Peptic Ulcer

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Latest Edit: Hector 2014-05-06 (EDT)

A peptic ulcer is a breach in the lining of the stomach or the initial portion of the small intestine (referred to as the duodenum due to damage of the mucosa. More specifically, a peptic ulcer is called a gastric ulcer if it occurs in the stomach and a duodenal ulcer if it is found in the duodenum. Approximately 75% of cases are duodenal with a peak age of 40s compared to 25% gastric with a peak age of 50s.[1]

Peptic Ulcer
Causes Infections, Smoking, Stress, Alcohol, Prescription Medications
See Also Digestive Conditions, Gastritis, Gastroesophageal reflux disease
Books Books on Digestive and Liver Conditions
Articles Articles on Digestive Conditions

Naturopathic Assessment

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With Peptic Ulcer, the causes are variable and include lifestyle and environmental factors. A detailed assessment is required to determine which factors are contributing to a peptic ulcer.

Social

  • Both acute and chronic stress is associated with the onset of ulcers.
  • Stressful situations such as multiple organ failure, trauma, surgery, illness etc. can cause a peptic ulcer.[2]

Environmental

  • Helicobacter pylori (H.pylori) infection of the GI tract is the most common cause of peptic ulcers.[2]

Lifestyle

  • Excessive alcohol drinking increases the risk of ulcers.[3]

External

  • Cigarette smoking appears to be a risk factor for the development, maintenance, and recurrence of peptic ulcer disease.[4]

Medical Interventions

  • Prescription Medications
  • Use of non-steroidal anti-inflammatory drugs (Aspirin, Ibuprofen, Naproxen, etc.) is the second most common cause of peptic ulcers.[2]
  • Other medications which can cause peptic ulcers include: steroids, bisphosphonates, potassium chloride, chemotherapeutic agents.[2]
  • Medical Treatment
  • Radiation treatments can cause a peptic ulcer.

Genetics

  • Sex
  • Peptic ulcers are more common in women.

Common Questions

  • Where? When did it start? Was the onset sudden or gradual? Has it changed since the onset? Does it wake you from sleep? How severe is the pain? What does the pain feel like?
  • Does food relieve the pain? Do antacids relieve the pain?
  • Have you ever been diagnosed with Helicobacter pylori infection?
  • What medications are you taking?
  • How often do you take nonsteroidal anti-inflammatory drugs?
  • Do you have any GI symptoms (gas, bloating, diarrhea, constipation, nausea, vomiting, heartburn)?
  • Have you had any changes to bowel habits?
  • Is there a history of prior surgery?
  • Any involuntary weight loss?

Diagnostic Testing

Ulcer.jpg

The following tests are often indicated in the diagnosis of peptic ulcers.

  • Imaging Studies including esophagogastroduodenoscopy or upper endoscopy, upper GI barium study.
  • Lab Tests may include CBC, stool occult blood test and testing for H. pylori.

Related Symptoms and Conditions

Due to the interrelatedness of the body it is common for the disharmony to be expressed in other ways such as:

Characteristics

Normally, the lining of the stomach and small intestines is protected against the irritating acids produced in your stomach. If this protective lining stops working correctly and the lining breaks down, it results in inflammation also known as gastritis or an ulcer.

Most ulcers occur in the first layer of the inner lining. A hole that goes all the way through the stomach or duodenum is called a perforation. A perforation is a medical emergency.

Common Symptoms

Small ulcers may not cause any symptoms, large ulcers can cause serious bleeding and may present with the following symptoms:

  • Abdominal pain that wakes you during the night
  • Loss of appetite
  • Feeling of fullness and at times unable to drink even water
  • Hunger and an empty feeling in the stomach, often 1 to 3 hours after eating
  • Mild nausea
  • Vomiting which is sometimes bloody
  • Weight loss
  • Stools that may be bloody or dark and tarry
  • Chest pain
  • Fatigue

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. Peptic Ulcer is typically a chronic disease which can be treated successfully with naturopathic medicine, antibiotics, or surgery.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

  • Ensure that you chew your food thoroughly because this increases secretion of saliva which contains agents that buffer against the development of peptic ulcers.[5]
  • Eliminate any prescription medications that may be contributing.[1]

Lifestyle

Lifestyle recommendations include:

  • Avoid food allergies and food sensitivities. Increased numbers of IgE containing cells were found in patients with gastric and duodenal ulcers upon biopsy of the tissue surrounding the ulceration.[5]
  • Eat small frequent meals.
  • Eliminate coffee, alcohol, spicy foods, fatty foods, and chocolate.
  • Eliminate salt as it can irritate mucous membranes.
  • Increase intake intake of dietary fiber.[5]
  • Ensure you drink adequate water.
  • Drinking raw cabbage juice may be helpful.
  • Stress reduction exercises are beneficial in preventing and treating peptic ulcer disease.

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies. Since the majority of eptic ulcer cases are caused by H. pylori infection, eradication of this infection is critical to successful treatment.

Naturopathic Therapies for Peptic Ulcer include:[6], [5], [6], [1]

  • Peptic ulcers are often associated with a Stomach Fire pattern.

References

Reviewed by Iva Lloyd, BScH, RPE, ND [1]

  1. 1.0 1.1 1.2 1.3 1.4 El-Hashemy Shehab, Skowron Jared, Sorenson Linda (2011) Textbook of Naturopathic Family Medicine & Integrative Primary Care: Standards & Guidelines CCNM Press.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 Ramakrishnan K, Salinas RC (2007 Oct) Peptic ulcer disease Am Fam Physician; Vol76(7):1005-12 PMID: 17956071.
  3. Dains JE, Baumann LC, Sceibel P (2007) Advanced Health Assessment and Clinical Diagnosis in Primary Care 3rd ed Mosby.
  4. Eastwood GL (1988) The role of smoking in peptic ulcer disease. J Clin Gastroenterol;10 Suppl 1:S19-23. PMID: 3053883.
  5. 5.0 5.1 5.2 5.3 5.4 Gaby AR (2011) Nutritional Medicine. Fritz Perlberg Publishing.
  6. 6.0 6.1 Prousky J (2008) Principles and Practices of Naturopathic Clinical Nutrition CCNM Press Inc.
  7. Bone Kerry 2007 The Ultimate Herbal Compendium, A Desktop Guide For Herbal Prescribers Phytotherapy Press, Australia