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Stomach Ulcer

Stomach Ulcer

Stomach Ulcer

Symptoms, Causes & Treatment

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 ulcers. 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

  • 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 Ulcers

  • 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: mucous membrane repair
  • Vitamin: mucous membrane repair
  • Vitamin: 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, a antimicrobial treatment plan designed by your functional medicine practitioner is required if you are positive to H.pylori.

Herbal medicine treatment for Stomach Ulcers

  • 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 successfully treated many cases of H.pylori and subsequently assisted the healing of associated ulcers and other digestive issues without the use of antibiotics.

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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Jarrod Cooper – ND

Jarrod Cooper – ND

Jarrod Cooper - ND is the founder of Advanced Functional Medicine Australia. He is a Naturopathic Doctor with extensive functional medicine training from leading practitioners in the USA and worldwide.

He is leading the way with advancements of functional medicine, clinically implementing worldwide best practices in Functional Medicine throughout Australia.

Jarrod consults in person from Perth, Western Australia and also online via Telehealth throughout Australia and worldwide.

If you are looking for personalised treatment, we highly recommend contacting Jarrod Cooper’s Advanced Functional Medicine clinic in Australia.

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