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Childhood stress = adulthood ulcer risk

Adults who had a difficult childhood may be at higher risk of developing a stomach ulcer than those with a less stressful past, a new study suggests.

Researchers found that certain measures of childhood "adversity" -- like growing up in a family with chronic financial problems or serious personal conflicts, or having a family member with a serious illness or drinking problem -- were linked to the risk of ulcer among nearly 20,000 Finnish adults.

The reasons for the connection are not certain, but there are some plausible links, the investigators report in the World Journal of Gastroenterology.

One possibility is that greater childhood adversity is a marker of lower income and poorer living conditions growing up -- factors that increase the risk of becoming infected with Helicobacter pylori bacteria.

H. pylori bacteria live in the lining of the stomach and small intestine, and the bug is believed to be the cause of most ulcers. It's estimated that about half of the world's population carries H. pylori bacteria, though most people do not develop ulcers because of it.

For the study, researchers led by Dr. Markku P.T. Sumanen, of the University of Tampere in Finland, analyzed data from 19,626 adults, 20 to 54 years old, who took part in a health survey in 1998 and 2003. Of these, 718 said they had been diagnosed with an ulcer.

Overall, the researchers found, ulcer patients had higher rates of various childhood adversities; 45 percent, for example, said their families had had long-term financial problems, versus 27 percent of ulcer-free study participants. Similarly, 42 percent said a family member had had a serious illness, compared with 27 percent of those without an ulcer.

The study team then factored in participants' ages, smoking and drinking habits, stress levels and use of non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen.

Smoking, heavy drinking and chronic NSAID use may help cause ulcers or worsen them; it's thought that habitual stress, while not a direct cause of ulcers, may exacerbate symptoms.

Even with those factors considered, childhood hardships were linked to a one-quarter to three-quarter higher risk of ulcer, the study found.

The findings, Sumanen's team writes, do not prove that childhood adversity, per se, is a risk factor for ulcers. But it may help predict which people are at greater odds of developing the condition.

"A more comprehensive understanding of peptic ulcer patients is worth aspiring to," they conclude. (Reuters Health)

SOURCE: World Journal of Gastroenterology, July 2009.

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