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

Then it happened.

“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.’’

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

None of the seven doctors are treating Tyson, 57, or are familiar with his case. But several said Tyson faced risks if he resumed training for his fight against Paul too quickly.

Rama Behara, a gastroenterologist in Texas who said he has treated college and professional athletes with ulcers, said he typically recommends three weeks off to let the wound heal.

“An untreated ulcer over time can erode deeper into the stomach and sometimes create a in the entire wall and that’s called a perforation,” said Behara, who works at Baylor Scott & White Medical Center – Centennial in Frisco, Texas. “So when that happens it can require an emergency surgery to fix it.”

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

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.

What else are doctors saying about Mike Tyson?

Advice from doctors is one thing. How athletes respond is another, according to Behara, a Texas gastroenterologist.

“It’s hard to sometimes to convince them to take that time off in when they’re in the middle of a heavy training,” he told USA TODAY Sports. “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. But Hoscheit also said Tyson’s case would be difficult to assess because it’s so rare — a 57-year-old former champion training for a sanctioned pro boxing match against a 27-year-old boxer.

“What this guy is doing is incredible,” Hoscheit said of Tyson. “It’s uncharted territory.

“It’s a lot of strain on the body. l  bet his training regimen is outrageous, so it’s a lot of stress for sure.”

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. Tyson’s representatives have not identified the type of ulcer he has.

“Peptic ulcers frequently present with abdominal pain and abdominal discomfort, nausea, vomiting, dyspepsia,” said Christopher Cao, an assistant professor of gastroenterology at the Icahn School of Medicine at Mount Sinai in New York. “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.’’