Peptic Ulcers (Duodenal or Gastric)

an out of order stomach

An ulcer occurs when the lining of the stomach or intestinal tract fails to provide protection against the acidic effects of gastric juices. In most cases, the body’s natural defense mechanism of secreting mucous in the gastrointestinal tract and the stomach to protect itself against hydrochloric acid, secreted by the stomach to break down and digest food, is compromised. Gastric acid and pepsin are without a doubt necessary for ulcer development. Peptic ulcers result from an imbalance between aggressive factors that damage the mucosal lining (gastric acid, pepsin and Helicobacter pylori) and factors which protect the mucosa (sodium bicarbonate.) This fact probably explains why the conventional medical practice is to reduce acid. However, in half the cases peptic ulcers occur when stomach acid levels are normal.

Peptic ulcer disease can refer to the type of ulcer where the lining of the stomach or small intestines, and the tissues beneath, have been eroded leaving an open wound. The area is left to fester with additional acidity and can lead to swelling, pain and irritation. Patients suffering from peptic ulcer disease can present with symptoms ranging from mild epigastric discomfort to a severe burning or gnawing pain in the stomach that may occur shortly after eating. This acidic state is often relieved when the patient takes antacids, drinks a glass of water, or eats a snack. 

Duodenal ulcers occur in the upper gastrointestinal tract (duodenum). Gastric ulcers occur anywhere in the gastrointestinal tract and usually these patients have higher acid output than with duodenal ulcers.

It was always believed that stress, anxiety, and a “nervous” stomach was the main cause of ulcers. Albeit stress plays a leading role in the manifestation of ulcer disease, but an infection from the bacteria Helicobacter pylori combined with the presence of stomach acid, can cause damage to the lining of the stomach or gastrointestinal tract.

Helicobacter pylori and Peptic Ulcer Disease

  1. pylori can be found in more than 90 percent of duodenal ulcer patients and in more than 60 percent of gastric ulcer patients.  Whether this organism is an etiological agent or an opportunistic pathogen is still in debate. Regardless, the eradication of the organism must be the part of any peptic ulcer disease treatment.  Eradication of H. pylori reduces both the severity of an ulcer and the risk of recurrences.

DIET

a variety of vegetables which are high in fiber

Diet can be a controversial area with physicians and health care practitioners dealing with peptic ulcer disease. Coffee (with or without caffeine) stimulates gastric acid secretions and should be avoiding in patients with ulcers. Leafy green vegetables (high fiber) provide vitamin B6, grains and beans provide zinc, and fruit and broccoli provide vitamin C. A diet rich in fiber is both preventative and therapeutic. Fiber helps to promote a healthy layer of mucin in the stomach and intestines as well as being a buffering agent. Eating whole foods decreases the risk of reducing the “good bowel” bacteria need for proper gastrointestinal function. Other nutritional advice includes:

  • Reduce your intake of sugar and refined carbohydrates (including white flour). Sugar increases stomach acid.  Reduce consumption of all ‘acidic’ foods (See Acid/Base protocol).
  • Severely limit the intake of alcohol, caffeine, and soft drinks (including aspartame). 
  • Desensitize food allergies, especially dairy products, wheat gluten, eggs, and white flour. 
  • Cow’s milk and cheese may seem helpful to ‘coat’ the stomach, but they are just as offensive as highly acidic foods (like soft drinks, alcohol, coffee and red meat.) Higher milk consumption heightens the risk of peptic ulcers, since milk increases stomach acid production. 
  • Reduce your intake of salt. Excess salt increases your risk of gastric ulcers. 
  • Try and consume more whole grains, fiber-rich foods, legumes, and vegetables (juicing is helpful.)
  • Many natural practitioners recommend ingestion of cabbage juice. 
  • The use of regular doses of calcium carbonate, sodium bicarbonate, and magnesium-related products that are used for dyspepsia (disturbances with digestion) are discouraged.

RISKS

Many factors may contribute to peptic ulcer disease. Some factors are genetics, poor diet, nutrient deficiency, stress, overuse of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), smoking, and excessive use of steroids. Certain drugs and supplements may also increase stomach acid. In addition to taking aspirin and NSAIDS, drugs including steroids and other arthritis drugs can irritate the lining of the stomach. Smoking is definitely associated with an increased risk of gastric and duodenal ulcers. Nicotine causes a deficiency in the production of pancreatic bicarbonate.

There is evidence that some ulcers may be caused by the bacterium known as Helicobacter pylori. A short-term treatment of antibiotics and sulfa drugs has been successful in eliminating bacteria. Unhealthy eating habits (stuffing oneself with food, alcohol overuse, and excessive antacid use) are always an additional risk, especially when exacerbated with stress and anxiety. Find ways to reduce stress in your life and learn to cope with healthier habits.

SUPPLEMENT PROTOCOL

  1. DEGLYCYRRHIZINATED LICORICE (Glycyrrhiza glabra)
    Licorice has been used as a demulcent and emollient for 2,000 years to promote the healing of ulcers by acting on the mucosal layer. Licorice promotes the healing of duodenal and gastric ulcers. Licorice helps to improve pancreatic bicarbonate secretion. DGL is as effective as many drugs used to treat ulcers and has inhibitory actions on strains of H. pylori. Dosage: 500 – 1,500 mg taken up to 3-4 times a day, 20 minutes before meals and at bedtime. If licorice tea is used, drink three cups daily. CAUTION: Long-term use can produce licorice-induced hypertension.
  2. PROBIOTIC SUPPORT
    Probiotics including acidophilus helps to promote a stable bowel flora in the gut and small intestines. Balanced bowel flora is vital if the body is to sufficiently assimilate nutrients and aid in digestion. Dosage: 1-2 capsules 2-3 times a day between meals. 
  3. MARSHMALLOW and SLIPPERY ELM
    These two mucilaginous demulcent herbs enhance mucous protection, and therapeutically, work well in combination with licorice. Dosage: As directed on label, take about 15-30 minutes before meals. 
  4. ALOE VERA JUICE
    Aloe vera juice has an ability to heal mucous membranes from the mouth to the anus. Aloe vera can speed relief and decrease the pain of the ulcer: Dosage: 1-4 ounces daily. 
  5. ZINC and CARNOSINE
    Taking zinc daily has been shown to speed the healing of ulcers. Based on selected clinical trials, zinc-carnosine can play an important role in the management of gastric ulcers and can improve the cure rate of
    H. pylori infections. Zinc is a potent antioxidant used in healing and a strong free-radical scavenger, while carnosine is a combination of the amino acids histidine and alanine that are reported to protect gastric mucosa. Dosage: 50-100 mg daily under the supervision of a qualified practitioner
  6. GOLDENSEAL
    An herb that is restorative to the mucous membranes and is also antibacterial. Dosage: As directed. Because of its bitterness it is best to give one tablet at a time. Dosage: As directed.
  7. VITAMIN A
    An antioxidant vitamin needed for healing and protecting the mucous membranes of the stomach and intestines. Dosage: 10-25,000 IU daily. 
  8. B-COMPLEX
    The B complex vitamins are essential for proper digestion and may help to decrease stress associated with the ulcer. B vitamins also help rejuvenate cell growth, aid in wound healing and promote healthy enzyme production. Dosage: 50 mg 1-3 times a day.
  9. L-GLUTAMINE
    An amino acid that helps the integrity of the intestinal lining, and may play an important role in healing peptic ulcers. Dosage: 500 mg 2-4 times a day on an empty stomach. 
  10. CAT’S CLAW
    Called “the vine of life” in the rainforests of the Amazon, Cat’s claw is healing and cleansing to the digestive tract and may relieve ulcer pain. Cat’s claw also helps to enhance the immune system. Dosage: As directed on label. Liquid or capsules available.
  11. VITAMIN C (BUFFERED OR ESTER) and VITAMIN E
    This antioxidant vitamin promoted healing and may protect the body against the infection caused by
    H. pylori. Most ulcer patients have low levels of vitamin C which can make them prone to infection. In a number of studies, vitamin E showed efficacy in accelerating the healing of or preventing gastric lesions.  More tests are needed before vitamins C and E can endorse strong recommendations, but preliminary data suggests a beneficial role. Dosage: Vitamin C 500-3,000 mg daily; Vitamin E 200-800 IU daily.
  12. ALKALINE MIXTURE
    A gentle alkalizing agent containing sodium and potassium bicarbonate along with sodium citrate.  This formula reduces systemic as well as local acidity. Alkaline powders are electrolyte balanced and are safe for patients with hypertension. The buffering effect will help avoid reflex hyperacidity.  Dosage: One spoonful of powder in a glass of warm water every few hours.
  13. GARLIC
    Garlic has anti-viral and anti-infective properties that may help to
    H. pylori, thus, lowering the risk of stomach cancer. Dosage: take 3-6 fresh cloves a day or 6-12 pills (try to avoid enteric-coated tablets if possible) containing 5,000 mcg of allicin per caplet daily. 
  14. PECTIN
    Pectin helps to relieve the effects of duodenal ulcers by creating a soothing layer or protective coating in the intestines. Dosage: As directed on package. 
  15. ECHINACEA
    An immune-enhancing herb may help to resolve
    H. pylori presence and improve repair mechanism. Dosage: As directed by body weight. 
  16. PROTEOLYTIC ENZYMES
    These enzymes effectively work on undigested food remaining in the colon. They can decrease inflammation associated with the disease. WOBENZYME is one of the most effective enzyme formulas. Dosage: As directed on label. 
  17. CABBAGE JUICE
    Cabbage juice has long been used traditionally as an ulcer-healing vegetable drink. Cabbage contains glutamine and S-methylmethionine (SAMe), two compounds with anti-ulcer properties. 
  18. BISMUTH
    Bismuth is a proven agent with potent anti-H. pilori properties. Bismuth acts by disrupting the glycocalyx of H. pylori causing it to swell and disrupt fluid/nutrient transport.  This action makes bismuth an effective bactericidal. Dosage: As directed on package.
  19. RHIZINATE
    A special licorice extract that is a remarkable anti-ulcer agent. Rather than inhibit the release of acid, rhizinate stimulates the normal defense mechanisms that prevent ulcer formation. 
  20. VALERIAN
    An herb that can have a calming and relaxing effect on the body. May be used for stressed patients suffering with ulcers. Dosage: See package. 
  21. COLOSTRUM
    This “pre-milk” has immune-boosting effects and can be used for 14 days to help alleviate ulcers and possibly diarrhea associated with poor motility. Dosage: As directed.
  22. GINGER
    An aromatic “bitter” herb that stimulates digestion and helps to improve sluggish digestion. Ginger contains 11 compounds that have anti-ulcer activity. Ginger can also help to protect the stomach lining against the damages done by NSAIDs. Dosage: as directed. Combining ginger with honey is sometimes recommended for flavor and additional antibacterial properties. 
  23. CHAMOMILE FLOWERS
    Chamomile has always been an excellent digestive aid and commonly used in Europe. Chamomile has anti-inflammatory, antispasmodic, and stomach-soothing properties. Chamomile flowers can be effectively mixed with Bismuth nitrate. Dosage: One cup of tea 1-3 times a day. 
  24. NUX VOMICA
    Nux vomica is the mainstay homeopathic remedy utilized in the treatment of peptic ulcers resulting from overindulgence and sympathetic nervous system hyperfunction.  Dosage: 10-15 drops in a teaspoon of water 1-3 times daily.
  25. TUMERIC (CURCUMIN)
    An Indian herb that helps to promote healing and decrease inflammation. Dosage: 250-500 mg 2-4 times a day. 

 

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