What is a peptic (stomach) ulcer:

Stomach ulcers (also known as peptic ulcers) are painful sores that affect the lining of the stomach. Overtime due to a variety of factors, the stomach lining becomes inflamed. Ulcers can also occur in the small intestine, most commonly in the duodenum.

Signs and Symptoms: Symptoms of ulcers vary from

  • burning upper abdominal pain
  • the feeling of fullness
  • Nausea
  • bloating
  • Reflux
  • loss of appetite
  • weight loss
  • In really severe cases bleeding may occur.

Causes of Stomach Ulcers:

Common Causes of ulcers include the use of nonsteroidal anti-inflammatory drugs (NSAIDs),  an infection with Heliobacter pylori,  both excessive or low stomach acid,  trauma and excessive alcohol consumption. It is very important to have a full assessment and investigate your unique cause. Some diagnostic tests may include gastroscopy, CBC, stool test, H.pylori test etc.

How to treat Naturally:

There are a variety of ways to treat stomach ulcers. Conventional therapies include antacids, acid blockers, proton pump inhibitors or antibiotic treatment if H.pylori is the underlying cause. In addition to conventional treatments, there are a variety of naturopathic treatments including lifestyle and dietary factors.

Lifestyle Factors:

Most importantly, stress management techniques need to be included in a treatment plan. Reducing levels of stress, especially while eating, is not only important to heal and prevent digestive issues but also to improve overall wellness.  The next most important lifestyle change is to reduce or avoid alcohol, caffeine, soda and quit smoking. Alcohol in excessive quantities irritates the stomach lining, contributing to more inflammation.  Caffeine in coffee, as well as soft drinks, stimulate stomach acid production. Soft drinks are also acidic which may increase the risk of ulcer development, although studies are lacking. Lastly, chew your food. By slowing down and chewing your food, your body will naturally produce more saliva which contains enzymes and buffering agents such as prostaglandin E2 (1). These all play a role in protecting the lining of the stomach.

 


Dietary Factors can also have a profound effect on reducing the risk and healing stomach ulcers.

#1. Food allergies or Sensitivities: There is some research that suggests that the formation of stomach ulcers may be due to an allergic process. In a small double-blind study of 30 patients with gastrointestinal food allergies, they found that applying the culprit food to the stomach lining with an endoscope resulted in swelling, erosion, and bleeding due to histamine release (2). Another study showed that identifying and avoiding food allergies resulted in resolution of ulcer symptoms in some patients. (3,4). One way you can identify food sensitivities is by asking your Naturopathic or Functional Medicine Doctor to run a food sensitivity test.

#2. Fiber: Research suggests that low fiber intake and the consumption of processed and refined grains to be associated with increased risk of developing peptic ulcers (5). High fiber foods require more chewing which creates the positive effects of increased saliva as discussed above. Secondly, high fiber food decreases the amount of reflux of damaging bile into the stomach (6). Fiber also appears to increase the number of goblet cells that secrete a protective mucus. Lastly, fiber slows the rate that the stomach emptying this reduces the amount of unbuffered acid the lining is exposed to (6).

#3. Broccoli sprouts & cruciferous vegetables: These superfoods may be beneficial in treating ulcers due to their ability to inhibit the growth of H.pylori (7). In one small study, patients consumed broccoli sprouts (14, 28, or 56 g) twice daily for 7 days. Results from stool antigen testing and urea breath testing showed consuming broccoli sprouts was associated with eradication of *H. pylori* infection in three of nine patients (7).

#4. Glutamine: Glutamine is the main fuel source of the small intestine cells that make up the lining. Supplementing with glutamine has been shown to inhibit peptic ulcers in animal studies and has improved the symptoms of ulcers in patients taking NSAIDs (8,9).

#5. Deglycchizinated licorice (DGL): Extracts of licorice have been shown to be beneficial in the treatment of peptic ulcers (10,13). However, adverse effects include salt and water retention, and high blood pressure. To reduce the adverse effects deglycyrrhizinated licorice removes the constituent, glycyrrhizinic acid. DGL appears to have benefit due to its ability to increase the number of protective mucus-secreting goblet cells.

Conclusion:

Healing your peptic ulcers will take time and commitment. Healing times vary depending on underlying root causes and the amount of dietary and lifestyle changes you are willing to undertake. Treatment to get rid of H.pylori for instance usually takes 2 to 3 weeks up to 8 weeks (14).  After your symptoms are clear the most important thing to do is continue with the same dietary and lifestyle changes that helped to heal your ulcer.  

References:

  1. Sarosiek, Jerzy, et al. “Enhancement of salivary esophagoprotection: rationale for a physiological approach to gastroesophageal reflux disease.” *Gastroenterology* 110.3 (1996): 675-681.
  2. Kralstein, Jeffrey, and LAWRENCE J. BRANDT. “Gastric mucosal reactions in patients with food allergy.” *Am J Gastroenterol1988* 83 (1988): 1212-19.
  3. Untersmayr, Eva, et al. “Anti-ulcer drugs promote IgE formation toward dietary antigens in adult patients.” *The FASEB journal* 19.6 (2005): 656-658.
  4. Ramakrishnan, Kalyanakrishnan, and Robert C. Salinas. “Peptic ulcer disease.” *American family physician* 76.7 (2007).
  5. 5.Ryan-Harshman, Milly, and Walid Aldoori. “How diet and lifestyle affect duodenal ulcers. Review of the evidence.” *Canadian family physician* 50.5 (2004): 727-732.
  1. Rydning, A., A. Nesland, and A. Berstad. “Influence of fiber on postprandial intragastric juice acidity, pepsin, and bile acids in healthy subjects.” *Scandinavian journal of gastroenterology* 19.8 (1984): 1039-1044.
  2. Galan, Mark V., Arfana A. Kishan, and Ann L. Silverman. “Oral broccoli sprouts for the treatment of Helicobacter pylori infection: a preliminary report.” *Digestive diseases and sciences* 49.7 (2004): 1088-1090.
  3. Amagase, Kikuko, et al. “New frontiers in gut nutrient sensor research: prophylactic effect of glutamine against Helicobacter pylori-induced gastric diseases in Mongolian gerbils.” *Journal of pharmacological sciences* 112.1 (2010): 25-32.
  4. Park, Sung Chul, et al. “Prevention and management of non-steroidal anti-inflammatory drugs-induced small intestinal injury.” *World journal of gastroenterology: WJG* 17.42 (2011): 4647.
  5. Asha, Mannanthendil Kumaran, et al. “In vitro anti-Helicobacter pylori activity of a flavonoid rich extract of Glycyrrhiza glabra and its probable mechanisms of action.” *Journal of ethnopharmacology* 145.2 (2013): 581-586.
  6. 11.Raveendra, Kadur Ramamurthy, et al. “An extract of Glycyrrhiza glabra (GutGard) alleviates symptoms of functional dyspepsia: a randomized, double-blind, placebo-controlled study.” *Evidence-Based Complementarily and Alternative Medicine* 2012 (2011).
  7. 12.Momeni, Ali, et al. “Effect of licorice versus bismuth on eradication of Helicobacter pylori in patients with peptic ulcer disease.” *Pharmacognosy research* 6.4 (2014): 341.
  8. 13.Vibha, J., et al. “A study on pharmacokinetics and therapeutic efficacy of Glycyrrhiza glabra: a miracle medicinal herb.” *Botany Research International*2.3 (2009): 157-163.
  1. https://familydoctor.org/condition/ulcers/