to Know About Peptic Ulcer Disease

Stress and spicy food don’t cause ulcers, but they can make them worse


spinner image Bruce Springsteen performs at Ernst Happel Stadion on July 18 in Vienna, Austria.
Mario Skraban/Redferns/Getty Images

Bruce Springsteen postponed the remainder of his concert performances for 2023 as the 74-year-old singer continues a steady recovery from peptic ulcer disease. He had previously postponed his September performances. 

About 1 in 10 Americans will develop a peptic ulcer at some point in their lives, most commonly in middle age. The open sore or raw spot that forms in the lining of the stomach or small intestine can cause heartburn, nausea and stomach pain.

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The good news for sufferers like Springsteen is that the prognosis for recovery from peptic ulcer disease is excellent after the underlying cause is successfully treated, according to the National Institutes of Health (NIH). It generally takes several weeks of treatment —which can range from an endoscopy procedure to prescription medications including antibiotics to protein pump inhibitors — for an ulcer to heal.

1. You may have an ulcer and not know it

Many older adults with an ulcer have few or no symptoms. And for adults who do have symptoms, they can vary. The most common symptoms are abdominal pain, heartburn and the sensation of acid backing up into the throat. Other symptoms can include bloating, a feeling of fullness, hunger and belching. Pain symptoms are often described as a burning or gnawing in the stomach.

Ulcers that form in the small intestine tend to cause more consistent pain, often appearing mid-morning and recurring about two to three hours after a meal. Pain from stomach ulcers often doesn’t follow a consistent pattern, according to the Merck Manual and the Icahn School of Medicine at Mount Sinai.

2. Stress isn’t behind the disease

Stress doesn’t cause peptic ulcers. However, it can make your symptoms worse, according to the Mayo Clinic. In most cases, peptic ulcers are caused by a bacterial infection from Helicobacter pylori that can sometimes cause inflammation of the stomach’s inner layer, producing an ulcer. The bacterium causes 90 percent of small intestine ulcers and 70 to 90 percent of stomach ulcers, according to the NIH.

The second most common cause of ulcers is long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), which can lead to a decrease in the gastric mucus that helps protect the inner lining of the stomach and small intestine. Women and older adults seem to be more susceptible to this, according to Harvard Medical School.

3. Some are more at risk than others

Peptic ulcer disease can occur at any age, though it is rare in children. Men are more likely than women to develop the disease. The risk of an ulcer in the first segment of the small intestine, or duodenum, is greatest among those ages 55 to 65.

People with rheumatoid arthritis, chronic low back pain, fibromyalgia and chronic headaches who use high doses of NSAIDs over an extended period are at higher risk of developing peptic ulcer disease. But anyone who uses NSAIDs, such as aspirin, ibuprofen or naproxen, is also at risk for gastrointestinal problems.

4. Signs you may need to see a doctor

If you are experiencing heartburn or mild abdominal pain, over-the-counter antacids and acid blockers may relieve your symptoms. If the pain returns, you should seek medical attention, according to the Mayo Clinic. If you have ulcer symptoms or feel dizzy or lightheaded, you should also see a doctor, according to Penn Medicine.

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In severe cases, symptoms can include dark or black stool (due to bleeding), vomiting, weight loss and severe abdominal pain. If you experience such symptoms, seek medical attention right away. Also get medical help right away if you have symptoms of shock, such as fainting, excessive sweating or confusion.

5. Bad habits can make ulcers worse

While certain habits don’t cause ulcers directly, some — such as smoking — can put you at greater risk of getting an ulcer or slow the healing process. Drinking is also a concern, because alcohol can irritate and erode the mucus protecting the stomach lining from digestive acids. Alcohol also can increase the production of stomach acids.

Spicy food can also irritate the stomach, according to the Mayo Clinic. Drinking milk may temporarily soothe ulcer pain, but it can also increase the production of stomach acid, the Cleveland Clinic notes.

6. The disease can turn serious

Left untreated, peptic ulcers can be dangerous. Complications include internal bleeding severe enough to require hospitalization. An ulcer could also eat a hole in your stomach wall, putting you at risk of serious infection. Peptic ulcers can also block food from passing through the digestive tract. And some studies have shown an increased risk of gastric cancer among people infected with the H. pylori bacterium, according to the Mayo Clinic.

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