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War Surgery and Medicine

Causes of Dyspepsia

Causes of Dyspepsia

Depression, anxiety, fatigue, and suggestion played an important part in the production of dyspepsia. Separation from home, true or imagined infidelity, family sickness, financial worry, or just boredom and discontent readily interfered with digestion. Army food, though not well tolerated by the soldier with a dyspeptic tendency, was not generally an important factor. As the Consultant Physician commented in 1942, ‘Many cases of nervous dyspepsia are not due to army diet or “ulcer diathesis” but to army life and certain psychological factors.’ The nervous strain of battle affected a few, and some men developed acute symptoms, such as retching or vomiting, during a battle.

Riley compared the ulcer (and ulcer-like) group with the nervous group. Just over a third of each group smoked more than twenty cigarettes daily, but only 10 per cent in each group admitted that they took more than an occasional alcoholic drink. A family history of dyspepsia was frequent in each group, and this affected a man in two ways. It provided him with a constitutional tendency to dyspepsia, with or without ulceration, and it also meant that he was surrounded in his early impressionable years by a stomach-conscious family. As one passed from the ulcer to the nervous group the influence of constitution gave place to that of environment. In the neurotic group depression, sleeplessness, and loss of appetite led to a loss of weight and energy. Food did not seem to be ‘digested properly’; the soldier told his friends that he had ‘no energy’. Sympathetically they suggested that he must have ‘a gastric stomach’. The unhappy fellow eagerly clutched at this hint of escape from his troubles, and after frequent calls at the Regimental Aid Post he eventually set out on the path that led to X-rays, test meals, and repeated admissions to hospital.