Skip to main content
British Journal of Sports Medicine logoLink to British Journal of Sports Medicine
. 2000 Apr;34(2):116–121. doi: 10.1136/bjsm.34.2.116

Does physical activity reduce the risk of developing peptic ulcers?

Y Cheng 1, C Macera 1, D Davis 1, S Blair 1
PMCID: PMC1724173  PMID: 10786867

Abstract

Background—Although Helicobacter pylori has been identified as a major cause of chronic gastritis, not all infected patients develop ulcers, suggesting that other factors such as lifestyle may be critical to the development of ulcer disease.

Aim—To investigate the role physical activity may play in the incidence of peptic ulcer disease.

Methods—The subjects were men (8529) and women (2884) who attended the Cooper Clinic in Dallas between 1970 and 1990. The presence of gastric or duodenal ulcer disease diagnosed by a doctor was determined from a mail survey in 1990. Subjects were classified into three physical activity groups according to information provided at the baseline clinic visit (before 1990): active, those who walked or ran 10 miles or more a week; moderately active, those who walked or ran less than 10 miles a week or did another regular activity; the referent group consisting of those who reported no regular physical activity.

Results—With the use of gender specific proportional hazards regression models that could be adjusted for age, smoking, alcohol use, body mass index, and self reported tension, active men were found to have a significant reduction in risk for duodenal ulcers (relative hazard (95% confidence interval) for the active group was 0.38 (0.15 to 0.94) and 0.54 (0.30 to 0.96) for the moderately active group). No association was found between physical activity and gastric ulcers for men or for either type of ulcer for women.

Conclusions—Physical activity may provide a non-pharmacological method of reducing the incidence of duodenal ulcers among men.

Key Words: alcohol; duodenal; exercise; gastric; ulcer; risk factors

Full Text

The Full Text of this article is available as a PDF (123.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aldana S. G., Sutton L. D., Jacobson B. H., Quirk M. G. Relationships between leisure time physical activity and perceived stress. Percept Mot Skills. 1996 Feb;82(1):315–321. doi: 10.2466/pms.1996.82.1.315. [DOI] [PubMed] [Google Scholar]
  2. Anda R. F., Williamson D. F., Escobedo L. G., Remington P. L., Mast E. E., Madans J. H. Self-perceived stress and the risk of peptic ulcer disease. A longitudinal study of US adults. Arch Intern Med. 1992 Apr;152(4):829–833. [PubMed] [Google Scholar]
  3. Bernersen B., Johnsen R., Straume B., Burhol P. G., Jenssen T. G., Stakkevold P. A. Towards a true prevalence of peptic ulcer: the Sørreisa gastrointestinal disorder study. Gut. 1990 Sep;31(9):989–992. doi: 10.1136/gut.31.9.989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Blair S. N., Goodyear N. N., Gibbons L. W., Cooper K. H. Physical fitness and incidence of hypertension in healthy normotensive men and women. JAMA. 1984 Jul 27;252(4):487–490. [PubMed] [Google Scholar]
  5. Blaser M. J. Helicobacter pylori and gastric diseases. BMJ. 1998 May 16;316(7143):1507–1510. doi: 10.1136/bmj.316.7143.1507. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Blaser M. J. Helicobacters are indigenous to the human stomach: duodenal ulceration is due to changes in gastric microecology in the modern era. Gut. 1998 Nov;43(5):721–727. doi: 10.1136/gut.43.5.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Brenner H., Rothenbacher D., Bode G., Adler G. Inverse graded relation between alcohol consumption and active infection with Helicobacter pylori. Am J Epidemiol. 1999 Mar 15;149(6):571–576. doi: 10.1093/oxfordjournals.aje.a009854. [DOI] [PubMed] [Google Scholar]
  8. Brenner H., Rothenbacher D., Bode G., Adler G. Relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection: cross sectional study. BMJ. 1997 Dec 6;315(7121):1489–1492. doi: 10.1136/bmj.315.7121.1489. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Eastwood G. L. Is smoking still important in the pathogenesis of peptic ulcer disease? J Clin Gastroenterol. 1997;25 (Suppl 1):S1–S7. doi: 10.1097/00004836-199700001-00003. [DOI] [PubMed] [Google Scholar]
  10. Ebell M. H. Peptic ulcer disease. Am Fam Physician. 1992 Jul;46(1):217–227. [PubMed] [Google Scholar]
  11. Everhart J. E., Byrd-Holt D., Sonnenberg A. Incidence and risk factors for self-reported peptic ulcer disease in the United States. Am J Epidemiol. 1998 Mar 15;147(6):529–536. doi: 10.1093/oxfordjournals.aje.a009484. [DOI] [PubMed] [Google Scholar]
  12. Friedman G. D., Siegelaub A. B., Seltzer C. C. Cigarettes, alcohol, coffee and peptic ulcer. N Engl J Med. 1974 Feb 28;290(9):469–473. doi: 10.1056/NEJM197402282900901. [DOI] [PubMed] [Google Scholar]
  13. Graham D. Y., Malaty H. M., Evans D. G., Evans D. J., Jr, Klein P. D., Adam E. Epidemiology of Helicobacter pylori in an asymptomatic population in the United States. Effect of age, race, and socioeconomic status. Gastroenterology. 1991 Jun;100(6):1495–1501. doi: 10.1016/0016-5085(91)90644-z. [DOI] [PubMed] [Google Scholar]
  14. Henriksson A. E., Edman A. C., Nilsson I., Bergqvist D., Wadström T. Helicobacter pylori and the relation to other risk factors in patients with acute bleeding peptic ulcer. Scand J Gastroenterol. 1998 Oct;33(10):1030–1033. doi: 10.1080/003655298750026705. [DOI] [PubMed] [Google Scholar]
  15. Johnsen R., Førde O. H., Straume B., Burhol P. G. Aetiology of peptic ulcer: a prospective population study in Norway. J Epidemiol Community Health. 1994 Apr;48(2):156–160. doi: 10.1136/jech.48.2.156. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Katschinski B. D., Logan R. F., Edmond M., Langman M. J. Physical activity at work and duodenal ulcer risk. Gut. 1991 Sep;32(9):983–986. doi: 10.1136/gut.32.9.983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Kikuchi S., Inaba Y., Wada O., Miki K., Tenjin H., Kaneko E., Mizukoshi H. The association of smoking and drinking habits with serum pepsinogens. Int J Epidemiol. 1995 Apr;24(2):346–353. doi: 10.1093/ije/24.2.346. [DOI] [PubMed] [Google Scholar]
  18. Levenstein S., Ackerman S., Kiecolt-Glaser J. K., Dubois A. Stress and peptic ulcer disease. JAMA. 1999 Jan 6;281(1):10–11. doi: 10.1001/jama.281.1.10. [DOI] [PubMed] [Google Scholar]
  19. Levenstein S. Stress and peptic ulcer: life beyond Helicobacter. BMJ. 1998 Feb 14;316(7130):538–541. doi: 10.1136/bmj.316.7130.538. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Markiewicz K., Cholewa M., Górski L., Chmura J. Effect of physical exercise on gastric basal secretion in healthy men. Acta Hepatogastroenterol (Stuttg) 1977 Oct;24(5):377–380. [PubMed] [Google Scholar]
  21. Marotta R. B., Floch M. H. Diet and nutrition in ulcer disease. Med Clin North Am. 1991 Jul;75(4):967–979. doi: 10.1016/s0025-7125(16)30424-2. [DOI] [PubMed] [Google Scholar]
  22. Marshall B. J., Warren J. R. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984 Jun 16;1(8390):1311–1315. doi: 10.1016/s0140-6736(84)91816-6. [DOI] [PubMed] [Google Scholar]
  23. Melmed R. N., Gelpin Y. Duodenal ulcer: the helicobacterization of a psychosomatic disease? Isr J Med Sci. 1996 Mar-Apr;32(3-4):211–216. [PubMed] [Google Scholar]
  24. Nieman D. C. Exercise and resistance to infection. Can J Physiol Pharmacol. 1998 May;76(5):573–580. doi: 10.1139/cjpp-76-5-573. [DOI] [PubMed] [Google Scholar]
  25. Nieman D. C., Pedersen B. K. Exercise and immune function. Recent developments. Sports Med. 1999 Feb;27(2):73–80. doi: 10.2165/00007256-199927020-00001. [DOI] [PubMed] [Google Scholar]
  26. O'Connor H. J. The role of Helicobacter pylori in peptic ulcer disease. Scand J Gastroenterol Suppl. 1994;201:11–15. [PubMed] [Google Scholar]
  27. Paffenbarger R. S., Jr, Wing A. L., Hyde R. T., Jung D. L. Physical activity and incidence of hypertension in college alumni. Am J Epidemiol. 1983 Mar;117(3):245–257. doi: 10.1093/oxfordjournals.aje.a113537. [DOI] [PubMed] [Google Scholar]
  28. Pahor M., Guralnik J. M., Salive M. E., Chrischilles E. A., Brown S. L., Wallace R. B. Physical activity and risk of severe gastrointestinal hemorrhage in older persons. JAMA. 1994 Aug 24;272(8):595–599. [PubMed] [Google Scholar]
  29. Ramsbottom N., Hunt J. N. Effect of exercise on gastric emptying and gastric secretion. Digestion. 1974;10(1):1–8. doi: 10.1159/000197517. [DOI] [PubMed] [Google Scholar]
  30. Richardson C. T. Role of aggressive factors in the pathogenesis of peptic ulcer disease. Scand J Gastroenterol Suppl. 1990;174:37–43. doi: 10.3109/00365529009091928. [DOI] [PubMed] [Google Scholar]
  31. Räihä I., Kemppainen H., Kaprio J., Koskenvuo M., Sourander L. Lifestyle, stress, and genes in peptic ulcer disease: a nationwide twin cohort study. Arch Intern Med. 1998 Apr 13;158(7):698–704. doi: 10.1001/archinte.158.7.698. [DOI] [PubMed] [Google Scholar]
  32. Schön I. M., Mellström D., Odén A., Ytterberg B. O. Peptic ulcer disease in older age groups in Gothenburg in 1985: the association with smoking. Age Ageing. 1991 Sep;20(5):371–376. doi: 10.1093/ageing/20.5.371. [DOI] [PubMed] [Google Scholar]
  33. Scully D., Kremer J., Meade M. M., Graham R., Dudgeon K. Physical exercise and psychological well being: a critical review. Br J Sports Med. 1998 Jun;32(2):111–120. doi: 10.1136/bjsm.32.2.111. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Shephard R. J. Exercise and relaxation in health promotion. Sports Med. 1997 Apr;23(4):211–217. doi: 10.2165/00007256-199723040-00001. [DOI] [PubMed] [Google Scholar]
  35. Sonnenberg A., Everhart J. E. The prevalence of self-reported peptic ulcer in the United States. Am J Public Health. 1996 Feb;86(2):200–205. doi: 10.2105/ajph.86.2.200. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Weatherall R., Shaper A. G. Overweight and obesity in middle-aged British men. Eur J Clin Nutr. 1988 Mar;42(3):221–231. [PubMed] [Google Scholar]
  37. Wilcox C. M., Alexander L. N., Straub R. F., Clark W. S. A prospective endoscopic evaluation of the causes of upper GI hemorrhage in alcoholics: a focus on alcoholic gastropathy. Am J Gastroenterol. 1996 Jul;91(7):1343–1347. [PubMed] [Google Scholar]
  38. Woods J. A., Davis J. M., Smith J. A., Nieman D. C. Exercise and cellular innate immune function. Med Sci Sports Exerc. 1999 Jan;31(1):57–66. doi: 10.1097/00005768-199901000-00011. [DOI] [PubMed] [Google Scholar]
  39. Zwas F. R., Lyon D. T. Occult GI bleeding in the alcoholic. Am J Gastroenterol. 1996 Mar;91(3):551–553. [PubMed] [Google Scholar]

Articles from British Journal of Sports Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES