A 1994 National Institutes of Health statement reports that “peptic ulcer disease is a chronic inflammatory condition of the stomach and duodenum that affects as many as 10 percent of people in the United States at some time in their lives. The disease has relatively low mortality, but it results in substantial human suffering and high economic costs.”

Gastric ulcers: Gastric ulcers occur in the stomach and the duodenum (the first section of the small intestine) where gastric juice has burned a hole in the lining. It hurts! Gastric juice is so acid it would burn your hand if you spilled some on it. A mucus layer protects the stomach tissue from being eaten away by pepsin (a protein-splitting enzyme) and the gastric juices.

Secretions of bicarbonate (baking soda) from the stomach lining are mixed into the mucus, buffering the acid. This makes an effective barrier to keep the stomach lining from harm. Pepsin, the real villain in this story, slowly digests this mucus layer, and if the mucus isn’t replaced, gastric juices come into contact with the stomach lining and ulcers occur.

Eighty percent of ulcers are caused by a bacterial infection called Helicobacter pylori (H. pylori), 10 percent are caused by the use of NSAID medications, and another 10 percent are of unknown origin. In 1982, Australian physician Barry Marshall discovered the presence of H. pylori between the stomach lining and the mucous membrane.

H. pylori infections deplete vitamin C levels in the gut. This bacteria is found in 80 percent of people with duodenal and stomach ulcers and with gastritis. H. pylori is found in about 30 percent of all people, but only 10 percent will experience ulcers.

This poses a curious question. Why do some people have helicobacter infection yet no GI upset? It’s probably due to a difference in genetics. If you have “lucky” genes in this case, you remain unaffected by the bacteria.

About 10 percent of stomach and duodenal ulcers are caused by the use of NSAIDs, such as aspirin, Tylenol, Motrin, and prescription pain relievers. Continued use of these therapies has been widely shown to cause ulcers and hospitalizations.

It has been estimated that 107,000 people are hospitalized each year because of NSAID complications, and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The stomach has three defense mechanisms against the highly acid stomach environment:

1. Mucus that coats the stomach lining
2. Bicarbonate that neutralizes the acids
3. Blood circulation in the stomach lining that aids in cell growth and repair.

NSAIDs hinder all three of these mechanisms, and ulcers result. The ulcers usually heal once you’ve stopped taking the NSAIDs, but you may want to use medications or herbs to help with the discomfort in the meantime. Ten percent of people with ulcers and gastritis do not have Helicobacter pylori infection, nor have they used NSAID medications.

For these people, the cause of ulcers and gastritis is still a mystery. Looking at stress, diet, and lifestyle may yield important clues. Stress plays a significant role in ulcers and gastritis. While low-grade stress probably won’t cause an ulcer, severe stress has been shown to cause ulcers in both animal and human studies.

Psychological stress increases stomach acid and causes the mucus to become more fragile, making it easier for ulcers to form. In the 1970s, receptor sites on the stomach lining were found that regulate secretion of HCl, and drugs were developed to block these receptor sites.

These drugs, called H2 blockers, have been effective in healing ulcers but not in preventing recurrence. More recently, a new class of drugs called protein-pump inhibitors has been used, the most common of which is Prilosec. These drugs absolutely block stomach acid production.

They appear to be safe, although approximately 2.5 percent may experience severe side effects. Long-term use can lead to gastric atrophy, poor HCl production, and poor vitamin B12 and mineral absorption. Protein-pump inhibitors are metabolized in the liver via the CP450 pathways.

It may be a good idea to do a liver cleanse/detox before going onto these drugs to increase their effectiveness. It is known that when H. pylori is eradicated, ulcers heal and don’t recur. It’s important to treat diagnosed helicobacter infections; long-term infection increases the risk of duodenal or gastric ulcers, asymptomatic chronic gastritis, chronic indigestion, and stomach cancer.

The most common therapies used by physicians are called triple therapies and consist of the use of an antibiotic or antiparasitic drug, an H2 blocker or a protein-pump inhibitor, and bismuth. Bismuth is an elemental mineral that protects the stomach lining by protecting the mucous membrane from being dissolved by pepsin.

Your doctor will choose the specific medications that will be most effective and most cost-effective. These short-term therapies are quite effective at eradicating Helicobacter pylori infections. Despite treatment, 20 percent have a relapse of their ulcer within six months without aggravation from NSAID medications.

Although this treatment has minor side effects, the overall outcome shows improved quality of living and less psychological stress after therapy. Because ulcers have been experienced throughout history, people have found effective natural therapies.

Most physicians are not aware of these therapies, but nutritionally oriented physicians have been using them with promising results. Some have been using a combination of antibiotic therapy and bismuth, with DGL licorice, citrus seed extract, goldenseal, activated charcoal, and aloe vera.

Glutamine, gamma oryzanol, SanoGastril, cabbage juice, comfrey, and calendula have also been shown to heal ulcers. Dietary recommendations for people with ulcers may be useful. Low-fiber diets may contribute significantly to ulcers.

A South African physician, G. Borok, studied more than a thousand patients with ulcers and concluded that elimination of refined sugars, white-flour products, milled maize, chocolate, fries, soft drinks, and desserts will reduce gastric irritation. He also suggests avoiding tea and coffee.

Another plug for a whole-foods diet! A recent study on the diet of people with duodenal ulcers found that people who had good vitamin-A intake, followed a high-fiber diet, or ate seven or more servings of fruits and vegetables per day, rather than three servings or fewer, reduced risks of developing ulcers by 54 percent, 45 percent, and 33 percent, respectively.

Again, this shows that a great diet can reduce your risk of all sorts of health problems. Gastritis: Gastritis is a stomach inflammation without an ulcer or sore. It’s usually caused by medications, including corticosteroids, NSAIDs, cancer drugs, and antibiotics; drinking alcoholic beverages; excessive coffee consumption; organ failure; and severe stress or trauma.

Common symptoms of gastritis include hiccups, loss of appetite, indigestion, nausea, vomiting, vomiting of blood, and dark stools. It is common in the elderly, affecting 20 percent of people between the ages of sixty and sixty-nine, and 40 percent of people over age eighty.

The lack of hydrochloric acid secretion in the elderly allows for bacterial growth, such as H. pylori; however, when treated with antibiotics, symptoms improve. Long-term effects of gastritis include poor vitamin B12 status in all people. Signs of B12 deficiency often mimic those of senility.

Many people have B12 deficiencies with normal serum levels. Tests for B12 status include homocysteine and methylmalonic acid. Atrophic gastritis is usually treated with H2 blockers or protein-pump inhibitors. Looking at triggers, such as stress, medications, and poor HCl production is also an important step toward prevention.

One new therapy uses lactoferrin, or cow’s colostrum, to eradicate H. pylori. Research has shown that use of triple therapy with added lactoferrin improves the success rate. Alone, it probably won’t do the job. People with high levels of gastritis and helicobacter also have concurrent high levels of lactoferrin in their stomach.

Is the lactoferrin helping the H. pylori gain a foothold and helping it gain necessary iron for its metabolism? Or is the lactoferrin called in by the body’s immune system to help rid us of the bacteria? At this point, no one really knows.

Healing Options

• Drink water. One very simple remedy for ulcers and gastritis is to drink huge amounts of water. Drink four to six glasses of water during the pain, and then it may magically disappear. A fascinating book on this subject is Your Body’s Many Cries for Water, by Fereydoon Batmanghelidj, M.D. Drink at least eight to ten glasses of water each day.

• Try licorice. DGL licorice helps heal the stomach’s mucous lining by increasing healing prostaglandins that promote mucus secretion and cell proliferation. Licorice enhances the blood flow and health of intestinal tract cells. It’s important to use DGL licorice to avoid side effects caused by whole licorice. Take capsules or chew 2 to 4 tablets three times daily.

• Use aloe vera. Aloe vera is a folk remedy for ulcers and has been approved by the FDA for use in oral ulcers. It is soothing and healing to mucous membranes.

• Try gamma oryzanol. Gamma oryzanol, a compound found in rice bran oil, is a useful therapeutic tool in gastritis, ulcers, and irritable bowel syndrome. It acts on the autonomic nervous system to normalize production of gastric juice and has also been shown to be effective in normalizing serum triglycerides and cholesterol, symptoms of menopause, and depressive disorders.

Studies involving 375 hospitals in Japan indicate that gamma oryzanol was effective in reducing symptoms from 80 to 90 percent, with more than half of the participants experiencing total or marked improvement. Typical dosage was 100 milligrams three times daily for three weeks.

Occasionally, the dosage was doubled, and often the therapy was used longer. Minimal side effects were experienced by 0.4 percent of the people. Take 100 milligrams of gamma oryzanol three times daily for a trial period of three to six weeks to determine if it relieves the problem.

• Drink cabbage juice. Cabbage juice is a long-standing folk remedy for heartburn. Drink 1 quart of cabbage juice daily for a trial period of two weeks.

• Try glutamine. Glutamine is the most popular antiulcer drug in Asia today. The digestive tract uses glutamine as a fuel source and for healing. It is effective for healing stomach ulcers, irritable bowel syndrome, and ulcerative bowel diseases. Begin with 8 grams daily for a trial period of four weeks.

• Try grapefruit or citrus seed extract. Citrus seed extract has widely effective antiparasitic, antiviral, and antibiotic properties. Take 75 to 250 milligrams three times daily.

• Use goldenseal. Goldenseal is soothing to mucous membranes, enhances immune function, and has antibiotic and antifungal properties.

• Try SanoGastril. SanoGastril is a chewable tablet that buffers the acidity of the stomach. (SanoGastril is marketed in this country by Nutri-Cology/Allergy Research Group; this is not an endorsement, but the only product of its type.)

SanoGastril is composed of an extract called glycine-max and a specific strain of Lactobacillus acidophilus plus vitamin C and other nutrients. A study using 2 tablets three times daily was done on ninety-three people with ulcers and gastritis.

After one month, each participant was xrayed to see progress. At that time, twelve out of twenty-two people with gastric ulcer, twenty-five out of fifty-eight people with duodenal ulcer, and four out of twelve people with gastritis were completely healed. Two tablets of SanoGastril three times daily before meals relieved heartburn completely within five to ten minutes in 76 percent of 158 people.

• Try slippery elm bark. Slippery elm bark has demulcent properties and has been a folk remedy for both heartburn and ulcers. It can be used in large amounts without harm. Drink as a tea, chew on the bark, or take in capsules. To make a tea, simmer 1 teaspoon of slippery elm bark in 2 cups of water for twenty minutes and strain. Sweeten if you want, and drink freely. Or, take 2 to 4 capsules three times daily for a trial period of three weeks.

• Use evening primrose, borage, or flaxseed oils. These oils increase the levels of prostaglandin E2 series, which promotes healing and repair. Take 1,000 to 2,000 milligrams of one of these oils or a combination oil three times a day for a trial period of four weeks.

Low dietary intake of linoleic acid, an essential fatty acid, has been associated with duodenal ulcers. Flaxseeds are excellent sources of linoleic acid. A benefit to using ground flaxseeds rather than the oil is that the mucous portion of the flaxseed buffers excess acid, which makes it ideal for inflammation in the stomach and throughout the gastrointestinal tract.

Grind them fresh daily or buy products with enhanced shelf life, and store in the refrigerator. Linoleic acid is also found in pumpkin seeds, tofu, walnuts, safflower oil, sunflower seeds and oil, and sesame seeds and oil. Use 2 to 3 teaspoons in smoothies or protein drinks, or on salads and vegetables.

• Take zinc. Zinc increases the rate of healing and can prevent damage to the stomach lining. Take 50 milligrams daily.

• Take vitamin A. Vitamin A is protective and promotes healing of gastric ulcers. Take 10,000 to 25,000 IU daily. Daily short-term treatment dosage may be 50,000 to 75,000 IU for up to three weeks. Pregnant women should not exceed 10,000 IU vitamin A.

• Take other important nutrients. You should also take 2 milligrams of copper daily, 400 IU of vitamin E daily, B complex, and N-acetyl cysteine.

• Try Turkish herbs. Six Turkish plant medicines were studied for their effectiveness against H. pylori in a laboratory setting. Five were found to be highly effective, with Cistus laurifolius (laurel rockrose) being the most effective.

The effective herbs were the flowers of Cistus laurifolius, cones of Cedrus libani (cedar of Lebanon), herbs and flowers of Centaurea solstitialis (yellow starthistle), fruits of Momordica charantia (bitter melon), herbaceous parts of Sambucus ebulus (danewort or dwarf elder), and flowering herbs of Hypericum perforatum (St.-John’s-wort).

We may begin to see research on some or all of these plant medicines. We may also begin to see them in supplements. There have been no human studies.

• Try comfrey and calendula. A Bulgarian study used comfrey and calendula either with antacid medications or alone in patients with peptic ulcers. Eighty-five percent of both groups felt better, but people who also used antacids felt better a few days earlier.

Gastric scoping showed equal healing of ulcers in both groups. Comfrey, one of my favorite herbs, has come under fire lately. It contains small amounts of pyrrolizidine alkaloids, which have liver damaging and possible carcinogenic effects.

Although there have been no known cases of toxicity in humans from comfrey, rat testing has caused it to be removed from many products and banned in several countries. Studies were done using the specific pyrrolizidine alkaloids, but in studies with whole comfrey, no adverse reactions were found.

While the controversy continues, be cautious about using comfrey internally. Restrict its internal use to two weeks. Comfrey has been used medicinally for hundreds of years to promote wound and bone healing. The combination of comfrey and calendula makes sense in terms of today’s triple therapy.

Comfrey promotes healing and protects the gastric mucosa. Calendula has antibacterial effects. Dosage in the Bulgarian study was unclear, but comfrey leaf and calendula flower tea at 3 to 4 cups daily would be appropriate.