Stress Is Back

For years, doctors believed that ulcers were psychosomatic, caused by stress. But then researchers discovered a hardy, virulent little bacterium known as Helicobacter priori. Able to survive and even thrive in stomach acid, this bacterium is so damaging it has been given Class 1 carcinogen status since it's known to be a direct precursor of certain stomach cancers. This led scientists to believe that it caused ulcers.

The discovery of H. priori was revolutionary. Doctors began to treat ulcers with antibiotics. A combination of ampicillin and metronidrazole (Flagyl), two common drugs, seemed to work best, and individuals who had been suffering for years with agonizing ulcer pain suddenly became well. Talk about a swing of the pendulum: a shocked medical community concluded that all ulcers were caused by infection. The search for a psychological root was abandoned.

End of story? Not quite. Eight out of 10 people infected with H. priori never get ulcers. As an article in the Journal of the American Medical Association points out, studies show that people who face serious life stress are more likely to develop a peptic ulcer over the next 15 years. Research reported in the Archives of Internal Medicine followed 4500 subjects and found that the incidence of ulcers in those who felt they were stressed was almost twice as great as in those who were stress-free. In addition, the incidence of ulcers seems to rise after national disasters. A review of medical records from 61 hospitals, published in the American Journal of Gastroenterology, found that the Hanshin-Awaji earthquake in Japan was followed by a marked increase in bleeding gastric ulcers.

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It's clear to me that the true origin of ulcers lies both in the mind and the body. As a physician, I can see that stress plays a huge role in all my patients' illnesses. I see flare-ups of asthma, hypertension and diabetes during periods of stress. When approaching treatment of any illness, I try to suggest nutritional and lifestyle changes, and when necessary, medicines, to help both mood and body.

For example, a 54-year-old woman recently sought my help. She'd suffered from ulcers for many years, and her doctor had given her multiple courses of antibiotic therapy. The drugs had always helped, but only temporarily; the ulcers always returned. Nobody had asked about her levels of anxiety, but when I inquired, she admitted that she'd just gotten out of a long and difficult marriage and was now a single mother with financial problems. Stress had been her constant companion for years.

I suggested a program of meditation and biofeedback to help her relax. I also prescribed a course of natural supplements, among them DGL (deglycyrrhizinated licorice), a licorice extract that helps heal the lining of the stomach, and aloe, another healing agent which soothes inflammation. That, along with a final course of antibiotics, alleviated her stress and quieted her inflamed gut. She hasn't suffered from an ulcer in over a year.

To understand any disease, we need to realize that illnesses almost always stem from multiple causes. Psychological factors should never be overlooked when treating disease, and the immune and nervous systems should be examined together. That's why I'm glad that stress is back at least where ulcers are concerned.

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