Ulcers

The highly concentrated acid produced by the stomach is quite capable of burning a hole through the tissue of the stomach and duodenum (part of the small intestine). That it usually does not do so is a tribute to the effectiveness of the methods that the body uses to protect itself. However, sometimes these protective mechanisms fail, and the ever-present acid begins to produce an ulcer.

Ulcer pain is caused by stomach acid coming into contact with unprotected tissue. Eating generally decreases ulcer pain temporarily because food neutralizes the acid. As soon as the food begins to be digested, the pain returns.

Conventional medical treatment for ulcers has gone through a slow revolution. A few decades ago, the prescribed response to ulcers was a bland diet—one low in spices and high in dairy products, which were believed to coat the stomach. However, eventually it was discovered that spicy foods are innocent and that milk itself is somewhat ulcer forming! The only other option at that time was surgery.

Next came antacids containing magnesium and aluminum (such as Maalox). However, these were seldom strong enough to allow the ulcer to heal fully. Ulcer treatment took a big step forward with the development of Tagamet (cimetidine), followed by Zantac (ranitidine), Pepcid (famotidine), and others. These drugs dramatically lower the stomachs production of acid. Later, a new class of even more potent acid suppressors appeared, led by Prilosec (omeprazole).

When stomach acid is suppressed, ulcer pain rapidly diminishes, and the ulcer heals. For a time, these drugs were regarded as the definitive answer to ulcers. This early enthusiasm began to fade when it became clear that ulcers frequently returned after the drugs were stopped. In the late 1980s, a new explanation for this problem began to surface. First regarded as a wacky theory, it has now become the accepted explanation.

We now believe that ulcers are caused by the bacteria Helicobacter pylori. Apparently, this previously ignored organism has the capacity to infect the stomach and, by so doing, weaken the stomach lining. Only when antibiotics to kill H. pylori are combined with stomach acid suppressants do ulcers go away and stay away. However, it isn’t easy to kill H. pylori; antibiotic treatment is not always successful, and it has side effects. Friendly bacteria (probiotics) may help this treatment work better.

Principal Proposed Treatments for Ulcers:

DGL

The most famous supplement used for ulcer disease is a special form of licorice known as deglycyrrhizinated licorice (DGL). This form of licorice eliminates the portion of the herb that can cause elevated blood pressure and other side effects.

Two controlled, but not double-blind, studies suggest that regular use of DGL in a combination product also containing antacids can heal ulcers as effectively as drugs in the Zantac family. However, DGL has not been shown to kill H. pylori. For this reason, it probably must be taken continuously to prevent ulcers.

Preliminary evidence suggests that DGL might also help protect the stomach from damage due to nonsteroidal anti-inflammatory drugs.

For more information, including dosage and safety issues, see the full licorice article.

Warning: Because ulcers can be dangerous, medical supervision of treatment is essential.

Probiotics

Probiotics are bacteria that are healthy for you. The most famous probiotic is Lactobacillus acidophilus, found in yogurt. There are many other probiotics as well. Evidence suggests that various probiotics in the Lactobacillus family can to inhibit the growth of H. pylori. While this effect does not appear to be strong enough for probiotic treatment to eradicate H. pylori on its own, preliminary studies (unfortunately, not double-blind) suggest that probiotics may help standard antibiotic therapy work better, improving the rate of eradication and reducing side effects.

For more information, including dosage and safety issues, see the full Probiotic article.

Other Proposed Treatments for Ulcers:

Test tube evidence suggests that garlic can kill H. pylori as well; however, studies in people have not been promising.

A collection of substances extracted from beeswax has been studied as a treatment for preventing and treating ulcers, with promising results. Known as "D-002," this product is chemically related to policosanol.

Fish oil in combination with antibiotic therapy has been tried as a treatment for eradicating H. pylori, but it did not prove particularly effective.

Rhubarb and aloe have been suggested as treatments for bleeding ulcers. However, this condition is sufficiently dangerous that conventional medical treatment is far more appropriate.

Highly preliminary studies suggest that various bioflavonoids can inhibit the growth of H. pylori. All fruits and vegetables provide bioflavonoids, but these substances can also be taken as supplements.

Colostrum might help protect the stomach from damage caused by anti-inflammatory drugs, at least according to one study in rats and a small human trial.

Very weak evidence also suggests that butterbur might help protect the stomach lining from ulcers.

Betaine hydrochloride, cats claw, glutamine, marshmallow, MSM, reishi, selenium, suma, vitamin A, vitamin C, and zinc have also been suggested as aids to ulcer healing, but there is as yet little to no scientific evidence that they are effective.

Contrary to some reports, the herb turmeric does not appear to be effective for treating ulcers, and it might increase the risk of developing ulcers if taken at excessive doses. Neither garlic nor cayenne appear to be helpful against H. pylori. However, some evidence suggests that cayenne can protect the stomach against damage caused by anti-inflammatory drugs.