Multiple Gastric Ulcerations 

What Are Multiple Gastric Ulcerations?

[dropcap]M[/dropcap]ultiple gastric ulcerations denote a stomach disorder that involves damage to the superficial mucosa characterized by many sores of the stomach antrum that are marked by inflammation, necrosis (death of the affected cells) and sloughing of destroyed tissue.

Q: Where is the stomach antrum?

A: The antrum is the lower region of the stomach before the pylorus which is nearest the duodenum (first part of the small intestine). The stomach and duodenum are separated by the powerful pyloric sphincter.

The stomach antrum propels food in the stomach against the pylorus which resists passage of food until it is turned into chyme. Chyme is highly acidic liquified food that has been thoroughly mixed with stomach juices.

Gastric ulcerations are typically associated with widespread gastritis (inflammation), inflammatory involvement of acid producing cells, and atrophy of acid and pepsin producing cells.¹

The primary causes of gastric ulcerations are H. pylori infection, use of Aspirin and non-steroidal drugs (NSAIDS), and stress.¹

What Are Multiple Gastric Ulcerations In Celiac Disease and/or Gluten Sensitivity?

• Multiple gastric ulcerations are a late digestive system complication of celiac disease.
• The usual sequence is the development of gastritis, or inflammation of the mucosal lining, next surface erosions, then deeper sores, or ulcers.

How Prevalent Are Multiple Gastric Ulcerations In Celiac Disease and/or Gluten Sensitivity?

Multiple gastric ulcerations are reported as a presentation of celiac disease.²

What Are The Symptoms Of Multiple Gastric Ulcerations?

Multiple gastric ulcerations are marked by epigastric pains.² These pains occur over the pit of the stomach, just below the breastbone.

How Do Multiple Gastric Ulcerations In Celiac Disease and/or Gluten Sensitivity Develop?

Multiple gastric ulcerations result from unclear etiology, or cause. However, gluten is involved in the inflammatory process which responds to elimination of gluten.²

Do Multiple Gastric Ulcerations Respond To Gluten Free Diet?

Yes. Celiac disease-related gastric ulcerations respond to gluten free diet.³

6 Steps To Improve Multiple Gastric Ulcerations In Celiac Disease and/or Gluten Sensitivity:

• [dropcap]1[/dropcap]Remove the Trigger. Maintain a Strict Gluten Free Diet:

This condition responds to the gluten free diet, the complete elimination of gluten, which is the required treatment that improves both gastric ulcerations and gut health.  It is important to understand that gut health is the foundation to restore all health.

Restored health will enable you to keep maintain a strict gluten free diet, just as other life tasks will be easier.

A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet. Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it damages structures and function, and instigates immune inflammatory responses.

Leakiness of the gut also allows OTHER unwanted substances to get into the body, such as bacteria and undigested foodstuffs like proteins. Undigested proteins in the body are unusable, causing inflammation and allergic reactions. They can also cause granulomas (encapsulations) or other problems.

You should begin to feel better within a week and notice more energy as the absorbing cells that make up the surface lining of your small intestine heal. Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.

Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.⁴

• [dropcap]2[/dropcap] Reduce Inflammation. Foods to Eat and Foods Not to Eat:

Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory). Licorice (gluten-free) works as well as ulcer treating drugs with fewer side effects. It strengthens the stomach’s normal protective mechanisms and induces healing.⁵

Avoid hot spices, particularly red and black pepper, alcohol, coffee and caffeine which can be in sodas and other drinks. Puree foods can ease digestion. Diet should include vegetables with fiber, particularly cabbage, and probiotics.

[box type=”shadow” ]Here Are Major Inflammatory Food Types:

• Damaging Foods. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.⁶
• Allergenic Foods. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.
• Shelf Stable Processed Foods. Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.⁶
• Bad Fats. Includes deep fried foods, trans-fats, saturated fats (animal fat/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.⁶.
• Excessive Refined White Flours (bran layer removed). Includes products made from them such as cookies, bread, cakes, pies. Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream. Also disrupt intestinal permeability causing leaky gut.⁶
• Refined Sugars.  Includes white sugar, corn fructose and high fructose corn syrup.
• Certain Spices. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.⁶
• Alcohol and Caffeine. Disrupt intestinal permeability causing leaky gut.⁶[/box]

[box type=”shadow” ]Here Are Important Anti-Inflammatory Food Types to Promote Health:

• Fruits. Contain ample amounts of vitamins, minerals and phytochemicals which are naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.
• Non-Starchy Vegetables. Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes lettuce, kale, onion, broccoli, garlic, and others.
• High Quality Complex Carbohydrates. Provide vitamins, minerals, phytochemicals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.
• Antioxidants. Protect the body from inflammatory oxidant molecules that continually occur and help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.
• Omega-3 Fatty Acids. Balance opposing omega-6 fatty acids and bad fats. Fish sources include tuna, salmon, cod, and others. Plant sources include flax, chia seeds, canola oil, and others.
• Probiotics. Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.
• Prebiotics/ High Fiber Foods.  Food with fiber keeps our population of colonic microbes healthy.
• Protective Herbs and Spices.  See below #6 for examples such as ginger.[/box]

• [dropcap]3[/dropcap] Information Sheet You Can Take to Your Doctor or Other Health Professional:

Click here.

• [dropcap]4[/dropcap] Manage Your Medications Safely: 

Certain prescription drugs used to treat the stomach cause nutritional deficiencies. Ask your doctor or pharmacist about this possible adverse effect on these drugs if you have been prescribed for gastric ulcerations. Do not stop prescribed medications without supervision.

 This is not a complete listing.

ANTACIDS / ULCER MEDICATIONS –

• Pepcid®, Tagamet®, Zantac®, Magnesium and Aluminum Antacid preparations (Gaviscon®, Maalox®, Mylanta®).

• Prevacid®, Prilosec®. 

• Alka Seltzer®, Baking Soda.

 CAUSE THESE NUTRIENT DEFICIENCIES

• Calcium, Chromium, Folic Acid, Iron, Vitamin A, Vitamin B12, Vitamin D,      Zinc, Magnesium, Copper, Potassium.

• Vitamin B12. 

• Folic Acid, Magnesium, Proteins, Potassium.

 

• [dropcap]5[/dropcap]Nutritional Supplements To Help Correct Deficiencies:

[box type=”shadow” ]

The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.

• Multivitamin/mineral combination that provides 100% once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.
• Vitamin A. Recommended dose is 10,000 IU per day until ulcer is healed. Before starting, ask doctor for a baseline blood test and repeat again in 3 months to discover your vitamin status and how to proceed.⁵
• Vitamin E. Recommended dose is 400 to 800 IU per day.⁵This is a safe dose to take until healed.
• B vitamin complex that contains 100 to 300% each. Do not buy bottles that have more than 300% each because the excess cannot be used. The body eliminates excess in the urine andin the process takes away needed minerals.
• Zinc. Recommended dose is 50 mg. This is a safe dose and needed to help heal the ulcer. Do not take with other supplements because of interactions.  Always check with your doctor when taking supplements to avoid interactions with medications.[/box]

Storage Note for Supplements: Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet or the fridge – not in the bathroom or on the kitchen table.

• [dropcap]6[/dropcap]Manage Natural Remedies:

[box type=”shadow” ]Hydration:

• Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.
• If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.
• Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.
• What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.[/box]

[box type=”shadow” ]Carminatives. The following  anti-inflammatory plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.

Carminative Food Remedies:

• Raspberry.
• Carrot is also a cleansing digestive tonic.
• Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.
• Redbeets also stimulate and improve digestion and are easily digested.
• Cabbage also stimulates and improves digestion and is also a liver decongestant.
• Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.
• Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.

Carminative Herb Remedies:

• Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa.  Drink as tea or use in cooking.
• Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.
• Parsley also relieves indigestion.
• Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion. However, because it increases blood sugar levels, it should not be used by persons with insulin resistance or diabetes.
• Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.

Carminative Spice Remedies:

• Cloves are also antispasmodic.
• Nutmeg is also useful for indigestion.
• Ginger.[/box]

[box type=”shadow” ]Exercise Helps:

Exercise improves circulation and rids the body of toxins.

• Walking is aerobic exercise that reconditions the whole body to improve stamina. Read more about Exercise and Fitness.
• Weight training builds muscle. Read more about Exercise and Fitness.
• Stretching improves flexibilty. Read more about Exercise and Fitness.

Note: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. [/box]

What Do Medical Research Studies Tell About Multiple Gastric Ulcerations In Celiac Disease and/or Gluten Sensitivity?

“Helicobacter pylori-negative gastric ulcerations associated with celiac disease at first presentation.” This case report describes a 53 year old woman with diarrhea, epigastric pain and abdominal distention. At upper GI endoscopy, biopsies were taken showing complete atrophy of the villi and colonization of the small bowel mucosa. Uncommon multilocular ulcers were seen in the gastric antrum that proved to be Helicobacter pylori-negative with no evidence of Zollinger-Ellison syndrome. Biopsy showed lymphocytic gastritis with an extensive infiltration of the lamina propria by almost exclusively celiac disease3- and celiac disease45RO- positive T-lymphocytes. Intraepithelial T-lymphocytes were found to be increased in the antral as well as the corpus mucosa.²

Sources:

1. Kathleen Mahan and Sylvia Escott-Stump, ed. Krause’s Food, Nutrition & Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000. [↩] [↩]
2. Domagk D, Avenhaus W, Ullerich H, Henschke F, Menzel J, Domschke W. Helicobacter pylori-negative gastric ulcerations associated with celiac disease at first presentation. Z Gastroenterol. 2001 Jul;39(7):529-32. [↩] [↩] [↩] [↩]
3. Domagk D, Avenhaus W, Ullerich H, Henschke F, Menzel J, Domschke W. Helicobacter pylori-negative gastric ulcerations associated with celiac disease at first presentation. Z Gastroenterol. 2001 Jul;39(7):529-32. [↩]
4. Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease. Clinical Science. Apr 2001;100(4):379-86. [↩]
5. The Herbal Drugstore. Linda White, M.D and Steven Foster. 2000. Rodale Inc. USA. [↩] [↩] [↩]
6. Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. Journal of Gastroenterology and Hepatology. 2003;18:479-91. [↩] [↩] [↩] [↩] [↩] [↩]