Brief Article
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World J Gastroenterol. Nov 14, 2013; 19(42): 7426-7432
Published online Nov 14, 2013. doi: 10.3748/wjg.v19.i42.7426
Hemorrhagic gastric and duodenal ulcers after the Great East Japan Earthquake Disaster
Kenichi Yamanaka, Hiroyuki Miyatani, Yukio Yoshida, Shinichi Asabe, Toru Yoshida, Misaki Nakano, Shin Obara, Hidehiko Endo
Kenichi Yamanaka, Misaki Nakano, Department of Gastroenterology, Iwate Prefectural Kamaishi Hospital, Kamaishi 026-8550, Japan
Hiroyuki Miyatani, Yukio Yoshida, Shinichi Asabe, Department of Gastroenterology, Jichi Medical University, Saitama Medical Center, Saitama 330-8503, Japan
Toru Yoshida, Shin Obara, Hidehiko Endo, Department of Surgery, Iwate Prefectural Kamaishi Hospital, Kamaishi 026-8550, Japan
Author contributions: Yamanaka K, Miyatani H, Yoshida Y, Yoshida T, Nakano M, Obara S, Endo H designed the research; Yamanaka K performed the research and analyzed the data, and wrote the paper; Asabe S revised the manuscript critically.
Correspondence to: Kenichi Yamanaka, MD, Department of Gastroenterology, Iwate Prefectual Kamaishi Hospital, 10-483-6 Kasshi-cho, Kamaishi-shi, Iwate 026-8550, Japan. stfchono@hotmail.com
Telephone: +81-193-252011 Fax: +81-193-239479
Received: May 20, 2013
Revised: September 18, 2013
Accepted: September 29, 2013
Published online: November 14, 2013
Processing time: 182 Days and 2.3 Hours
Abstract

AIM: To elucidate the characteristics of hemorrhagic gastric/duodenal ulcers in a post-earthquake period within one medical district.

METHODS: Hemorrhagic gastric/duodenal ulcers in the Iwate Prefectural Kamaishi Hospital during the 6-mo period after the Great East Japan Earthquake Disaster were reviewed retrospectively. The subjects were 27 patients who visited our hospital with a chief complaint of hematemesis or hemorrhagic stool and were diagnosed as having hemorrhagic gastric/duodenal ulcers by upper gastrointestinal endoscopy during a 6-mo period starting on March 11, 2011. This period was divided into two phases: the acute stress phase, comprising the first month after the earthquake disaster, and the chronic stress phase, from the second through the sixth month. The following items were analyzed according to these phases: age, sex, sites and number of ulcers, peptic ulcer history, status of Helicobacter pylori (H. pylori) infection, intake of non-steroidal anti-inflammatory drugs, and degree of impact of the earthquake disaster.

RESULTS: In the acute stress phase from 10 d to 1 mo after the disaster, the number of patients increased rapidly, with a nearly equal male-to-female ratio, and the rate of multiple ulcers was significantly higher than in the previous year (88.9% vs 25%, P < 0.005). In the chronic stress phase starting 1 mo after the earthquake disaster, the number of patients decreased to a level similar to that of the previous year. There were more male patients during this period, and many patients tended to have a solitary ulcer. All patients with duodenal ulcers found in the acute stress phase were negative for serum H. pylori antibodies, and this was significantly different from the previous year’s positive rate of 75% (P < 0.05).

CONCLUSION: Severe stress caused by an earthquake disaster may have affected the characteristics of hemorrhagic gastric/duodenal ulcers.

Keywords: Great East Japan Earthquake Disaster; Hemorrhagic gastric; Duodenal ulcer; Helicobacter pylori infection; Stress

Core tip: We determined the characteristics of hemorrhagic gastric/duodenal ulcers in the post-earthquake period within one medical district. We divided hemorrhagic gastric/duodenal ulcers into two groups, the acute stress phase group, consisting of the first month after the earthquake disaster, and the chronic stress phase group, from the second through the sixth month. We concluded that severe stress caused by this earthquake disaster exacerbated the characteristics of hemorrhagic gastric/duodenal ulcers.