Condition - Peptic ulcers
Peptic ulcers - The pain in your stomach
They are extremely common and extremely painful - peptic ulcers affect the lining of any part of the gastrointestinal tract exposed to acid and pepsin, usually the stomach or the first part of the small intestine; the duodenum1. They are crater-like sores that can be one to two inches in diameter. An ulcer formed in the stomach is called a gastric ulcer, in the duodenum a duodenal ulcer and they can also be found less commonly in the oesophagus, called an oesophageal ulcer2. The damage occurs when the usually-protected lining is exposed to gastric juices normally intended for use with breaking down food.
The symptom experienced with an ulcer is, most commonly, a burning pain, ranging from slight to severe. The pain may be felt anywhere from the navel to the breastbone and last from a few minutes to many hours and may flare up at night3. A relief may be felt temporarily after consuming food, but this is due to the buffering effect the food has on the stomach acid, relieving symptoms. An ulcer pain can return after years of absence, so it is important to follow certain lifestyle choices if you have ever experienced an ulcer of any kind, as discussed below.
The causes are unknown but there are studies to confirm that the bacterium Helicobacter pylori (H. pylori), found in the stomach, causes more than 90% of duodenal ulcers and up to 80% of gastric ulcers4. H. pylori causes chronic low level inflammation of the stomach lining and colonises by surviving the acidic pH environment, by burrowing into the mucous membrane5. Many bacteria can be found here but mucous-secreting cells normally remove these. To avoid this removal, H. pylori uses a clever trick, sensing the pH gradient and swimming away from the acidic contents towards the more neutral pH environment6. The removal of H. pylori infection has been shown to accelerate the healing of peptic ulcers and the recurrence is significantly reduced7. H. pylori can be tested via blood, stool or breath. When visiting your GP with a suspected H. pylori infection, antibiotics are usually administered. However, it can become resistant to the antibiotics.
A number of botanicals and herbs are thought to be protective of H. pylori getting a hold; Korean ginseng, flavonoids found in broccoli, sprouts, garlic, probiotics and green tea8. A study led by scientists at Beth Israel Deaconess Medical Centre (BIDMC) revealed that the amino acid glutamine, found in many foods as well as in dietary supplements, may prove beneficial in offsetting gastric damage caused by H. pylori infection9.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and other pain-relieving drugs, are also a possible contributing factor with ulcers. They irritate and inflame the lining of the stomach and small intestine. Regular use of NSAIDs has been linked with upper gastrointestinal complications and increased damage to the permeability of the intestine has been well documented10. Ninety per cent of peptic ulcers can be related to the use of NSAIDs combined with H. pylori infection11. NSAIDs damage the intestinal mucosal lining that is vital for keeping the contents of the gastrointestinal tract restricted to the gastrointestinal organs. Leaching into any other parts of the body can cause complications. If ulcers are induced by the use of NSAIDs, it is necessary to discontinue them12.
Stress is one of the main concerns regarding peptic ulcers. Although it is not a direct cause, it is certainly a contributing factor. Much emphasis today is placed on mental and emotional stress and its effects on our physical health. Stress can be manifested as headaches, muscle tension, acne, immune dysfunction and peptic ulcer disease13. As well as learning coping mechanisms to deal with stressful situations, it can be beneficial to provide your body with neutraceutical support, via the means of supplements and herbs such as rhodiola. A nerve-supporting complex containing taurine and theanine aid the production of a neurotransmitter called GABA, which stimulates feelings of calmness and encourages a relaxed disposition. Enhancing serotonin levels may be achieved by taking a complex providing the nutrient 5HTP alongside tyrosine and B vitamins.
Lifestyle habits of smoking (including passive smoking) and excessive alcohol consumption are linked to having an effect on the development of ulcers. Alcohol can irritate and erode the mucous lining of the stomach and it increases the amount of stomach acid that is produced. Peptic ulcers are associated with heavy drinking14, which may surprise you to know is classified as an average of more than two drinks per day for men and more than one drink per day for women. Having alcohol-free days and focusing on ways to quit smoking can prevent the development of an ulcer. A brain complex supplement that has a powerful blend of amino acids to support people attempting to reduce alcohol consumption and smoking can be useful for achieving your goals.
Other lifestyle factors include the choice over which foods we eat. Living with a food sensitivity or intolerance can be hard to detect if you haven’t considered this a possibility. Many people suffer silently with gastrointestinal complaints too embarrassing to consult their GPs about or do not consider as urgent. Both food allergies and intolerances have been commonly found in cases of peptic ulcers. The food allergens can induce gastric mucosal damage in sensitised people15.
The complications surrounding peptic ulcers include bleeding and perforation where, if either are found, surgery may often be performed to repair the ulcer. Things to consider with continued bleeding are iron deficiency and B12 deficiency.
1 Osiecki, H. The Physicians Handbook of Clinical Nutrition, Seventh Edition, July 2006, Bio Concepts, Australia, pg 661
2 Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com. Copyright © 2009. Accessed May 6, 2009.
3 Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com. Copyright © 2009. Accessed May 6, 2009.
4 Osiecki, H. The Physicians Handbook of Clinical Nutrition, Seventh Edition, July 2006, Bio Concepts, Australia, pg 661
5 Amieva MR, El–Omar EM (January 2008). "Host–bacterial interactions in Helicobacter pylori infection". Gastroenterology 134 (1): 306–23. doi:10.1053/j.gastro.2007.11.009. PMID 18166359.
6 Schreiber S, Konradt M, Groll C, et al. (April 2004). "The spatial orientation of Helicobacter pylori in the gastric mucus". Proc. Natl. Acad. Sci. U.S.A. 101 (14): 5024–9. doi:10.1073/pnas.0308386101. PMC 387367. PMID 15044704. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=387367.
7 Osiecki, H. The Physicians Handbook of Clinical Nutrition, Seventh Edition, July 2006, Bio Concepts, Australia, pg 661
8 Lee, SY, Shin, YW, Hahm, KB. “Phytoceuticals: mighty but ignored weapons against Helicobacter pylori infection”. Journal of digestive diseases 9 (3): 129–39, 2008
9 May 2009 issue of the Journal of Nutrition
10 Osiecki, H. The Physicians Handbook of Clinical Nutrition, Seventh Edition, July 2006, Bio Concepts, Australia, pg 661
11 Osiecki, H. The Physicians Handbook of Clinical Nutrition, Seventh Edition, July 2006, Bio Concepts, Australia, pg 661
12 Osiecki, H. The Physicians Handbook of Clinical Nutrition, Seventh Edition, July 2006, Bio Concepts, Australia, pg 662
13 Osiecki, H. The Physicians Handbook of Clinical Nutrition, Seventh Edition, July 2006, Bio Concepts, Australia, pg 662
14 Courtney KE, Polich J. Binge drinking in young adults: Data, definitions, and determinants.Psychol Bull. 2009 Jan;135(1):142–56.
15 Osiecki, H. The Physicians Handbook of Clinical Nutrition, Seventh Edition, July 2006, Bio Concepts, Australia, pg 662