Text Size

Site Search powered by Ajax

Ulcers

Ulcers

Description

Peptic ulcers, the most common form of ulcers, are specifically circumscribed lesions in the gastric mucous membrane, or lesions which develops in the lower esophagus, pylorus, duodenum, or jejunum. Gastric ulcers are not related to the oversecretion of acid. Other peptic ulcers are related to contact with gastric juices, primarily gastric acid and pepsin.

Benign gastric ulcers tend to recur. Duodenal ulcers, accounting for 80% of all peptic ulcers, often follow a chronic course. There is usually remission and exacerbation. 5-10% of individuals with duodenal ulcers will develop complications requiring surgery.

Peptic ulcers are common in men between the ages of 20 and 50. Gastric ulcers specifically are most common in middle-aged and elderly men. One-fourth of all men and one-sixth of all women in the United States suffer from peptic ulcers.

Ulcers are not usually life threatening, healing in two to six weeks after onset. Treatment is symptomatic; rest and drug therapies, including careful use of antacids, anticholinergics and cimetidine, are often recommended. Diets designed to neutralize stomach acidity are extremely successful. If none of the aforementioned treatments is successful, surgery may be required.

Causes

Primary Factors
The precise cause of a peptic ulcer is unknown, but primary contributing factors include:

Increased contact with stomach acid and pepsin
Decreased mucous membrane resistance
Inadequate mucosal blood flow
Defective mucus

Predisposing Factors
Acid hypersecretion, especially in the elderly (may relate to an overactive vagus nerve)
Worn down pylorus which permits biliary reflux
Excessive consumption of caffeinated beverages
Delayed stomach emptying (still under investigation)
Use of nonsteroidal, anti-inflammatory drugs
Adrenocorticosteroid therapy
Overuse of aspirin
Persons with type O blood
Chronic gastritis
Alcoholism
Cushing's syndrome
Smoking
Emphysema
Infection
Liver disease
Rheumatoid arthritis
Malnutrition
Heredity
Psychogenic factors of any sort which stimulate long-term oversecretions; this is especially common in the case of prolonged stress

Signs & Symptoms

Peptic ulcers
Heartburn
Indigestion
Pain in the abdomen
Burning in the abdomen above the navel
Gnawing in the abdomen
Aches
Soreness
Empty feeling when not eating
Feeling of fullness
Feeling of distention
Weight gain
Sensation of hot water bubbling in the back of the throat
Severe backache
Hunger pangs
Pain in the epigastric region after a large meal

Duodenal ulcers
Temporary relief from pain in the midepigastric region after a large meal
Nausea
Vomiting
Constipation
Symptoms of internal bleeding such as:
Dehydration
Blood in the stool
Blood in the vomit
Weakness
Fatigue
Anemia
Pancreatitis
Pyloric obstruction
Hemorrhage
Perforation

Nutritional Supplements

Structure & Function:
        Immune System Support &
        Intestinal Health


---------------------------------
General Supplements
---------------------------------

Adult
Calcium 400 - 600 mg
EPO 2 - 3 g
Fiber*
Glutamine*
Magnesium 400 - 600 mg
Proanthocyanidins*
Spirulina*
Vitamin A10,000 - 20,000 IU
Vitamin C 3 - 5 g
Vitamin E 200 - 400 IU
Zinc*
Luteolin*



* Please refer to the respective topic for specific nutrient amounts.

Discussion:

Gastric ulcers are regarded differently now by orthodox medicine, given the discovery of h. pylori. Substances which combat infections have a more accepted role, this would include e.g. bee pollen and bee propolis.

Aloe vera may be helpful in both peptic and leg ulcers, the former as a beverage, the latter as a topical preparation.

Fiber, specifically guar gum, is also recommended for duodenal ulcers.

Vitamins A and E help maintain the normal acid resistance of the digestive tract.

Zinc will stimulate the production of mucin in the digestive tract.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Dietary Considerations

As part of the Elimination Diet the following foods should be eliminated. They have been clinically proven to increase gastric secretions:

Black pepper
Hot chili pepper
Caffeine in tea - black, coffee, chocolate, and cola drinks
Meat extracts in broths and gravies
Ethanol
Aspirin
Corticosteroids

Homeopathic Remedy

Ulcers - gastric

1. Graphites - 15C

Ulcers - mouth

1. Arsenicum Album - burning mouth ulcers.

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency

Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.

References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Tissue Salts

Open sores

Calc. Fluor.deep-seated ulceration, thin, burnign discharge;
Calc. Phos.weak constitution, anemic ;
Calc. Sulf.yellow, bloody pus, failure to heal;
Kali Mur.white discharge, bland, white-coated tongue;
Siliceabase of ulcer is spongy, bleeds readily, hard edges, thin yellow secretion, itching;



4 tablets every 2 hours in acute cases.

Herbal Approaches

----------
Herbs
-----------


Chamomile
Goldenseal
Licorice
Marshmallow root
Rhubarb plant
Slippery elm bark

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Discussion:

Duodenal / Gastric ulcers

Chamomile, marshmallow root and slippery elm bark are recommended for duodenal amd gastric ulcers:

Chamomile reduces inflammation, counteracts flatulence and reduces pain. (1,000 mg t.i.d. between meals.)

Goldenseal blocks the action of H. pylori upon the gastric epithelium.

Slippery elm bark is also a mucilaginous product which soothes and heals. (1,000 mg t.i.d. between meals.)

Peptic / Gastric ulcers

Licorice (deglycyrrhizinated or DGL) may be especially useful in countering the toxins released by H. pylori, together with Slippery elm bark. (Mitchell, 1996)

Licorice is recommended for GI ulcers by the German Commission E.

Marshmallow root is a mucilaginous product which soothes and heals peptic ulcers and general gastric inflammation of the epithelium. (1,500 mg t.i.d. between meals.)

Simply drinking raw cabbage juice, or freshly ground flax seed (in warm water) is also efficacious!

Rhubarb plant (powdered root) is used in China has scored a 97% cure rate for digestive diseases (e.g. bleeding and ulcers).

References:

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Chaturvedi, G et al., Some clinical and experimental studies on whole root of Glycyrrhiza glabra Linn in peptic ulcer. Indian Med Gaz. 113 (1979): 200-205.

Feldman, H & Gilat, T: A trial of deglycyrrhizinated licorice in the treatment of duodenal ulcer. Gut 12 (1971): 449-45I.

Gaby, A. (1988) Deglycyrrhizinated licorice treatment of peptic ulcer. Townsend Letter for Doctors. July: 306.

Glick, L. Deglycyrrhizinated licorice in peptic ulcer. Lancet 2 (1982): 817.

Dong-Hai, J et al., Resume of 1,000 emergency cases of 3 kinds of digestive tract diseases treated with a single recipe of rhubarb. Chung Hsi I Chieh Ho Tsa Chih. 1982, 2:66.

Johnson, B & Mclssac, R: Effect of some antiulcer agents on mucosal blood flow. Brit J Pharmacol 1 (1980): 308.

Mitchell, W: Helicobacter pylori and ulcers: Naturopathic Rx. The Protocol J. of Botanical medicine, 1996, Winter:200-202.

Rees, W et al., Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroent 1979, 605-607.

Scalzo, R: Therapeutic botanical protocol for peptic ulcer. The Protocol J. of Botanical medicine, 1996, Winter: 208-209.

Tagi, K. et al. (1965) Peptic ulcer inhibiting activity of licorice root. Proc. Int. Pharmacol. 7(1).

Winston, D: Eclectic and specific botanical protocols: peptic ulcer. The Protocol J. of Botanical medicine, 1996, Winter: 205.

Aromatherapy - Essential Oils

Gastric or Duodenal ulcers may be treated using the following essential oils:

Chamomile Essence,Geranium Essence,
Lemon Essence.

Related Health Conditions

AcheInfection
AlcoholismInflammation
AnemiaLiver disease
ConstipationMalnutrition
Cushing's syndromePain
EmphysemaPancreatitis
FatiguePyloric obstruction
GastritisRheumatoid arthritis
HeartburnSmoking
HemorrhageStress
IndigestionVomiting



Abstracts

References

Allison, M. C. et al: Gastrointestinal Damage Associated With the Use of Nonsteroidal Antiinflammatory Drugs, New England Journal of Medicine, September 10, 1992;327(11):749-54.

Andre, C. et al: Evidence for anaphylactic reactions in peptic ulcer and varioliform gastritis. Ann. Allergy, 1983, 51: 325-328.

Arakawa, T. et al: Effects of Zinc L-Carnosine on Gastric Mucosal and Cell Damage Caused by Ethanol in Rats: Correlation With Endogenous Prostaglandin E2. Digestive Diseases and Sciences, May 1990;35(5):559-566.

Asante M et al.: Gastric mucosal hydrophobicity in duodenal ulceration: role of Helicobacter pylori infection density and mucus lipids. Gastroenterology, 1997 Aug, 113:2, 449-54.

Banos, J.E. & Bulbena, O. : Zinc compounds as therapeutic agents in peptic ulcer. Methods Find. Exp. Clin. Pharmacol. 1989, 11(Supp. 1): 117-122.

Berkow, R. 1977. The Merck Manual. Merck Sharp and Dohme Research Laboratories Pub., Rahway, New Jersey. 2165 pp.

Bins, M. & C.B. Lamers. Prevalence of Achlorhydria and Its Relation to Serum Gastrin. Hepatogastroenterology, 31. 1984.

Carey, M.C. & C.M. Bliss. Lipid Digestion and Absorption. Annual Review Physiology, 45. 1983.

Chan FK et al.: Does smoking predispose to peptic ulcer relapse after eradication of Helicobacter pylori? Am J Gastroenterol, 1997 Mar, 92:3, 442-5.

Cheney, G.: Anti-peptic ulcer dietary factor. JADA. 1950, 26: 668-672.

Chernow, MS et al: Stress ulcer: a preventable disease. J. Trauma, 1972, 12: 831.

Cho, C.H. & Ogle, C.W.: Does increased gastric mucus play a role in the ulcer-protecting effects of zinc sulfate? Experientia, 1978, 34:90.

Cho, C.H.: Protective Effects of Zinc L-Carnosine (Z-103) on Reserpine-Induced Gastric Ulceration in Rats. Drug Development Research, 1992;27:61-65.

Crescenzo, V.M. & Cayer, D. : Plasma vitamin C levels in patients with peptic ulcer. Response to oral load of ascorbic acid. Gastroenterology, 1947, 8: 755-761.
Degtyareva, I.I. et al: Lipid Peroxidation and Vitamin E Concentrations in Ulcer Patients on Treatment. Klin Med, 1991;7:38-42.

Doll, R. et al: Clinical trial of a triterpenoid liquorice compound in gastric and duodenal ulcer. Lancet, 1962,ii: 793-796.

Dubey, P. et al: Effect of tea on gastric acid secretion. Dig. Dis. Sci. 1984, 29(3): 202-206.

Dubey, S.S. et al : Ascorbic acid, dehydroascorbic acid, glutathione and histamine in peptic ulcer. Indian J. Med. Res. 1982, 76: 859-862.

Duroux, P. Et al : Early dinner reduces nocturnal gastric acidity. Gut, 1989, 30(8): 1,063-1,067.

Falanga, V. & Iriondo, M.: Zinc Chloride Paste For The Debridement of Chronic Leg Ulcers. Journal of Dermatol. Surg. Oncol., July 1990;16(7):658-661.

Feldman, E.J. & Sabovich, K.A.: Stress and peptic ulcer disease. Gastroenterol. 198, 78: 1,087-1,089.

Fischer, Boguslav H.: Treatment of Ulcers on Legs With Hyperbaric Oxygen. Journal of Dermatological Surgery, October 1975;1:3:55-58.

Frommer, D.J.: The healing of gastric ulcers by zinc sulfate. Med. J. Aust. 1975, 2: 793-796.

Gisbert JP et al.: Unhealed duodenal ulcers despite Helicobacter pylori eradication. Scand J Gastroenterol, 1997 Jul, 32:7, 643-50.

Glick, L. Deglycyrrhizinated licorice in peptic ulcer. Lancet 2 (1982): 817.

Gorbach, S.L. : Bismuth therapy in gastrointestinal diseases. Gastroenterology, 1990, 99(3): 863-875.

Graham, D. Exocrine Pancreative Replacement Therapy in Chronic Pancreatic Insufficiency. N Engl Journal Of Medicine, 220. 1979.

Graham, D. Y. et al: Spicy food and the stomach: evaluation by videoendoscopy. JAMA. 1988, 260(23): 3,473-3,475.

Graham, D. Y. et al: Effect of Treatment of Helicobacter Pylori Infection on Long Term Recurrence of Gastric or Duodenal Ulcer. Ann. of Int. Med. 1992;116(9):705-8.

Grant, H.W..et al: Duodenal ulcer is associated with low dietary linoleic acid intake. Gut, 1990, 31(9): 997-998.

Greenberg-PD et al: Clinical utility and cost effectiveness of H. pylori testing for patients with duodenal and gastric ulcers. Am-J-Gastr. 1996 Feb; 91(2): 228-32.

Guslandi, M.: Importance of defensive factors in the prevention of peptic acid recurrence. Acta Gastro-Ent. Belg. 1983, 46: 411-418.

Harrell, H. L.: L-Carnitine For Leg Ulcers. The Annals of Internal Medicine, September 1, 1990;113(5):412.

Harris, P.L. et al: dietary production of gastric ulcers in rats and prevention by tocopherol administration. Proc. Soc. Exp. Biol. Med. 1947, 4: 273-277.

Henrotte-JG et al: Effect of pyridoxine and magnesium on stress-induced gastric ulcers in mice selected for low or high blood magnesium levels. Ann-Nutr-Metab. 1995; 39(5): 285-90.

Hollander, D & Tarnawski, A.: Dietary essential fatty acids and the decline in peptic ulcer disease - a hypothesis. Gut, 1986, 27: 239-242.

Hollander, D & Tarnawski, A.: The Role of Nutrient Fatty Acids in Gastric Mucosal Protection. Gastric Cytoprotection, Plenum Publishing Corporation, 1990.

Hui, W. M. et al: Life Events and Daily Stress in Duodenal Ulcer Disease. Digestion, 1992;52:165-172.

Ippoliti, A.F. et al: The effect of various forms of milk on gastric-acid secretion. Ann. Int. Med. 1976, 84: 286-289.

Jaramillo, E., et al: The Effect of Arachidonic Acid and Its Metabolites on Acid Production in Isolated Human Parietal Cells. Scandinavian Journal of Gastroenterology, 1989;24:1231-1237.

Jimenez, E. et al: Meta-Analysis of the Efficacy of Zinc Acexamate in Peptic Ulcer. Digestion, 1992;51:18-26.

Kang, J.Y. et al: Dietary supplementation with pectin in the maintenance treatment of duodenal ulcer: a controlled study. Scand. J. Gastroenterol. 1988, 23(1): 95-99.

Katschinski, B.D. et al: Duodenal ulcer and refined carbohydrate intake. Gut, 1990, 31(9): 993-996.

Kearney, J. Et al: Dietary intakes and adipose tissue levels of linoleic aciud in peptic ulcer disease. Br. J. Nutr. 1989, 62: 699-706.

Kirk, R.M.: Could chronic peptic ulcers be localised areas of acid susceptibility generated by autoimmunity? Lancet, 1986, 1: 772-774.

Kirschmann, J.D. 1990. Nutrition Almanac: Nutrition Search. McGrew-Hill: NY.

Kumar, N. et al : Effect of milk on patients with duodenal ulcers. BMJ. 1986, 293: 666.

Lenz, H.J. Wine and 5 percent alcohol are potent stimulants of gastric acid secretion in humans. Gastroenterology, 1983, 85(5): 1,082-1,087.

Loguercio, C., et al: Glutathione Prevents Ethanol Induced Gastric Mucosal Damage and Depletion of Sulfhydryl Compounds in Humans. Gut, 1993;34:161-5.

Lotz, M. et al: Evidence for a phosphorus-depletion syndrome in man. NEJM. 1968, 278(8): 409-415.

Mahmood, T. et al: Prevention of duodenal ulcer formation in the rat by dietary vitamin A supplementation. JPEN, 1986, 10(1): 74-77.

Malhotra, S.L. : A comparison of unrefined wheat and rice diets in the management of duodenal ulcer. Postgrad. Med. 1978, 54: 6-9.

Mann, N.S. et al: Effect of Zinc Sulfate and Acetylcysteine on Experimental Gastric Ulcer: In Vitro Study. Digestion, 1992;53:108-113.

Marcuard, S. P. et al: Ornithine Decarboxylase Activity During Gastric Ulcer Healing in Dogs. Digestive Diseases and Sciences, July 1992;37(7):1015-1019.

Markin, R. S. et al: Esophageal Ulceration Following Doxycycline Ingestion. Postgraduate Medicine, January 1992;91(1):179-181.

Marotta, R.B. & Floch, M.H. : Diet and nutrition in ulcer disease. Med. Clin. N. Am. 1991, 75(4): 967-969.

McAllan, A.B. & R.H. Smith. Estimation of Flows of Organic Matter and Nitrogen Components in Postluminal Digesta. British Journal Of Nutrition, 49. 1983.

McArthur, K. Et al : Relative stimulatory effects of commonly ingested beverages on gastric acid secretion in humans. Gastroeneterology, 1982, 83: 199-203.

Meyer-JH : Nutritional outcomes of gastric operations. Gastroenterol-Clin-North-Am. 1994 Jun; 23(2): 227-60.

Misiewicz JJ: Management of Helicobacter pylori-related disorders. Eur J Gastroenterol Hepatol, 1997 Apr, 9 Suppl 1:, S17-20; discussion S20-1, S27-9.

Miwa, M. Et al: The therapeutics of peptic ulcers: clinical evaluation of C-Fe therapy. Tokai J. Exp. Clin. Med. 1980, 5(1): 41-44.

Muller-Lissner, S.A.: Bile reflux is increased in cigarette smokers. Gastroenterol. 1986, 90: 1,205-1,209.

Navarro, C., et al: Effect of Zinc Acexamate and Ranitidine on Chronic Gastric Lesions in The Rat. Digestion, 1990;45:121-129.

O’Connor, J.H. et al: Vitamin C in the human stomach: relation to gastric pH, gastroduodenal disease and possible sources. Gut, 1989, 30(4): 436-442.

Orange, L. M.: The High Cost of Managing NSAID-Induced Ulcers. Family Practice News, January 1, 1993;16.

Pennington, J.1978. Nutritional Diet Therapy. Bull Publ Co, CA. 106 pp.

Pollard, H.M. & Stuart, G.J.: Experimental reproduction of gastric allergy in human beings with controlled observations on the mucosa. J. Allergy, 1941, 13: 467-473.

Rebhun, J.: Duodenal ulceration in allergic children. Ann. Allergy, 1975, 34: 145-149.

Reed, P. et al: Comparative study on carboxenolone and cimetidine in the management of duodenal ulcer. Acta Gastro-Enterol. 1983, 46: 459-468.

Russell, R.L. et al: Ascorbic acid levels in leucocytes of patients with gastrointestinal hemorrhage. Lancet, 1968, 2: 603-606.

Rydning, A. Et al: Prophylactic effect of dietary fiber in duodenal ulcer disease. Lancet, 1982, 2: 736-739.

Salim, A. S.: Oxygen-Derived Free Radicals and the Prevention of Duodenal Ulcer Relapse: A New Approach. The American Journal of Medical Sciences, 1990;300(1):1-6.

Sanderson, C.R. & Davis, R.E. : Serum pyridoxal in patients with active peptic ulceration. Gut, 1975, 16(3): 177-180.

Shive, W. Et al: Glutamine in treatment of peptic ulcer. TX State J. Med. 1957, 53: 840-843.

Siegel, J. : Gastrointestinal ulcer - Arthus reaction! Ann. Allergy, 1974, 32: 127-130.
Siegel, J. : Immunolgical approach to the treatment and prevention of gastrointestinal ulcers. Ann. Allergy, 1977, 38: 27-29.

Smith, D.T. et al: Peptic ulcers (gastric, pyloric and duodenal) occurrence in guinea pigs fed on a diet deficient in vitamin C. Arch. Int. Med. 1933, 51: 413-426.

Stark-RM et al: Physiology and biochemistry of Helicobacter pylori. r-J-Biomed-Sci. 1995 Dec; 52(4): 282-90.

Tovey, F.I., et al: Diet: Its Role in The Genesis of Peptic Ulceration. Digestive Diseases, 1989;7:309-323.

Tovey-FI: Diet and duodenal ulcer. J-Gastroenterol-Hepatol. 1994 Mar-Apr; 9(2): 177-85.

Turpie, A.G. et al: Clinical trial of deglycyrrhizinate liquorice on gastric mucosal damage by aspirin. Scand. J. Gastroent. 1979, 14: 605-607.

Watanabe-T et al: Zinc deficiency delays gastric ulcer healing in rats. Dig-Dis-Sci. 1995 Jun; 40(6): 1340-4.

Watkins GR: Music therapy: proposed physiological mechanisms and clinical implications. Clin Nurse Spec, 1997 Mar, 11:2, 43-50.

Welsh, J.D. : Diet therapy of peptic ulcer disease. Gastro. 1977, 72: 740-745.

Wyngaarden, J.B. & L.H. Smith. 1985. Cecil's Textbook of Medicine. Saunders Pub Co., Philadelphia. 2341 pp.

Yoshikawa, T. et al: Vitamin E ion gastric mucosal injury induced by ischemia-repurfusion. Am. J. Clin. Nutr. 1991, 53: 210S-214S.

Yoshikawa, T. et al: The Antioxidant Properties of a Novel Zinc-Carnosine Chelate Compound, N-(3-Aminopropinyl)-L-Histidinato Zinc. Biochimica Et Biophysica Aceta, 1991;1115:15-22.

Main Menu