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Stress and the psychosomatic model have indeed been "out of fashion" as a cause of peptic ulcer since the discovery of the pathogenic role of Helicobacter pylori in this disease.¹ It is not unusual in the history of medicine for new discoveries to push previous evidence into the background.

The role of H pylori and the "need" to eradicate it from the gastric-duodenal tract with appropriate medical treatment have, in fact, obscured the well-documented importance of psychological stress in the genesis of peptic ulcer.

It is not by chance that the article by Dr Levenstein and colleagues¹ begins by recalling that Alexander the Great (356-323 BC) probably died of a perforated duodenal ulcer, apparently caused by the stress of "founding an empire." Benito Mussolini (1883-1945) similarly experienced dramatic exacerbations of epigastric pain and dyspepsia (related to a duodenal ulcer) simultaneously with important stressful events of his life (such as negative . . . [Full Text of this Article]

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RELATED ARTICLE

Stress and Peptic Ulcer Disease
Susan Levenstein, Sigurd Ackerman, Janice K. Kiecolt-Glaser, and André Dubois
JAMA. 1999;281(1):10-11.
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