"Oh, Doc . . . help me. I think I've got an ulcer. I'm tired of chasing every meal with Tums® or Maalox®) . . . Think I need Tagamet® or Pepcid®?" Millions of Americans suffer with nagging gastrointestinal pain. Until recently, Tagamet® (cimetidine) has been the second most prescribed drug in this country.(l) The reclassification of Tagamet,® Pepcid® and Zantac® as over-the-counter drugs will likely be a boon to the pharmaceutical industry as millions more people begin to self-medicate without the need for a doctor's prescription. However, persistent gastrointestinal pain should be a signal that it is definitely time to visit a health care practitioner. Peptic ulcers can develop into emergency situations.

WHAT CAUSES ULCERS?
Approximately one in ten men and one in twenty women can expect to experience a peptic ulcer in their lifetimes.(2) These include both gastric and duodenal ulcers, which are localized erosions of the mucosal lining caused by the digestive action of gastric juice.(2,7,3) But is excess acid the root of the problem?

Mucosal tissue succumbs to excess acid-pepsin erosion, resulting from the decreased integrity of the mucosal barrier. However, specific causes include 1) bacterial infection by Helicobacter pylori; 2) increased acid secretion, sometimes stimulated by the bacterial infection or by stress; 3) use of aspirin or other NSAIDs; 4) use of steroids; 5) food allergies/sensitivities; 6) excess alcohol or caffeine consumption; 7) smoking; 8) increased intake of sugar and fat; 9) decreased intake of linoleic acid.

H. Pylori
Between 75 and 93% of all peptic ulcers occur in patients with H. pylori infections, which can last a lifetime unless eradicated with antibiotics.(3) The bacterium can penetrate the mucosal barrier and literally liquefy it with digestive enzymes. With the barrier destroyed, even normal acid contact causes excessive pain.

Asprin and Other NSAIDs
Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) occupy second place in direct causes of ulceration. This poses a significant risk to the elderly since they frequently take these drugs for high blood pressure and arthritis. One study estimated that 29% of peptic ulcer disease in the elderly was caused by aspirin and NSAIDs.(4) Matthijs Janssen, M.D., et. al., noted that the presence of gastric acid is not necessary for the development of ulcers during NSAID use, and that the most important therapeutic anti-ulcer measure is to stop the use of NSAIDs.(5) Systemic inhibition of prostaglandin production may cause their ulcerogenic effects.

Food Allergies
Evidence indicates that food allergies play a major role in the development of peptic ulcers.(6) One study showed that 98% of patients with radiographic evidence of peptic ulcers also suffered from respiratory tract allergies.(1,2,7) Food allergy also correlates with the high recurrence rate of peptic ulcers. Removing the offending foods from the diets of these individuals is essential to prevent ulcer recurrence. ELISA/ACT and RAST testing or subcutaneous testing by neutralization can detrmine those foods to which one is allergic or sensitive.

Stress
Stress, once considered the major culprit, can increase acid/pepsin production. However, unless the acid level increases significantly, stress may be more of an aggravational factor to an already inflammed or ulcerated mucosa. Smoking and alcohol consumption, often related to stress, also are associated with ulcers.(l)

THE DRUG ROUTE
Conventional treatment focuses on helping the patient feel better quickly, not always on solving the problem. The patient may have tried various antacid remedies without lasting success before seeking professional help. In the past, doctors might prescribe histamine H2-receptor antagonist drugs (such as Tagamet®, Pepcid® or Zantac®) that significantly reduce the production of hydrochloric acid in the stomach by as much as 50% or more within one hour and 75% within two hours of a meal.(8) When the H2-inhibitor drugs do not achieve the desired effect, another drug omeprazole (Prilosec®), can also reduce acid output by 50% through another pathway.(8)

Before the discovery of H. pylori involvement in ulcers, treatment would be chronically ongoing since the source of the problem in those affected with it was never eradicated. Today, antiboiotics can clear up the infection if it exists.

All of the acid-inhibiting drugs are intended for short-term use (no longer than 6 to 8 weeks) at full dosage. Maintenance dosages have been tested for up to five years with Tagamet®. However, Prilosec® should not be taken as maintenance therapy.(8).

RESULT OF CONVENTIONAL TREATMENT
Since antacids and acid-reducing drugs counteract the acid production necessary for thorough digestion of food, "indigestion" becomes "un-digestion". While the chronic or severe pain may disappear, nutrient loss occurs because of the inability to digest foods completely, as well as the non-absorption of minerals in a sub-optimal acid environment. Even food supplements may pass by the critical absorption sites of the various vitamins and minerals without being absorbed. Supplements in tablet form may pass whole from an underacid stomach, traveling the entire length of the GI tract without disintegrating for intestinal absorption.

Since complete digestion of protein requires adequate hydrochloric acid, reduced production might even lead to a "leaky gut." If the mucosal lining is already inflamed or perforated, incompletely broken down amino acid clusters may pass through the intestinal mucosa into the bloodstream. A lack of digestive enzvmes coupled with existing or drug-induced hypochlorhydria may very well be the initial cause of the leaky gut.

NATURAL IS BETTER
It is clear that ulceration of the mucosa does not result from a deficiency of antacids or H2 inhibiting drugs. Although they can give rapid relief from the burning pain of ulcers, they do not solve the problem. There is a higher relapse rate after discontinuation of maintenance treatment with cimetidine (Tagamet® than with any other anti-ulcer medication.(l)

A number of natural nutritional remedies can heal the gut lining as effectively as pharmaceutical drugs and avoid the high relapse rate of H2-inhibitors. Licorice has demonstrated remarkable ability to heal ulcers by stimulating the production and secretion of protective mucous compounds that coat the mucosal lining of the digestive tract. One of its constituents, glycyrrhizinic acid, was the first compound proven to promote the healing of gastric and duodenal ulcers.(l) However, it tends to cause edema, hypertension and low potassium levels. Removing the glycyrrhizinic acid yields deglycyrrhizinated licorice, or DGL, which numerous studies have shown to produce verv successful results without any known side effects. DGL must mix with saliva to be effective. DGL capsules may be swallowed provided they contain parotid substance, a source of serous saliva.

DGL stimulates the growth and regeneration of stomach and intestinal cells. It also reduces bleeding caused by aspirin, and is strongly indicated for prevention of gastric ulcers in patients requiring long-term treatment or those on NSAIDs. Use of DGL has even prevented the need for surgery.(l) In one study, DGL performed as well as antacids and H2-inhibitors, but there were fewer relapses in the DGL group.(l) Four to eight 200 mg. capsules may be taken 20 minutes before meals for 8-16 weeks.(1)

N-acetyl glucosamine (NAG), an amino-sugar, assists in forming the protective mucous layer and cellular cement that regulate the intestinal permeability. Its role in repairing mucous membranes reaches to the core of the problem rather than applying the "band-aid" of anti-ulcer drugs. Vitamins A (25,000-50,000 I.U.) and E (400-800 I.U.), and zinc (50-80 mg) have a healing effect on ulcers and prevent recurrences. They promote intestinal integrity, and zinc can reduce pain markedly by increasing mucus production.(1,6) Pantothenic acid (500 mg) helps to maintain a healthy digestive tract. L-glutamine (400 mg. 1 hour before meals and at bedtime) enhances intestinal cellular growth and prevents increased permeability, and has shown X-ray evidence of complete healing within 4 weeks. Drinking 1 liter/day of concentrated cabbage juice (high in L-glutamine) has resulted in complete healing of ulcers in up to 92% of patients studied.(l,2,6) Prostaglandins in evening primrose oil and fish oils aid in reducing inflammation and protecting the mucosal surface. Glutathione and DMSO impart anti-oxidant protection to the gut lining. Bismuth (120 mg. 4 times daily) can aid in the control of H.pylori.

HOW DIET CAN HELP
Preventative, as well as therapeutic, dietary measures include the consumption of generous amounts of whole grains, beans, fiber, cabbage and linoleic acid. Milk has a temporary neutralizing effect on gastric acidity, but is followed by an increase in acid secretion.(2,6) Bland diets have not been proven effective.(6)

Home | Online Catalog | Newsletters | Therapy Index | Psoriasis / Eczema | Free Vitamins | Order | Contact Us

Copyright © 1996-2007 Nutrimed Labs, Inc.