ABSTRACT
Introduction Gastric and duodenal ulcers are both relatively common conditions, although there is some disagreement as to their prevalence. Self-reports suggest that in any given year as many as 3% of the population are affected by peptic ulcers,1 whereas the annual incidence of physician-diagnosed lesions is much lower, in the range 0.10-0.19%.2 Endoscopy of symptomless Louisiana volunteers found a prevalence between these two extremes, 1.1% for gastric ulcers and 1.8% for duodenal ulcers.3,4 Ulceration is apparently associated with endogenous factors such as heredity, an excessive secretion of gastric acid and pepsin and an impaired mucosal blood flow, as well as exogenous influences that include Helicobacter pylori infection, smoking, excessive alcohol consumption, stress and an overuse of nonsteroidal anti-inflammatory drugs.5,6 However, interactions between these several predisposing factors hamper a determination of the dominant aetiology.4 The potential impact of habitual physical activity upon peptic ulceration has as yet received little attention, and data linking human peptic ulceration and habitual physical activity are particularly limited. After reviewing the available empirical data, we will explore mechanisms whereby regular physical activity could modify the known risk factors for peptic ulceration (see Table 4.1).
