peptic ulcer disease

What is John Henryism? by Sue Gardner John Henryism (JH) is a term used to describe a strategy for coping with prolonged exposure to stresses such as social discrimination by expending high levels of effort which results in accumulatingphysiological costs.[1][2] Statue of John Henry outside the town of Talcott in Summers County, West Virginia The term was conceived in the 1970s byAfrican-American epidemiologist and public health researcher Sherman James, while he was investigating racial health disparitiesbetween African-American people and others in North Carolina. One of the people he interviewed was a blackman who, despite being born into an impoverished sharecropper family and having only a second grade education, could read and write. The man had freed himself and his offspring from the sharecropper system, had 75 acres (30 ha) of farmed land by age 40, but by his 50s had hypertension, arthritis, and severe peptic ulcer disease.[2] His name, John Henry Martin, and his circumstances were evocative of folk heroJohn Henry, an African American who worked vigorously enough to compete successfully with a steam powered machine, but died as a result of his effort.[3][4] James developed a scale for measuring JH based on agreement with a series of statements such as “When things don’t go the way I want them to, that just makes me work even harder” and “I’ve always felt that I could make of my life pretty much what I wanted to make of it.” Men who score higher on this scale generally have higher blood pressure than men with lower scores. This effect is strongest in those who are poor.[2] Studies have found that African-Americans with high JH scores are less likely to be current or former smokers than African-Americans with low JH scores, and that African-American college students with high JH scores were less likely to have carried a weapon on campus for self-defence, more likely to have been arrested for driving under the influence, and more likely to have missed a class due to alcohol use.[5] Allostatic loadPsychoneuroimmunologyStress (biology) ReferencesEdit James, S. A.; Keenan, N. L.; Strogatz, D. S.; Browning, S. R.; Garrett, J. M. (1992). “Socioeconomic status, John Henryism, and blood pressure in black adults. The Pitt County Study”. American journal of epidemiology 135 (1): 59–67.PMID 1736661. editSteele, Claude M. (2011). Whistling Vivaldi: How Stereotypes Affect Us and What We Can Do (Issues of Our Time). W. W. Norton & Company. ISBN 978-0393341485. Retrieved2014-11-25.Tracy, Steven C.; Bradford, Roark (2011).John Henry: Roark Bradford’s Novel and Play. Oxford University Press, USA. ISBN 0-19-976650-9.“John Henry, Present at the Creation”, Stephen Wade, NPR, September 2, 2002Jackson, Yolanda (2006). Encyclopedia of Multicultural Psychology. SAGE Publications Inc.

What is Peptic Ulcer Disease?

External image

Peptic ulcers are sores or eroded areas that form in the lining of the digestive (gastrointestinal) tract. They usually occur in the stomach (gastric ulcer) or in the duodenum (duodenal ulcer), which is the upper region of the small intestine. The two primary causes of peptic ulcers are infection with specific bacteria (Helicobacter pylori) and use of nonsteroidal antiinflammatory medications.

Helicobacter pylori

Helicobacter pylori (H. pylori) is a gram-negative rod-shaped bacteria. It is s-shaped/spiral, has flagella, and resides in the antrum of the stomach between the mucous and epithelial cells. It migrates proximally over time. 

Pathology      

  • Secretes urease
  • Urease and other factors compromise integrity of gastric/duodenal mucosa
    • Gastritis, ulcer formation
  • Incidence of infection increases with age
  • Related pathology
    • Chronic active gastritis
    • Majority of PUD cases
    • Can lead to B12 malabsorption and anemia
    • MALT lymphoma and gastric CA
  • Documentation
    • Urea breath test – test of choice
      • Must be off PPO 7-14 days and ABX 28 day before test
    • Fecal H. pylori antigen test
    • Rapid urease testing
    • Bacterial culture
    • Serology

Upper gastrointestinal endoscopy is the procedure of choice for the diagnosis of suspected peptic ulcer disease. It is highly sensitive and allows for direct visualization, with the potential for biopsy and cytologic brushing of suspected lesions. The endoscopy image shown is from a 35-year-old woman who presented with tarry stools and a hemoglobin level of 75 g/L.

It’s ‪Microbiome Monday‬! In the mid-1980s, internist Barry J. Marshall tested, and proved, his theory that ulcers could be cured with antibiotics by infecting himself with the corkscrew-shaped bacterium Helicobacter pylori. This not only earned him the nickname “guinea pig doctor” but also the Nobel Prize, which he shared in 2005 with pathologist J. Robin Warren for their discovery that H. pylori caused gastritis (irritation or inflammation of the stomach lining) and peptic ulcers, diseases that were long thought to be caused by excess acid resulting from stress. 

Their work led to the near-eradication of stomach ulcers in developed countries through treatment with antibiotics, as well as to a drop in stomach cancers, for which gastritis is a risk factor. But as welcome as these cures are, researchers now think H. pylori isn’t just a pathogen. Studies strongly suggest that it is essential to the prevention of asthma, allergies, gastroesophageal reflux disease, and esophageal cancer.

Read the full story on the Museum blog