小児の胃・十二指腸潰瘍はどう変わったか

How Gastric and Duodenal Ulcers in Children Has Changed with Tine

　小児を小児科で取り扱う0～14歳までの年齢層とみなして，以下小児の胃・十二指腸潰瘍（便宜上単に小児潰瘍という）の動向と，それに関連する背景因子などについて述べる．

　小児潰瘍に関しては，国内国外における頻度，臨床症状の特徴Dや問題点，さらに新生児や乳幼児にみられる急性潰瘍は，その成因からいっても別個のものとして考えなければならないことなどについて，筆者²⁾はすでに本誌（9巻8号，1975年）に発表しているので，今回はこうした点の重複はさけ，その後の知見を含めて，テーマに即した参老事項をあげてみたい．

　Until twenty years ago the incidence of gastric and duodenal ulcers in children from birth until 14 years of age was rare. Recently in Japan the occurrence has increased.

　We performed endoscopic studies on children who had symptoms of abdominal pain, hematemesis, melena, and anemia, etc. From 1962 to the present we found 180 cases of ulcerative lesions in the stomach and duodenum. A markedly increasing incidence of ulcerative lesions in the stomach and duodenum has been noted, especially since 1974. One possible explanation for this increased incidence is the concurrent increased psychological stresses which have their origins in the complex social and environmental factors of modern society.

　Psychological stresses in children are defined as follows:

1. Anxiety and tension concerned with high school entrance examination in junior high school students.

2. Attendance to special cramming school (Juku)-85% of the children who have gastric and/or duodenal ulcers attend such schools and 80% of these children attended reluctantly. 60% of these children took more than 3 different kinds of “enrichment lessons”.

3. Difficulties in communicating homeroom teacher.

4. Marital, social, economic, and environmental problems of parents and problems in parent-child relationship.

　Some of the characteristic and important facts from the social standpoint are listed above.