Gone are the old days of ulcer treatments with their incredibly restrictive diets, hourly swigs of Maalox, and sending of patients off to surgery–thank heaven. Today, we know a lot more about the little sores found in the lining of the stomach (gastric ulcers) or the first part of the small intestine, the duodenum (duodenal ulcers), than we used to. Although still associated with the stressed executive (stress increases acid flow), we now know that ulcers are caused by a specific bacterium called Helicobacter pylori. We still don’t know for sure how people become infected in the first place. But it’s a very democratic germ: Anyone can get an ulcer. And drinking alcohol or too much coffee, or taking aspirin (or NSAIDs), or being overstressed–all simply make the situation worse.
The natural approaches we advocate at WholeHealth Chicago can help relieve symptoms and speed your healing process. However, if you’ve got the symptoms of an ulcer, chiefly that telltale ache just before or a few hours after a meal, you must get tested for H. pylori. If it’s found, you’ll need a short course of antibiotics. (Sorry, no natural alternative to this.)
What are Ulcers?
A peptic ulcer–named after pepsin, an enzyme secreted by glands in the stomach–is a painful crater-like sore in the lining of the stomach or intestine. It’s called a gastric ulcer when it occurs in the stomach; a duodenal ulcer when it occurs in the part of the small intestine just past the stomach; and an esophageal ulcer when it occurs in the passageway between the throat and the stomach. Normally, certain glands in the stomach secrete acids and pepsin to aid in digestion, while other glands in the stomach and duodenum secrete mucus to protect the lining of the digestive tract from these corrosive chemicals. If that balance breaks down, these gastric juices can begin to eat into the lining of the stomach or intestinal wall. Over time, this erosion leads to an ulcer.
One in 10 Americans will have an ulcer at some point in their life. Ulcers generally affect people over the age of 30, but children have been known to get them as well. Duodenal ulcers, which afflict more men than women, are the most common variety. Gastric ulcers typically strike people between the ages of 60 and 70, perhaps because of long-term use of aspirin, ibuprofen or other anti-inflammatory drugs taken for arthritis. Esophageal ulcers, the least common type, are usually caused by alcohol abuse and/or the splashing up, or “reflux” of stomach acid into the esophagus that occurs with chronic heartburn.
While they are painful and often recur, ulcers are seldom life threatening and rarely cancerous. Left untreated, however, they can lead to serious complications, such as bleeding, obstruction of the digestive tract (due to scarring) or serious infection due to leaking of the intestinal contents into the belly.
A gnawing, burning or aching pain in the upper abdomen–either just before a meal or several hours afterward. The pain is usually mild to moderate, lasts from half an hour to several hours, and may be accompanied by nausea, indigestion, vomiting, loss of appetite or weight loss.
In some cases, an ulcer can be present without causing any symptoms.
The presence of ulcers can only be determined by looking into your stomach with a endoscopic tube or obtaining an X-ray picture of your stomach after you have swallowed a liquid–such as barium–that outlines the stomach surface. Emergency symptoms:
- Sudden severe abdominal pain, indicating a possible perforation of the intestinal wall
- Black, tarry, or bloody stool
- Vomiting blood or particles that look like coffee grinds
What Causes Ulcers?
Until recently, ulcers were routinely blamed on stress and a diet rich in fatty or spicy foods. But research now indicates that most ulcers are associated with an infection by a bacterium called Helicobacter pylori. Once in the digestive tract, this pathogen is believed to weaken the protective mucous membrane and make the lining more susceptible to erosion by stomach acids.
Although ulcers themselves are not contagious, the germ that causes them may be transmitted orally. Heredity also seems to play a role, because tendencies to develop ulcers often run in families.
Researchers believe that infected children and adolescents are more likely to transmit the germ to each other and to adults than adults are to transmit it to other adults. Nevertheless, most people infected by the H. pylori germ never develop ulcers.
After an ulcer forms, it is aggravated by stress, diet, alcohol, caffeine, aspirinlike drugs, or smoking.
Treatment and Prevention
If you have recurrent or persistent symptoms or any sign of bleeding complications, your doctor will obtain an image of your stomach and intestine to diagnose the condition.
Often the problem can be resolved in the “pre-ulcer” stage, with an eight-week course of an acid-blocking drug (such as Zantac or Pepcid). These drugs are available in over-the-counter and prescription-strength forms.
If you have recurrent ulcers, complications of ulcers or blood tests indicate the presence of H. pylori, your doctor will prescribe antibiotics and other medications. But whether the bacterium is present or not, there are a host of natural remedies that will speed up the healing process, which can take up to two months. All of them are safe to use together and in conjunction with prescription medications. Taken diligently, these supplements should start to relieve the pain in about a week.
How Supplements Can Help
Deglycyrrhizinated licorice (DGL) wafers can prevent ulcers and promote healing similarly to the common acid-blocking drugs. For best results, use the chewable wafers between meals for about two months. Although it is perfectly safe, there is no great benefit in using DGL in addition to a prescription acid-blocking drug.
Aloe vera juice offers relief by healing the stomach lining, reducing stomach acid secretions and aiding in the prevention of internal bleeding.
Vitamin A helps protect the lining of the stomach and small intestine, which will foster healing, and zinc is necessary for wound healing.
Glutamine, an amino acid, speeds up the healing process by nourishing the cells that line the digestive tract. As an alternative to glutamine, gamma-oryzanol, an extract of rice bran oil, may be beneficial because it promotes healthy levels of digestive juices.
Eat a well balanced diet rich in fiber. In the past, doctors recommended various dietary changes–eating bland foods, having small meals throughout the day and drinking milk. But research has shown that none of these measures are particularly effective. In fact, too much milk may actually increase the amount of acid produced by the stomach.
Quit smoking–nicotine is believed to increase acid secretion and prevent the pancreas from secreting enzymes that protect the intestinal lining
If you know you have an ulcer, never take aspirin or aspirinlike products. If you do need aspirin or an NSAID, always take the smallest possible dose and always with food.
Herbal teas made from marshmallow, slippery elm or meadow sweet all help to soothe the irritated lining of the stomach and duodenum.
Avoid trigger foods that seem to initiate indigestion or pain. Reduce or eliminate your intake of coffee, tea, or other caffeine-containing beverages.
If you know you have an ulcer, alcohol is forbidden because it breaks down the mucus in the stomach, which protects the lining from acid erosion. If you drink alcohol, reduce your intake. Never drink on an empty stomach.
If stress seems to bring on painful episodes, take steps to release tension. Meditate, get adequate sleep and exercise regularly.
When to Call a Doctor
- If you have any of the emergency symptoms listed above
- If you vomit blood
- If you feel faint or if you do faint
- If your stool is black, tarry, or bloody
- If ulcer symptoms are combined with back pain
- If you’ve been diagnosed with an ulcer and look pale or feel fatigued
- If ulcer symptoms persist after using over-the-counter remedies or supplements
From David Edelberg, M.D. at WholeHealth Chicago: If you have ulcer symptoms, you don’t have to wait for a Helicobacter pylori test to start using these healing remedies. These supplements can all safely be taken together and along with conventional drugs; they will not interfere with any diagnostic testing.
With these supplements, your pain may begin to ease in a day or so and even be almost gone within a week. But don’t let the easing of your symptoms fool you. Remember, if you do have H. pylori, your symptoms might return unless your doctor prescribes appropriate antibiotics.
How to Take the Supplements
Start with the DGL (deglycyrrhizinated licorice), which has been shown to be as effective as the ulcer medications called H-2 blockers, as well as the herbal aloe vera juice (available at health-food stores), vitamin A, and zinc. In addition, you should add the amino acid glutamine.
If you’ve been prescribed a conventional medication, such as an H-2 blocker (Tagamet, Zantac, Axid) or a proton-pump inhibitor (Prevacid, Prilosec), stay on it. If you tested positive for H. pylori, you’ll be prescribed a ten-day course of antibiotics.
The recommended supplements will work well with any prescription medication and may even enhance the drugs’ effectiveness. You should begin to feel better rather quickly, as the lining of the gastrointestinal tract is one of the fastest healing tissues in the body.
Continue the supplements for 30 days. At the end of that time, stop all the supplements except the DGL, which you’ll continue for an additional month. If you’re on conventional medications, wait until your doctor gives you the okay before stopping any of them.
For a flare-up: If you experience discomfort in the future, begin taking the DGL again, perhaps adding some aloe vera liquid to soothe your stomach. Unfortunately, H. pylori can sometimes reappear even after treatment, so if your symptoms get severe, be sure and have yourself retested.
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
David Edelberg, MD