Psychological Stress Increases Risk for Peptic Ulcer, Regardless of Helicobacter pylori Infection or Use of Nonsteroidal Anti-inflammatory Drugs

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

“…However, notwithstanding the importance of H. pylori for peptic ulceration (and gastric cancer), several studies in the human and in rodents show that stress plays a significant role in peptic ulceration (Matsushima et al 1999, Kim et al 2002, Levenstein 2009, McColl 2009). The role of stress in the causation of peptic ulceration in the human is exemplified by the fact that the HanshinAwaji earthquake, which occurred on 17 January 1995, was followed by a significant increase in the number of people with peptic ulceration (McColl 2009, Levenstein et al 2015. Among the physically injured, stomach ulcers developed independently of H. pylori infection.…”

“…However, in addition to the possible effects of neuroendocrine (hypothalamic-pituitary-adrenal)-induced elevation of glucocorticoid levels on the gastro-duodenal mucosa (Levenstein et al 2015), central and peripheral dopaminergic mechanisms remain contenders (Szabo 1979, Glavin & Szabo 1990, Ozdemir et al 2007, Rasheed & Algsham 2012. The clue to a possible role of central dopamine came from clinical observations and hypotheses regarding the etiology of Parkinson's disease and schizophrenia.…”

“…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). Finally, a recent population-based Danish cohort (n = 2410) study showed that psychological stress increased the incidence of peptic ulcer in subjects with or without H. pylori infection (Levenstein et al 2015).…”

Non-communicable diseases in the Western Area District, Sierra Leone, before and during the Ebola outbreak

“…Possible explanations may be that patients were more likely to present to hospital with abdominal pain, as this is a recognised symptom of EVD, 17 the excessive use of high-dose antipyretics and analgesics to deal with fever, 18 or Ebola outbreak-induced stress. 19 We do not know why a higher proportion of females presented with NCDs during the Ebola outbreak compared with pre-Ebola, but this may be related to the general observation that women are more likely to access health services in general in Africa compared with men. 20 This study has important implications.…”

A rare case of kissing gastric ulcers caused by trauma

“…Given the abrupt development of the gastric ulcers, common causes were ruled out. Research has shown that stress causes peptic ulcers much like those associated with H. pylori infection or non-steroidal anti-inflammatory drugs (6). Endoscopic studies have revealed that between 74-100% of critically ill patients have stress-related mucosal damage within 24 h of admission (7).…”