title: Hemorrhagic gastric and duodenal ulcers after the Great East Japan Earthquake Disaster.
abstract: OBJECTIVE
  To elucidate the characteristics of hemorrhagic gastric/duodenal ulcers in a post-earthquake period within one medical district.
  
  
  METHODS
  Hemorrhagic gastric/duodenal ulcers in the Iwate Prefectural Kamaishi Hospital during the 6-mo period after the Great East Japan Earthquake Disaster were reviewed retrospectively. The subjects were 27 patients who visited our hospital with a chief complaint of hematemesis or hemorrhagic stool and were diagnosed as having hemorrhagic gastric/duodenal ulcers by upper gastrointestinal endoscopy during a 6-mo period starting on March 11, 2011. This period was divided into two phases: the acute stress phase, comprising the first month after the earthquake disaster, and the chronic stress phase, from the second through the sixth month. The following items were analyzed according to these phases: age, sex, sites and number of ulcers, peptic ulcer history, status of Helicobacter pylori (H. pylori) infection, intake of non-steroidal anti-inflammatory drugs, and degree of impact of the earthquake disaster.
  
  
  RESULTS
  In the acute stress phase from 10 d to 1 mo after the disaster, the number of patients increased rapidly, with a nearly equal male-to-female ratio, and the rate of multiple ulcers was significantly higher than in the previous year (88.9% vs 25%, P < 0.005). In the chronic stress phase starting 1 mo after the earthquake disaster, the number of patients decreased to a level similar to that of the previous year. There were more male patients during this period, and many patients tended to have a solitary ulcer. All patients with duodenal ulcers found in the acute stress phase were negative for serum H. pylori antibodies, and this was significantly different from the previous year's positive rate of 75% (P < 0.05).
  
  
  CONCLUSIONS
  Severe stress caused by an earthquake disaster may have affected the characteristics of hemorrhagic gastric/duodenal ulcers.
authors.affiliation: Kenichi Yamanaka, Misaki Nakano, Department of Gastroenterology, Iwate Prefectural Kamaishi Hospital, Kamaishi 026-8550, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Miyatani
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Shinichi
authors.initials: S
authors.lastname: Asabe
authors.forename: Toru
authors.initials: T
authors.lastname: Yoshida
authors.forename: Misaki
authors.initials: M
authors.lastname: Nakano
authors.forename: Shin
authors.initials: S
authors.lastname: Obara
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Endo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D002908:Chronic Disease; D004190:Disasters; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000453:epidemiology*; D055866:Earthquakes; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013276:Stomach Ulcer / Q000175:diagnosis / Q000453:epidemiology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Duodenal ulcer; Great East Japan Earthquake Disaster; Helicobacter pylori infection; Hemorrhagic gastric; Stress