سنجش رابطه استرسهای زندگی و بیماریهای گوارشی (زخم معده)

Background : The Association between physical and psychological disorders has been demonstrated repeatedly. Gastro intestinal disorders are common medical diseases which have similar symptoms with mental disorders and also may produce psychiatric problems or be aggravated under psychological distress. Gastro intestinal complaints are among the most common symptoms in primary care and internal clinics that frequently remained unexplained. Most of prior studies are dealing with mental changes following the digestive disease. The present study has evaluated mental changes during the prior year of digestive disease diagnosi in a group of patients with definite peptic ulcer. Materials and methods : 200 peptic ulcer cases (140 males and 60 females) who had referred during 1376.10.20 and 1377.10.20 and indicated for endoscopy were randomly selected. We completed Holmes-Rahe mental-social table and a questionnaire dealing with risk factors of digestive diseases such as cigarette smoking, NSAIDs, alcohol, and caffeine use and also O blood group. Patients were assigned in two groups of A (disease onset prior to 6 months ago) and B (disease onset during the past 6 months). Results : The mean stress of male patients in group A and B was 253 and 218, respectively. These figures were 257 and 221 in females. Of 140 males, 104 (74.2%) had blood group O, 17.2% were smoker and 8.6% had the history of NSAIDs use. The corresponding figures were 46.6%, 26.6% and 26.7% in females. Among 200 patients, endoscopy failed to show evidences of cancer or helicobacter pylori infection in 120. These patients were discharged by antacid, H2 blocker and mild tranquilizer therapy. The remaining 80 cases had positive pathologic findings favourable of helicobacter infection with gastric, esophageal, or pancereas malignancies.  Conclusion : Results have revealed that 60% of the studied patients had just one stress tension during their life. Thus, mental changes are prior to physical changes. Physicians should concern more about the mental-social changes in patients liable to digestive system diseases. Stress should always be kept in mind in the management of the affected patients.