From the history of epidemiology of peptic ulcer disease in the 20th century: social factors and the prevalence
Keywords:
peptic ulcer, morbidity, social factorsAbstract
The dynamics of ulcer disease morbidity in Russia and the developed world from the end of the 19th to the beginning of the 21st century are analyzed. The recorded peaks of peptic ulcer disease morbidity in the 20th century coincide with World War I and World War II, as well as with the Great Depression. Materials from the seminal work Experience of Soviet medicine in the Great Patriotic War of 1941–1945” help to clarify the particular characteristics of peptic ulcer pathomorphism during global conflict. A sustained reduction of morbidity began to be recorded from the mid-1950s, while the frequency of complicated forms of the disease remained unchanged. Against this background, groups of patients exhibiting signs of social deprivation stand out. They are characterized by an increase in the incidence of peptic ulcer disease, complicated progressions and poor treatment outcomes. The analysis of the specifics of such cases of peptic ulcer progression can be most justified from the standpoint of psychosomatic medicine, rather than the theory of infectious ulceration, as in this case the impact of persistent stress and/or depression in patients at risk is clearly demonstrated. The epidemiological aspects of peptic ulcer disease present an obvious model for the study of the relationship between the inherent psychosocial and behavioral characteristics of patients from the at-risk group, as well as external and socioeconomic factors in the occurrence of infectious disease. The dynamics of peptic ulcer disease from the 19th century to the 21st century show a distinct connection to global and local social conflicts, as well as an adherence to cyclic rhythms (circadian, annual, perennial) affecting biological systems. Violation of these circadian processes is reflected in both the development and pathomorphism of peptic ulcers. Thus, an analysis of the impact of global and local conflicts in peptic ulcer diseases from the perspective of the history of medicine is not just a look back at the past,”but also an attempt to rethink the etiopathogenesis of the disease.
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