Gastric Ulcer

Gastric ulcer is one of the three subcategories of peptic ulcer. Peptic ulcer is the condition in which patients experience abdominal pain as open sores develop in the lining of the esophagus (esophageal ulcer), upper part of the small intestine (duodenal ulcer), or stomach (gastric ulcer). Symptoms include a burning sensation from the breastbone down to the navel area of the body that can be worse when hungry. The pain can sometimes be temporarily relieved by eating certain foods or taking medication. Symptoms of severe gastric ulceration may include vomiting of blood, excessive weight loss, nausea, and black blood in stool.

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Turmeric [1, 24, 25, 26, 27, 28, 29]:

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: Weakly in favor (Early laboratory studies show that turmeric may be of benefit in the treatment of ulcers. However, further studies are needed)

Grade of Evidence: Low quality of evidence

Pokeweed Antiviral Protein (PAP) [1, 19, 20, 21, 22, 23,]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. Warning! All parts of the plant, Pokeweed (Phytolacca Americana), is poisonous and should not be ingested. Thoroughly cooking the plant reduces that toxicity. The effects of the improperly prepared plant include vomiting, diarrhoea, cramps, headache, confusion, convulstions, low blood pressure, heart block and death. Only plant extracts (PAP) or thoroughly prepared plants should be ingested, and even then, under professional medical guidance.

Recommendation: No recommendation (There is insufficient evidence to support claims that PAP helps to treat ulcers)

Grade of Evidence: Very low quality of evidence

Licorice (Glcyrhiz Gaba) [1, 15, 16, 17, 18]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. Licorice has been shown to have potentially harmful side effects in people with high blood pressure, liver or kidney diseases)

Recommendation: Weakly in favor (Small studies and laboratory tests show that Licorice may help in the treatment of peptic ulcers,but more research is needed)

Grade of Evidence: Low quality of evidence

Goldenseal (Hydrastis Canadensis) [1, 8, 9, 10, 11, 12, 13, 14]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly against (There is insufficient evidence to support claims that Goldenseal helps to treat ulcers. More studies are needed. Goldenseal may produce toxic effects, including depression, constipation, rapid heartbeat, stomach pain, mouth ulcers and vomiting.)

Grade of Evidence: Low quality of evidence

Comfrey (Blackwort, Symphytum Officinale)  [1, 5, 6, 7]:

Please note, this herb is TOXIC IF TAKEN ORALLY, OR IF APPLIED TO AN OPEN WOUND. Can cause severe liver or kidney damage and lead to death. May ONLY be used as a cream over intact skin, and does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Strongly Against  (ONLY TO BE USED AS A CREAM OVER HEALTHY SKIN. If taken orally to treat the gastric ulcer, Comfrey can lead to severe liver and kidney damage, and can even lead to death.)

Grade of Evidence: Low quality of evidence

Chlorella (Green Algae, Chlorella Pyrenoidosa) [1, 2, 3, 4]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation  (There is insufficient evidence to support claims that Chlorella helps to treat gastric ulcers in any way)

Grade of Evidence: Very low quality of evidence

Red Pepper (Capsaicin):

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (There is insufficient evidence to support claims that red peppers help to treat or prevent gastric ulcers)

Grade of Evidence: Very low quality of evidence

Moxibustion:

Recommendation: No recommendation (there is insufficient evidence to show that Moxibustion helps in the treatment of gastric ulcers)

Grade of Evidence: Very low quality of evidence

Hyperbaric Oxygen Therapy (HBOT):

NOT RECOMENDED

Recommendation: Strongly against (available evidence shows that HBOT is in no way useful in treating cirrhosis, and can have harmful effects. NOT RECOMENDED)

Grade of Evidence: Moderate quality of evidence

Pau Darco (Lapachol, Tabebuia Impetiginosa, Tebebuia Heptaphylla) [41]:

Please note, this treatment has potentially serious side effects. Some of the chemicals in the plant are known to be toxic. High doses are known to cause liver and kidney. Even at low doses, chemicals in the plant may interfere with blood clotting, causing excess bleeding and anaemia. Pau D'Arco should be avoided, especially by pregnant or breastfeeding women.

Recommendation: Strongly against (There is insufficient evidence to support claims that Pau D'arco helps to treat gastric ulcer. This, combined with its potentially harmful side effects if taken without supervision from a doctor or pharmacist gives enough reason to avoid this treatment.)

Grade of Evidence: Very low quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. Nakano, S et al. “Maternal-fetal distribution and transfer of dioxins in pregnant women in Japan, and attempts to reduce maternal transfer with Chlorella (Chlorella pyrenoidosa) supplements...” Chemosphere 2005 Dec; 61(9): 1244–55.

3. http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=11347287&dopt=Abstract

4. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/chlorella

5. http://www.ncbi.nlm.nih.gov/pubmed/19460762

6. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/comfrey

7. http://www.ncbi.nlm.nih.gov/pubmed/2103401

8. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/goldenseal

9. http://nccam.nih.gov/health/goldenseal/

10. Tierra Michael (1998): The Way of Herbs. New York, Pocket Books

12. Grieve M. (1971): A Modern Herbal. New York, Dover Publications, Inc

13. Mills S. and Bone K. (2000): Principles and Practice of Phytotherapy. Philadelphia, Churchill Livingstone

14. Tice Raymond (1997): Goldenseal and Two of its constituent alkaloids: berberine and hydrastine Research Triangle Park, National Institute of Environmental Health Sciences, in Seiger E: Review of Toxilogical Literature

15. http://www.henriettesherbal.com/eclectic/ellingwood/hydrastis.html

16. Winston, David; Steven Maimes (2007). Adaptogens: Herbs for Strength, Stamina, and Stress Relief. Healing Arts Press.

17. http://www.ncbi.nlm.nih.gov/pubmed/15190039

18. http://nccam.nih.gov/health/licoriceroot/

19. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-licorice.html

20. http://www.cbif.gc.ca/pls/pp/ppack.info?p_psn=12&p_type=all&p_sci=sci&p_x=px

21. http://www.pfaf.org/user/Plant.aspx?LatinName=Phytolacca+americana

22. http://www.ncbi.nlm.nih.gov/pubmed/315368

23. http://www.nlm.nih.gov/medlineplus/ency/article/002874.htm

24. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/pokeweed

25. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/turmeric

26. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-turmeric.html

27. http://nccam.nih.gov/health/turmeric/index.htm

28. http://news.bbc.co.uk/2/hi/health/1668932.stm

29. http://www.mirror.co.uk/news/top-stories/2009/10/28/curry-kills-cancer-cells-and-other-health-benefits-of-the-nations-favourite-dish-115875-21779950/

30. http://clinicaltrials.gov/ct2/results?term=turmeric

31. http://www.nlm.nih.gov/medlineplus/ency/article/000206.htm

32. http://www.hmc.psu.edu/healthinfo/g/gastriculcer.htm

33. http://www.wrongdiagnosis.com/g/gastric_ulcer/intro.htm

34. http://www.patient.co.uk/health/Stomach-(Gastric)-Ulcer.htm

35. http://www.medicinenet.com/peptic_ulcer/article.htm

36. http://familydoctor.org/online/famdocen/home/common/digestive/disorders/186.html

37.  http://hcd2.bupa.co.uk/fact_sheets/html/peptic_ulcer.html

38. http://emedicine.medscape.com/article/175765-overview

39. http://www.ecureme.com/emyhealth/data/Gastric_Ulcer.asp

40. http://www.medterms.com/script/main/art.asp?articlekey=3550

41. http://www.webmd.com/vitamins-supplements/ingredientmono-647-pau%20d'arco.aspx?activeingredientid=647&activeingredientname=pau%20d%27arco