Lifestyle, Stress, and Genes in Peptic Ulcer Disease

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Abstract
A FAMILIAL accumulation of peptic ulcer disease has been well established.1,2 Theoretically, the familial overrepresentation of disease may be attributable to the aggregation of environmental exposures (shared environment), genetic effects, or both. The concept of the inheritance of peptic ulcer disease has been commonly accepted, while the effect of environmental predisposing factors such as the use of anti-inflammatory analgesics,3 smoking,4 alcohol consumption, and mental stress5 has also been emphasized. Several characteristics with genetic influence are associated with duodenal ulcer: blood group O, nonsecretors of blood group substances, hyperpepsinogenemia I, rapid gastric emptying, and postprandial hypergastrinemia.6-8 Hyperpepsinogenemia I is inherited as an autosomal dominant trait and it is present in 50% of patients with duodenal ulcer disease. There is, however, evidence that Helicobacter pylori infection elevates serum pepsinogen levels, and therefore the genetic transmission of hyperpepsinogemia has been questioned.9,10