Since bleeding ulcers can be fatal, we can all agree that they are NOT a good thing. Along these same lines, anything that can improve or worsen the outcome of a bleeding ulcer is important to know.
To begin, it would be important to know what can lead to a bleeding ulcer. Top of the list is drugs, most notoriously the anti-inflammatory class of NSAIDs. They kill anywhere from 16-21,000 people per year from bleeding ulcers alone (add in the cardiac dangers and the number is much, much higher). Poor lifestyle habits like excessive alcohol intake and smoking are on the list as well.
As much as I have an issue with the overuse of pharmaceutical drugs for every minor and major ill known to man, they do have a place in society. Bleeding ulcers is one of these. It’s not the time to try natural approaches when your life is on the line. However, if you’d like to avoid a bleeding ulcer in the first place, or if you suffer from gastritis or reflux (GERD, heartburn), then medicine has no place and will likely make the condition worse.
GERD is is quite common and is routinely treated with drugs that shut down acid production in the stomach under the mistaken idea that these patients make “too much” stomach acid. There is absolutely no evidence to support this wild notion of having too much acid. I had a new patient in the office today that has been on omeprazole (generic Prilosec) since high school (about 10 years). Not an uncommon story despite the fact that this drug was only designed for short term (3-6 months) use. If you want to really screw someone’s health up, go ahead and shut down digestion indefinitely. It’s not important anyway.
Instead of shutting down digestion, going the opposite direction and actually supporting digestion is a great first approach for most upper digestive disorders. Our office has seen some pretty amazing outcomes in patients who had been told they “make too much stomach acid” but really had the opposite and took digestive support supplements. When you consider that stress shuts down digestion, how many people in todays’ stressed-out society do you think would actually qualify as making too much stomach acid?
Some of you may have heard about a bacteria that contributes to ulcers called Helicobacter pylori. Back in the mid 1980′s, a doctor by the name of Barry Marshall drank a concoction of the bacteria H. pylori to prove that ulcers were caused by bacterial infection. He ended up with a Nobel Prize and forever changed medicine’s view of ulcers. Thus began the “blinders on” approach to eradication of H. pylori every time it was found. Destroying this bacteria is a good thing, right?
Of course, we can all agree that wanton use of antibiotics (and they use 2 types of antibiotics in the treatment of H. pylori) is never a good thing. I have long stood by the belief that H. pylori is merely an opportunistic infection, growing in strength when the patient is not taking care of themselves. The research continues to support this viewpoint, although medicine continues to focus on wiping out this bacteria when it is found.
This particular article adds more weight to the idea that we should not be wantonly killing off the H. pylori bacteria when it is found. Researchers looked at a group of 2242 patients with upper gastrointestinal bleeding and what effect the presence of H. pylori had on the outcomes of the bleeding. Here’s what they found:
- In this group, about 26% had gastroduodenal ulcer disease.
- Of this group, about half (228, 10% overall) had evidence of Helicobacter pylori infection and half (216, 10% overall) had no evidence of Helicobacter pylori infection.
- Non H pylori patients had a longer list of diseases and ill health (as measured by Charlson Index comorbidity scores).
- Hospital stay was longer for non H pylori patients (11.4 vs 6 days).
- Rebleeding events within 30 days were more frequent in non H pylori patients (11% vs 5%).
- Rebleeding was most frequent in non H pylori patients who had no reported use of NSAIDS (18%).
Overall, the presence of H. pylori led to better outcomes in those patients who were admitted to the hospital with upper gastrointestinal bleeding. Kind of flies in the face of Helicobacter pylori being a dangerous invader that needs to be destroyed on sight with a concoction of multiple antibiotics…