Stomach Ulcers

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Located on the left side of the upper abdomen, the stomach is the major organ that makes up the digestive system and its primary function is to digest food. The stomach is made up of structural layers of different types of tissue:

Glandular tissue - secretes fluids, such as acid and enzymes, that digest food.

Muscular tissue - churns and breaks up food and other particles/substances in the stomach.

Epithelial tissue - Lines the inner and outer surfaces of the stomach.

Layers of muscle tissue called gastric rugae layer the surface of the stomach, which are essentially folds in the stomach which function to create a larger surface area enabling maximum nutrient absorption. The stomach and intestines have a mucous membrane lining that provides protection against hydrochloric acid and other digestive juices. If too much digestive acid is produced it can harm the mucous lining.1

Stomach ulcers

Stomach ulcers are exposed sores that can form on the mucous lining of the stomach, essentially an erosion of the lining of the stomach, and are also known as gastric ulcers.2

Causes of stomach ulcers

Ulcers are largely caused by Helicobacter pylori, a bacteria already present in the body in many people. If too much of this bacteria is present in the stomach it eats away at the stomach lining causing it to become inflamed, which leads to stomach ulcers forming. The link made between Helicobacter pylori, inflammation of the stomach lining, and stomach ulcers is of huge scientific importance in modern medicine and saw scientists, Barry Marshall and Robin Warren awarded in 2005 with the Nobel Prize in Physiology or Medicine for their efforts in this major discovery.3

Stomach ulcers can also be caused, less commonly, by long-term use of painkillers such as ibuprofen, ketoprofen, aspirin, or naproxen; referred to as nonsteroidal anti-inflammatory drugs (NSAIDs). These painkillers can cause inflammation to the stomach lining which can lead to stomach ulcers.4

Who’s at risk?

People of all ages can get stomach ulcers but they are more likely to occur in the elderly population, with people over 60 years old affected more commonly than young people. Stomach ulcers occur more frequently in men than women.5

Signs and symptoms

Abdominal pain. Usually, the first sign of a stomach ulcer is a burning pain in the abdomen. The pain experienced can spread from the abdomen into the neck and back. Stomach ulcers aren't always accompanied by pain though.

  • Heartburn
  • Indigestion
  • Nausea

The symptoms associated with stomach ulcers can be exacerbated by acid produced in the stomach, as it seeps through the eroded stomach lining. In extreme cases this can cause the stomach lining to bleed; lead to infections; or affect the proper functioning of the digestive tract, making it harder for food to move through it.

Stomach ulcers in the UK

It's not clear how many people suffer from stomach ulcers, but they are a common issue and some studies have shown that 1 in 10 people will get a stomach ulcer at some point.6

Myths and misconceptions

A common myth is that spicy foods cause stomach ulcers. It’s true that spicy food is thought to adversely affect stomach ulcers and make symptoms worse in some people, but is not a cause of stomach ulcers.7 On the other hand, quite the opposite; it’s argued that spicy foods can, in fact, stimulate the release of protective secretions in the stomach and can provide antibacterial action, which will counteract the growth of H. pylori bacteria, so could actually help to both prevent and heal stomach ulcers.8

It’s a widespread misconception that smoking cigarettes can help to improve heartburn, a common symptom of stomach ulcers. In fact, smoking could actually increase/exacerbate heartburn.9

Although factors such as consuming rich fatty foods and coffee, smoking and alcohol consumption have been shown to worsen the symptoms of stomach ulcers (such as abdominal pain and heartburn) by aggravating the lining of the stomach; putting extra pressure on the digestive system; and possibly contributing further to the erosion of the stomach lining by increasing the production of stomach acids; they can not be attributed to being a cause of stomach ulcers as was once popularly believed. It’s a wise move to avoid these negative influences on the stomach and digestive system, however, when trying to effectively manage the symptoms associated with stomach ulcers.10

Many people believe that too much stress can cause stomach ulcers. Although stress can worsen the symptoms of ulcers there is no evidence to suggest a direct link of stress as a cause.11 Stress is believed to have a negative impact on the body as a whole, and in the case of stomach ulcers, it can make the situation worse, as with the other irritants discussed above, by increasing the secretion of acid. The bacteria, H. pylori, that cause stomach ulcers, work to erode the protective lining of the stomach, which makes the stomach lining barely protected by the mucus layer and much more susceptible to the effects of the increased acid.12

Contrary to popular belief, milk cannot cure ulcers but it is thought to alleviate the symptoms by helping to soothe the digestive tract and providing a temporary protective layer against stomach acid.13

Treating stomach ulcers

Stomach ulcers are often kept under control with antibiotics or medications to reduce, block, or neutralize stomach acid, helping to minimize the symptoms. There are some simple and effective dietary and lifestyle changes that can be adopted which can go a long way to helping alleviate the symptoms of stomach ulcers and in some cases contribute to prevention and healing.

Dietary changes to improve health

Eat Healthily. A balanced, healthy diet which covers all of the basic essentials the body needs to survive is paramount to optimal health and will significantly help with the management of stomach ulcers. It’s clear diet can play a vital role in lifelong health, helping to boost immunity and our body’s natural defences; helping the body to get well and stay well; as well contributing to how we feel within ourselves on a day to day basis; and that a healthy diet can contribute to overall feelings of wellness and vitality and help us to avoid ill health and disease.

High fibre foods are beneficial. Whole grains, vegetables, and fruits are good foods to consume and to base your diet on if you have a stomach ulcer. Fruits and vegetables rich in beta-carotene and vitamin C can help by aiding the digestive tract and protect the natural lining of the stomach. Berries, for example, with a high antioxidant content, can help the body by reducing oxidative stress, increase immunity and support the proper functioning of the digestive system.

Avoid fat and sugar. Fatty foods cause the stomach to produce more acid which can make symptoms worse. Cutting back on red meat consumption, due to its high-fat content, is advised by health professionals.

Avoid caffeinated food and drinks as caffeine can irritate the stomach lining and the stomach ulcer, and can contribute to increased acid production. Instead how about trying a variety of herbal teas, many of which are known to have a calming effect on the digestive system such as peppermint, ginger, lemon, liquorice and turmeric.

Avoid smoking and alcohol. Both act as irritants to the stomach lining and can increase the amount of acid produced in the stomach.

Eat 5-6 small meals a day instead of 2-3 large meals. Big meals cause the stomach to produce more stomach acid which can increase the severity of the symptoms associated with stomach ulcers. Ensuring food is chewed properly and eaten slowly can help the process of digestion.

Increase intake of omega 3 fatty acids. These are essential because they cannot be synthesised by the body but are proven to be essential for optimum health. Fish such as salmon, mackerel, sardines, tuna, and herring are a fantastic source of omega 3 fatty acids. Plant based foods such as avocado, sunflower oil, flax, linseed oil, and walnuts also contain omega 3 fatty acids. Green leafy vegetables are another great source of these EFA’s. Research has shown that these essential fatty acids contain compounds called prostaglandins which can help protect the mucous membrane lining of the stomach. It’s clear to see how this could help in the case of stomach ulcers.14

Increase consumption of Probiotics. The word probiotic translates to 'for life'. To properly absorb nutrients, synthesise vitamins, and eliminate waste effectively the intestines need certain levels of probiotics or ‘friendly’ bacteria. Eat plenty of probiotic yoghurt containing good bacteria which can help keep the digestive tract happy and promote a healthy gut.

Avoid highly processed and refined foods which tend to contain carbohydrates and sugars that the intestine struggles to break down and absorb.

Drink plenty of water. Water helps the body to break down food so that we can absorb nutrients from food and helps to flush waste from the intestines. Keeping our body hydrated is essential for all bodily functions to operate efficiently. Try drinking lemon water; packed with Vitamin C, it can also help soothe the digestive system.

Try introducing fermented food into your diet, such as sauerkraut, pickles, kimchi and tempeh which are packed with probiotics which help keep the digestive-tract healthy and can help boost healthy gut bacteria which aids the process of digestion.

Some supplements and probiotics like those containing Lactobacillus casei and Saccharomyces boulardii can help aid healthy digestion.

Eat more cabbage? Raw cabbage juice is a traditional remedy, rooted in popular folklore, used to heal stomach ulcers. Interestingly, a scientific study has also revealed a connection between raw cabbage and improvement in stomach ulcers. A trial found that patients suffering with peptic ulcers who consumed one litre or more of raw cabbage juice per day took only eleven days to heal in comparison to the thirty-seven days for those under the placebo.15

Lifestyle changes to improve health

Exercise. To maintain good all round health and a healthy body weight we not only need to eat healthily we need to exercise and keep our bodies active as well. Too little exercise can lead to weight and other health issues. Too much exercise can also be harmful.

The recommended amount of exercise for the average adult is 150 minutes of weekly physical activity, consisting of a mixture of aerobic and strength exercises. This equates to 30 minutes of exercise over 5 days of the week. It’s worth noting that one minute of vigorous activity provides the same health benefits as two minutes of moderate activity.16

Exercise could help to manage the symptoms of stomach ulcers and prevent additional ulcers forming by helping to maintain overall health; helping to maintain a healthy weight and is believed to help increase immunity, preventing infection and disease.17

Managing stress levels

Although stress can’t give you a stomach ulcer it can severely worsen the symptoms and make coping with a stomach ulcer much harder; as well as making life generally much harder to deal with. It’s easy to say, “try to avoid getting stressed” but there are some practical steps we can take to lessen the stress we experience which will help alleviate some of the issues surrounding stomach ulcers.

Make positive changes where possible: Identifying some of what makes us feel stressed and then taking steps to change what we can is a good start. We may not be able to eliminate every stress from our lives but by changing the things we do have the power to change we can take the pressure off a little.

Don’t worry about the things we can’t change. Sounds simple, but we all know telling someone not to worry doesn’t really work. Try telling yourself not to worry instead. Worrying about something we have no control over is quite simply a waste of time. Try to find ways of doing what you can to change thought patterns associated with worrying about things you have no control over.
Get organised:
Organising time is essential to eliminating stress. Being organised in our everyday lives, responsibilities and activities really does help life to flow more sweetly and stress-free. Being organised can help to bring about a sense of calm and a clear head, which can help us to cope with life better, helping us to feel less stressed.

Sleep: Getting regular sleep can make such a difference to stress levels. Sleep gives our bodies the chance to rest, grow, build, repair and rejuvenate. Sleep helps us to go about our daily lives with enough energy and vitality to achieve what we need to physically. Furthermore, lack of sleep can impair the immune system and interfere with vital processes meaning we’re more likely to get unwell.

Relax: Try doing something relaxing, such as listening to calming music, taking a gentle stroll, reading a book, having a bath or meditating.

Exercise: Exercise is a great stress-buster and a regular exercise regime can significantly help bring about feelings of vitality, health, well-being, increased energy levels, a sense of calm, a sense of well-being. Sport and physical activity helps us to relax physically and also releases endorphins in the body which produce a real feeling of well-being. Exercise basically makes us feel good! Further to this exercise helps us to relax and helps us to sleep better too.

Have fun: Laughter is a fantastic stress buster!

Supplements for stomach ulcers

Garlic

The commonly known "Garlic" is grown on the native Asian plant, Allium Sativum. The Allium Sativum is part of the Lily family and is best grown in environments with a high water content such as riverbeds. The plant grows to around half a metre and develops bulbous roots that are used for extract. It is well known for its use as a flavouring in cooking, but its use in medicine far precedes this. There is evidence of medicinal use as far back as 1,500BC in Ancient Egypt, Greece, India, and China. History shows that Garlic was a method of payment and a staple part of the diet for workers building the pyramids. It was also used as food for soldiers in Greece and Rome as they believed it gave them strength.

Modern science has now dictated the real benefits and how these affect the body. The active ingredient is of Garlic is Allicin. Allicin is an organic sulphur based compound. The main property of Allicin is its anti-bacterial, antiviral and antifungal nature. This is incredibly beneficial to health as it regulates the pathogenic levels, between narrow limits within the body. This leads to the promotion of immunity and balance of the healthy microbiota in the gut, hence its use to benefit the digestive system and suggested benefits for stomach ulcers. In addition to this, Garlic is rich with antioxidant properties that lead to a decrease in cell damage and the onset of disease. The role of an antioxidant is complex, but it scavenges harmful particles called free radicals that attack tissue integrity via oxidation. Lastly, it has been linked with the therapeutic regulation of blood glucose concentration, promotion of insulin secretion and maintenance of healthy carbohydrate metabolism.18

Vitamin E

Vitamin E is a fat soluble vitamin. When required Vitamin E can be consumed, in much smaller quantities than a water soluble vitamin because it has a greater storage capacity within the body. There are 8 forms of Vitamin E. These include four tocopherols and four tocotrienols.

Vitamin E has antioxidant properties and is valued for its many health benefits. The main role of Vitamin E is a potent antioxidant. The role of an antioxidant is to reduce oxidative stress, it does so by scavenging free radicals and preventing them from oxidising tissues. By reducing oxidative stress it decreases cellular damage and maintains the integrity of the body tissues. This mainly protects DNA, proteins and lipids. Vitamin E plays important roles in adjusting the oxidation of fat, removing free radicals and protecting the cells. Research has shown that Vitamin E can also stop the growth of the bacteria responsible for causing stomach ulcers, helicobacter pylori.19

Vitamin E is found naturally in some foods and also present in some fortified foods. Good natural sources of Vitamin E are nuts (particularly almonds, hazelnuts and peanuts) cold-pressed sunflower oil, olive oil, corn oil, soybean oil, avocado, asparagus, wheat germ, sesame oil, peanut oil, spinach, salmon and butter.20

Capsicum (capsaicin)

Capsicum is most commonly known as cayenne pepper. Capsicum is sourced from the shrub plant Capsicum Annuum. The red fruit produced by the Capsicum Annum is part of the pepper family, and known for its intense heat. This has been used in traditional medicine and cooking for many years, particularly in the continent of Africa. It was originally grown and cultivated in Mexico, South America, but it is now grown worldwide. Capsicum Annuum is best suited to subtropical climates, but they are hardy plants that have the ability to survive many variations in weather conditions.

The medicinal claims of Capsicum include the promotion of gastric health, and gastric protection against irritating substances, so this supplement could be a wise choice for managing stomach ulcers.21 Some research has shown that Capsicum could help prevent and heal stomach ulcers. Such studies show that Capsicum helps to prevent acid secretion, while activating secretions of alkali and mucus and most importantly stimulating gastric mucosal blood flow.22

Licorice

Licorice is an herb that grows naturally in the Mediterranean, southern and central Russia, and Asia Minor to Iran. Many species are now grown throughout Europe, Asia, and the Middle East.

Licorice is used for a range of digestive system issues including stomach ulcers, heartburn, colic, and ongoing inflammation of the lining of the stomach (chronic gastritis). Licorice is a great supplement to take for stomach ulcers as it’s thought to increase production of the chemicals in the body that heal ulcers. Indeed there is some evidence to indicate licorice will speed up the healing of stomach ulcers.23

Licorice root is believed to benefit the intestinal lining by encouraging the growth of mucus-secreting cells and increasing blood supply to the gut’s mucous membranes.24

Turmeric

The Turmeric Plant is native to India but has been cultivated in Bangladesh, China, Thailand, Cambodia, and Malaysia.

The Turmeric plant and its extract is a well known plant used in cooking and medicinal use. It’s extracted from the Curcuma Longa Plant which is a distant relative of the Ginger plant. Turmeric is best known for its antioxidant and anti-inflammatory properties. The powerful anti-inflammatory and antioxidant active ingredient of the Turmeric plant is Curcumin. The roots are the source of the Turmeric extract, they are then cut, dried and powdered for medicinal purpose.

Most critically, its properties are known for stimulating a healthy appetite to gain the correct nutrition from food. Turmeric is thought to benefit gastrointestinal health in general and used traditionally to aid the digestive system and as a treatment for indigestion. It was known as the “warming” plant because it is applied to disorders that require a warming effect such as relieving gas, improving digestion and as a blood purifier. With regards to stomach ulcers in particular, studies have shown curcumin could “help regulate the enzymes involved in ulcer wounds, reverse cell damage, and accelerate healing”.

In addition to this, its antioxidant properties are believed to aid the health and performance of the liver, joint, bones, and upper respiratory tract. Turmeric can also help the health and efficiency of the heart by contributing to normal circulation and function. In addition, its antioxidants and main powerful active ingredient, Curcumin, can actively aid the health of the skin. In traditional Asian medicine, Turmeric has, for many years, been used to treat sores and skin diseases and to heal wounds.25

Turmeric and Black Pepper tablets

This clever formulation of Black Pepper and Turmeric is used for its antioxidant and anti-inflammatory properties, appetite stimulation and healthy aid of digestion so it’s clear to see how it could benefit the symptoms of stomach related issues such as managing a stomach ulcer. Combined with the beneficial action of Turmeric, Black Pepper is thought to contribute to normal function and efficiency of the of digestive and intestinal systems. By aiding normal digestive functions black pepper helps to increase digestion and absorption of nutrients, while helping in body weight control.26

Ginger

Ginger is sourced from the plant, Zingiber Officinale. It's a native plant of South-East Asia, but is now typically grown in Africa, Latin America, Australia and the Caribbean.

The bulb or root that we traditionally use is technically a branched rhizome, and is the section of the plant that grows underground. The rhizome has a brown/beige thick outer skin, and within is a fleshy pale yellow spiced centre containing the essential oils and flavours we typically recognise as ginger. The active ingredients of ginger are essential oils called Shogaols and Gingerols.

Ginger comes from the same family as Turmeric (Curcuma Longa), and so has very similar medicinal effects.

Ginger is well known for its antiseptic, anti-allergenic and anti-inflammatory properties, and hence, why it has been used as a natural source for supplemental health. Ginger claims to aid the stomach and digestive system due to its powerful anti inflammatory properties. Ginger stimulates the balance of anti-inflammatory and inflammatory hormones known as prostaglandins.27 Stomach ache, due to increased digestive juices and acid in the stomach, can be a nasty symptom of stomach ulcers. Ginger is well known for its soothing and healing properties and its calming effect on the digestive system and is used to ease stomach pain.

Zinc

Zinc (Zn) is a trace element, that’s found in almost every cell in the human body and is a vital cofactor component of many enzymes. It’s essential, meaning it’s only found in the body due to its consumption in foods; we are unable to make it.

Zinc is found naturally in foods such as organ meats, yeast, seafood, whole grains and eggs.

Zinc is known to have beneficial effects on the gastrointestinal mucosa, the mucous membrane which provides protection against stomach acid and digestive juices, by increasing the production of this essential protective substance. Zinc has also been shown to help stomach ulcers by preventing the growth of the bacteria Helicobacter pylori; as well as having anti-inflammatory and antioxidant capabilities. 28

Living life to the full

Stomach ulcers can be very painful and, if experiencing bad symptoms on a regular basis, can affect quality of life and feelings of well being and happiness. With some lifestyle and dietary adjustments it is possible to effectively manage the everyday experience of life with stomach ulcers and to live a full and active life. Try supplementing a healthy diet suitable for stomach ulcers with a combination of supplements that can help to alleviate symptoms and promote ulcer healing; Avoid dietary and lifestyle influences that may worsen the symptoms of stomach ulcers; Exercise is good for everyone and can only serve to improve general overall health; And finding a sense of balance and harmony, where the stresses don’t tip you over the edge, will really help to make life with a stomach ulcer that much easier, ultimately helping to avoid exacerbating the symptoms, which if left untreated and unaddressed can adversely affect enjoyment of life and feelings of well-being.

 

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1 http://health.in4mnation.com/peptic-ulcers-remedies-myths/

3 Lochhead P, El-Omar EM. Helicobacter pylori infection and gastric cancer. Best Pract Res Clin Gastroenterol. 2007;21(2):281-97.
Wilson KT, Crabtree JE. Immunology of Helicobacter pylori: insights into the failure of the immune response and perspectives on vaccine studies. Gastroenterology. 2007 Jul;133(1):288-308.

14 Mori et al, 2006. Retrieved from: https://napiers.net/stomach-ulcer-diet.html

15 Rapid Healing Of Peptic Ulcers In Patients Receiving Fresh Cabbage Juice. Garnett Cheney. Retreived from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1643665/?page=1

22 https://www.ncbi.nlm.nih.gov/pubmed/16621751. Crit Rev Food Sci Nutr. 2006;46(4):275-328.
Capsaicin and gastric ulcers.Satyanarayana MN.

24 The Encyclopedia of Natural Medicine Third Edition Paperback – 20 Nov 2014
by Michael T. Murray M.D. (Author), Joseph Pizzorno (Author)

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