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PubMedDate not supplied

Duodenal ulcer: the helicobacterization of a psychosomatic disease?

The discovery of Helicobacter pylori has revolutionized thinking about the etiology of duodenal ulcer, where it is thought to play a central role in the vast majority of cases. The colonization of the gastric antrum by Helicobacter now explains a number of the principal changes of gastric physiology in patients with duodenal ulcers, especially those related to the secretion of gastrin and acid and their regulation, as well as of serum pepsinogen levels. One principal effect of this discovery has been to trivialize the role of psychosocial factors in ulcer causation, as reflected by a dramatic reduction in the number of published papers on this aspect of the problem in the years following 1983, the year in which the first report of Helicobacter appeared. However, given the widespread occurrence of infection with H. pylori in first and third world country populations, only very small numbers of subjects actually develop duodenal ulcers. The epidemiological, clinical and genetic evidence strongly suggests that host factors, especially the effects of stress (in the broadest psychosocial sense) may be decisive in determining who develops a duodenal ulcer. This therefore seems an appropriate time to devote greater research efforts at better understanding how stress influences the essential stability of the Helicobacter-host interaction to promote the development of duodenal ulcers.

Causality↗
PubMed1978

Psychosomatic gastro-intestinal disease.

Psychosomatic disease is the commonest disorder in clinical gastro-enterology. It may be of primary importance in the patient's presentation, or act in a secondary role to modify organic disease and its management. Careful history-taking is essential in differentiating whether symptoms arise as a result of psychological stimuli or organic disease, as the effects may be indistinguishable to the patient. Organic disease should always be excluded by appropriate screening investigations.

Colonic Diseases, Functional↗
PubMed2004

[Clinical analysis of pulmonary tuberculosis detected during follow-up of other underlying diseases].

OBJECTIVE: The objects of this study were to analyze clinically the outpatients and inpatients who were diagnosed as pulmonary tuberculosis during the follow-up of other underlying diseases at our affiliated hospitals and to review the past problems and to discuss how to improve the situation. METHODS: Sixty five outpatients or inpatients diagnosed as pulmonary tuberculosis during the follow-up of other underlying diseases were collected from 508 patients with pulmonary tuberculosis at our affiliated hospitals over the past 10 years. RESULTS: The proportion of elderly patients over 65 years old among 65 index cases was significantly higher as compared to the control group. Forty three of these index patients were outpatients and 22 were inpatients. The most frequent underlying diseases excluding respiratory diseases were malignant diseases followed by diabetes mellitus, gastrointestinal diseases and psychosomatic diseases in order. Pulmonary tuberculosis without clinical symptoms was detected by periodic chest X-ray in 21 cases (32%). There were some severe TB cases caused by the doctor's delay who were followed for malignant or psychosomatic diseases. CONCLUSION: Although many doctors except for respiratory specialists tended to pay attention to pulmonary tuberculosis as a possible complication during periodic health examination, further intensive education regarding pulmonary tuberculosis is required for doctors who treat malignant or psychosomatic diseases at special hospitals because TB patients who were smear positive when they were detected may cause outbreak of tuberculosis in the hospital.

Adult↗
PubMed1997

[Insecure attachment and psychosomatic skin disease].

Alexithymia is not infrequent among psychosomatic patients. The incapacity to decode one's own emotional experience implies an exacerbation of the physiological response through a recursive loop. If this vicious circle is maintained it can increase the risk of psychosomatic diseases which could be in this way regarded as functions of external meaningful events mediated by the central nervous system. The meaning varies from one individual to another and depends on his cognitive-emotional organisation. In order to study such an organisation, it can be useful to classify his mental state regarding his attachment. The authors, who previously observed an association between psychosomatic skin disease and the "non-free" mental state with regard to attachment, suggest that further studies on psychosomatic patients should be conducted applying the principles and methods of the attachment theory.

Adult↗