In the planning of clinical investigations on ulcer etiology, it is important to determine to what extent peptic ulcer patients can contribute to every day emotional stress. In this report, as a model to establishing an emotional stress condition, we took attention to the emotional conflict of the patients just before surgery. Changes of plasma concentration of corticosteroids (11-OHCS) were measured in resting, emotional-stressed preoperative condition and after surgery. Therewithal, gastric secretion was measured. In resting condition, determination of plasma 11-OHCS levels in patients with peptic ulcer failed to detect differences from control subjects.
Slight increase in plasma 11-OHCS levels was observed both in the patients with or without peptic ulcers. During emotional stress condition, a significant increase in gastric acid and pepsin secretion was observed in duodenal and gastro-duodenal ulcer patients. Stress-induced gastric acid and pepsin secretion were reduced by atropin sulfate injection to 50% and 30%.
The inhibitory rate of gastric secretion by the drug was less striking as compared with those levels in non-stressed resting condition. Laparotomy (physical stress) enhanced the gastric pepsin release in spite of vagotomy.
The role of the emotions in altering gastric secretion was recognized in individuals with duodenal or gastro-duodenal ulcers.
Emotional stress may plays an important role in the ulcer etiology.
Although, the precise mechanism by which emotional stress affects the ulcerogenesis remains to be clarified, the role of extra-vagal humoral pathway (via the hypothalamo-pituitary-adrenal axis) is not a negligible matter.
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