Stress is a factor that contributes for the induction of gastric ulcers, could these ulcers develop to gastric cancer? What are the factors involved in this process?
I think there is no direct relationship so far between gastric cancer and peptic or gastric ulcer. The pathophysiology are quite different.
May be this paper help to find the answer http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952980/
Peptic ulcer (GU & DU are different), gastric ulcer is not involved with stress as duodenal ulcer which is more related to the stree. It is very known from the experiments and clinical history that the stree is not a major factor in the pathology of GU. The stree models on experimental animals indicate that GU does not influenced by stree conditions. The pathological studies also indicate different aetiology. The development of GU to cancer due to environmental factors is unlikely known
Dear Dr Fathi, you said :"gastric ulcer is not involved with stress as duodenal ulcer which is more related to the stress".
Is it possible to give us evidence or name of some references of this point.
Thank you
According to my knowledge,chronic gastric ulcer is a leading cause of gastric carcinoma. And H. pylori infection is an important risk factor for the development of gastric cancer.
Healing of chronic,larger and deeper gastric ulcers lead to a few complications and one of which is malignant transformation. Chronic ulcers lead to continuous healing and then again ulceration that causes increased mitosis of mucosa and submucosa that may transform into cancerous tissue.
If you'll allow me to answer
there are many ways that can be used to induce stress ulcers in animals
the best one which I used water immersion restraint stress (WIRS)
'Stress was conducted by placing each rat in a plastic restrainer individually, after which they were immersed neck-deep in a water bath at room temperature (23°C) for 3.5 hours. This procedure was done following the method by Nishida et al. (1997). '
Thank you Dr Ibrahim for sharing your knowledge,but I actually wanted to ask about the mental stress that causes increased secretion of gastric HCl,i.e, how do you induce anxiety in animals.
The method mentioned by you is a way to induce physical stress.....
Chronic gastric ulcer can turn malignant and one should not forget that gastric ca is associated with atrophic gastritis and hypo- or achlorohydria.
Chronic gastric ulcer is not a right diagnosis because can be the result of two basically opposite process: carcinogenesis and peptic ulcerogenesis. When chronic gastric ulcer is associated with duodenal peptical ulcer, this gastric peptic ulcer never is cause of gastric carcinoma. There is no doubt of this question because peptic disease prevent and does not fuel gastric carcinogenesis. When chronic gastric ulcer is an episode in the context of a precursor lesions of gastric cancer like the alimentary multifocal atrophic gastritis with or without intestinal metaplasia, obviously this type of chronic gastric ulcer is linked with gastric cancer risk. Finally there are early gastric cancer ulcerated that clinically are chronic gastric ulcer.
Stress can induce ulcers and concurrent stress can develope cancer. The prodisposing factors can be concerned.
Peptic ulcers and gastric cancer are multifactorial process, but their paths are opposite. People who have a tendency to make peptic ulcers, are not in risk of gastric cancer. Stress and Hp infection promote both process, but Hp infection is a crucial factor and stress a minor factor. You can manage stress but you never can forget Hp infection.
Only when a gastric ulcer is associated with duodenal ulcer you can say that the gastric ulcer is a peptic ulcer. This is the only proof that a gastric ulcer is a peptic ulcer. Near all duodenal ulcers are peptic, but only a few gastric ulcers are peptic ulcers. Stress promote peptic ulcers, but helicobaceter infection is the crucial etiological factor because it is a necesary factor for the development of peptic ulcers.
Dear Friends,I think an important point to ponder here is that stress can cause damage to gastric mucosa, mild inflammation, regeneration and repair, whereas a prolonged stress, a protracted inflammation and the reactive changes thereof. Stress can also lead to flare up of H pylori infection, thus adding up more stress and perpetuation of inflammation or precisely chronic active inflammation, culminating in dys-regulation of immune response, a major factor incriminated in gastric ulceration as well as gastric cancerogenesis associated with HP.
Stress related ulcers with monofactorial origin are rare. Gastric ulcer has a multifactorial origin which account for a reduction of protective factors of mucosal gastric barrier (eptithelial turnover, mucus and prostaglandins) and an increase of aggressive intraluminal ones (acid, pepsin, H. pylori). The development of cancer on these lesions depends on alterations in proliferation/apoptosis ratio of the epithelium, oncogene early mutation - p53 and ras, immunological events (crossa reactivity between parietal cells and H. pylori, diet habits (salt), carcinogen exposure. I think that a combination of so much factors cannot focus whether the stress has a real role. Dedicated studies may be interesting topic.
The natural history of Malignant ulcers is very difficult to distinguish. I have no doubt that stress contributes hugely to many upper GI symptoms particularly GORD. I have not seen convincing evidence to associate levels of psychological stress with malignant gastric ulcers
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