Dear Readers, this week’s column comes from a health issue I’ve personally suffered and what I learned through that experience that can help others who develop the condition. I’m talking about stomach (peptic) ulcers.
“In the United States, peptic ulcer disease affects approximately 4.6 million people annually, with an estimated 10% of the US population having evidence of a duodenal ulcer at some time. [20] H pylori infection accounts for 90% of duodenal ulcers and 70-90% of gastric ulcers. [21] The proportion of people with H pylori infection and peptic ulcer disease steadily increases with age..” BS Anand, MD; Medscape
Stomach ulcers are actually fairly common by middle age, with a slightly higher prevalence in males than females. While it used to be thought that stress was the sole cause of ulcers, we now know they’re strongly associated with an H. pylori infection. As stated above, 90 per cent of duodenal and up to 80 per cent of gastric ulcers are caused by H. pylori.
Data shows that infection prevalence is closely related to geography, with higher rates of infection in developing countries. It also shows that risk increases over the lifespan, such that 1 in 2 people have H. pylori by the time we reach 60.
An interesting aside here, one of the two gentlemen who discovered that peptic ulcers were caused by a Helicobacter pylori infection, Barry Marshall, consumed a glass of the bacteria to give himself ulcers, after which he treated them with antibiotics. Marshall and his colleague Robin Warren went on to win the Nobel Prize in Medicine for the discovery. If you find the history interesting you can read the full story here.
There are other factors that can predispose us to developing ulcers. The top one is the use of non steroidal anti-inflammatories like aspirin or ibuprofen drugs, of which I was guilty. I used ibuprofen for headaches for years. After that comes alcohol and coffee consumption, as well as a diet high in processed foods and eating foods to which we are sensitive.
We may not have a full allergy, but being sensitive to them means they bring out inflammation in our bodies. Inflammation damages tissues like the stomach lining slowly over time. So healing the ulcer means removing these substances fully in the short term and reducing them greatly in the long term. NSAIDs are not recommended at any point after developing an ulcer.
Holistic clinicians like Chris Kresser and Dr. Berg have been talking about dietary treatments for stomach ulcers for quite some time. And the registered herbalist I studied under at the Institute of Holistic Nutrition, Susan Elliotson, who is also now the director of the Ontario Herbalists Association, taught that herbal gruels can be extremely healing in the case of digestive ulcers.
So when I developed a stomach ulcer, this is what I turned to. For my gruel I used a combination of several herbs, ground up and mixed into water and taken 2x per day. I used marshmallow root, slippery elm root, ginger root, calendula flower, and cayenne pepper.
Yes, I said cayenne pepper for ulcers! I remember when Susan taught this to us in class. I immediately stopped the lecture. Say what? I couldn’t have heard her right. She smiled and explained that indeed I had. Cayenne is used in this case to bring the blood flow to the site of injury, which helps stimulate healing. It also, incredibly, helps with burning pain!
She explained that capsaicin, the compound in cayenne that gives the pepper its heat, is known to have powerful, pain-killing properties when applied to the skin. It’s known to reduce the amount of a chemical (substance P) that relays pain messaging to the brain. It sort of tricks the brain into thinking there is no pain, rather similar to how other analgesics like tylenol work.
Additionally, years later in my studies of classical homeopathy, I learned the medical philosophy that like cures like. This means a substance that causes burning in a healthy tissue/host will help heal burning where that is the symptom in suffering. For burning pain on the skin, apply a cream with cayenne mixed in. You will be amazed at the amelioration you experience!
The other herbs are healing in other ways. Marshmallow and slippery elm are demulcents. Think of them as soothing moisturizers for swollen, inflamed, or chapped skin. They can be used for the digestive system but can even help soothe an inflamed bladder and urinary tract! Calendula is antifungal, antibacterial, and anti-inflammatory and is known to facilitate healing of wounds. It can be used externally or internally.
Ginger has anti-inflammatory, analgesic, and antibacterial properties and is a digestive tonic. This means it’s known to help strengthen digestive tissues while reducing inflammation, pain, and bacterial overgrowth. Together with cayenne these herbs soothe, protect, stimulate tissue repair, reduce inflammation, reduce pain, and protect against fungal and bacterial infections. That’s quite an incredible gruel!
To understand how a holistic model for ulcers works, we need to understand the stomach. The lining of the stomach and digestive system are actually not unlike our skin. Both are epithelial cells. Both are barrier cells to protect our inner organs from harm. Both have a protective film. In the digestive tract we have a mucosal barrier. In the stomach we have stomach acid. On our skin we have an acid mantle. All of these secretions need to be in good health to preserve the integrity of the cells underneath.
So in holistic medicine, we look at the health of the stomach secretions that protect the stomach tissue in order to understand the root cause of ulcers in that region. It’s well known that stomach acid production often deteriorates as we age. The hydrochloric acid in stomach secretions coats our stomach wall in a protective film that kills bacteria and parasites. It also chemically breaks down foods (especially proteins) to allow us to absorb and utilize them.
Reduced acidity in the stomach makes us more susceptible to a whole host of parasites and other opportunistic infections like H. pylori. It also causes the common condition of acid reflux or GERD. Yes, I said that GERD is often associated with too little stomach acid, not too much. I wrote an article on this in 2019. If you haven’t read it or don’t remember it, you can find that article here.
Let’s review what we know. Stomach acid decreases as we age, while H. pylori infections increase. H. pylori increases the occurrence of stomach ulcers and stomach ulcers increase as we age. It would seem a no brainer, then, that increasing the stomach acid would be part of a plan to protect and heal the stomach. Interestingly, modern medicine does the exact opposite, prescribing drugs to block the production of stomach acid when there is an ulcer.
And while pain may subside with this approach, there are deleterious effects of prolonged low stomach acid - namely not being able to break down proteins properly to absorb and use. Over time this causes muscle wasting and a deterioration in strength and balance, in digestive health (since proteins form most enzymes) and brain health, since they also form neurotransmitters. Stomach acid is essential for good health!
How do we increase stomach acid with an active ulcer? There are two very effective methods for instant results but it’s best to undertake these after the ulcer has been healed with the herbs above in addition to a few key supplements. L-glutamine helps heal the tight junctions in the digestive wall to strengthen it, while zinc speeds healing of tissues.
Zinc, by the way, is often low when stomach acid is low because stomach acid is needed to extract it from foods. Quercetin helps reduce oxidative stress and inflammation from poorly digested foods and hidden food intolerances. Vitamin D helps heal wounds like ulcers and has been shown in studies to be deficient in those who don’t tend to heal well. I combine these in my ulcer protocol. The improvements are almost instant.
Lastly, I use a lozenge / supplement called DGL. It’s licorice root, which is extremely healing to ulcers and diseases of low stomach acid like GERD and heartburn. But it contains no glycyrrhizin so it’s safe for people with high blood pressure. Regular licorice root can be contraindicated in such cases. DGL can be taken before meals and to ameliorate pain. It’s really quite impressive how well it works.
Once the wound is healed, which is usually signaled by lack of pain or discomfort, a return to a normal appetite, and no blood in the stool, I work on increasing the stomach acid. For detailed directions (pdf) on how to do this as well as a link to the supplements and herbs recommended in this article, readers can send me an email. The information is free.
Stomach ulcers affect a lot of us by midlife, but they don’t have to initiate a lifelong dependence on questionable medications that slowly undermine our health. Natural solutions are very effective and affordable.
I hope this is helpful to readers. As always I welcome your nutrition and health questions. You can email me at [email protected] and can find me online at hopenotdope.ca.
Namaste!
Nonie Nutritionista