AUSTRALIAN NATUROPATHIC NETWORK
 Serving the community since 1998

The following case studies do not represent implemented treatment programs. They are protocols developed by students in the course of their studies, and should be taken as examples only.

Note - Anyone suffering from the conditions described below should seek advice from a primary health care practitioner. No responsibility is taken for any individual attempting to use the treatments described in these studies.

Describe your management of peptic ulcer in 44 year old female.

Condition Description

Slow-healing erosion in the wall of the stomach or duodenum – ‘gastric’ or ‘duodenal’ respectively¹.

Signs and Symptoms

Upper abdominal pain 45 – 60 minutes after meals or during night. Pain is relieved by food, antacids or vomiting².

Diagnosis confirmed by X-ray or fibre optic examination².

It is important to eliminate the likelihood of a more serious pathology.

Possible Causes

• An imbalance in the intrinsic protective factors of the mucosa and the aggressive forces of gastric acid and pepsin³.

• Weakening of the protective factors can be caused by drugs (aspirin) or bacteria³.

• Helicobacter pylori as the cause of ulceration is the subject of intense debate. Generally Helicobacter is very common in older people regardless of whether they have an ulcer³.

Mitigating Factors

• Food allergies.
• Lowered fibre intake.
• Aspirin – an irritant that damages the lining of the GIT.
• Antacids – many popular antacids should not be taken in the case of ulcer. Overuse can cause other problems such as kidney stones and heart conditions.
• Smoking – strong links have been shown between ulcers and smoking.
• Stress and emotional factors – typically characterised by people trying to surpress emotions⁴. It is the way people handle stress not the stress itself that is a factor in the development of ulcers.
• Miscellaneous factors – Vitamin A & E inhibit Zinc which is needed for the production of mucin⁴.

Approach to healing

It is necessary to attempt to eliminate all mitigating factors that are implicated in the development of the ulcer: food allergy, cigarette smoke, stress and drugs (especially aspirin, and other NSAIDs). Once this is controlled focus can be placed on healing and promoting tissue resistance and repair. Finally the diet and lifestyle must be attended to prevent recurrence.

Non-pharmacological measures

Avoid: Coffee, tea, alcohol, sugars, citrus, nuts, seeds, beef, pork, and raw fibrous foods¹.

Take: Steamed vegetables, grains and fruits, yogurt, fish, tofu, eggs, soft cheeses¹.

If stress is a mitigating factor attempt to find better ways to manage stress.

Follow these Golden Rules for Good Digestion. (With thanks to RK)

1. Chew food properly
2. Eat only when relaxed
3. Eat in a comfortable environment
4. Don’t over eat
5. Combine foods sensibly
6. Not too much fluid with meal
7. Avoid excesses of irritating foods
8. Identify allergens and avoid them
9. Try and eat amin meal several hours prior to bed
10. Allow time to digest food before eating next meal

Prostaglandins are cytoprotective agents and preserve cells that will repair the damaged mucosa³, thus an increase intake of essential fatty acids may be beneficial.

Herbal Therapeutics

The following classes of herbs are required:

Specifics – herbs specific to the treatment of ulcers

Demulcents – sooth and protect damaged lining to provide barrier whilst healing takes place

Vulneraries – repair tissue damage

Acid normalisation – reduce acidity to enable healing

Antibacterial/Antimicrobial – to eliminate Helicobacter pylori if possible

Astringent – to aid in the repair of the lining of the damaged tissue

Nervines – if stress is indicated

Antiinflamatories – to ease inflammation

Carminitives – to reduce bloating and flatulence

Hepatics – to stimulate liver function and aid digestion (avoid bitters in acute stages)

The following formula is recommended:

Dosage 5mls three times a day.

Ulmus fulva is also recommended. Take 1 tablespoon in glass of water 30 minutes before meals.

References

1. Mills, S., The Complete Guide to Modern Herbalism, Thorsons, London, 1989.
2. Murray, M., Pizzorno, J.,Encyclopaedia of Natural Medicine, Little, Brown and Company, UK, 1995.
3. Willis Hurst, J., (Ed.), Medicine for the Practicing Physician – 3^rd Edition, Butterworth-Heinemann, USA, 1992.
4. Pizorno, J., Murray, M., Textbook of Natural Medicine, Bastyr College, Seattle, 1989.