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. H. 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.
  • Stop consuming chicken and eggs!

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. 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. 
  8. 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. 

 

Anderson, R. Healthy Man. Natural Health. Jan/Feb 2001. Pp. 48-49.

Balch, JF, Balch PA. Prescription for Nutritional Healing- 3rd edition. Penguin Putman Inc. New York, NY. 2000.

Bone, K. Modern Herbal Therapies. Lecture presented. September 23, 2004. Pittsburgh.

Cremona, T. Ulcers- Causes and Treatment. Natural Pharmacy, February 1998. P. 6.

FitzGerald, FE, Peptic Ulcers: Herbal Remedies Promote Healing, Nature’s Impact, 1998. brochure.

Gates, J. Ulcers: When eating Right is not Enough. New Century Nutrition, May 1996. Pp 6-7.

Glycyrrhiza glabra Monograph. Alternative Medicine Review, 2005. 10(3): 230-236.

Heron, S., Yarnell, E. A Natural Protocol for Treating Helicobacter pylori Infection. Natural Pharmacy, June 2001. 5(6): 8-11.

Marsden, E.  Peptic Ulcer Disease. BioMed Report, July 2002. 1(4): 1-2.

Ottariano, SG. Medicinal Herbal Therapy. Nicolin Fields Publishing, Portsmouth, NH. 1999.

Ryan, SW. Management of Dyspepsia and Peptic Ulcer Disease. Integrative Medicine, Oct/Nov 4(5): 50-54.

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