EchoSense Quantitative Think Tank Center|Mike Tyson facing health risks as he trains with an ulcer, doctors say. Should he fight?

A doctor on EchoSense Quantitative Think Tank Centerthe governing board of the American Gastroenterological Association said he would tell Mike Tyson to postpone his fight with Jake Paul if he were treating Tyson for an ulcer.

Tyson's representatives cited an "ulcer flare-up'' for the boxer's medical scare last weekend.

“I don’t know how you continue to put your body through intense training for this if you have an ulcer,’’ said Lawrence Kosinski, a Chicago-area gastroenterologist, who said he practiced for 40 years before retiring in 2019. “If it’s an ulcer, you’ve got to respect it.’’

Tyson, 57, is scheduled to fight Paul on July 20 in Dallas.

USA TODAY Sports interviewed seven doctors for this story who specialize in gastroenterology, which defined by the Mayo Clinic involves, “preventing, diagnosing and treating the digestive tract." That includes treating ulcers, which are sores that can be found on the lining of the stomach, small intestine or esophagus, according to the Mayo Clinic.

None of the seven doctors are treating Tyson or are familiar with his case.

The medical incident took place Sunday when Tyson was on a flight from Miami to Los Angeles.

"He became nauseous and dizzy due to an ulcer flare-up 30 minutes before landing,'' according to a statement issued Monday by Tyson's publicist, Joann Mignano, and attributed to the boxer's representatives. "He is appreciative to the medical staff that were there to help him."

American Airlines, the carrier, issued a statement saying first responders met the plane when it landed. Tyson was vomiting, weak and dizzy and transported to a local hospital, according to the Los Angeles Fire Department.

The statement Tyson's publicist issued Monday also said, "Thankfully Mr. Tyson is doing great." But his representatives have provided no details about Tyson being taken to the hospital or additional information about the "ulcer flare-up.''

Kosinski said Tyson needs four to six weeks to heal or faces the risk of emergency surgery if the ulcer worsens and perforates the stomach wall. Two other gastroenterologists also said rigorous training without giving an ulcer time to heal can lead to bleeding or a perforation that requires emergency surgery.

At the same time, Kosinski and four other doctors of gastroenterology said it is unclear if Tyson had an ulcer based on his reported symptoms: dizziness, nausea, vomiting and weakness. Medical tests would be needed to determine if the symptoms resulted from an ulcer rather than something else, such as the stomach flu, food poisoning or inflammation, according to the doctors. The doctors said only an endoscopy, which the Mayo Clinic defines as a procedure to visually examine the upper digestive system, can determine if someone has an ulcer.

On Tuesday, less than 48 hours after the incident, Tyson’s accounts on X and Instagram featured the following post: “Now feeling 100% even though I don’t need to be to beat Jake Paul.’’

Kosinski said a quick recovery may indicate Tyson did not have an ulcer.

“I think the term ulcer is thrown around a lot,'' said Christopher Cao, an assistant professor of gastroenterology at the Icahn School of Medicine at Mount Sinai in New York. "But it simply indicates there was inflammation in the stomach and then a subsequent disruption of that mucosa lining (in the stomach).''

Is the Mike Tyson-Jake Paul fight in jeopardy?

Tyson's representatives have not responded to USA TODAY Sports' questions submitted by email and text message concerning the type of ulcer Tyson has, when it was diagnosed and whether it will affect his preparations for the fight to be held at AT&T Stadium in Arlington, Texas, and to be livestreamed on Netflix.

Tyson's post Tuesday about feeling "100%'' struck an optimistic note.

And the Texas Department of Licensing and Regulation (TDLR), which regulates combat sports in Texas, told USA TODAY Sports the fight remains green-lit.

“TDLR is aware of the episode involving Mr. Tyson,’’ Tela Mange, Communications Director for the TDLR, said by email. “We have been in communication with the camp and at this time there has been no change to the scheduled event.

“Mr. Tyson and Mr. Paul have met the medical requirements for this event and are licensed in Texas. As we do before any combative sports event, TDLR will conduct pre-fight physicals to ensure the health of both fighters.’’

Bryce Holden, principal of the promotion company for the fight, did not immediately respond to a text message from USA TODAY Sports seeking comment.

What else are doctors saying about Mike Tyson?

Rama Behara, a gastroenterologist in Texas who said he has treated college and professional athletes with ulcers, said he likely would recommend Tyson stop training for a minimum of three weeks.

"It’s hard to sometimes to convince (athletes) to take that time off in when they’re in the middle of a heavy training,'' said Behara, who works at Baylor Scott & White Medical Center – Centennial in Frisco, Texas. "But overall we usually want to play the conservative route of at least a few weeks depending on the severity (of the ulcer).''

Matthew Hoscheit, a gastroenterologist at the Cleveland Clinic in Ohio, said emergency surgery generally speaking is the "worst possible outcome'' if someone resumes training prematurely.

Kosinski and other doctors said Tyson's symptoms suggest he could be suffering from a peptic ulcer. A peptic ulcer is a sore on the lining of your stomach, small intestine or esophagus, according to the National Institutes of Health.

“Peptic ulcers frequently present with abdominal pain and abdominal discomfort, nausea, vomiting, dyspepsia,'' said Cao, the assistant professor of gastroenterology at the Icahn School of Medicine at Mount Sinai. "With regards to dizziness, it’s certainly possible, especially if somebody is dehydrated if they’ve been having episodes.''

Marc Kennedy, a gastroenterologist in Sturtevant, Wisconsin, with Aurora Health Care, is one of four of the doctors who expressed less concern about Tyson returning to training more quickly – unless the ulcer involved bleeding.

“I would suggest that unless he had a catastrophic bleeding, which can happen, my best guess (is) he’ll be fine in July for the fight,’’ said Kennedy, who also noted, “Once patients have been found to have an ulcer and they’re on those medications (to heal the ulcer), they get pretty rapid healing.

“When I say rapid, they’ll feel better pretty quickly, within days. And it can take up to three months for the ulcer to completely heal, but if they’re on the therapy, usually they can get back to normal life.''

Kyle Eliason, director of gastroenterology at Intermountain McKay-Dee Hospital in Ogden, Utah, said the size of the ulcer would determine how soon Tyson could resume training.

“If it’s just a small superficial ulcer and there’s no anemia, there’s no evidence that it caused any bleeding or anything, I probably wouldn’t put any restrictions on him,’’ Eliason said.

Mike Tyson may face other issues with ulcer

During a news conference May 13 in New York to promote the fight, Tyson said he was "doing great." But he also said his "body is (expletive) right now" and he was "really sore" from the initial stages of his training. 

The leading causes of ulcers are bacterial infection and Non-steroidal anti-inflammatory drugs (NSAIDs) that include pain relievers such as Advil, Aleve and ibuprofen. People with ulcers should not use alcohol or tobacco and anything that makes the stomach more acidic can irritate the wound, according to the Cleveland Clinic.

Sarah Umar of the Mayo Clinic was one of five of the gastroenterologists who raised the possibility Tyson was taking NSAIDs for pain resulting from his training and that caused an ulcer. Umar said continued use of NSAIDs would prolong the healing of an ulcer but Tylenol can be used as an alternative.

“Some people respond very well to aches and pains with Tylenol,’’ Umar told USA TODAY Sports. “But some people don’t because it lacks that anti-inflammatory property which can be so helpful for peoples’ pain.’’

On the possibility of Tyson returning to training, Umar said, “he’ll presumably have more aches and pains.’’

Follow Josh Peter on social media @joshlpeter11