Peptic Ulcer

The conventional biomedical model used for medical research and disease management is a linear model in which the cause-effect relationship is important. In contrast, the model used in psychosomatic medicine is a bio-psychosocial model in which much importance is attached to interactions and relationships among various factors, as well as to the individuality of the patients. When peptic ulcer is studied or treated, it is meaningless to argue about whether this is an infectious or a stress-related disease. Although there is a lot of evidence that the eradication of Helicobacter pylori (H.pylori ) prevents ulcer recurrence, the development of ulcers only occurs in several percent of persons infected with H. pylori . It has been estimated that 70–80% of the population aged 40 years or older are infected with H. pylori . Although stress is associated with ulcer development in 30– 40% of all patients with peptic ulcer, many persons who are under stress do not suffer from this disease. The organ affected by stress varies depending on many factors, including individual predisposition (vulnerable organ), smoking, drinking, and dietary habits. Because peptic ulcer is a multifactorial disease, a bio-psychosocial approach adjusted for the individual patient should be applied to its diagnosis and management, with careful consideration of the association of this disease with many factors including H. pylori and stress.