Development of New Symptoms Following Medical and Surgical Treatment for Duodenal Ulcer

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Abstract
Summary The purpose of the present investigation was to test the hypothesis that removal of duodenal ulcer symptoms by medical or surgical treatment may result in the development of new symptoms. The experimental group consisted of 30 patients who had been treated for duodenal ulcer by means of gastrectomy, a procedure which abolished the ulcer symptoms completely in 57 per cent of these patients. The control group consisted of 30 patients with duodenal ulcer who had been treated by conservative medical measures, and in whom complete remission of ulcer symptoms did not occur. Both groups were subjected to a follow-up study which consisted of: (1) A detailed interview by one of the investigators; (2) an interview by a psychiatric social worker with complete social case study; and (3) medical, laboratory, and x-ray follow-up examinations. An attempt was made to determine the incidence and severity of symptoms of all types that were present before and after treatment. The surgically treated group revealed a significant decrease in ulcer symptoms following gastrectomy, but this was compensated for by a significant parallel increase in other psychosomatic and psychoneurotic symptoms. The medically treated control group, in which ulcer symptoms were not significantly reduced in incidence or severity, revealed no such redistribution of symptoms following treatment. These findings support the hypothesis that successful removal of duodenal ulcer symptoms by gastrectomy, without resolution of the associated psychopathogenic conflicts may result in the development of new symptoms.