Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

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Peptic ulcers are interesting disorders to the physician, but very distressing to the patient. As yet, there is no clear harmony of opinion as to the exact cause of peptic ulcers. We know certain things enhance the likelihood of getting a peptic ulcer. We know that certain classes of thoughts cause the equivalent of paling of the skin, but in this instance, it occurs in the stomach. Anxiety, fear, discontent, remorse, grief, etc. can cause a patch of the lining of the stomach to fail to receive sufficient blood supply. The reduction in blood supply weakens the resistance of the lining of the stomach, and auto-digestion by acid and pepsin can result in gastritis or peptic ulcer.

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CAUSES

Spices, Irregular Mealtimes, Improper Chewing

The use of spices, alcohol, aspirin, vinegar and other stomach irritants are notoriously prone to promote peptic ulcers. In the person whose emotional status is likely to induce an ulcer, who also uses these food items, there is a greater likelihood of developing ulcer. Failure to chew food properly, eating too frequently, eating meals late at night, and eating under stressful conditions all take their toll in causing peptic ulcers.

In the treatment of peptic ulcers, the first item should be that of avoiding all known causes. The stomach irritants should be avoided. These include spices, caffeine, alcohol, aspirin, vinegar and vinegar dressings, baking soda and baking powder products, black pepper, and in some individuals certain types of foods.

The individual who is ulcer prone should eat at the same time each day, should chew his food well, take small bites and eat slowly, and avoid all between-meal feedings. There should be at least five hours between the end of one meal and the beginning of the next. There should be no food taken within several hours of going to bed.

Protein: A Factor

A low protein diet should be taken, which actually means that an emphasis should be placed on fruits, vegetables, and whole grains. All other classes of foods should be taken in vanishingly spare quantities. Meat, milk, eggs, cheese, nuts, and protein supplements should all be eaten in very small quantities, if at all. The presence of protein in the stomach is a potent cause of excessive acid production. The use of milk in ulcer treatment is a time-honored practice that many patients are reluctant to abandon, because they feel better after drinking milk. While it is true that milk has a moderate buffering action on stomach acid, the effect is short lived. The net result, because of the excessive protein in milk, is an increase in acid production and pain. Most modern gastroenterology textbooks now state that milk is contraindicated in peptic ulcer. Thus, it has taken us over half a century to learn enough physiology to undo some of the mischief caused by the Sippy regimen of frequent feedings of milk and alkalies.

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TREATMENT

Liquids Between Mealtimes Only

Since all liquids tend to dilute the digestive juices and delay digestion, no liquid food should be taken with meals. That includes soups, juices, milk and beverages. The food should be taken as dry as possible and should be chewed well to mix saliva thoroughly. If one finds one does not have sufficient saliva, this usually means that he does not drink sufficient water between meals. Generally speaking one should drink only water between meals and take no beverages with meals. Nothing nourishing should be taken between meals. Water should be taken at tap temperature, since food and drink that is too hot or too cold tends to irritate the stomach.

Fasting

For the person who tends to have stomach trouble, a set meal mealtime should be maintained, not being varied by so much as five minutes during the most active treatment period. We recommend that the person who begins a treatment program should start with a 24-hour fast. Most ulcer patients think this is the very wrong thing to do, but almost invariably find that their pain and discomfort goes away when they fast for several hours. If the person has pain, this should be controlled by drinking cool water and applying hot wet compresses over the midsection, centering on the painful area.

One should not take antacids, as these cause "rebound" acid formation. What happens is that the antacid makes the pH of the stomach quite alkaline. Since the stomach recognizes that this is an abnormal condition for it, it simply pours from its pumps large quantities of acid and the end result is a more acid condition than would have been present, if antacids had not been taken.

Charcoal

Most individuals who have peptic ulcers or gastritis can tolerate charcoal tablets. We recommend that 2 or 3 charcoal tablets be taken as a test to see if the charcoal will irritate that particular person. Usually charcoal is well tolerated, but an occasional person will get a bit of irritation, because the charcoal is grainy. Charcoal tends to take up excessive acid and to bind any toxic materials that may be aggravating the ulcer. Eight to ten charcoal tablets or four or five charcoal capsules may be taken two or three times daily for one week. Since charcoal for an occasional person may cause a bit of constipation, an enema may be necessary at some time during the taking of charcoal. Certainly, the person should drink lots of water to try to prevent constipation from charcoal.

The Anti-Gizzard Erosion Factor

Certain substances have the "anti-gizzard erosion factor," which was discovered in work with chickens, hence its name. This factor is soothing and healing to the stomach. Fresh cabbage juice, no more than five minutes from the juicer, may be taken, being sipped slowly at the beginning of breakfast or dinner. It may be taken as a small supper meal, all solid food being omitted. The best meal pattern is the principle meal at breakfast time, a moderately large meal at the middle of the day or early in the afternoon, and a small supper being taken in the early evening. Ripe olives also contain the anti-gizzard erosion factor and may be taken in the quantity of 4-6 olives at the beginning of breakfast or dinner. Use only black or green ripe olives, never those that are canned with vinegar.

The Ideal Meal Plan

The most ideal meal plan contains only two meals: breakfast and dinner in the early or mid-afternoon and no supper. The ulcer patient usually thrives on this meal plan. With such treatment, the stomach has plenty of time to rest, recuperate, and recover from its illness in the fasting period.

Soothing Grains

Some individuals can use to good advantage millet or oatmeal with unsweetened applesauce as a topping instead of milk. Millet is soothing to the gastrointestinal tract and can usually be tolerated well by ulcer patients. If apples are known to cause sensitivity some other fruit should be used to make a sauce. Use unsweetened canned fruit, pour it into a blender, and blend for a few seconds to get a fruit sauce.

Proper Clothing

Proper clothing is important to the person who has peptic ulcer disease. The extremities should always be well clothed to make certain that the circulation is properly distributed, and that there is no congestion around the stomach.

Outdoor Exercise

One should set up a program of vigorous outdoor exercise. At no time should the exercise of one who has peptic ulcer disease be described as violent. The exercise may be vigorous, but violent exercise often tends to aggravate an ulcer.

Soothing Substances

Helicobacter pylori (H. pylori) germ has been identified in the stomach content of around 85% of persons with peptic ulcer disease. It can be treated using Aloe vera (one ounce of the fresh liquid, or a commercial product effectively used daily, and continued daily one Tbsp at night for several weeks, after symptoms have subsided). Ripe olives have a soothing effect on the stomach. Take 4-8 black or green ripe olives with each meal. Apricot juice or puree, 3-4 ounces with each meal has an antibacterial effect on H. pylori, when it is mixed with two tablespoons of lemon juice.

Other soothing substances for pain of peptic ulcers:

• chamomile
• charcoal
• licorice root
• papaya
• slippery elm
• catnip
• golden seal capsules—2 to 4—just after eating and at bedtime
• grapefruit seed extract, four drops in a full glass of water three times a day. After 5-7 days, try to increase to six drops in a glass of water three times a day.

Finally: Eat a low-protein diet to reduce stomach acid. Hot applications over the stomach as with an electric heating pad, hot water bottle or heat lamp. Avoid all foods to which you are sensitive. Obey all natural laws of health. Keep up the treatments for 30-90 days, until completely healed.