title: Peptic ulcers after the Hanshin-Awaji earthquake: increased incidence of bleeding gastric ulcers.
abstract: OBJECTIVE
  Although physical stresses are known to induce peptic ulcers in the upper gastrointestinal tract, it remains controversial whether emotional stress can cause peptic ulcers. Therefore, we examined retrospectively the influence of the Hanshin-Awaji earthquake that occurred in Japan in January 1995 on the occurrence of peptic ulcer disease among noninjured residents.
  
  
  METHODS
  Sixty-one hospitals, covering 70% of all endoscopy examinations performed in this area, joined the study and were divided into three areas according to the severity of the damage. A comparison was made between a group of 10,831 patients who underwent upper gastrointestinal endoscopy within 2 months after the earthquake and 16,100 who did so in the same hospitals during the corresponding period in 1994.
  
  
  RESULTS
  In the most devastated area, in spite of a dramatic decrease in the total number of endoscopies (50.0%), patients with gastric ulcer (GU) were increased in 1995, whereas those with duodenal ulcer were decreased, resulting in a higher ratio of gastric to duodenal ulcers than in 1994 (3.07 vs 1.88). In particular, there was a marked increase in bleeding GU. The mean age of patients with GU was significantly higher in 1995 than in 1994.
  
  
  CONCLUSIONS
  The Hanshin-Awaji earthquake-induced life event stress not only triggered but also exacerbated GU, particularly in the elderly.
authors.affiliation: Second Department of Internal Medicine, Kobe University School of Medicine, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Aoyama
authors.forename: Y
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: S
authors.initials: S
authors.lastname: Fujimoto
authors.forename: S
authors.initials: S
authors.lastname: Himeno
authors.forename: A
authors.initials: A
authors.lastname: Todo
authors.forename: M
authors.initials: M
authors.lastname: Kasuga
authors.forename: T
authors.initials: T
authors.lastname: Chiba
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004190:Disasters; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D017678:Sex Distribution; D013276:Stomach Ulcer / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D013315:Stress, Psychological / Q000150:complications*