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Peptic Ulcer Disease

H. pylori infection

A peptic ulcer is a sore in the lining of the stomach or the small intestine. It is caused by irritation over a period of time. Ulcers may cause pain in the upper part of the belly, bloating, and nausea. Bleeding can happen in with severe ulcers. The most common causes of irritation are:

  • Helicobacter pylori (H. pylori) infection
  • Regular use of Nonsteroidal anti-inflammatory drug (NSAID)

Antibiotics will treat H. pylori. NSAID medicine will be stopped. Acid reducers can ease irritation of ulcer until it heals.

Natural Therapies

Some natural therapy may help with ulcers related to H. pylori infection. The supplements below work best with standard medicine.

Likely Effective

  • Cranberry juice or capsules—may make it hard for H pylori bacteria to stick to the stomach lining.A1-A3
  • Probiotics —increase good bacteria in gut. May help to get rid of H. pylori.B1-B10

Possibly Effective

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about all herbs or pills you are taking. Some may get in the way of your treatment or other health problems you may have. Some supplements discussed here have certain concerns such as:

  • Cranberry may increase the effect of blood thinners.
  • Vitamin C—Too much vitamin C can cause kidney stones. Do not take vitamin C with iron supplements or blood thinners. Use caution when taking vitamin C and acetaminophen.
  • Vitamin E—Too much vitamin E may cause problems for people who take blood thinners, are diabetic, or are taking chemotherapy for cancer treatment.
 

References

Cranberry

A1. Zhang L, Ma J, Pan K, Go VL, Chen J, You WC. Efficacy of cranberry juice on Helicobacter pylori infection: a double-blind, randomized placebo-controlled trial. Helicobacter. 2005;10(2):139-145.

A2. Shmuely H, Yahav J, Samra Z, Chodick G, Koren R, Niv Y, Ofek I. Effect of cranberry juice on eradication of Helicobacter pylori in patients treated with antibiotics and a proton pump inhibitor. Mol Nutr Food Res. 2007;51(6):746-751.

A3. Seyyedmajidi M, Ahmadi A, Hajiebrahimi S, et al. Addition of cranberry to proton pump inhibitor-based triple therapy for Helicobacter pylori eradication. J Res Pharm Pract. 2016;5(4):248-251.

B. Probiotics

B1. Sheu BS, Cheng HC, Kao AW, Wang ST, Yang YJ, Yang HB, Wu JJ. Pretreatment with Lactobacillus- and Bifidobacterium-containing yogurt can improve the efficacy of quadruple therapy in eradicating residual Helicobacter pylori infection after failed triple therapy. Am J Clin Nutr. 2006;83(4):864-869.

B2. Tong JL, Ran ZH, Shen J, Zhang CX, Xiao SD. Meta-analysis: the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther. 2007;25(2):155-168.

B3. Park SK, Park DI, Choi JS, Kang MS, Park JH, Kim HJ, Cho YK, Sohn CI, Jeon WK,Kim BI. The effect of probiotics on Helicobacter pylori eradication. Hepatogastroenterology. 2007;54(79):2032-2036.

B4. Kim MN1, Kim N, Lee SH, et al. e effects of probiotics on PPI-triple therapy for Helicobacter pylori eradication. Helicobacter. 2008;13(4):261-268.

B5. Hurduc V, Plesca D, Dragomir D, Sajin M, Vandenplas Y. A randomized, open trial evaluating the effect of Saccharomyces boulardii on the eradication rate of Helicobacter pylori infection in children. Acta Paediatr. 2009;98(1):127-131. (side effects)

B6. Szajewska H, Horvath A, Piwowarczyk A. Meta-analysis: the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment. Aliment Pharmacol Ther. 2010;32(9):1069-1079.

B7. Bekar O, Yilmaz Y, Gulten M. Kefir improves the efficacy and tolerability of triple therapy in eradicating Helicobacter pylori. J Med Food. 2011;14(4):344-347.

B8. Wilhelm SM, Johnson JL, Kale-Pradhan PB. Treating bugs with bugs: the role of probiotics as adjunctive therapy for Helicobacter pylori. Ann Pharmacother. 2011;45(7-8):960-966. (side effects only)

B9. Navarro-Rodriguez T, Silva FM, Barbuti RC, Mattar R, Moraes-Filho JP, de Oliveira MN, Bogsan CS, Chinzon D, Eisig JN. Association of a probiotic to a Helicobacter pylori eradication regimen does not increase efficacy or decreases the adverse effects of the treatment: a prospective, randomized, double-blind, placebo-controlled study. BMC Gastroenterol. 2013;13:56.

B10. Li S, Huang XL, Sui JZ, Chen SY, Xie YT, Deng Y, Wang J, Xie L, Li TJ, He Y, Peng QL, Qin X, Zeng ZY. Meta-analysis of randomized controlled trials on the efficacy of probiotics in Helicobacter pylori eradication therapy in children. Eur J Pediatr. 2014;173(2):153-161.

Vitamin C and E

C1. Chuang CH, Sheu BS, Kao AW, et al. Adjuvant effect of vitamin C on omeprazole-amoxicillin-clarithromycin triple therapy for Helicobacter pylori eradication. Hepatogastroenterology. 2007;54(73):320-324.

C2. Sezikli M, Çetinkaya ZA, Güzelbulut F, Yeşil A, Coşgun S, Kurdaş OÖ. Supplementing vitamins C and E to standard triple therapy for the eradication of Helicobacter pylori. J Clin Pharm Ther. 2012;37(3):282-285.

Last reviewed March 2019 by EBSCO NAT Review Board Richard Glickman-Simon, MD  Last Updated: 3/2/2019