> Health and Disease > Gastrointestinal > ulcers

Looking at the literature on the cause of ulcers is like watching a shell game. Which shell is the pea under now? Which explanation for ulcers is being touted today? There have been several theories that move in and out of favour, but all generally tend to be the current medical trend, not a sound explanation of the real cause. Some of the old tried-and-true methods for dealing with ulcers work just as well, if not better than antibiotics, but without the obvious side-effects.

Ulcers are more common than most people think. About 10 percent of our population will show clinical evidence of ulcers sometime during life. Many people don’t even know they have ulcers. Since this condition can be life threatening, if you even suspect you have this problem, you should consult a health-care provider to find out.

Ulcers are either of the peptic or gastric (stomach), or duodenal (upper intestine) varieties, and are four times more common in men than in women. Duodenal ulcers are four to five times more common than peptic ulcers. Even though duodenal and gastric ulcers occur in different parts of the body, the underlying mechanism appears to be the same. In both cases some factor damages the protective lining of the stomach or duodenum. A crater-like lesion is left on the surface of the mucous membrane when dead tissue sloughs off as a result of localized necrosis (tissue death). Gastric juices eat away the lining of the stomach or duodenum, causing bleeding in severe situations. This can result in shock, anemia and other complications. A perforated ulcer occurs when the juices eat right through the mucous membrane. Severe inflammation of the peritoneal membrane lining of the abdominal cavity may result, accompanied by a substantial amount of persistent pain and often nausea and vomiting.

What Causes Ulcers?

Most of the research in the past has focused on acidic secretions and stress. Even though gastric acids are very corrosive, with a pH of 1 to 3, usually peptic ulcer patients have reduced or normal acid output. In contrast, half of the patients with duodenal ulcers show increased acid levels. Even this excess has been shown not to cause the ulcers on its own. The medical literature is quite controversial on the cofactor of stress and ulcers. Large studies have not shown evidence of any particular type of stress being directly related to the ulcer. It most likely has less to do with the type of stress itself and more to do with how an individual copes with the stressors in his life. The presence of stress and a person’s coping style certainly contribute to a predisposition to develop ulcers.

The combination of stress and high levels of gastric secretions appear to be relevant factors for explaining a large percentage of duodenal ulcers, but not all. Present research focuses mostly on Helicobacter pylori (H. pylori) and non-steroidal anti-inflammatory drugs (NSAIDs). There is a strong correlation between H. pylori and ulcers, as more than 90 percent of patients with duodenal ulcers, and 70 percent of those with gastric ulcers, test positive for it. However, it is important to note that 50 percent of the population over the age of 50 also test positive for H. pylori, but have no symptoms of ulcers. So, yes, H. pylori can reduce the integrity of the stomach and duodenum, but is it the sole cause? The presence of the bacteria does not mean they caused the ulcer. On the other hand, it doesn’t mean they are not a contributing factor.

Aspirin and other NSAIDs have been shown to increase the incidence of peptic ulcers. Doses as low as 75 mg per day can cause problems in some sensitive people. Smoking has been shown to decrease a person’s response to ulcer medication, while increasing complications including mortality. Smoking has been shown to decrease pancreatic bicarbonate (an important neutralizer of gastric juices); increase reflux of bile salts into the stomach; and accelerate gastric emptying into the duodenum. All of these consequences can contribute to ulcers.

The Nutrition Connection

Terry Willard is a writer, practitioner, teacher and director of the Wild Rose College of Natural Healing in Calgary, AB.

Source: alive #228, October 2001