Which factor is associated with increased risk for stress-induced peptic ulcer bleeding?

The factor associated with an increased risk for stress-induced peptic ulcer bleeding is severe burns greater than 35% total body surface area (TBSA). This condition leads to a significant physiological response due to the extensive injury and subsequent stress. When the body experiences severe burns, it does not just suffer from direct tissue injury; the stress response activates a cascade of physiological changes, including increased catecholamine release and alterations in blood flow, particularly to the gastrointestinal tract.

These changes can compromise the gastric mucosal barrier, making it more susceptible to damage from gastric acid, and can lead to the development of stress ulcers. The mechanism is rooted in the body's prioritization of blood flow to vital organs, which can reduce mucosal perfusion in the gastrointestinal tract, increasing vulnerability to ulceration.

The other factors, such as a high fiber diet, low cholesterol levels, and regular exercise, do not correlate with the same severe physiological stress or mucosal ischemia seen with significant burns. They are generally associated with health benefits and do not contribute to the same level of risk for stress-induced peptic ulcer bleeding. Therefore, severe burns exceeding 35% TBSA represent a well-recognized risk factor for the development of stress ulcers in critical care settings.