Gastric Ulcer Formation after the Hanshin‐Awaji Earthquake: A Case Study of <i>Helicobacter pylori</i> Infection and Stress‐Induced Gastric Ulcers

Matsushima, Yumi; Aoyama, Nobuo; Fukuda, Haruhiko; Kinoshita, Yoshikazu; Todo, Akio; Himeno, Seiichi; Fujimoto, Sotaro; Kasuga, Masato; Nakase, Hiroshi; Chiba, Tsutomu

doi:10.1046/j.1523-5378.1999.98290.x

Cited by 34 publications

(14 citation statements)

References 23 publications

(58 reference statements)

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“…Indeed, H. pylori infection cannot account for the pathogenesis of gastric ulcer by itself, since most infected individuals do not develop ulcers. The great Hanshin earthquake in Kobe, Japan in 1995 was strongly associated with a significant increase in the development of gastric ulcers and their complications in H. pylori-infected patients compared to non-infected individuals [90,91]. The hypothesis seems to be confirmed after the results of experimental work.…”

Section: Stomachmentioning

confidence: 88%

The Effects of Physical and Psychological Stress on the Gastrointestinal Tract: Lessons from Animal Models

Caso

Leza²,

Menchén³

2008

CMM

111

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Physical and psychological stresses are widely accepted as triggers and / or modifiers of the clinical course of diverse gastrointestinal disorders such as peptic ulcer, irritable bowel syndrome or inflammatory bowel disease. Growing experimental evidence from a variety of models such as immobilization, thermal injury or early maternal deprivation in laboratory animals uniformly supports the ability of stress to induce the development of gastric ulcers, altered gastrointestinal motility and ion secretion, and increased intestinal permeability leading to the passage of antigens to the lamina propria and bacterial translocation. Stress can also synergize with other pathogenic factors such as Helicobacter pylori, non-steroidal anti-inflammatory drugs or colitis-inducing chemicals to produce gastrointestinal disease. The brain-gut axis provides the anatomical basis through emotions and environmental influences modulate the gastrointestinal function through the regulation of gastrointestinal immune system and mucosal inflammation; in this sense, mucosal mast cells - at cellular level - and corticotropin releasing factor (CRF) - at molecular level - seem to play a crucial role. On the other hand, an array of adaptive responses have been evolved in order to maintain the homeostasis and to ensure the survival of the individual. In the gut mucosa anti-inflammatory pathways counteract the deleterious effect of the stressful stimuli on the gastrointestinal homeostasis. In the present review we discuss the several experimental approaches used to mimic human stressful events or chronic stress in laboratory animals, the evidence of stress-induced gastrointestinal inflammation and dysfunction derived from them, and the involved cellular and molecular mechanisms that are being discovered during the last years.

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Section: Stomachmentioning

confidence: 88%

The Effects of Physical and Psychological Stress on the Gastrointestinal Tract: Lessons from Animal Models

Caso

Leza²,

Menchén³

2008

CMM

111

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“…This indicates that in chronic, relapsing DU disease, the H. pylori infection itself is the egg, and the increased neuroticism and anxiety the chicken. The relation between life-event stress and H. pylori-infection was highlighted in a study of gastric ulcer formation after an earthquake in Japan in 1995 (17). It was found that 83.1% of the patients who developed gastric ulcer after the earthquake were infected with H. pylori, indicating that H. pylori is a potent risk factor enhancing the ulcer development when a person is subject to environmental stress.…”

Section: Discussionmentioning

confidence: 99%

Reduced relapse rate in duodenal ulcer disease leads to normalization of psychological distress: twelve‐year follow‐up

Wilhelmsen

Berstad²

2004

Scandinavian Journal of Gastroenterology

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“…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.…”

Section: Helicobacter Pylorimentioning

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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Gastric Ulcer Formation after the Hanshin‐Awaji Earthquake: A Case Study of Helicobacter pylori Infection and Stress‐Induced Gastric Ulcers

Abstract: H. pylori infection may play an important role in the development of GUs that are induced by emotional life-event stresses.

Cited by 34 publications

References 23 publications

The Effects of Physical and Psychological Stress on the Gastrointestinal Tract: Lessons from Animal Models

The Effects of Physical and Psychological Stress on the Gastrointestinal Tract: Lessons from Animal Models

Reduced relapse rate in duodenal ulcer disease leads to normalization of psychological distress: twelve‐year follow‐up

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

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