Abstract: The conventional biomedical model used for medical research and
disease management is a linear model in which the cause-effect relationship is
important. In contrast, the model used in psychosomatic medicine is a bio-psychosocial
model in which much importance is attached to interactions and relationships
among various factors, as well as to the individuality of the patients. When
peptic ulcer is studied or treated, it is meaningless to argue about whether this is
an infectious or a stress-related disease. Although there is a lot of evidence that the
eradication of Helicobacter pylori (H.pylori ) prevents ulcer recurrence, the development
of ulcers only occurs in several percent of persons infected with H. pylori .
It has been estimated that 70–80% of the population aged 40 years or older are
infected with H. pylori . Although stress is associated with ulcer development in 30–
40% of all patients with peptic ulcer, many persons who are under stress do not
suffer from this disease. The organ affected by stress varies depending on many
factors, including individual predisposition (vulnerable organ), smoking, drinking,
and dietary habits. Because peptic ulcer is a multifactorial disease, a bio-psychosocial
approach adjusted for the individual patient should be applied to its diagnosis
and management, with careful consideration of the association of this disease
with many factors including H. pylori and stress.