title: Stress-induced hemorrhagic gastric ulcer after successful Helicobacter pylori eradication: two case reports.
abstract: BACKGROUND
  Helicobacter pylori infection is a major cause of gastric ulcers, and Helicobacter pylori eradication drastically reduces ulcer recurrence. It has been reported, however, that severe physical stress is closely associated with gastric ulceration even in Helicobacter pylori -negative patients.
  
  
  METHODS
  We report the cases of a 47-year-old Japanese man and a 69-year-old Japanese man who developed psychological stress-induced hemorrhagic gastric ulcers, in both of whom Helicobacter pylori had been successfully eradicated.
  
  
  CONCLUSIONS
  Our cases strongly suggest that not only physical but also psychological stress is still an important pathogenic factor for peptic ulceration and accordingly that physicians should pay attention to the possible presence of psychological stress in the management of patients with peptic ulcers.
authors.affiliation: Department of Psychosomatic Internal Medicine, Health Sciences University of Hokkaido, Japan. moriyami@pop21.odn.ne.jp.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Moriya
authors.forename: Akira
authors.initials: A
authors.lastname: Uehara
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Okumura
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo