Lifestyle, Stress, and Genes in Peptic Ulcer Disease

Räihä, Ismo; Kemppainen, Helena; Kaprio, Jaakko; Koskenvuo, Markku; Sourander, L.

doi:10.1001/archinte.158.7.698

Cited by 72 publications

(25 citation statements)

References 28 publications

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“…This observation is in agreement with previously published epidemiological data [6, 7, 10, 11, 12, 13]. …”

Section: Discussionsupporting

confidence: 94%

“…Why peptic ulcers develop only in the minority of infected persons remains unclear. Various important risk factors for ulcer development have been identified [6, 7, 8, 9, 10, 11, 12, 13]which suggests that the etiology of duodenal ulcer is multifactorial and involves environmental factors, host genetic factors and specific properties of the infecting H. pylori strains. In fact, our and other authors’ recently published results [14, 15, 16]revealed that vacA s1 genotype and cagA+ status of H. pylori were associated with a higher prevalence of duodenal ulcer.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Multivariate Analysis of Risk Factors for Development of Duodenal Ulcer in Helicobacter pylori-Infected Patients

Reguła

Hennig²,

Burzykowski³

et al. 2003

Digestion

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Background: Although Helicobacter pylori is a significant etiologic factor of peptic ulcer disease, it remains unknown why ulcers develop only in the minority of infected individuals. Aim: The aim of this cross-sectional study was to evaluate the association between the presence of duodenal ulcer in H. pylori-infected patients and different risk factors. Methods: A total of 122 H. pylori-infected patients were enrolled; 79 had duodenal ulcer and 43 gastritis. Univariate analysis was conducted using either Fisher’s exact test or exact Cochrane-Armitage trend test. In multivariate analysis the logistic model was used. Results: Univariate analysis indicated six factors (male sex, smoking, antral H. pylori density, cagA presence in antrum, and vacA s1a presence in antrum and corpus). Four factors (sex, smoking-alcohol index, H. pylori density index, and cagA index) were found to be significant in multivariate analysis. The best model predicting duodenal ulcer included male sex, smoking, presence of H. pylori on histopathology in antrum and cagA presence in corpus. Conclusion: Although several risk factors were significantly associated with duodenal ulcer, we failed in the identification of either a single risk factor or a set of factors that can unequivocally differentiate patients with ulcer from those with gastritis.

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“…This observation is in agreement with previously published epidemiological data [6, 7, 10, 11, 12, 13]. …”

Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Multivariate Analysis of Risk Factors for Development of Duodenal Ulcer in Helicobacter pylori-Infected Patients

Reguła

Hennig²,

Burzykowski³

et al. 2003

Digestion

View full text Add to dashboard Cite

show abstract

“…Thus, for example, a Finnish nationwide twin cohort study of lifestyle, stress and genes in peptic ulcer disease led to the conclusions that, first, familial aggregation of the peptic ulcer disease is modest and attributable almost solely to genetic factors, and, second, that the data did not support the concept that risk factors such as H. pylori infection could explain familial peptic ulcer disease (Räihä et al 1998). A comprehensive study in Thailand of 70 patients with perforated peptic ulcer compared with a balanced number of control subjects led to the conclusion that stress, but not H. pylori, is associated with peptic ulcer disease in this Thai population (Wachirawat et al 2003).…”

Section: :3mentioning

confidence: 99%

Selye’s general adaptation syndrome: stress-induced gastro-duodenal ulceration and inflammatory bowel disease

Fink

2017

Journal of Endocrinology

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Hans Selye in a note to Nature in 1936 initiated the field of stress research by showing that rats exposed to nocuous stimuli responded by way of a 'general adaptation syndrome' (GAS). One of the main features of the GAS was the 'formation of acute erosions in the digestive tract, particularly in the stomach, small intestine and appendix'. This provided experimental evidence for the view based on clinical data that gastroduodenal (peptic) ulcers could be caused by stress. This hypothesis was challenged by Marshall and Warren's Nobel Prize (2005)-winning discovery of a causal association between Helicobacter pylori and peptic ulcers. However, clinical and experimental studies suggest that stress can cause peptic ulceration in the absence of H. pylori. Predictably, the etiological pendulum of gastric and duodenal ulceration has swung from 'all stress' to 'all bacteria' followed by a sober realization that both factors play a role, separately as well as together. This raises the question as to whether stress and H. pylori interact, and if so, how? Stress has also been implicated in inflammatory bowel disease (IBD) and related disorders; however, there is no proof yet that stress is the primary etiological trigger for IBD. Central dopamine mechanisms seem to be involved in the stress induction of peptic ulceration, whereas activation of the sympathetic nervous system and central and peripheral corticotrophin-releasing factor appears to mediate stress-induced IBD.

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“…Although a substantial percentage of PUD patients have H. pylori, only a small percentage of individuals with H. pylori develop ulceration [9]. Therefore unidentified host characteristics, including genetic influences [10], strain variability and other factors, must play a role in the pathogenesis of PUD [7]. …”

Section: Introductionmentioning

confidence: 99%

Peptic Ulcer Disease and Neuroticism in the United States Adult Population

Goodwin

Stein²

2002

Psychother Psychosom

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Background: The goal of the current study was to determine the association between personality factors and peptic ulcer disease (PUD) among adults in the general population. Method: Data were drawn from the Midlife Development in the United States Survey (MIDUS), a representative household survey of the adult population (ages 25–74; n = 3,032) of the United States. Multiple logistic regression analyses were used to determine the association between the big five personality factors and PUD, adjusting for differences in sociodemographic characteristics, psychiatric and physical comorbidity. Results: Neuroticism was associated with significantly increased odds of PUD [OR = 1.5 (95% CI: 1.03, 2.4)], which persisted after controlling for differences in sociodemographic characteristics, cigarette smoking, perception of poor health, comorbid mental disorders and physical illnesses. This relationship was specific to neuroticism. Conclusions: These findings are consistent with and extend previous clinical and epidemiologic data by providing evidence of an independent association between neuroticism and PUD among adults in the general population. Future work investigating the relationship between neuroticism and the development of PUD in prospective data, including objective measures of physical and mental health status, may contribute to our understanding of this association.

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Lifestyle, Stress, and Genes in Peptic Ulcer Disease

Cited by 72 publications

References 28 publications

Multivariate Analysis of Risk Factors for Development of Duodenal Ulcer in Helicobacter pylori-Infected Patients

Multivariate Analysis of Risk Factors for Development of Duodenal Ulcer in Helicobacter pylori-Infected Patients

Selye’s general adaptation syndrome: stress-induced gastro-duodenal ulceration and inflammatory bowel disease

Peptic Ulcer Disease and Neuroticism in the United States Adult Population

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