Peptic ulcers
Description
An in-depth report on the causes, diagnosis, treatment, and prevention of stomach and GI ulcers.
Alternative Names
Duodenal ulcers; Gastric ulcers; H. pylori
Lifestyle Changes
It was common in the past to restrict people suffering from peptic ulcers to frequent intake of small amounts of bland foods and milk. Exhaustive research conducted since then has shown that a bland diet is not effective in reducing the incidence or recurrence of ulcers, and that frequent small meals throughout the day are no more effective than consumption of three meals per day. Large amounts of food should still be avoided because stretching or swelling of the stomach can result in painful symptoms.
Fruits and Vegetables.
The good news is that a diet rich in fiber may cut the risk of developing ulcers in half and speed healing of existing ones. Fiber found in fruits and vegetables is particularly protective; vitamin A contained in many of these foods may increase the benefit. Some studies on associations between specific food chemicals and ulcers are as follows:
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In one study, apples and yams appeared to be especially helpful.
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Apples, celery, cranberries, onions, red wine, and green and black tea are also high in natural chemicals known as flavonoids that appear to inhibit
H. pylori
growth and have many other health benefits. In fact, cranberry juice specifically may have properties that help prevent
H. pylori
from infecting the intestinal lining.
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Grapefruit has antioxidant properties that may help heal ulcers
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Laboratory experiments suggest that a compound found in broccoli and broccoli sprouts, called sulforaphane, may also be lethal to even drug-resistant strains of
H. pylori.
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Tea has chemicals that may help protect against cancers in the stomach and esophagus.
Milk.
Milk actually encourages the production of acid in the stomach, although moderate amounts (two to three cups a day) can be drunk without harm.
Coffee and Carbonated Beverages.
Coffee (both caffeinated and decaffeinated), soft drinks, and fruit juices with citric acid increase stomach acid production. Although no studies have proven that any of these drinks contribute to ulcers, consuming more than three cups of coffee per day may increase susceptibility to
H. pylori
infection.
Spices and Peppers.
Studies conducted on spices and peppers have yielded conflicting results. The rule of thumb is to use these substances moderately, and to avoid them if they irritate the stomach.
Garlic.
Some studies suggest that high amounts of garlic may have some protective properties against stomach cancer, although a recent study concluded that it offered no benefits against
H. pylori
itself and, in high amounts, causes considerable GI distress.
Vitamins.
Although no vitamins have been shown to protect against ulcers,
H. pylori
appears to impair absorption of vitamin C, which may play a role in the higher risk of stomach cancer.
Exercise
Some evidence exists that exercise may help reduce the risk for ulcers in some people. In one 2000 study, exercise was associated with a lower risk for duodenal (but not gastric) ulcers in men. In this study, exercise appeared to have no effect on ulcer development in women.
Stress Relief
Stress relief programs have not been shown to promote ulcer healing, but they may have other health benefits.
Alternative Treatments
Melatonin is a hormone found in the brain that is normally associated with its role in sleep. Researchers have also observed that the GI tract is rich in melatonin, and that the hormone may have properties that help prevent ulcers, reduce acid secretion, and improve blood flow. It is not known whether this would benefit people with peptic ulcers, but it appears to warrant some research. Melatonin is a powerful hormone that can have major effects on all parts of the body. High doses of melatonin can disrupt the body's natural clock in the brain, and long-term consequences on sleep are unknown. High doses have been associated with the following adverse events:
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Mental impairment.
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Severe headaches.
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Nightmares.
Interactions with other drugs are not completely known. It should be stressed that in the United States, melatonin is currently classified as a dietary supplement and not as a drug, so its quality and effectiveness is uncontrolled. (The U.S. is the only developed nation that does not regulate this agent.) The bottom line is that at this time, people who take melatonin are experimenting on themselves.
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Review Date: 7/14/2006
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Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital
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