Stomach Ulcer treatment, symptoms and causes

Stomach ulcers also known as peptic ulcers are an ulceration (erosion) of the mucosal lining of either the stomach (gastric ulcer) or duodenum (duodenal ulcer). Duodenal ulcers are four times as common as gastric ulcer in Perth and Australia wide. They may occur at any age, but most commonly between 45 and 55 years.

In the past, it was thought that stomach ulcers were caused by increased stomach acid. However, up to 50% of patients do not have increased stomach acid and many may have low stomach acid.

Most cases of a stomach ulcer are attributed to the Helicobacter pylori bacteria, although people can also have the bacteria but not have peptic ulcer.

Researchers now believe that the causes are more complex and involve a failure of the stomach’s cell protection mechanisms due to lowered prostaglandin activity. Prostaglandins govern mucous secretion and other mechanisms that protect the stomach lining from injury by gastric secretions.

In lab testing, low secretory IgA and high calprotectin are commonly found in the presence of ulcers or other inflammatory conditions of the gastrointestinal tract. Long term food intolerances and allergies can be a driving factor in the development of ulcers.

Causes of Stomach Ulcers

Helicobacter pylori infection: occurs in 90% of duodenal ulcers and 70% of gastric ulcers; infection with H.pylori increases risk of ulceration by 2-6 times.
Long-term or repeated use of NSAIDs or aspirin
Stomach carcinoma
Zollinger-Ellison syndrome: causes increased production of gastrin leading to severe peptic ulceration

Risk factors for stomach ulcers

Increasing age
Genetic predisposition
H.pylori infection
Chronic stress causing increased acid production (favourable for growth of H.pylori)
Excessive alcohol use
Smoking: doubles the chance of peptic ulcer
Food allergy / intolerances

Signs & symptoms of Stomach Ulcers

Epigastric pain: gastric ulcers < during meals; duodenal ulcers <3 hrs after eating.
Belching, bloating and abdominal fullness
Loss of appetite and weight
Nausea and vomiting

Differential diagnosis

Non-ulcer dyspepsia
Inflammatory bowel disease
Gastric carcinoma
Gastritis
Pancreatitis
Gallbladder disease

Investigations

Endoscopy
Advanced Stool Testing
H.pylori serology or urea breath test
SIBO Breath test

TREATMENT STRATEGY FOR STOMACH ULCERS

Stomach ulcer treatment can involve multiple factors; these include

Regulate gastric acidity
Protect / repair gut mucosa
Regulate inflammatory prostaglandins
Address H.pylori infection and other gut pathogens
Identify and eliminate food allergens / sensitivities
Support gut immunity / address dysbiosis
Manage stress

Diet plan guidelines for Stomach Ulcers

Acute treatment:
Diet of warm soups, ripe banana, stewed fruit, steamed vegetables, brown rice, yoghurt, avocado, potato, porridge.
Avoid raw foods, meat, spicy foods, salty foods, acidic foods
Regulate gastric acidity
Avoid sugar, coffee (including decaffeinated), alcohol, carbonated drinks, refined carbohydrates, acidic foods, fried foods and excessive animal proteins, including dairy foods (dairy will temporarily decrease stomach acid, but this is followed by a rebound increase)
Increase dietary fibre: fibre has been shown to be beneficial in the healing of ulcers, partly due to the increase of transit time. Soluble fibre, in particular, is mucilaginous and can help with coating and soothing the gastric mucosa.
Avoid overeating and frequent snacking
Eat slowly and chew food thoroughly
Protect/repair gut mucosa:
Include glutamine rich foods: beans, brown rice, eggs, fish, legumes and cabbage juice: cabbage juice is high in glutamine; studies have found that 1L daily can facilitate healing of ulcers
Emphasise antioxidant-rich foods to promote tissue repair: berries, green tea, turmeric, fruits and vegetables
Regulate inflammatory prostaglandins
Minimise pro-inflammatory foods: sugar, refined carbohydrates, trans fats, excessive commercially produced red meat, omega-6 fatty acids, caffeine and alcohol
Emphasise anti-inflammatory foods: in cold-water oily fish, berries, nuts and seeds, turmeric, ginger, green tea, olive oil
Address H.pylori infection and any other bacterial infections in the gut
Identify food allergies and intolerances: a wheat and dairy-free diet may be recommended.

Supplements that support Stomach Ulcer treatment

Slippery elm: 1-2 tsp in water 3-4 times daily with food or made into a porridge. Helps soothe and repair gut mucosa
Glutamine: repair gut mucosa
Zinc: repair gut mucosa
Vitamin A: mucous membrane repair
Vitamin E: mucous membrane repair
Vitamin C: supports immune health and inhibit growth of H.pylori
Probiotics: restore healthy gut, reduce gastric inflammation flora, assist with H.pylori eradication and prevents adhesion of H.pylori to stomach and gut lining and counters side-effects of antibiotics.

** H.pylori requires a an extensive protocol to treat, an antimicrobial treatment plan designed by your functional medicine practitioner is required if you are positive to H.pylori.

Herbal medicine treatment for Stomach Ulcers

Herbal medicine treatment of stomach ulcers can be very beneficial, herbs include;

Demulcents: licorice, slippery elm, marshmallow
Mucosal repair: goldenseal, calendula, aloe, bilberry
Antacids: meadowsweet, alfalfa
Carminatives: chamomile, lemon balm, fennel, peppermint
Anti-microbials: echinacea, goldenseal, chamomile, barberry, Oregon grape
Gentle bitters: chamomile, centaury
Nervines: oats, vervain, passionflower

FUNCTIONAL MEDICINE TREATMENT OF STOMACH ULCERS

The above considerations may assist with the management of stomach ulcers and the H.pylori infection but will not eradicate it, a comprehensive antimicrobial program is required to clear H.pylori. We have experience with H.pylori and understand the health problems in can cause if the infection isn’t eradicated.

If you or a family member are require assistance with stomach ulcers, helicobacter or H.pylori infections or other gut pathogens and bacteria’s we would love to hear from you.

Have you successfully treated H.Pylori without antibiotics? Did you use antibiotics, if so, how did you respond? Please write a comment below.

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Stomach Ulcer Treatment