If you've got an ulcer, chances are you're taking an over-the-counter (OTC) antacid and/or prescription medication to neutralize gastric acid or inhibit its production. These medications include proton pump inhibitors (PPIs), such as esomeprazole (Nexium) and lansoprazole (Prevacid), and H2-blocking drugs, such as cimetidine (Tagamet) and ranitidine (Zantac).

What most people don't realize: There are several natural, complementary remedies that help reduce ulcer symptoms and promote healing while conventional treatment is under way. Some of these treatments also can help prevent ulcers in some patients.

What Causes Ulcers

It's been more than 20 years since doctors learned that an infectious disease—rather than emotional stress—was the primary cause of most ulcers.

A screw-shaped bacterium, Helicobacter pylori, or H. pylori, burrows through the protective mucous lining in the small intestine and/or stomach, allowing harsh digestive fluids to accumulate and ulcerate the lining. About 50% of Americans over age 60 are infected with H. pylori.

The bacterium doesn't always cause ulcers—but about 60% of patients with ulcers harbor H. pylori.

The remainder of ulcers are caused by regular use of stomach-damaging nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil) and naproxen (Aleve).. alcohol...and/or smoking Excessive alcohol wears down the lining of the stomach and intestines. Nicotine causes the stomach to produce more acid.

Best complementary treatments...

*Check with your doctor before taking supplements. They can interact with prescription medications.

Non-Drug Therapies

  • Probiotics. The intestine contains up to four pounds of "friendly" bacteria, which aid digestion. There's some evidence that maintaining adequate levels of beneficial bacteria helps create an inhospitable environment for H. pylori and makes it harder for this ulcer-causing bacterium to thrive.

Self-defense: Take a probiotic supplement that contains Lactobacillus acktophlhts and Bifidobacterium bifidus. These organisms create a healthful mix of bacteria and can inhibit the growth of harmful organisms. Probiotics are helpful if you've taken antibiotics, which can kill off some beneficial bacteria.

The optimal dose for probiotics hasn't been determined. Preliminary research cites a daily dose of up to 10 billion organisms—the amount usually included in one to two capsules. Probiotics are available at health-food stores.

  • Cabbage juice. This folk remedy has some evidence to support it. Cabbage is high in vitamin C, which seems to inhibit growth of H. pylori. It also contains glutamine, an amino acid that may strengthen the protective lining in the stomach.

A small Stanford University School of Medicine study found that ulcer patients who drank about a quart of cabbage juice daily healed significantly faster than those who didn't drink it.

Self-defense: If you have an active ulcer, consider drinking a quart of cabbage juice (about the amount in half a head of cabbage) once daily for up to two weeks.

  • Deglycyrrhizinated licorice (DGL). Herbalists often recommend fresh licorice root to heal ulcers. Licorice contains mucin, a substance that protects the stomach lining, and antioxidants that may inhibit H. pylori growth. However, natural licorice can increase the effects of aldosterone, a hormone that promotes water retention and can increase blood pressure in some people. DGL supplements (available at health-food stores) are a better option, because the substances that increase blood pressure have been removed.

Self-defense: Take one DGL tablet before meals, and another before bed. DGL may be effective for people with ulcers whose H. pylori has been successfully treated with antibiotics but who still have some stomach irritation.

  • Vitamin A. Vitamin A helps repair dam-aged mucous membranes. A report in the British medical journal The Lancet suggests that ulcers heal more quickly in patients given supplemental vitamin A.

Caution: High-dose vitamin A therapy can be toxic, so get your vitamin A from dietary sources along with a daily multivitamin—not from a separate vitamin A supplement.

Self-defense: Get 10,000 international units (Ill) of vitamin A daily if you're undergoing ulcer treatment. (A multivitamin typically contains 3.500 IC to 5.0001U of vitamin A.)

Good food sources: Beef liver (one-and-one-half ounces contains 13,593 IU)...carrots (one raw carrot contains 8,666 IU)...and spinach (one cup of raw spinach contains 2,813 IU).

  • Zinc. Like vitamin A, zinc is involved in tis-sue healing. In Europe, a drug compound made with zinc plus an anti-inflammatory is often used for treating ulcers. Early studies indicate that zinc alone can speed ulcer healing and possibly even help prevent some ulcers.

Self-defense: Don't exceed the recommended daily intake (15 mg) of zinc. Take a daily multivitamin that includes zinc...and get adequate intake from dietary sources (five medium oysters, 13 mg...1/4 cup fortified breakfast cereal, 15 mg...three-ounces lean beef tenderloin, 5 mg).

Another Way To Fight Ulcers

NSAIDs alleviate pain by inhibiting the production of pain-causing chemicals called prostaglandins. However, the body produces several kinds of prostaglandins, including some that protect the stomach lining. That's why NSAIDs, which block the production of pain-causing and stomach-protecting prostaglandins, make people who regularly use the drugs more susceptible to ulcers.

Self-defense: If you require regular pain relief, start with acetaminophen (Tylenol). It renews pain without depleting stomach-protecting prostaglandins.

Caution: Taking more than the recommended dosage or drinking alcohol with acetaminophen can cause liver damage.

Also helpful: Ask your doctor about taking Arthrotec, a prescription drug combination that includes the NSAID diclofenac along with misoprostol, which protects the stomach and intestinal lining. One study found that patients taking Arthrotec experienced up to 80% fewer ulcers than those taking an NSAID alone.

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