title: Gastric ulcer formation after the Hanshin-Awaji earthquake: a case study of Helicobacter pylori infection and stress-induced gastric ulcers.
abstract: BACKGROUND
  Both Helicobacter pylori (H. pylori) infection and various stresses are known to induce peptic ulcer disease of the upper gastrointestinal tract. However, the pathogenetic relationship between the two factors has not yet been clarified. We conducted a case-control study to examine whether H. pylori infection played a role in the development of gastric ulcer (GU) induced by life-event stresses that were experienced after the Hanshin-Awaji earthquake.
  
  
  METHODS
  Serum samples from patients in the devastated area who developed GUs during the 2 months following the Hanshin-Awaji earthquake and those from GU patients in the same area during the corresponding period of the previous year, and from gender-, age- and institute-matched ulcer-free controls were tested for the presence of the H. pylori IgG antibody.
  
  
  RESULTS
  A significant association between H. pylori infection and the development of GU in uninjured patients was observed in all sets [matched odds ratio (OR) = 3.23, 95% confidence interval: 1.95-5.35]. Moreover, the prevalence of H. pylori infection in patients who developed GUs after the earthquake was not different from that for GU patients in the previous year. In contrast, there was no association between H. pylori infection and the development of GU in the physically injured patients after the earthquake.
  
  
  CONCLUSIONS
  H. pylori infection may play an important role in the development of GUs that are induced by emotional life-event stresses.
authors.affiliation: Fourth Department of Internal Medicine, Kobe University School of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Matsushima
authors.forename: N
authors.initials: N
authors.lastname: Aoyama
authors.forename: H
authors.initials: H
authors.lastname: Fukuda
authors.forename: Y
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: A
authors.initials: A
authors.lastname: Todo
authors.forename: S
authors.initials: S
authors.lastname: Himeno
authors.forename: S
authors.initials: S
authors.lastname: Fujimoto
authors.forename: M
authors.initials: M
authors.lastname: Kasuga
authors.forename: H
authors.initials: H
authors.lastname: Nakase
authors.forename: T
authors.initials: T
authors.lastname: Chiba
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood; D016022:Case-Control Studies; D015984:Causality; D004190:Disasters; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013276:Stomach Ulcer / Q000209:etiology*; D013312:Stress, Physiological / Q000150:complications*
chemical_list: D000907:Antibodies, Bacterial