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Page: Stress and Ulcers
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Despite the finding that a bacterial infection is the cause of ulcers in more than 75% of cases, established medical beliefs are difficult to change. Because bacterial infection does not appear to explain all ulcers, researchers continue to look at stress as a possible cause, or at least a complication in the developement of ulcers.
An expert panel convened by the Academy of Behavioral Medicine research concluded that ulcers are not purely an infectious disease and that psychological factors do play a significant role. Researchers are examining how stress might promote H.pylori infection. For example, Helicobacter pylori thrives in an acidic environment, and stress has been demonstrated to cause the production of excess stomach acid.
The discovery that Helicobacter pylori is a cause of peptic ulcer has tempted many to conclude that psychological factors are unimportant. But this is dichotomised thinking. There is solid evidence that psychological stress triggers many ulcers and impairs response to treatment, while helicobacter is inadequate as a monocausal explanation as most infected people do not develop ulcers. Psychological stress probably functions most often as a cofactor with H pylori. It may act by stimulating the production of gastric acid or by promoting behavior that causes a risk to health. Unravelling the aetiology of peptic ulcer will make an important contribution to the biopsychosocial model of disease.
According to the US National Digestive Diseases Information Clearinghouse's website "The majority of peptic ulcers are caused by the H. pylori bacterium. Many of the other cases are caused by NSAIDs. None are caused by spicy food or stress." However their website does not offer any references or evidence to support this statement.
A study of peptic ulcer patients in a Thai hospital showed that chronic stress was strongly associated with an increased risk of peptic ulcer, and a combination of chronic stress and irregular mealtimes was a significant risk factor (PMID 12948263).
A study on mice showed that both long-term water-immersion-restraint stress and H.Pylori infection were independently associated with the development of peptic ulcers (PMID 12465722).
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