How many people do you know who are constantly popping antacid pills and complaining of indigestion? A good many, I’d guess, and perhaps even you are one of them.

Chances are very good that most of those people, especially if they are middle-aged or older, are infected with a bacterium called H. pylori that is strongly associated with stomach pain and the development of peptic ulcers.

There are two types of peptic ulcers: gastric, which occur in the stomach, and duodenal, affecting the upper part of the small intestine. H. pylori is implicated because it thrives in the acidic environment of the digestive tract, causing chronic inflammation of the mucosa, the lining that protects the stomach and duodenum walls from gastric acid. An ulcer occurs when the irritation breaks through the mucosa, exposing the tissues within to painful acid burning.

But chronic stomach pain, especially 45-60 minutes after eating, doesn’t necessarily mean you have an ulcer. It could be merely inflammation – more than 80% of H. pylori-infected people never develop ulcers. There are, however, many other contributing factors, likely working in combination with the bacterium.

Stress is probably the most significant of these. The correlation between stress and hyperacidity is well documented, and any increase in acid secreted into the digestive tract can only further the production of H. pylori.

Alcohol is irritating to the stomach, and can also be a factor. As can smoking, which constricts the vascular system and reduces blood supply to the mucosa. Irregular meals, nutritional deficiencies and food allergies are also possible contributors to the formation of ulcers.

While the role of H. pylori may have diminished somewhat due to antibiotics, NSAIDS (non-steroidal, anti-inflammatory drugs) such as Ibuprofen and Aspirin have emerged as potent causes of peptic ulcers, particularly in combination with smoking.

If some of those pill poppers we mentioned do in fact have ulcers (four times as many men than women are affected), they may never know it, as only about 20% of people with the condition ever seek medical attention. It’s possible to live with an ulcer for years – provided it doesn’t perforate or bleed severely.

A perforated ulcer breaks through the wall of the stomach or duodenum, releasing the contents of the digestive tract into the abdominal cavity. This is a serious medical condition that requires immediate surgery. Bleeding from an ulcer is not unusual, but serious blood loss can occur if the infection breaches a large vein or artery. Black or red blood will show in the stool.

There are many effective preventatives and curatives for ulcers. A daily litre of raw cabbage juice for 10 days has resulted in total healing of an ulcer in some patients. Bismuth subcitrate – a compounding pharmacy can formulate it for you – is a good antacid. Licorice, either as a tincture or extract, acts as a demulcent, coating and helping to heal ulcers. (Do not use licorice candy – the essential ingredient has been removed.) And maintaining a high fibre diet (fruits, vegetables, grains) with a minimum of refined sugar has been shown to counteract the disease.

Finally, do not drink milk to “soothe” the stomach, as many people with indigestion do. It is highly allergenic for people with food sensitivities, and milk tends to increase acid production, contributing to inflammation of the mucosa.

©Dr. Ashely Gordon, 2008.