What is peptic ulcer disease?
It’s estimated that about 10% of the world’s population develops a peptic ulcer at some point in their lives. A peptic ulcer is an acid-induced sore that develops on the lining of the stomach due to decreased mucosal protection from gastric juices needed to digest foods. (7)Peptic ulcer causes
There are two primary causes of peptic ulcer disease—Helicobacter pylori (H. pylori) infection and the chronic use of non-steroidal anti-inflammatory drugs (NSAIDs). (5) It is estimated that more than half of the world’s population is infected with the damaging human pathogen H. pylori with a prevalence as high as 90% in some countries. (9) NSAIDs are the most commonly prescribed medication for pain and inflammation, and in addition to peptic ulcers, chronic use can lead to gastrointestinal bleeding, cardiovascular issues, and nephrotoxicity. (14)Further, genetics can play a role in peptic ulcers. For example, children of parents with a peptic ulcer are three times more likely to be diagnosed with an ulcer later in life. (13)
Alcohol and tobacco use can also lead to peptic ulcers as these substances can reduce protective mucus and increase acid secretion in the stomach. (13) Stress and spicy foods do not cause peptic ulcers, but both can aggravate symptoms. (12)
Peptic ulcer symptoms
The most common symptom of a peptic ulcer is a significant burning pain that typically occurs on an empty stomach between meals or during the night and gets better briefly with food intake or antacid use. (12) Other less common peptic ulcer symptoms can include:- Bloating
- Burping
- Nausea
- Poor appetite
- Vomiting
- Weight loss (11)
Peptic ulcer treatment
The cause of a peptic ulcer typically dictates the treatment. From a conventional medicine standpoint, common medications used to treat both forms of peptic ulcers include proton pump inhibitors, histamine receptor blockers, and protectants. (11) From an integrative medicine perspective, peptic ulcers can be addressed with a combination of diet and lifestyle modifications and dietary supplements.Peptic ulcer diet
There are two sides to the peptic ulcer dietary coin: eating foods that heal and avoiding foods that harm. Foods that heal will actually soothe the stomach lining and help reverse NSAID or H. pylori damage. These foods to enjoy include:- Antioxidant-rich foods, such as berries and leafy greens
- Fiber-rich foods, such as beans and whole grains
- Healthy fats, such as olive oil and oily fish
- Fermented foods, such as sauerkraut and yogurt (13)
- Alcohol
- Coffee and other caffeinated beverages
- Fried foods, such as French fries and fried chicken
- Soft drinks (13)
Dietary supplements for peptic ulcer
When it comes to the leading cause of peptic ulcers, H. pylori infection, several natural substances have been shown to suppress H. pylori activity and even eradicate the infection, including:- Broccoli sprouts/sulforaphane
- Curcumin
- Cranberry
- Garlic
- Ginger
- Green tea
- Probiotics
- Resveratrol (8)(15)
Stress management
While stress is not a direct cause of peptic ulcers and addressing stress is not considered a primary treatment, stress management can help mitigate symptoms and compliment the peptic ulcer treatment plan. In addition, research shows that a high degree of perceived stress does increase the risk of the development of peptic ulcers. Therefore, stress management techniques, such as meditation, deep breathing, and journaling, may be used as a part of a proactive prevention plan. (3)The bottom line
Healing peptic ulcers involves getting to the root cause by addressing possible H. pylori infection, chronic NSAID use, and lifestyle factors such as smoking, alcohol, stress, or a poor diet. An integrative treatment approach that includes dietary and lifestyle recommendations, as well as dietary supplements, can be effective at reversing peptic ulcer disease.References
- Badr, G. M., & Al-Mulhim, J. A. (2014). The protective effect of aged garlic extract on nonsteroidal anti-inflammatory drug-induced gastric inflammations in male albino rats. Evidence-based complementary and alternative medicine: eCAM, 2014, 759642. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4021990/
- Chatterjee, A., & Bandyopadhyay, S. K. (2014). Herbal remedy: an alternate therapy of Nonsteroidal anti-inflammatory drug induced gastric ulcer healing. Ulcers, 2014. https://www.hindawi.com/journals/ulcers/2014/361586/
- Deding, U., Ejlskov, L., Grabas, M. P., Nielsen, B. J., Torp-Pedersen, C., & Bøggild, H. (2016). Perceived stress as a risk factor for peptic ulcers: a register-based cohort study. BMC gastroenterology, 16(1), 140. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126869/
- Hajiaghamohammadi, A. A., Zargar, A., Oveisi, S., Samimi, R., & Reisian, S. (2016). To evaluate the effect of adding licorice to the standard treatment regimen of Helicobacter pylori. The Brazilian Journal of Infectious Diseases, 20(6), 534-538. https://www.sciencedirect.com/science/article/pii/S1413867016301696
- Kavitt, R. T., Lipowska, A. M., Anyane-Yeboa, A., & Gralnek, I. M. (2019). Diagnosis and treatment of peptic ulcer disease. The American Journal of Medicine, 132(4), 447-456. https://www.amjmed.com/article/S0002-9343(19)30004-X/abstract
- Khoder, G., Al-Menhali, A. A., Al-Yassir, F., & Karam, S. M. (2016). Potential role of probiotics in the management of gastric ulcer. Experimental and therapeutic medicine, 12(1), 3–17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906699/
- Kuna, L., Jakab, J., Smolic, R., Raguz-Lucic, N., Vcev, A., & Smolic, M. (2019). Peptic Ulcer Disease: A Brief Review of Conventional Therapy and Herbal Treatment Options. Journal of clinical medicine, 8(2), 179. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406303/#!po=32.8947
- Lee, S., Shin, Y. W, & Hahm, K. (2008). Phytoceuticals: mighty but ignored weapons against Helicobacter pylori infection. Journal of Digestive Diseases, 9, 129-139. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1751-2980.2008.00334.x
- Lim Y. J. (2014). Genetic susceptibility of gastroduodenal disease in ethnic and regional diversity. Gut and liver, 8(6), 575–576. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215439/
- Momeni, A., Rahimian, G., Kiasi, A., Amiri, M., & Kheiri, S. (2014). Effect of licorice versus bismuth on eradication of Helicobacter pylori in patients with peptic ulcer disease. Pharmacognosy research, 6(4), 341–344. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166824/
- National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed 2020, November). Symptoms & Causes of Peptic Ulcers. https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/symptoms-causes#symptoms
- US National Library of Medicine. (2020, October 2). Medline Plus Peptic Ulcer. https://medlineplus.gov/pepticulcer.html
- Vomero, N. D., & Colpo, E. (2014). Nutritional care in peptic ulcer. Arquivos brasileiros de cirurgia digestiva: ABCD = Brazilian archives of digestive surgery, 27(4), 298–302. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743227/
- Wongrakpanich, S., Wongrakpanich, A., Melhado, K., & Rangaswami, J. (2018). A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in The Elderly. Aging and disease, 9(1), 143–150. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772852/
- Yousef-Nezhad, Y., & Hejazi, N. (2017). Anti-bacterial properties of herbs against Helicobacter pylori infection: a review. International Journal of Nutritional Sciences. 2(3), 126-133. https://ijns.sums.ac.ir/article_43410_5a1fdbffe2183049b913e70b3087a845.pdf
