Since childhood, mothers and grandmothers have warned us to eat regularly, stating that skipping lunch could cause a stomach ulcer. We decided to investigate whether skipping lunch can actually cause a stomach ulcer or if it’s simply another scare story.
Speaking in scientific terms, stomach ulcer disease (SUD) is a condition that involves a defect in the mucous membrane of the gastrointestinal tract, typically in the stomach (gastric ulcer) or the initial parts of the duodenum (duodenal ulcer), which extends beyond the muscular layer. One of the most prominent symptoms of this condition is known as “hungry” or “sucking” pains. Patients may also experience heartburn, acid regurgitation, nausea and vomiting, and weight loss. SUD is a widespread disease, with a diagnosis already made in 4% of the world’s population. According to the Russian Gastroenterological Association, as many as 14% of men and 11% of women may develop SUD in their lifetime.
The folk term for the distinct pains associated with SUD (“hungry” or “sucking” pains) likely contributed to the belief that irregular eating habits are the root cause of ulcers. An alternative explanation is that consuming something like biscuits or dry bread immediately after experiencing the characteristic pain can provide relief, which may have also led to the idea that irregular eating habits cause SUD.
For an extended period, the scientific consensus held that ulcers were a disease related to stress. Hungarian endocrinologist Hans Selye conducted experiments on rats, exposing them to various stressors such as extreme temperatures, intense physical activity, loud noises, and toxic substances. After approximately 48 hours, the animals became weak and gradually perished, with their gastrointestinal tracts exhibiting characteristic SUD lesions. Selye extrapolated his findings from rats to humans, examining patients whose bodies began to malfunction without any apparent cause. Their symptoms did not correspond to any known illness, so he termed the condition “syndrome of distress.” Stomach ulcers were also viewed as a stress-related pathology during this time.
In 1979, an Australian pathologist named Robin Warren was able to cultivate the bacterium Helicobacter pylori in an artificial environment. Along with his colleague Barry Marshall, Warren discovered in 1983 that the bacterium neutralizes stomach acid, leading to gastritis and peptic ulcer disease. However, the scientific community was initially slow to accept the bacterial theory and abandon the neurogenic theory. To prove their discovery, Barry Marshall took an extreme step. He concocted a drink using the cultivated Helicobacter pylori bacterium and consumed it. Several days later, he exhibited the typical changes of peptic ulcer disease in his stomach. Marshall subsequently cured himself by taking a course of antibiotics that the bacterium was sensitive to. In 2005, Warren and Marshall’s breakthrough was recognized with the Nobel Prize in Physiology or Medicine for their discovery of the bacterial nature of stomach ulcers.
Thus, scientists proved that a bacterial disease with a distinct causative agent and treatment methods primarily causes stomach ulcers. Helicobacter pylori is believed to cause approximately 90% of duodenal ulcer cases and 70% of gastric ulcer cases. However, this bacterium is not always responsible for the pathology.
The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is the second factor that can provoke stomach ulcers. This group of substances includes aspirin, analgin, ibuprofen, meloxicam, diclofenac, and others. These drugs interfere with the normal protection and restoration of the stomach’s mucous membrane, making it more susceptible to acid. On the other hand, smoking hinders ulcer healing and increases the frequency of relapses. Although alcohol serves as a potent stimulator of acid secretion, it does not contribute to the onset of ulcers or delay their healing. It is important to note that smoking alone does not cause ulcers.
Genetic factors rank third after bacteria and NSAIDs in contributing to the development of stomach ulcers. By analyzing the genotypes of 456,327 Britons, scientists identified eight loci (gene locations on the chromosome map) that play a role in the development of peptic ulcers. Additionally, 50-60% of children with duodenal ulcers have a family history of the disease, providing further evidence for this hypothesis. In addition to bacteria, NSAIDs, and genetics, scientists attribute peptic ulcers to even rarer causes, such as:
- Zollinger-Ellison syndrome (tumor of the pancreatic islet cells);
- Malignant processes (stomach cancer, lung cancer, lymphomas);
- Some viral infections;
- Vascular insufficiency;
- Radiation therapy;
- Crohn’s disease (or non-specific ulcerative colitis);
- Chemotherapy;
- Shock (extensive burns, trauma, surgical interventions).
In their review article on peptic ulcers, the American College of Gastroenterology analyzed and debunked several myths about this condition. They found that emotional stress or anxiety, spicy food, and diet are not the causes of ulcers. Although certain foods may irritate an existing ulcer, food does not cause ulcers. Individuals diagnosed with peptic ulcers do not need to follow a strict diet for the rest of their lives as the days of limiting ulcer patients to a specific set of foods are over.
Treating an existing stomach ulcer requires regular eating as an essential component. A special therapy involving prescribed medications must be taken followed by eating something within the specified interval, usually 30 minutes to an hour.
Although irregular eating does not cause stomach ulcers, it can still be harmful to the body. It can lead to a disruption in acid secretion and a decrease in the quality of stomach acid secretion. Additionally, people tend to eat on the go and consume fast food when they have irregular eating habits. Swedish doctors discovered in a 27-year study that irregular eating during adolescence is linked to an increased risk of developing metabolic syndrome, which includes excess fat in the waist area, elevated blood glucose levels, elevated cholesterol levels, and hypertension.
Although childhood fears of irregular eating causing stomach ulcers are unfounded, this eating pattern can lead to other damaging health conditions. It is therefore advisable to keep track of meal frequency and minimize snacking on the go.
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