ULCERS
Ulcers are a common health problem that occurs 4 times as often in men. Ulcers on the duodenum (the first part of the small intestine that the stomach empties into) occur 4 times as often as stomach ulcers. An ulcer is erosion in the mucous lining. Typical symptoms of an ulcer are burning pain in the upper abdomen (stomach area) starting an hour after meals. Heartburn is due to regurgitation of stomach acid up into the esophagus. Symptoms will usually disappear with eating a meal or taking antacids.
Diagnosis of an ulcer is made by a typical history and testing with either direct visualization by a flexible endoscope or x-rays following swallowing barium dye. A new development is research showing that many people with ulcers have an infection of the stomach lining with bacteria called Helicobacter pylori. When this is diagnosed by a biopsy of the mucous lining or a blood antibody test, a two-week treatment with two antibiotics and an acid-suppressing drug is given. Successful eradication of the infection helps prevent the reoccurrence of the ulcer. In people without infection, healing of an ulcer can usually occur by taking drugs to suppress stomach acid. Most ulcers will heal in 1-2 months with this approach. One drawback is that stomach acid is necessary for proper digestion and the drugs used can have side effects.
Causes of ulcers include aspirin, NSAID’s (ibuprofen, naprosyn, Feldene, and a variety of other anti-inflammatory medications), cortisone derivatives, coffee, caffeine, alcohol, cow’s milk (increases acidity greatly in some people), smoking, nutrient deficiency and stress. A major complication of ulcers is their tendency to bleed. This can be slow and lead to anemia (low red blood count) or it can be rapid and cause black, tarry stools. In extreme cases, massive bleeding can cause shock and death.
In order to both heal and prevent reoccurrence of ulcers, risk factors should be addressed. Reducing or eliminating drugs that cause ulcers is vital. Eliminating alcohol and tobacco use is essential. If stress is a major factor in the person’s life, learning and practicing new ways to lower stress’s effect on them is important. This might include relaxation exercises, meditation, biofeedback, guided imagery, hypnosis, breathing exercises, yoga and regular aerobic exercise. If significant dysfunction in family and interpersonal relationships exists, personal and family therapy can be very helpful. A sense of connectedness to others and a good social support network enhance overall health and lower stress levels.
Because free radicals (health damaging chemicals) appear to be involved in H. pylori-infected ulcer patients, increasing anti-oxidants by diet or supplements should help. Vitamins A, C, E, B-complex, zinc, Lactobacillus acidophilus, potassium, high fiber intake, omega-3 oils, bioflavinoids and glutamine all show evidence of possible benefit.
Food allergies are an often overlooked factor in chronic health problems. An elimination diet removing the common offenders such as dairy products, wheat, corn, eggs, tomato, coffee, oranges, chocolate, peanuts and spices may help to keep ulcers from recurring.
Herbs definitely have a place in treatment. Ginger tea or capsules strengthen the lining of the stomach and intestines. Aloe vera juice is reported to help. Licorice root (DGL-deglycyrrhizinated licorice) has been studied and found to be comparable to the acid suppressing drugs in effectiveness.
Acupuncture, homeopathy and Ayurvedic medicine are systems of care that may also be helpful in bringing the body back into balance and promoting the healing process. Ulcers signify imbalance in a person’s life. Simply taking a pill to suppress stomach acid may alleviate symptoms but does nothing to address the underlying causes. Energetically, the stomach area is the third chakra, which has to do with power and integrity. Unresolved issues concerning self-responsibility, self-esteem and fear of rejection can manifest as physical symptoms in this area. In addition, suppressing feelings causes blocked energy in this area of the body. This is another avenue for exploration in those interested in the achieving the highest level of wellness.
Daniel Blodgett MD