The ailment that kept Bruce Springsteen off-stage

As a rock fan, Joseph Cobb. M.D. was surprised when Bruce Springsteen cancelled a series of concerts recently. As a gastroenterologist, he understood when he found out the reason: the Boss was suffering from peptic ulcers

“They can be very painful,” said Dr. Cobb, who has seen Springsteen in concert two times.

“Peptic ulcers, often referred to as ulcers, are an ulceration in the upper digestive tract, be it in the bottom of the esophagus, the stomach, or the beginning part of the intestine. They are generally caused by excessive stomach acid wearing away the top lining of the GI tract. It can be painful because of the nerve fibers underneath that top lining.”

In August, Springsteen cancelled two shows in Philadelphia due to an unspecified illness. On Sept. 6, the day before a concert in Syracuse, NY, he announced that he was being treated for peptic ulcers and that his medical advisors had recommended he postpone all his shows for the rest of the month. On Sept. 27, he announced he was rescheduling the remainder of his 2023 shows to next year.

“Bruce Springsteen has continued to recover steadily from peptic ulcer disease over the past few weeks and will continue treatment through the rest of the year on doctor’s advice,” said a statement released via Springsteen’s social media.

“Thanks to all my friends and fans for your good wishes, encouragement, and support,” Springsteen said in the statement. “I’m on the mend and can’t wait to see you all next year.”

About Peptic Ulcers

The chief symptom of a peptic ulcer is abdominal pain (“a gnawing discomfort,” said Dr. Cobb). Some patients vomit blood or have bleeding in their stool.

Peptic ulcers are slow to form and are not caused by stress or diet, he said.

“One main cause is use of nonsteroidal anti-inflammatory drugs, like aspirin, Motrin or ibuprofen, because they wear away the protective coating of the top lining of the stomach,” he said. “The other is an infection with a bacteria called H pylori or Helicobacter pylori.”

Peptic ulcers are diagnosed clinically, using an endoscope to look at their esophagus, stomach, and first portion of their intestine. There's also a breath test, a blood test and a stool test.

Treatment

The primary form of treatment is using acid-blocking medication, such as a proton-pump inhibitor.

“You take those drugs for about a month and it makes most ulcers go away,” Dr. Cobb said.

Treatment also includes finding alternatives to any aspirin-like medicines the patient is using, along with taking antibiotics to combat an infection. Dietary changes are not called for.

People over 70 (Springsteen turned 74 in September) are at higher risk for peptic ulcers, partly due to years of exposure to H pylori and partly because they’re more likely to be taking daily pain medications like aspirin, he said. Smokers also are more susceptible to peptic ulcers.

Treatment typically lasts four to six weeks, but longer if there is internal bleeding. People can often continue working while being treated – although someone who travels to put on three-hour concerts might benefit from taking some time off, he added. “The amount of effort Springsteen puts into each show; I think it'd probably be hard for a 74-year-old without an ulcer to do it.”