The peptic ulcer: facts and fantasies

Nutrition Health Review, Fall, 1989 by Ray Williamson

The Peptic Ulcer Facts and Fantasies

Sometimes regarded as the price of success, often misrepresented as the result of eating exotic and spicy foods, but too frequently misunderstood for their deadly potential, gastric and duodenal ulcers affect a large part of the population. In 1988, more than five million cases were reported.

The following collection of questions and answers represents both scientific facts and suppositions among the medical profession in fathoming the persistent mystery of ulcers of the digestive tract.

Q: Peptic ulcer, gastric ulcer,

duodenal ulcer -- how do they differ? A: Peptic ulcer is the term that covers

both gastric ulcer, a disorder of the

stomach lining, and duodenal ulcer, an

abrasion in the upper intestine (the

duodenum). Peptic ulcers can also be

found in the esophagus, the

passageway between the mouth and the

stomach, and even in the large

intestine.

Q: Physically, what happens that

causes peptic ulcers to form? A: In the development of peptic ulcer, two

components of stomach juice are

involved: hydrochloric acid and pre-enzyme

pepsinogen. An enzyme is a

substance secreted by the body's cells

that acts as a catalyst to effect chemical

changes in other substances.

Pepsinogen is inactive and harmless at

alkaline levels (when the stomach is

not overly acidic). Activated by the

enzyme pepsin, however, it becomes

extremely corrosive, damaging, and

begins to eat away the linings of the

stomach and upper duodenum.

Under normal conditions, the

membrane lining of the gastrointestinal

tract is well shielded from effects of

activated gastric juice. It is the

apparatus that protects against formation

of peptic ulcers. The opposite action

can be considered gastrointestinal

self-destruction and autodigestion!

Q: Can a peptic duodenal ulcer cause

cancer? A: No evidence exists to prove that

assumption in the case of duodenal

ulcers. Some doctors suspect

longstanding gastric ulcers, however, to be

vulnerable to cancer formation. Others

believe that tumors are usually

destroyed by the high acidic content of the

stomach. But that theory does not

explain the persistence of others forms

of stomach cancer. If a patient has an

ulcer and the stomach seems to be

incapable of producing acid, the

diagnosis of cancer is usually seriously

considered. Aggressive testing must

include endoscopic examination.

Q: Is there an "ulcer personality?" A: Many elements go into making the

ulcer-prone individual. Overproduction

of stomach acid is one. Some people

are genetically motivated to

overproduce. Taking large amounts of certain

medications is another. How one deals

with stresses of work and play can be

a determination. Diet and nutritional

deficiencies can cause vulnerability.

Combine some or all of these, and a

high-risk, ulcer-prone personality is

created.

Q: Since children are ordinarily

protected from the stresses of adult

life, why should there be a

growing incidence of peptic ulcer

among them? A: Young children are often confronted

with stressful home environments,

parental discord, anxiety, and deep

insecurity. A great amount of

suppressed anger is another device with

which children deal in a fearful

environment.

Children in our society are also

vulnerable to nutritional deficiencies because

so much processed food is part of their

diet. Stress caused by parental absence

(many mothers work and have little

time to minister to youngsters'

apprehensions and needs).

No one condition causes an ulcer. Add

vulnerability, and the risk factors

become enormous.

Q: Peptic ulcers have been known as

the "executive's disease." How

much truth is there to the term? A: No doubt, many executives suffer from

ulcers. Is it primarily a stress disease?

Probably not.

In parts of Africa, India, China, and

Japan, farmers, agricultural workers,

and unskilled laborers also have a high

incidence of ulcers. Other studies,

among white-collar workers, bus

drivers, taxi drivers, and airline personnel,

have revealed a higher than average

incidence of peptic ulcers. There does

not seem to be a consistent relationship

between occupation and ulcer

vulnerability.

Q: Do the ulcer-prone suffer from

psychosomatic illness? Is it a

matter of repressed emotions? A: A cynic, describing the unbearableness

of married life, once remarked: "A

peptic ulcer may be the hole in a man's

stomach through which he crawls to

escape from his spouse ..."

Considerable evidence links mental and

emotional processes with bodily

function. Anyone who sees himself

"imprisoned", with no exit, could become

vulnerable to illness.

More subtle processes are also affected

by the emotions. Studies in the

production of stomach acid in male college

students have demonstrated that

during the periods in which no exams

were given less gastric acid was

secreted than during exam periods.

Certainly, most vulnerable are

personality types who are driven by ambition,

who are overly demanding, and who

register high levels of anxiety,

instability, insecurity, and restlessness.

Q: Is there a scientific theory to

bolster the theoretical link

between ulcers and emotions? A: Writing in the medical textbook

Gastroenterology, Doctors H. Shay and D.C.