What to know about Bruce Springsteen’s postponed shows and peptic ulcer disease

Bruce Springsteen has postponed all performances with the E Street Band for September as he undergoes treatment for peptic ulcer disease, the legendary rock singer announced.

Springsteen, 73, shared a note on his Instagram page, telling fans that a concert scheduled for Thursday in Syracuse, New York, will be moved. He noted that medical advisers said he should postpone his September shows as he undergoes treatment for the disease.

“Over here on E Street, we’re heartbroken to have to postpone these shows,” he wrote Wednesday. “We’ll be back to pick these shows up and then some. Thank you for your understanding and support. We’ve been having a blast at our US shows and we’re looking forward to more great times. We’ll be back soon.”

His website listed the postponed shows, which included performances in New York, Maryland, Pennsylvania, Connecticut, Ohio and D.C. Those with tickets to the upcoming shows will be notified about rescheduled dates.

Springsteen also cancelled shows in March and August

Springsteen will have a two-month break to recover from his symptoms, as the tour does not have any October dates planned and will probably pick up in November with performances in Canada.

He has been on tour for the first time since February 2017. The tour drew controversy for steep ticket prices, which were linked to Ticketmaster’s dynamic pricing system, according to Forbes. In all, there are more than 60 dates planned across 51 locations.

In March, Springsteen cancelled shows in Connecticut, Ohio and New York because of an unspecific illness. He also slashed a pair of shows in Philadelphia back in August, citing illness as well. Springsteen, however, returned for three shows in New Jersey last week.

What is peptic ulcer disease?

Peptic ulcer disease is a break in the lining of the stomach or intestine caused by increased acid, said Judith Kim, a gastroenterologist at NYU Langone Health. It affects about 5 to 10% of the population.

Peptic ulcer disease can range from mild to severe with life-threatening complications since ulcers can bleed, perforate and cause scarring to block the outlet of the stomach, said Michael Goggins, professor of pathology, medicine and oncology at Johns Hopkins University School of Medicine.

Peptic ulcer disease is caused by bacteria

The main causes are a bacteria called Helicobacter pylori and use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen, experts said. Some steroids and blood thinners have also been associated with ulcers, Kim said.

The bacteria alters the stomach’s protective mechanisms against acid to make the stomach more susceptible to acid-related injury, said Amy Oxentenko, a gastroenterologist at the Mayo Clinic.

Most people are infected with H. pylori, usually from water, when they are young, said James Hartman Frank, a gastroenterologist with MedStar Health in Washington. “It just takes a long time for it to form into an ulcer,” he said.

Smoking and alcohol can be risk factors for peptic ulcer disease, experts said.

Stress does not cause ulcers, as many people commonly believe, though, “we do see stress ulcers in patients who have been in critical care units for prolonged periods,” Kim said.

The incidence of peptic ulcer disease increases with age, she said. “There is similar prevalence in men and women, though stomach ulcers tend to be more common in women and ulcers in the intestine more common in men,” Kim said.

Peptic ulcer symptoms include pain and nausea

Peptic ulcers often cause abdominal pain and nausea, as well as discomfort when eating, according to the National Institute of Diabetes and Digestive and Kidney Diseases. People can also lose their appetite and weight, and may see blood in their stool if it moves down through the intestine, experts said.

The “peptic” in peptic ulcers refers to the disease having to do with pepsin, which are digestive enzymes, Frank said. Peptic ulcers can cause pain that can include the “worst indigestion”; patients with pain usually feel the sensation at the bottom of their breastplate.

A majority of peptic ulcers do not cause symptoms, some studies have shown, said Scott Gabbard, section head for the center of neurogastroenterology and mobility at the Cleveland Clinic. “Only 30% of patients with ulcers have those classic symptoms, and 70% of patients with ulcers may not even know they have them,” he said.

“Sometimes maybe you just have anemia, you’ve lost some blood quietly, you don’t know why and it turns out that the ulcer is bleeding and causing problems that way.” Goggins said.

Antibiotics and other medications can treat a peptic ulcer

A doctor may suggest tests to detect H. pylori, and if it is present, would treat it with a two-week course of antibiotics and try to lower acid levels, Frank said, typically with a proton pump inhibitor.

Ulcers, without H. pylori, are usually treated with proton pump inhibitors, which decrease acid produced in the stomach. “The usual duration is about two months, and they have a very, very high healing rate,” Gabbard said.

Surgery is rarely recommended for peptic ulcers, experts said.

Avoiding NSAIDs or other irritants such as tobacco and alcohol help recovery, Kim said.

People with persistent and severe symptoms such as bleeding should get an endoscopy, which allows a physician to examine the upper digestive system for ulcers. They would “try to seal it with various endoscopic devices to prevent or stop active bleeding,” Goggins said.

How to prevent peptic ulcers?

Some ulcers can be prevented by avoiding NSAIDs or by treating H. pylori infection early before ulcers develop, Kim said. Avoiding smoking and alcohol can also help to prevent ulcer disease.

Diet does not play a major role in peptic ulcer disease

Diet plays a minor role in peptic ulcer disease, Gabbard said. “There’s really no data that a lot of the things associated with ulcers actually have any cause or effect relationship with ulcers: spices, acidic foods, coffee – they’re not associated, interestingly,” he said.

Springsteen said on Tim McGraw’s new show, Beyond the Influence Radio, on Apple Music that he takes his diet rather seriously since it helps him stay onstage longer.

“The biggest thing is diet, diet, diet,” Springsteen said. “I don’t eat too much, and I don’t eat bad food, except for every once in a while when I want to have some fun for myself. So I think anybody that’s trying to get in shape, exercise is always important of course, but diet is 90 percent of the game.”