Stress + coffee + no sleep = ulcer?

Dear Ulcer & Deathly Ill,

Having stomach acid burn your throat can be quite painful and worrisome. Additionally, when paired with a lack of regular sleep and a stressful roommate situation (more on these issues later), dealing with all that’s on your respective plates may be a lot to manage. While the symptoms you both described may be linked to an ulcer, gastroesophageal reflux disease (GERD), or another health condition — only a health care provider can truly assess your specific situations and provide an accurate diagnoses. On the plus side, there are still some simple steps to take that may provide relief and boost your overall health.

Now, time to get an update on ulcers. Stomach ulcers (also known as peptic ulcers) are open sores along the stomach walls or intestinal linings. The stomach walls and intestinal linings are protectively coated with a layer of mucus; the more an acidic substance excessively “bathes” this mucus, the higher the chance that the mucus breaks down, forming open sores. These sores then may come into contact with the stomach’s digestive acids, primarily hydrochloric acid, and produce a burning sensation. Ulcers may be formed due to the presence of a bacteria, Helicobacter pylori (H. pylori) or frequent use of non-steroidal anti-inflammatory drugs (including aspirin and ibuprofen). As you can see, neither stress nor diet are on the list of causes. While they don't cause ulcers, they may worsen the symptoms of existing ulcers. To learn more about ulcers, including potential causes, symptoms, diagnostic methods, and treatment options, you can take a look at Ulcers in the Go Ask Alice! archives.

While burning sensations can be a common symptom of stomach ulcers, it's also a symptom of multiple health conditions including acid reflux, particularly gastroesophageal reflux (GER) and the more severe GERD. Symptoms of both GER and GERD include acid indigestion, acid regurgitation, and heartburn. The main difference between the two conditions is found in the frequency of symptoms; GER exists when the symptoms are short-term, and GERD occurs when these symptoms are persistent, may increase in intensity, and could extend to include vomiting and respiratory issues. Similar to ulcers, there are foods and drinks which can worsen GER and GERD symptoms, including spicy or greasy foods, alcoholic drinks and... coffee! So, even though your five cups of coffee may be delicious, Deathly Ill, they could be slowing your stomach’s natural healing process and triggering worsened burning sensations. If cutting your coffee consumption becomes necessary you could consider swapping out some of your coffee for seltzer or water with lemon. Or, you might alternate which days you drink coffee, and balance each cup with plenty of water.

There's something else that may increase your risk for GER(D)……sleep deprivation! As it turns out, researchers have found higher rates of GERD amongst individuals who regularly lack a sufficient night’s sleep, as sleep allows the digestive track to recover and function optimally. Additionally, as individuals suffering from GER(D) typically experience discomfort at night, many experience sleep dysfunction and disruption, seemingly creating a cycle between sleep deprivation and worsened GER(D) symptoms. Beyond GER(D), you might reflect upon your lack of sleep as it could increase your risk for developing diabetes and obesity, as well as negatively impact your cognitive functions (e.g. impaired focus, short-term memory, and reasoning ability). Some quick and easy steps you might consider to improve your sleep are:

• Avoid drinking coffee (or any caffeinated beverage) in the evening — especially closer to bedtime.
• Refrain from using your television, computer, tablet, or smartphone right before bed to minimize exposure to blue light.
• Try to make your room as dark as possible by closing your binds and turning off all bedroom lights.
• Use a white noise machine, ear plugs, or noise cancelling headphones to help with ambient noise.
• Track your sleep and identify patterns or factors that may affect your zzzs by using a sleep tracking diary.

For more tips to improve your sleep schedule, take a gander at the Sleep category in the Go Ask Alice! archives.

Lastly, you’ve both expressed concern over stressful roommate situations. As mentioned earlier, stress may heighten the physical discomfort you’re feeling. However, it's unlikely that daily roommate stressors could lead to an ulcer. Research indicates that it's severe physiological stress, paired with severe illness, which can lead to stress-related ulcers. Although roommate troubles may not result in an ulcer, it's still worth addressing as stress can negatively impact sleep, which can worsen ulcers and other digestive issues. To increase general comfort in living spaces, you both might try speaking with your roommates about your concerns. To help address your respective roommate concerns, you may be interested in checking out some of the Q&As in the Roommate Rumblings category in the Go Ask Alice! archives.

Ultimately, speaking with a medical professional about these burning questions will likely help with finding answers (including a diagnosis and any appropriate treatment) — and hopefully some relief.  No matter the cause for the discomfort, prioritizing some healthy behaviors may help bring some relief, including cutting down on coffee consumption, getting more sleep, and employing stress management strategies. Hopefully, the uncomfortable burning sensation will soon subside and you will find yourself less stressed and more at ease!