Peptic Ulcer Disease
What is the conventional treatment of peptice ulcer disease?
Ulcers can sometimes be identified with an upper GI X-ray, but are most often visualized directly with the use of an endoscope, a long narrow tube that is threaded down the esophagus of an anesthetized patient and into the stomach and upper small intestine. If necessary, a biopsy of tissue can be taken close to the ulcer to check for the presence of H. pylori and to rule out cancer. Blood, breath and stool tests can also detect the presence of H. pylori and are a good way to monitor treatment progress.
The conventional treatment of peptic ulcer disease focuses on killing the bacteria and reducing the level of acid in the stomach to relieve pain and encourage healing. This is done with a combination of two antibiotics ( most commonly amoxacillin or metronidazole together with clarithromycin ) plus a drug to reduce or neutralize stomach acid (such as omeprazole ), so-called “triple therapy.” The duration of treatment is typically only two weeks, yet the approach is often very effective.
Ulcers that do not heal with treatment may indicate a resistant form of H. pylori or the presence of other factors interfering with the healing process like smoking, alcohol or NSAID use. Rare causes of ulcers include extreme overproduction of stomach acid (Zollinger-Ellison syndrome), stomach cancer, or Crohn’s disease.
What therapies does Dr. Weil recommend for peptic ulcer disease?
- Dietary changes: As a general guideline, follow the anti-inflammatory diet for peptic ulcer disease. Specifically:
- Avoid all coffee and other sources of caffeine, including decaffeinated coffee, as well as alcohol and tobacco.
- Avoid milk and milk products as well, they increase acid secretion. Eat smaller amounts of foods more frequently.
- Don’t let your stomach go empty for long periods of time.
- Drink peppermint tea and chamomile teas frequently. Both soothe the lining of the digestive tract; however, if you have been diagnosed with GERD it is best to avoid peppermint, which may worsen symptoms of GERD.
- Try taking one teaspoon of aloe vera juice after meals.
- Sip red pepper tea (one quarter teaspoon of cayenne pepper steeped in a cup of hot water) or a small capsule of the powder. Cayenne pepper has a good local anesthetic effect.
- For prevention, be sure to eat foods high in vitamin C. If acidic sources like citrus fruits and tomatoes are bothersome, try apples, asparagus, berries, broccoli, cabbage, melon (cantaloupe, honeydew, watermelon), cauliflower, kiwi, fortified foods (breads, grains, cereal), dark leafy greens (kale, spinach), peppers (especially red bell peppers), and potatoes.
- Supplements: Avoid frequent use of aspirin and other salicylates, and nonsteroidal anti-inflammatory drugs (NSAIDs). Use acetaminophen (Tylenol) or an herbal anti-inflammatory for the treatment of mild pain instead, but even acetaminophen may not be safe for long-term use. Don’t take steroids unless your doctor insists.To protect the lining of your stomach and duodenum take deglycyrrhizinated licorice (DGL), which has excellent soothing and healing properties. The dose is one half teaspoon of DGL powder or two tablets of DGL extract (chew these slowly) before or between meals. You can continue taking DGL as long as you have symptoms.
- Mind/Body Medicine: Make serious efforts to neutralize stress in your life by practicing healthy stress management techniques such as breathing exercises and meditation, learning visualization or hypnotherapy (or both) to heal your ulcer, or by taking a course of biofeedback training. As necessary, create positive changes in whatever in your life causes you the most stress – your job, living situation, or relationships.