Licorice Root Extract and Stomach Ulcer Prevention

By Decker Weiss, NMD.

Conventional medical treatment of peptic ulcers, an extremely common health problem, has dramatically changed in recent years. A huge variety of antacids, histamine blockers, and proton pump blockers are now considered standard ulcer therapy. However, these medicines do not address the underlying factors of ulcer formation. They only block an ulcer’s effects. Fortunately, there is an effective natural supplement available that stimulates the body’s normal defense mechanisms to prevent ulcer formation. And, in the presence of peptic ulcers, this natural supplement promotes true healing.

Stomach Ulcer Symptoms Include:

Stomach pain that comes and goes, for several days or weeks.
• Occur two to three hours after eating.
• Occur in the middle of the night.
• Be relieved by food. Other symptoms of a peptic ulcer may include weight loss, poor appetite, bloating, burping, nausea, vomiting.1,2

What causes stomach ulcer symptoms?

Over the past 20 years, there has been a radical shift in thinking regarding the cause of peptic ulcers. No longer blamed entirely on stress, spicy foods, alcohol consumption, gastric acid production, or heredity, most peptic ulcers are now known to be caused by a bacterial infection. Helicobacter pylori (H. pylori) is the bacteria that accounts for the vast majority of peptic ulcers.1-3 However, use of over-the-counter and prescription painkillers known as nonsteroidal anti-inflammatory drugs (NSAIDs) also causes peptic ulcers.1-6 A common example of NSAIDs is ibuprofen (Motrin®, Advil®). Other medications are currently being studied for their role in peptic ulcer development.7-9

How can individuals tell if they have this bacterium?

H. pylori is diagnosed through blood, breath, and tissue tests. Blood tests, the most common diagnostic tool, are used to detect antibodies to H. pylori bacteri10 A breath test, called a urea breath test, is used after treatment to determine if the treatment worked.11 It is interesting to note that about 20% of people under 40 and over half of the people over the age of 60 are infected with H. pylori. However, infected individuals do not always develop ulcers. Researchers are trying to determine why H. pylori does not cause ulcers in every infected person. Furthermore, many people take NSAIDs for long periods of time and do not develop ulcers. Infection with H. pylori or irritation from medication use may be dependent on the gastric or intestinal environment of the person who develops an ulcer.5,6

How are H. pylori positive peptic ulcers medically treated today?

The focus of medical treatment is to kill the H. pylori bacteria and reduce stomach acid. Medical treatment usually involves the use of “triple therapy”: a combination of antibiotics, acid suppressors, and stomach protectors. H. pylori peptic ulcers are treated with antibiotics to kill the bacteri13 Acid-suppressing medications include the histamine2-receptor antagonists cimetidine (Tagamet®), ranitidine (Zantac®), or famotadine (Pepcid®) and proton pump inhibitors omeprazole (Prilosec®), and lansoprazole (Prevacid®).

How are other stomach ulcers medically treated today?

Conventionally, acid-suppressing drugs and stomach-lining protectors are used for ulcer treatment.14-17 Is it necessary to treat ulcers with medical treatments? Are there natural alternatives? The biggest risk for individuals with ulcers is that the ulcer will perforate (erode through) the entire stomach lining. Life-threatening bleeding and infections (peritonitis) can occur.1-3 Therefore, anyone who suspects he or she may have an ulcer should seek treatment from a licensed health care practitioner. It may be necessary to use medications initially despite risks of adverse effects. However, there are certain natural supplements that work well with prescription medications to enhance healing. There may also be instances in milder pre-ulcer conditions that your licensed health care practitioner chooses to use a natural intervention first.

What natural supplement can be used to complement antibiotic therapy? An extremely effective natural supplement for ulcers is a form of licorice root that has been specially processed. Deglycyrrhizinated licorice is an important component of a complementary natural health approach—together with other therapeutic measures recommended by your health care professional. Many researchers have studied de-glycyrrhizinated licorice (often referred to as DGL) in the treatment of gastric and duodenal ulcers.18-25

The use of DGL compared to standard drug therapy is a classic example of addressing the underlying cause of a condition rather than simply blocking an effect. Use of DGL addresses the underlying factors and promotes true healing by stimulating the normal defense mechanisms that prevent ulcer formation. Specifically, DGL improves both the quality and quantity of the protective substances that line the intestinal tract.23,27-30 DGL is a special extract of licorice from which the glycyrrhizin molecules have been removed, leaving biologically active flavonoids. The value of DGL over other forms of licorice is that it eliminates adverse effects associated with long-term use of very high doses of conventional licorice (including sodium and water retention, high blood pressure, and low potassium levels).31,32

How does use of DGL compare to Tagamet® or Zantac®?

Researchers reported in 1982 in Gut that DGL is as effective as cimetidine Tagamet®) for reversing gastric ulcers.30 That same year, Lancet reported DGL to be as effective as ranitidine (Zantac®).19

Researchers report licorice root extract stimulates the release of secretin, which, in turn, has a protective effect on the gastric mucos The body’s production of secretin by such natural agents may play a signif-icant role in their mucosal protective action, note researchers. In fact, they attribute the anti-ulcer effect of licorice root extract to its unique ability to stimulate the body to release endogenous secretin, which helps to rebuild the stomach or intestine’s protective lining.33

What about using antacids for peptic stomach ulcers?

Antacids are alkaline compounds that neutralize stomach acid. At one time, antacids were the mainstay of anti-ulcer therapy. However, these drugs have been largely replaced by the histamine2- receptor antagonists and the proton pump inhibitors.34 Most antacids adversely affect the bowels. Some (e.g. aluminum hydroxide) promote constipation while others (e.g. magnesium hydroxide) promote diarrhe Some antacids contain significant amounts of sodium. Furthermore, by raising the stomach’s pH, antacids can influence the absorption of other drugs.34

Can DGL be used with antibiotic therapy?

Yes. DGL can be used as an additive or adjunct treatment with antibiotics and other agents that may be prescribed by your health care professional. Consumers will find DGL’s restorative effects on the gastric mucosa help to hasten healing and prevent recurrences.

How does DGL compare to standard peptic ulcer therapy?

The drugs used in standard therapy do not address the underlying cause of peptic ulcers. They merely treat the symptoms caused by an ulcer. DGL does not inhibit stomach acid production, neutralize stomach acid, or block histamine. Use of DGL promotes true healing by stimulating the normal defense mechanisms that prevent ulcer formation and improve the integrity of the stomach lining. And, DGL accomplishes this without any of the side effects associated with standard peptic ulcer therapy.

What is the best way to use DGL?

DGL should mix with the saliva to promote release of salivary compounds that stimulate the growth and regeneration of stomach and intestinal cells. Several forms of chewable DGL are available.

How much DGL should be taken?

For treatment of peptic ulcer, take 760 to 1,520 mg of DGL between, or 20 minutes before, meals. Never use after meals, due to lack of efficacy. Use for eight to 16 weeks or as recommended by your health care professional.

Are there side effects or complications related to use of DGL?

As mentioned earlier, DGL is a specially processed form of licorice that avoids the main hazards of regular licorice. Thus, there are no known side effects or drug interactions with use of DGL. Pregnant or nursing women should discuss use of dietary supplements with their licensed health care practitioner.

Stomach Ulcer Conclusion

In summary, DGL is a supplement that improves the integrity of the stomach lining, stimulates the normal defenses that prevent ulcer formation, and enhances the body’s healing powers.

References

1. Peptic ulcer. In: Guyton AC, Hall JE. Textbook of Medical Physiology. Philadelphia, Pa: W.B. Saunders Company;1998:846-847.

2. Peptic ulcer disease. In: Porth CM. Pathophysiology: Concepts of Altered Health States. 5th ed. Philadelphia, Pa: Lippincott; 1998: 725-728.

3. National Digestive Diseases Information Clearinghouse Web site. H. Pylori and Peptic Ulcer, Accessed March 22, 2001. Available at: www.niddk.nih.gov/health/digest/pubs/hpylori/hpylori.

4. Hawkey CJ, Nonsteroidal anti-inflammatory drug gastropathy. Gastroenterology. 2000;119:521-535.

5. Dajani EZ, Klamut MJ. Novel therapeutic approaches to gastric and duodenal ulcers: an update. Expert Opin Investig Drugs. 2000;9:1537-1544.

6. Cappell MS, Schein JR. Diagnosis and treatment of nonsteroidal anti inflammatory drug-associated upper gastrointestinal toxicity. Gastroenterol Clinical North Am. 2000;29:97-124.

7. Elliot SN, McKnight W, Davies NM, MacNaughton WK, Wallace JL. Alendronate induces gastric injury and delays ulcer healing in rodents. Life Sci. 1998;62:77-91.

8. Graham DY, Malaty HM. Alendronate and naproxen are synergistic for development of gastric ulcers. Archive International Medicine. 2001; 161:107-110.

9. Seinela L, Ahvenainen J. Peptic ulcer in very old patients. Gerontology. 2000; 46:271-275.

10. Borody TJ, Andrews P, Shortis NP. Evaluation of whole blood antibody kit to detect active Helicobacter pylori infection. American Journal of Gastroenterology. 1996;91:2509-2512.

11. Graham DY, Klein PD. Accurate diagnosis of Helicobacter pylori. I3Curea breath test. Gastroenterol Clinical North Am. 2000;29:885-893.

12. Cohen H. Peptic ulcer and Helicobacter pylori. Gastroenterol Clinical North Am. 2000;29:775-789.

13. Kim HS, Lee DK, Kim KH, et al. Comparison of the efficacy and safety of different formulations of omeprazole-based triple therapies in the treatment of Helicobactor pylori-positive peptic ulcer. Journal of Gastroenterology. 2001;36:96-102.

14. Sipponen P. Update on the pathologic approach to the diagnosis of gastritis, gastic atrophy, and Heliobacter pylori and its sequelae. Journal of Clinical Gastroenterology. 2001;32:196-202.

15. Scheiman JM. The impact of nonsteroidal anti-inflammatory druginduced gastropathy. American Journal of Manag Care. 2001;7:10-14.

16. Cappell MS, Schein JR. Diagnosis and treatment of nonsteroidal anti inflammatory drug-associated upper gastrointestinal activity. Gastroenterol Clinical North Am. 2000;29:97-124.

17. Yoemans ND. Approaches to healing and prophylaxis of nonsteroidal anti-inflammatory drug-associated ulcers. Amercian Journal of Medicine. 2001;8:24S-28S.

18. Engqvist A, von Feilitzen F, Pyk E, Reichard H. Double-blind trial of deglycyrrhizinated liqourice in gastric ulcer. Gut. 1973;14:711-715.

19. Glick L. Deglycyrrhizinated liquorice for peptic ulcer. Lancet. 1982;9:817.

20. Bardhan KD, Cumberland DC, Dixon RA, Holdsworth CD. Clinical trial of deglycyrrhisinated liqourice in gastric ulcer. Gut. 1978;19:779-782.

21. Balakrishnan V, Pillai MV, Raveebdran PM, Nair CS. Deglycrrhizinated liqourice in the treatment of chronic duodenal ulcer. Journal of Associated Physicians India. 1978;26:811-814.

22. Rees WDW, Rhodes J, Wright JE, Stamford IF, Bennett A. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scandinavian Journal of Gastroenterology. 1979;14:605-607.

23. Tewari SN, Wilson AK. Deglycrrhizinated liquorice in duodenal ulcer. Practitioner. 1973;210:820-823.

24. Abrahamsson H, Dotevall G. Pharmacological and clinical aspects of some drugs used in peptic ulcer treatment. Scandinavian Journal of Gastroenterology. 1979;55:117-120.

25. Bardnan KD, Cumberland DC, Dixon RA, Holdsworth CD. Proceedings: Deglycrrhizinated liqourice in gastric ulcer: a double-blind controlled trial. Gut. 1976;17:397.

26. Dehpour AR, Zolfaghari ME, Sadian T, Vahedi Y. The protective effect of liquorice components and their derivatives against gastric ulcer induced by aspirin in rats. Journal of Pharm Pharmacology. 1994;46:148-149.

27. Morgan AG, Pacsoo C, McAdam WAF. Maintenance therapy: a two year comparison between Caved-S and cimetidine treatment in the prevention of symptomatic gastric ulcer recurrence. Gut. 1985;26:599-602.

28. van Merle J, Aarsen PN, Lind A, van Weeren-Kramer J. Deglycrrhizinated liquorice (DGL) and the renewal of rat stomach epithelium. European Journal of Pharmacology. 1981;72:219-225.

29. Morris TJ, Calcraft BJ, Rhodes J, Hole D, Morton MS. Effect of deglycrrhised liquorice compound on the gastric mucosal barrier of the dog. Digestion. 1974;11:355-363.

30. Morgan AG, McAdam WAF, Pacsoo C, Darnborough A. Comparison between cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance therapy. Gut. 1982;23:545-551.

31. Negro A, Rossi E, Regolisti G, Perazzoli F. Liquorice-induced sodium retention. Merely an acquired condition of apparent mineralocorticoid excess? A case report. Ann Ital Med Int. 2000;15:296-300.

32. Khanna A, Kutzman NA. Metabolic Alkalosis. Respir Care. 2001;46: 354-365.

33. Takeuchi T, Shiratori K, Watanabe S, Chang J-H, Moriyoshi Y, Shimizu K. Secretin as a potential mediator of antiulceractions of mucosal protective agents. Journal of Clinical Gastroenterology. 1991;13:83-87.

34. Lehne RA. Antacids. In: Pharmacology for Nursing Care. 3rd ed. Philadelphia, Pa: W.B. Saunders; 1998:781-783.

35. Cimetidine. In: Physicians’ Desk Reference. 54th ed. Montvale, NJ: Medical Economics Company, Inc; 2000:3043-3046.

36. Ranitidine. Ibid. pp. 1310-1312.

37. Omeprazole. Ibid. pp. 617-621.

38. Lansoprazole. Ibid. pp. 3105-3110.




Decker Weiss

Author Decker Weiss is a licensed naturopathic medical doctor in the state of Arizona.

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