500,000 Americans are diagnosed with peptic ulcer disease every year. Helicobacter pylori infection accounts for approximately half of these cases; use of nonsteroidal anti-inflammatory drugs (NSAIDs) is responsible for another 25%. The remaining cases are secondary to the use of other medications (corticosteroids, for example), hypersecretion syndromes (e.g., Zollinger-Ellison), and illness-related stress ulcers. (Am Fam Physician 2007;76:1005-12, 1013)
Current recommendations for treating ulcers include eradication of H. pylori (if present) with antibiotics, proton pump inhibitors to suppress acid secretion, various other drugs to protect the stomach lining and decrease acid secretion, and, occasionally, surgery. Even though prescription drugs are the mainstays of today’s therapeutic approach, herbs can still be useful.
Herbs that Help Ulcers Heal
- Astragalus (Astragalus membranaceus): Used traditionally to treat ulcers
- Aloe vera: Soothing, astringent, and anti-inflammatory
- Oregon grape (Mahonia aquifolium) and barberry (Berberis vulgaris): Contain berberines, which have been shown to inhibit bacterial growth.
- Cranberry (Vaccinium species): May prevent colonization and infection by H. pylori
- Licorice root (Glycyrrhiza glabra): Acts as a demulcent (soothes and coats the stomach lining); also increases gastric circulation and mucus production. Deglycyrrhizinated licorice (DGL) is recommended, as the native root causes fluid retention and hypertension
- Slippery elm (Ulmus fulva): High in mucilage content; thought to coat the stomach lining
- Turmeric (Curcuma longa): Used by Chinese and Ayurvedic physicians to treat gastrointestinal disorders; may decrease acid production in the stomach. However, high doses can actually damage the stomach lining
- Marshmallow (Althea officinalis): Another demulcent
- Cabbage juice: High in glutamine, which has been shown to help heal ulcers; juicing cabbage is inconvenient, so glutamine capsules or tablets can be substituted
- Rhubarb (Rheum species): Rich in flavonoids, which may inhibit the growth of H. pylori
- Cat’s claw (Uncaria tomentosa): Decreases inflammation at ulcer sites
- Dong quai (Angelica sinensis): Animal studies have shown a potential for ulcer healing, but human studies are lacking
- Chamomile, calendula, cinnamon, agrimony, Indian basil, ginger, and capsaicin (found in hot peppers) have all been used in various ulcer formulations
Lifestyle Changes that Help Heal Ulcers
As always, for those individuals suffering from illness, it pays to examine habits and behaviors that affect the disease condition. In the case of peptic ulcer disease, the following lifestyle changes have proven beneficial:
- Consume a diet rich in fiber, paying particular attention to fruits and vegetables that are high in flavonoids
- Add 500 to 1000 mg of vitamin C to your daily routine. Vitamin C appears to inhibit H. pylori’s growth in some people
- Add probiotics (e.g., Lactobacillus, Bifidobacterium) to your diet. These live organisms, commonly found in yogurt and readily available in capsule form, appear to compete with H. pylori
- Eliminate alcohol, which inflames the stomach lining
- Eliminate or limit coffee and carbonated drinks. Even when decaffeinated, these beverages can increase stomach acid production
- If you regularly take NSAIDs (aspirin, ibuprofen, naproxen, etc.) discuss options with your physician
- Stop smoking. Nicotine is extremely irritating to the stomach lining, and its use increases ulcer risk, slows ulcer healing, and increases recurrence rates
Peptic ulcer disease is a relatively common condition. Aside from the discomfort and inconvenience it causes, its complications can seriously impair one’s quality of life. Herbs can add an extra dimension to standard treatment regimens; individuals wishing to add herbal supplements to their medical program should first consult with their health care practitioners.
