Peptic ulcers after the Great East Japan earthquake and tsunami: possible existence of psychosocial stress ulcers in humans

Abstract

In addition to the increased incidence of peptic ulcers, compositional changes in the disease were observed after the Great East Japan earthquake. The significant increase in the proportion of non-H. pylori and non-NSAID ulcers after the earthquake indicated that psychological stress alone induced peptic ulcers in humans independently of H. pylori infection and NSAID intake.

Decreased stress resilience in young men significantly increases the risk of subsequent peptic ulcer disease – a prospective study of 233 093 men in Sweden

“…Instead, our resilience measure captured susceptibility to stressful exposures and the results indicate an independent association between stress resilience and subsequent PUD risk. Sub-analysis in our study showed a higher magnitude association of stress resilience with gastric ulcers, consistent with the results from the study by Kanno et al 10 where psychological stress was more notably associated with gastric than duodenal ulcers. We can only speculate on the reasons for this, but animal studies may suggest that exposure to stress can affect the stomach as 10 it activates the HPA axis and influences mast cells in the stomach to release histamine 4, 10 and other chemical mediators, such as proteases.…”

“…Sub-analysis in our study showed a higher magnitude association of stress resilience with gastric ulcers, consistent with the results from the study by Kanno et al 10 where psychological stress was more notably associated with gastric than duodenal ulcers. We can only speculate on the reasons for this, but animal studies may suggest that exposure to stress can affect the stomach as 10 it activates the HPA axis and influences mast cells in the stomach to release histamine 4, 10 and other chemical mediators, such as proteases. These mediators trigger acid production increasing gastric ulcer risk, 10 as acid damage is one of the mechanisms that causes gastric ulcers; 4 but critically, mediators such as proteases cause deterioration of the gastric mucosa and thus susceptibility.…”

“…In contrast, a recently conducted retrospective observational study, 10 showed an association between psychological stress and PUD independent of other known risk factors (H. pylori infection and NSAID use). Johansen et al, 11 argued that some reports of associations between exposure to psychosocial stress and PUD may be unreliable, as both exposure and CI, confidence interval; HR, hazard ratio; n, number; SEI, socioeconomic index.…”

“…A study by Kanno and colleagues 10 evaluated the incidence of PUD 3 months after the earthquake in Japan in 2011, compared with the same months during the previous year. Both Kanno et al 10 and Anda et al 8 concluded that psychosocial stress could increase the risk of PUD in the absence of H. pylori infection and NSAID use. Our study did not measure exposure to stress and was unable to account for the same major risk factors.…”

Mental Health Crisis in Northeast Fukushima after the 2011 Earthquake, Tsunami and Nuclear Disaster

“…Previous studies have shown that disaster-related psychological stress could have induced several physical and mental disorders (Kanno et al 2013;Tsuboi et al 2014;Hasegawa et al 2015), but mental health care for all victims seems to be insufficient. In fact, it is still difficult to know the number of people in Soso who are now suffering from post-traumatic stress disorder or other mental disorders caused by the disaster, because of the scarcity of mental health specialists.…”