What are Stomach Ulcers? 

If a patient has uncontrollable stomach pain, nausea and/or vomiting that won’t go away after a few days, they may be signs of a stomach ulcer, also called a duodenal ulcer. It affects about 4.5 million people a year in the United States. Most patients with stomach ulcers are older because the risk tends to increase with age.

A peptic ulcer is an open sore in the digestive tract lining. A stomach ulcer develops inside the duodenum, in the small intestine just below the stomach. An ulcer may also develop in the esophagus, just above the stomach. These are called gastric ulcers. Both gastric and duodenal ulcers are types of peptic ulcers. In some people, small ulcers heal on their own without treatment, but patients may experience severe and more serious complications.

Symptoms of Stomach Ulcers 

Some people with stomach ulcers do not experience symptoms. If the patient does show symptoms, the signs are not always exactly the same. However, the most common symptom is a burning pain in the stomach. The patient usually feels intense stomach pain that does not subside or a dull, gnawing pain that fluctuates in severity. The pain may be more severe during the night and during or between meals when the stomach is empty. Some patients find relief after they eat or take antacids.

Other symptoms may include chest pain, heartburn, weight loss and belching. The patient may experience nausea, bloating, vomiting, bloody stool, fatigue and they may vomit blood. The stomach muscles feel tight and the patient may have difficulty breathing and drinking liquids.

Complications from Stomach Ulcers

Stomach ulcers can cause other health complications. For example, patients can develop anemia, a blood disorder in which the body cannot produce enough red blood cells to deliver oxygen throughout the body. Without treatment, the sore can cause a hole to develop in the stomach or the intestine, called a perforated ulcer, that can spread infection. Inflammation, scarring or spasms in the intestine can block food from passing through the digestive system, which can cause severe vomiting and weight loss.

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Causes of Stomach Ulcers

Stomach ulcers develop when the mucus coating inside the stomach is damaged and stomach acid attacks the lining. There are several reasons that may cause an ulcer to grow in the stomach. For example, Helicobacter pylori (H. pylori) bacteria naturally lives in the stomach and can damage the stomach lining. This causes inflammation in the stomach, eventually developing into an ulcer. In rare cases, cancerous or noncancerous tumors in the pancreas, stomach or duodenum can cause ulcers. This is a rare condition called Zollinger-Ellison syndrome.

Risk Factors for Stomach Ulcers

There are several risk factors that increase the likelihood of developing a stomach ulcer. Medical conditions as well as lifestyle behaviors may play a role. For example, Crohn’s disease, an inflammatory bowel disorder, can cause ulcers. Patients undergoing chemotherapy or radiation therapy are at a higher risk, as well as those who take nonsteroidal anti-inflammatory drugs (NSAIDs) or SSRI antidepressants. Alcohol and tobacco use damages the body and increases the risk for sores in the stomach. Ongoing anxiety may also cause ulcers.

Myths vs. Facts about Stomach Ulcers

• Stress and spicy foods do not cause stomach ulcers, but they can exacerbate them
• Using acetaminophen (paracetamol) is not a risk factor for stomach ulcers
• Drinking milk does not heal ulcers, but it can neutralize stomach acid
• Food doesn’t cause the pain, but stomach acid or an empty stomach can make it worse
• Stomach ulcers themselves are not contagious, but H. pylori bacteria can spread through vomit and feces
• Research links the risk of developing ulcers to obesity

Treatment for Stomach Ulcers

Medication

Prescription medications such as antibiotics and ranitidine aim to destroy (H. pylori) bacteria and lower stomach acid levels so the ulcers can heal. A physician may recommend esomeprazole or an antacid. However, antibiotic treatment is not always fully effective because (H. pylori) is developing a strong global resistance to standard antibiotics. If an ulcer does not heal, continues to bleed or causes a tear, the patient may need surgery.

Lifestyle Changes 

There are a number of natural remedies that can help to reduce (H. pylori) in the stomach, reduce pain and inflammation and expedite healing if the patient uses them with prescription medications. Certain lifestyle and diet changes will also support these effects.

Try to address and reduce stress or anxiety. Avoid smoking, chewing tobacco and drinking alcohol. Do not use aspirin, ibuprofen or naproxen because they can make the condition worse. Patients should also avoid intense exercise and eat small meals during the day.

Dietary Changes

It is essential for patients with ulcers to change their diets. Avoid late night snacks. Eating more does not help heal an ulcer, so eat small, frequent meals instead of large ones. Several different foods can make an ulcer worse and increase the severity of the symptoms. Research claims that certain foods can even soothe the stomach or help reduce H. pylori.

Foods to Avoid

Avoid acidic, fatty and spicy foods and seasonings. In some patients, certain foods may make their symptoms worse but it may act differently for other patients. According to research, patients with a stomach ulcer should avoid the following foods that can worsen the condition:

• High-fat meats such as bacon and salami
• Black and red pepper seasoning, chili powder
• Full-fat dairy
• Lemons
• Tomatoes and tomato products
• Chocolate
• Coffee, soda, alcohol
• Peppermint, spearmint, green and black tea

Salt Foods to Include

Patients with a stomach ulcer should follow a healthy, variable diet with products from all food groups:

• Lean meats, oily fish or fish oil supplements
• Beans and lentils
• Fruits
• Vegetables
• Healthy oils
• Low-fat dairy products
• Yogurt or probiotics

Supplements for Stomach Ulcers

Several supplements have properties that can promote healing for stomach ulcers and benefit overall digestive health. Supplements aim to promote general well-being, so it is important to note that these remedies are by no means a substitute for legitimate medical advice. It is always best to talk to a doctor if you are experiencing problems with your health before taking any supplements.

Acai Berry

Acai berry, the fruit from a South American palm (Euterpe oleracea), is a traditional remedy from Amazonian tribes. It has potent antioxidant and antimicrobial properties and many other health benefits. In studies, researchers concluded that polysaccharides in acai are powerful immune system boosters resistant to strong acids in the stomach. The berries are also high in anthocyanins, which can fight different types of cancer cells and tumors, including stomach and intestinal cancers. Because of its anti-inflammatory properties, it may also reduce pain.

In addition, research discovered that Vitamin A and polyphenols in berries may boost healing. Acai also provides prebiotic benefits to the digestive system. Prebiotics help improve immune system defense and reduce disease-causing bacteria.

As a dietary supplement, the recommended dosage for acai berry extract is 1,200 mg (¾ tsp) a day. Anyone with an allergy should consult with a physician before taking acai supplements and follow all medical advice.

African Mango

The seeds in African mango (Irvingia gabonensis) have a high fiber content, as well as painkilling, antimicrobial and antioxidant effects and beneficial gastrointestinal activity. Studies have found that fiber can potentially help heal the sore and reduce side effects. Research also notes its ability to reduce pain. In an animal study, African mango extract increased mucus in the stomach, reduced stomach acid and ulcer development as effectively as other medications.

The recommended dosage for African mango seed extract powder is 1,200 mg per day. Possible side effects include headaches and trouble sleeping. Consult with a physician before taking this supplement.

Aloe Vera

As an oral remedy, aloe vera can strengthen the body’s immune system. Several studies show that it has anti-inflammatory and anticancer properties that may support stomach ulcer treatment. Researchers support its ability to control the production of stomach acid, which may significantly reduce stomach ulcers. In another study, aloe vera stopped bacterial growth in half of H. pylori strains that the researchers tested. In an animal study, a combination of aloe vera, garlic and cabbage extracts completely healed ulceration and reduced the amount of stomach acid the animal subjects produced.

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The recommended dosage for aloe vera extract powder as a dietary supplement is 1,000 mg a day with water. Patients may experience possible side effects including bowel irritation and it may also affect blood sugar levels. Pregnant or nursing women should not take aloe vera. Diabetics, patients with Crohn’s disease, ulcerative colitis or kidney problems should consult with a physician. Also, the supplement may not be safe to consume within two weeks of a scheduled surgery.

Schisandra

Schisandra chinensis, or magnolia berry, is an adaptogen that boosts energy and athletic endurance. It has anti-inflammatory, antioxidant and cell-protecting properties with positive effects on the stomach. For example, several studies praise its strong antioxidant and wound-healing properties, as well as beneficial effects on the stomach and intestines. This includes preventing the body from overproducing acid and improving ulcers. A Chinese study found that schisandra was significantly active against H. pylori bacteria. Another study concluded that it reduced stress-related stomach ulcers in animals.

The recommended dosage for schisandra extract powder is 910 mg once or twice a day with meals to avoid heartburn or minor stomach upset.  Pregnant or nursing women should not take it. Servings within the suggested dosage should be safe for other healthy adults, but it is best to consult a doctor to confirm.

Slippery Elm Bark

Native to North America, slippery elm bark (Ulmus rubra) has been a natural remedy for skin inflammation and burns for thousands of years. It also benefits digestive health. It is a possible remedy for heartburn, gastroesophageal disease (GERD) and other gastrointestinal conditions. Studies have shown that slippery elm bark contains an ingredient that turns into a gel when mixed with water to coat and protect the linings of the throat, stomach and intestines. It also boosts mucus production, which may further protect the digestive system against excess acid and ulcers. Research also states that it may be effective to relieve inflammation and lubricate the stomach lining and intestines.

As a dietary supplement, take 700 mg of slippery elm bark extract powder a day. Pregnant and nursing women should consult with a physician before taking slippery elm. However, servings within the suggested dosage should be safe for other healthy adults.

 L-Methionine 

L-methionine is an essential amino acid in various types of food. It has antioxidant properties and may improve digestive health. One study found that L-methionine prevented stomach ulcers from developing in animal subjects.  In another study, L-methionine supplements, paired with an anti-inflammatory steroid, reduced the number of stomach ulcers in animal subjects.

Additionally, L-methionine helped reduce pain and heal stomach ulcers faster than standard treatment. The body makes a chemical called S-adenosylmethionine (SAM-e) from L-methionine and studies have noted that this chemical reduced stomach pain and inflammation in animals with ulcers.

As a dietary supplement, the recommended dosage for L-methionine powder is 500 mg once or twice a day. As always, consult with a physician before taking L-methionine or any other supplement. 

The Bottom Line

An ulcer is an open sore in the lining of the digestive tract. The can form in the esophagus or in the duodenum, in the small intestine. Stomach ulcers can cause a host of distressing symptoms, including extreme pain and excessive bleeding, as well as belching and heartburn. There are several factors that can cause a stomach ulcer. For example, a bacteria called Helicobacter pylori (H. pylori) live naturally in the stomach and can cause damage to the stomach lining. Smoking, tobacco and stress may also increase the risk. Doctors usually prescribe antacids or antibiotics that target H. pylori. There are also other natural remedies that destroy the bacteria, reduce their numbers, soothe stomach pain and accelerate the healing process.