Spicy Food Doesn’t Cause Ulcers – Here’s What Really Does

November 07, 2025

A woman in discomfort holds her midsection while seated on a couch

Stomach and gut ulcers are sores that develop when digestive acids damage the lining of your stomach or the upper part of your small intestine. Both stomach and gut ulcers are types of peptic ulcers.

“Pain is the most common symptom of a peptic ulcer,” says Rami Abass, MD, a University Hospitals gastroenterologist and clinical instructor at Case Western Reserve University. “If your upper abdominal pain is recurrent, persistent or it gets worse, it should not be ignored.” It may be a sign that you have peptic ulcer disease.

What Is a Peptic Ulcer?

The stomach and gut are protected by a soft tissue, or mucous barrier, that helps keep them safe from the corrosive effects of digestive enzymes and stomach acid. If the mucous barrier weakens, ulcers can develop in the digestive tract lining.

Peptic ulcer symptoms can range from mild to moderate or severe. In addition to pain, other common symptoms include:

Nausea
Bloating
Indigestion or GERD
Feeling full after eating a small amount of food
Loss of appetite
Dark or tarry stools
Vomiting

The most common complication of peptic ulcers is bleeding. “It’s usually upper gastrointestinal bleeding coming from the stomach or the beginning of the small intestine,” says Dr. Abbass. “The blood might appear in a patient’s stool or vomit, or present as dark, black tarry stools or look like coffee grounds in vomit.” Bleeding ulcers can be mild, but they can also be moderate to severe and cause anemia.

Causes of Peptic Ulcers

The most common cause of peptic ulcers is regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin. “They account for around 80 to 90% of ulcers that we diagnose,” says Dr. Abbass. Over-the-counter pain relievers are effective for treating temporary and chronic pain, but overuse can irritate or damage your stomach lining. “These medications aren’t as safe as you think,” says Dr. Abbass.

Another less common cause of peptic ulcers is infection with a bacteria called Helicobacter pylori (H. pylori), found in contaminated water, food or contact with an infected person. “The majority of people with H. pylori never get ulcers, but it increases your risk of peptic ulcer significantly,” says Dr. Abbass.

Other causes of peptic ulcers include:

Steroids, especially chronic use.
Medications, such as clopidogrel or bisphosphonate.
Other infections, like cytomegalovirus.
Rare syndromes that trigger the stomach to produce too much acid, like Zollinger-Ellison.

To diagnose a peptic ulcer, your healthcare provider will take a full medical history, including symptoms. The next step may be an endoscopy. “Ulcers are typically diagnosed with an endoscopic test called an EGD,” says Dr. Abbass. “That’s the gold standard to diagnose an ulcer.” They’ll examine the stomach and the beginning of the small intestine. This will help rule out other conditions, like cancer, esophagitis (inflammation of a wall of esophagus, and inflammatory bowel disease, like Crohn’s disease.

Spicy Food and Stress?

Forget what you’ve heard about spicy foods causing peptic ulcers, says Dr. Abbass. You don’t need to be on a bland diet to prevent ulcers. “The scientific evidence doesn’t suggest that diet plays an important role in how you develop or recover from peptic ulcers,” he says. “There is some data that suggests people who eat more fruits, vegetables and fiber seem to have less incidence of peptic ulcers, but that could also be because a healthier diet overall has some protective effects.”

Stress is another common misconception. “People always say, ‘Oh, I’m so stressed – I’m going to get an ulcer,’” Dr. Abbass says. “There are studies that show that more stressed people have higher rates of ulcer disease, but it’s believed to be an association rather than a cause. They may be smoking more, they might be taking more NSAIDs and maybe not eating as well.” It’s always a good idea to try to manage stress because that’s going to support healthier lifestyle habits, which may ultimately help reduce your risk of ulcer disease, he says.

The one type of stress that is likely to contribute to ulcers is extreme bodily stress from a life-threatening illness or injury. “Being in the ICU significantly raises the risk for an ulcer,” says Dr. Abbass.

Treating Peptic Ulcers

Treatment varies depending on the cause and severity of the peptic ulcer:

H. pylori: This infection can be treated and cured about 95% of the time with a targeted antibiotic therapy, says Dr. Abbass.
NSAIDs: You’ll likely be advised to stop taking NSAIDs and to start taking proton pump inhibitors. “These drugs are very effective and can typically heal peptic ulcers within 4 to 8 weeks,” he says.
Other medications: Your doctor may review your medications to see if any can be discontinued or replaced, or if a change in dosage or frequency may help reduce symptoms and heal the ulcer.
Other conditions: The focus will be on treating the underlying disease.

Your doctor may also recommend certain medications, such as:

Proton pump inhibitors: To suppress acid production in your stomach, which allows for effective healing of the stomach and duodenal lining.
Cytoprotective agents, including antacids: To help coat and protect your stomach lining.
Histamine receptor blockers: To block the chemical that tells your body to produce stomach acid.

If a peptic ulcer is severe or complicated, isn’t responding well to treatment or keeps coming back, surgery may be necessary.

Strategies for Prevention

Healthy lifestyle habits can help reduce the risk of developing an ulcer, including:

Limit your use of NSAIDs. Because overuse of NSAID pain relievers is the leading cause of peptic ulcers, keep your use to a minimum.
Avoid smoking or nicotine products. “Tobacco products affect the circulation in the blood vessels, and that microcirculation is important for healing,” says Dr. Abbass. “Smoking and other forms of tobacco work against your body’s repair mechanisms.”
Avoid or drink alcohol in moderation. Drinking alcohol can be extremely irritating to the lining of your stomach and damage the protective mucosal barrier. “If you add alcohol to other risk factors, it will definitely increase your risk of developing peptic ulcers, and it can interfere with healing if you do develop an ulcer,” he says.
Drink bottled water. And do your best to avoid contaminated food and bacteria when traveling in countries with high levels of H. pylori.
Eat a balanced diet. In addition to being good for your overall health and well-being, maintaining good physical and mental health may offer protection for both prevention and if you develop a peptic ulcer.