In this article, we compiled 13 etiological theories, 15 characteristics, and 81 observations/phenomena of peptic ulcers, reported in reproducible, peer-reviewed studies from the literature, to reflect the historical evolution of studies on peptic ulcers and to provide a multidisciplinary view of this disease. This data was collected during the systematic review of topics on peptic ulcers including genetics, etiology, epidemiology, psychology, anatomy, neurology, bacteriology, pathology, and clinical statistics. The data curated herein was extracted via application of recently published basic theories and methodologies.
Peptic ulcers, including duodenal and gastric ulcers, are currently studied as an infectious disease caused by Helicobacter pylori. However, this etiology cannot elucidate the major characteristics and observations/phenomena of the disease, as well as the roles of gastric acid and NSAIDs. Additionally, many patients with severe ulcer symptoms have no infection, suggesting bacterial eradication cannot prevent relapses in all ulcer patients. To address these challenges, a recently published Complex Causal Relationship with its accompanying methodologies was applied to analyze the existing data. Peptic ulcers were identified as a psychosomatic disease triggered by psychological stress, where Helicobacter pylori plays a secondary role in only the late phase of ulceration. An integration of five major etiological theories in history illustrated the entire pathogenesis of peptic ulcers, which addressed all the characteristics, observations/phenomena, controversies, and mysteries of the disease in a series of 6 articles. This first article focuses on the pathogenesis of duodenal ulcers. The hyperplasia and hypertrophy of gastrin and parietal cells induced by chronic stress potentiate the individual’s response to immediate stress, resulting in the hypersecretion of gastric acid and eventually, duodenal ulceration. This psychopathological mechanism resolved all the controversies associated with Helicobacter pylori and explicitly elucidated 7 characteristics of duodenal ulcers, as well as 42 observations/phenomena. The roles of gastric acid, Helicobacter pylori, and NSAIDs in duodenal ulcers were also identified. The effectiveness validated the etiology of duodenal ulcers identified by the Complex Causal Relationship, indicating stress management is essential for a complete cure of the disease without relapse.
The first detailed description of the morphology of gastric ulcer was reported ~230 years ago, but the mechanism has yet to be elucidated. Moreover, peptic ulcers, including duodenal and gastric ulcers, are currently considered an infectious disease caused by Helicobacter pylori, but how the infection leads to ulceration remains elusive. To address these challenges, a recently published Complex Causal Relationship was applied to analyze the existing data. Peptic ulcers were identified as a psychosomatic disease triggered by psychological stress, where Helicobacter pylori plays a secondary role in only the late phase of the disease. This etiology explained all the characteristics and observations/phenomena of peptic ulcers in a series of 6 articles. This second article focused on the pathogenesis of gastric ulcers. Based on hereditary predisposition, the accumulation of past life experiences incurs the formation of a negative lifeview. Consequently, the individual tends to negatively evaluate themselves or current life events, leading to acute psychological stress. The psychological stress triggers the release of aberrant neurotransmitters in the central nervous system, which in turn cause the transmission of pathogenic nerve impulses to the stomach, resulting in a ‘pre-ulcer lesion’ in the gastric wall and eventually, gastric ulcer. This psychopathological model elucidated 12 characteristics and 24 observations/phenomena of gastric ulcer, along with the roles of gastric acid, Helicobacter pylori, and NSAIDs. The effectiveness suggests that theoretical research and empirical study are equally important in medical explorations, and the guiding roles of philosophy are indispensable for the major progress of life science and medicine.
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