Peptic Ulcers

There are two types of ulcers classed as peptic ulcers; those found in the stomach and those found in the duodenum.

This may be the most complex subject we have dealt with so far; partly because of the complexity of the subject itself, and partly because of the lack of agreement about the probable causes and preferred treatment. Because of this, we must point out that large parts of this article are our opinion only, and that if you have this problem, it is advisable to consult a medical practitioner.

What are peptic ulcers?

Peptic ulcers are circumscribed (confined to one particular area) erosions of the mucous membranes of the stomach or duodenum. They can bleed, and can have many causes.

The above two statements about ulcers are the only two statements which are not the subject of controversy. The statements in the rest of the article are all subjects of ongoing debate.

Causes of Ulcers

For many years, it was considered that ulcers were caused by stress and excess acid. This view is now almost totally in disfavour.

So what are the real causes?

Among the more enlightened members of the medical community, it is now agreed that the main causes of ulcers are:

¨ Infection by the bacterium Helicobacter Pylori. The probability of this is increased by low stomach acid.

¨ Irritation of the stomach wall by agents such as caffeine, very highly spiced foods and chemical-rich foods such as fizzy drinks.

¨ The modern cause of ulcers; erosion of the stomach wall by aspirin and more powerful non-steroidal anti-inflammatory drugs (NSAIDs).

¨ A high-sugar and high refined carbohydrate diet is low in the fibres and protein which can buffer the effects of high stomach acid.

¨ Various nutritional deficiencies.

Note: None of the above have anything to do with stress or excessive levels of acid!

Treatment

Here is where the subject gets very complex and difficult. The facts of the matter are that when food enters the mouth, the human body is designed to release copious amounts of a very powerful acid (hydrochloric acid) into the stomach. The purpose of this is to liquefy the food, and to break down the large protein molecules into smaller units, ready to be acted on by the digestive enzymes in the duodenum. This acid does not digest the stomach wall because of protective mucus which is continually produced, and coats the stomach wall.

The hydrochloric acid has another function; that is to kill any bacteria that may invade the stomach and infect the stomach walls.

Here lies a major problem. The acid protects against bacteria which can burrow into the stomach wall and destroy the mucosal membrane, thus causing ulcers, but once the ulcer is formed, the acid could burn through and cause more serious problems.

One of the protective agents (acid) must therefore be guarded against once the ulcer has formed.

Let us assume that ulcers are of two main types:

A) Those caused by infectious agents (H. Pylori etc.)

B) Those caused by chemical agents or dietary irritants.

A/ Infectious

Where there is known to be an infection present, the standard method used nowadays is a combination of antibiotics to kill the bacteria, together with protection for the stomach or intestinal surface, such as bismuth or acid-reducing drugs. In addition to killing the bacteria, all the actions mentioned under (B) below need to be carried out, in order to allow healing to take place.

B/ Dietary or chemical agents

Probably the most important action to be taken is to cease ingesting materials which can erode the stomach walls and that of the duodenum. At the top of the list is aspirin and other non-steroidal anti-inflammatory drugs. Smoking doesn’t help. Alcohol, sugar, coffee, tea and fizzy drinks, especially colas, should be avoided. There are a number of foods which cause intolerance reactions in a fairly high proportion of people, and should therefore be avoided. These are citrus fruits, cow’s milk, wheat and tomatoes. Other foods can cause allergies, and an allergy test may be wise.

Suggested Nutritional Supplements

L-glutamine

The intestinal surfaces are the most dynamic in the human body, and all cells are replaced every six days. This is because the intestines come into contact with more potentially damaging substances than any other part of the body, and are therefore continually being damaged and needing replacement.

It therefore follows that the ability of the intestinal surfaces to repair themselves is very great, given the correct materials to do so. L-glutamine performs this function very well.

In Eastern countries, this is the major prescription medicine for healing ulcers. It is the principal energy source for replacement of intestinal surface cells, and also an important part of their structure. We would suggest two teaspoons per day (2x5 grams) taken 1½ hours away from food.

Vitamin A and Zinc

These nutrients are generally regarded as the most important nutrients for skin surfaces. Suggested doses 10,000iu of vitamin A per day, and 20-40mg per day of zinc. Zinc depletes copper, so 1-3mg per day of copper is needed.

Goldenseal

This has very powerful anti-bacterial effects, and would aid the work of antibiotics.

Manuka Honey

Mastic Gum

Another powerful antibacterial, and also anti-inflammatory and helps the immune system.

Chamomile

Slippery Elm

Has mucilaginous properties. Coats intestinal walls and helps protects against irritation.

Deglycyrrhised Liquorice (DGL)

Liquorice has powerful anti-inflammatory effects, partly by encouraging the adrenal glands to produce cortisone, but also increases the production of mucin, which protects intestinal surfaces. The action of liquorice has, in trials, compared favourably to Tagamet.

DGL is available as chewable tablets, and this is the form that will probably work best.

Note: DGL is also very helpful in general cases of gastritis and other stomach upsets.