Role of Stress in Functional Dyspepsia / 대한소화관운동학회지

BACKGROUND/AIMS: Pathogenesis of functional dyspepsia consists of motor abnormality, sensory abnormality, and psychologic abnormality. Anxiety, depression, and psychosomatic disorders are well known psychopathologies that lead to dyspepsia, and stress seems to be an additional etiology. The aim of this study is to assess whether stress can cause and/or provoke dyspepsia. METHODS: Functional dyspepsia was defined and classified by Rome criteria. SCL-90-R for the detection of psychopathology, measurement of life stress scale by self-administered questionnaire, and measurement of stress coping mechanisms using a multidimensional stress coping scale test were performed in 79 functional dyspeptic patients and 25 normal controls. RESULTS: No significant difference was found in the total amount of stress between functional dyspeptic patients and the normal control. However, the patients were more stressful about issues relating to health and marital relationship among stresses in individual daily life. As the patients become more stressful, they used more negative coping mechanisms such as restraint, fatalism, criticism, religiousness, and negativism. These seem to provoke several psychopathologies including interpersonal sensitivity, depression, anxiety, hostility. However, there was no relationship in the amount of stress, the stress coping mechanism, and psychopathology among the dyspeptic symptoms and subgroups of functional dyspepsia. CONCLUSION: There was no difference in the total amount of stress between functional dyspeptic patients and the normal control. In some individuals who utilize inadequate coping mechanisms against stress, the stress can provoke dyspepsia.

Role of Stress in Functional Dyspepsia / 대한소화관운동학회지

BACKGROUND/AIMS: Pathogenesis of functional dyspepsia consists of motor abnormality, sensory abnormality, and psychologic abnormality. Anxiety, depression, and psychosomatic disorders are well known psychopathologies that lead to dyspepsia, and stress seems to be an additional etiology. The aim of this study is to assess whether stress can cause and/or provoke dyspepsia. METHODS: Functional dyspepsia was defined and classified by Rome criteria. SCL-90-R for the detection of psychopathology, measurement of life stress scale by self-administered questionnaire, and measurement of stress coping mechanisms using a multidimensional stress coping scale test were performed in 79 functional dyspeptic patients and 25 normal controls. RESULTS: No significant difference was found in the total amount of stress between functional dyspeptic patients and the normal control. However, the patients were more stressful about issues relating to health and marital relationship among stresses in individual daily life. As the patients become more stressful, they used more negative coping mechanisms such as restraint, fatalism, criticism, religiousness, and negativism. These seem to provoke several psychopathologies including interpersonal sensitivity, depression, anxiety, hostility. However, there was no relationship in the amount of stress, the stress coping mechanism, and psychopathology among the dyspeptic symptoms and subgroups of functional dyspepsia. CONCLUSION: There was no difference in the total amount of stress between functional dyspeptic patients and the normal control. In some individuals who utilize inadequate coping mechanisms against stress, the stress can provoke dyspepsia.

Clinical Features of Hepatitis A in Korean Adults / 대한내과학회지

OBJECTIVE: This study was aimed to characterize the clinical features and course of acute hepatitis A in Korean adults. METHODS: One-hundred and thirteen cases of acute hepatitis A, diagnosed between Jan. 1995 to July 1998 at 6 medical centers in Korea, were reviewed retrospectively. The clinical course of 94 cases with follow-up duration longer than 3 months were analyzed. RESULTS: The median age was 26 (16-65) years and 97.3% of the patients were under 40 years. The presumed sources of infection were identifed in 62 cases (54.9%). Among those, the leading source was ingestion of raw food. All patients showed normalization of bilirubin level within 8 weeks. The ALT levels normalized within 8 weeks in all patients except three patients (3.2%). Three patients with prolonged elevation of ALT showed second rise of ALT, suggesting a possibility of relapsing hepatitis. Prolonged fever (>38 degree C) more than 10 days was observed in 3 patients (3.2%). One case showed prolonged elevation of alkaline phosphatase (> x3 upper normal limit). No case of fulminant hepatic failure or death was observed. CONCLUSION: The majority of cases with acute hepatitis A in Korean adults showed self-limited course with full recovery.

Two Cases of Collagenous Colitis / 대한소화기내시경학회지

Collagenous colitis was first described by Lindstrom in 1976. Now this disorder is recognized as one of the more common causes of chronic diarrhea of obscure origin. This disorder is described as a disease of colon associated with chronic watery diarrhea and the typical histologic findings of a thickened subepithelial collagenous band. But in korea a few cases have been reported. We had observed a 52-year-old businessman with chronic watery diarrhea without abdominal pain in the past. And then we had reported previously that case. We also recently observed a 42-year-old housewife with chronic watery diarrhea with lower abdominal discomfort for 10 years. Colonoscopy disclosed no gross abnormalities through the entire colon ineluding the terminal ileum but we could find the pronounced thickening of subepithelial collageous band and chronic inflammation in the lamina propria in the histologic examination. We summarized the above two cases of collagenous colitis with a review of literatures.