Heartburn and ulcers

Category: Illness or disabilities

Type

Involuntary

Introduction and description

The section Stomach disease provides an overview of both how the stomach works, the general threats it encounters and the diseases of the stomach.  This section, however, provides us with a chance to show you some specific research related to heartburn and ulcers.

• Peptic ulcer disease (PUD), also known as a peptic ulcer or stomach ulcer, is a break in the lining of the stomach, first part of the small intestine, or occasionally the lower esophagus. An ulcer in the stomach is known as a gastric ulcer while that in the first part of the intestines is known as a duodenal ulcer.
• Gastroesophageal reflux disease (GERD), gastro-oesophageal reflux disease (GORD), gastric reflux disease, acid reflux disease, or reflux (in babies and young children) is a chronic condition of mucosal damage caused by stomach acid coming up from the stomach into the esophagus (chronic reflux).
• Heartburn, also known as acid indigestion, is a burning sensation in the central chest or upper central abdomen.  The pain often rises in the chest and may radiate to the neck, throat, or angle of the jaw.  Heartburn is usually due to regurgitation of gastric acid (gastric reflux) into the esophagus and is the major symptom of gastroesophageal reflux disease (GERD).

Symptoms

Heartburn and ulcers produce stomach pain (stomach ache).  There may be nausea, there may even be vomiting.  There can be bloating, belching, and headache.  Stools may be abnormal.

Additional symptoms, especially of GERD include regurgitation of semi digested food and acid, pain with swallowing/sore throat, increased salivation, chest pain, and coughing.

The pain of very bad heartburn may even travel up to the face and result in eye pain, ear pain and muscle pains in the face.  But here care is needed.....

Heart disease - One of the early indicators of heart disease is a pain which is almost identical to heartburn. It starts in the chest and travels up and can reach the face and neck where it manifests as pain in the jaw, the eyes and between the eyes. It can be excruciatingly painful. Interestingly there may be no pain down the arms and none of the tight chested feeling that comes later with angina.
Heartburn treatments are not a great deal of help here!  Go to a cardiologist.

Causes

One of the old medical chestnuts prevalent when I was young, was that coffee caused ulcers and heartburn.  Thankfully that wrong thinking has been squashed, but an excess of strong coffee drinking - enough to send the adrenaline racing in false panic - just might, because it simulates stress

Stress and fear and Overeating

Any emotion or environmental stressor that invokes the sympathetic nervous system – the fight or flight system - can result in heartburn and indigestion.  The flight and fight system is geared to halting the digestion of food whilst the fighting and flighting is going on.  The logic is obvious - if we are  fighting or 'flighting', our energy needs to be concentrated in our limbs not our stomach and thus digestion is put on hold.  All our energy is needed to metaphorically flee, so the stomach – a muscle – stops working.  The sympathetic nervous system also stops us weeing and pooing, as if we are fleeing a dinosaur, the weeing and pooing would be a distraction – and a bit messy.  The larger the meal and the more stressed, frightened, grief stricken agitated or angry we are, the more we will suffer.  If we eat when this stressed, we end up with a full stomach and nothing happening, which causes pain. 

Physiologically this was known as far back as the 1800s.  Claude Bernard, in his lectures in 1860, showed that

The solution here is thus smaller meals and the adoption of methods of stress reduction.  As such the answer is to calm down before we eat - meditation, listening to nice music and not to eat in a hurry and when over wrought.  Furthermore, after a meal we need to sit down somewhere very comfortable and take the time to relax - calm down.

Any form of antacid is by definition not just unhelpful, it is counter-productive.

On the odd occasion when very rich or over rich food, excessive consumption of fat, irritant spices or alcohol and other abuses of the stomach have occurred, doctors may say that a case has been made for their use. But the stomach is actually doing its best to handle this abuse by secreting gastric acids, as such to neutralise them does not help. The pain is there to tell you you have been a twerp and it may be better to grin and bear it.

A cup of coffee should help.

Food Allergies

Food allergies such as gluten intolerance or dairy product intolerance, result in exactly the same sort of symptoms as other forms of heartburn – bloating, pain, wind and burping, headaches, occasional nausea and vomiting and fatigue, for example:

Severe stomach pain with bloating and wind is a well recognised symptom of coeliac disease and gluten and wheat intolerance.

Antacids applied if you have a food allergy can make you feel extremely ill.

Bacteria

Perhaps the best known bacteria to be implicated in the development of ulcers is Helicobacter pylori, a Gram-negative, microaerophilic bacterium naturally found in the stomach.  It was identified in 1982 by Australian scientists Barry Marshall and Robin Warren, who found that it was present in a person with chronic gastritis and gastric ulcers, conditions not previously believed to have a microbial cause. It is also linked to the development of duodenal ulcers and stomach cancer. What has always been confusing, however, is that over 80% of individuals ‘infected’ with the bacterium are asymptomatic – simply not ill.  Furthermore there is additional evidence that H. pylori is part of our gastro-intestinal flora.  And there is extra evidence that it may play an important role there:

So by giving anyone antibiotics you increase the chances of giving them asthma, diabetes, metabolic syndrome and obesity.  We can add to this paper results from other papers, which show that the presence of this bacteria in the stomach, reduces the prevalence of rhinitis, dermatitis, and inflammatory bowel disease.

As Professor Blaser says, however, the theoretical costs of carrying H. pylori include peptic ulcers and adenocarcinoma of the distal stomach.  But again one must ask the question, why do some people carrying the bacteria develop ulcers and others not?

Up to 85% of people harbouring H. pylori never experience symptoms or complications.  At least half the world's population is known to harbour the bacterium, making it the most widespread so called infection in the world.  The so called developing world has much higher rates of colonisation than the West (Western Europe, North America, Australasia).  But it is the peoples of the west that have the ulcers and the stomach cancer.

Furthermore, individuals with H. pylori have only a 1 to 2% risk of acquiring stomach cancer.  Perhaps of equal importance , H. pylori if it plays a role at all, only has an effect in the first stage of chronic inflammation, but not in further stages leading to carcinogenesis.  Let us put this another way.  H.  pylori does not actually cause the cancer, something else does.

So the big question is, what is that something?

H. pylori migrates to the stomach lining.  In addition to using chemotaxis to avoid areas of low pH, H. pylori also neutralizes the acid in its environment by producing large amounts of urease, which breaks down the urea present in the stomach to carbon dioxide and ammonia. The ammonia, which is basic, then neutralizes stomach acid.  If there is not enough stomach acid then the ammonia can become a problem.  There is a possibility that H pylori actually helps provide a protective barrier for the stomach lining, meaning that if H pylori is weakened or not present more acid can attack the stomach lining and heartburn and ulcers will result.

In effect, the very antibiotics and other pharmaceuticals used to supposedly help us, may actually be providing the environment in which the real pathogens – mostly it appears being viruses, can flourish.  By using an antacid, you could be disrupting the bacteria’s normal effects and the ammonia that results could be the culprit.  So the answer to the question ‘what is the true cause’ is viruses aided by doctor or self administered pharmaceuticals.

It is worth mentioning that the outer membrane of this bacteria contains cholesterol glucosides, which are found in few other bacteria.  So any pharmaceutical that directly attacks cholesterol may kill the bacteria.

Viruses

Although viruses are less frequently mentioned as a problem, there appears to be every reason to consider them a major cause.  They become a problem in the ‘immunocompromised host’, but we should not forget that this is not a person with, for example, HIV.  Anyone who has been prescribed immunosuppressants is immunocompromised.  But viruses are a problem in the immunocompetent too.  The herpes virus is one culprit:

A number of other viruses are also starting to be implicated:

And

And

A squamous cell papilloma is a papilloma that arises from the stratified squamous epithelium of the skin,or some other bodily membrane.  Squamous cell papillomas according to Wikipedia “are a result of infection with human papillomavirus - types HPV-6 and HPV-11”.  But in the paper the virus is unknown:

Bacteriophage

The one area that has received only minor attention is that of the bacteriophage.  Bacteriophage are viruses that colonise bacteria, and H.  pylori attracts a number of phages.

We saw that Helicobacter pylori is associated with ulcers and the development of gastric cancer – but only sometimes. Several genes, including cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA), are associated with increased gastric cancer risk. And one recent finding is that these strains of H. pylori also contain sequences related to bacteriophage phiHP33.

It is worth adding that phages are still being identified and some appear to be new :

And

So, as we have seen, antibiotics and other pharmaceuticals used to supposedly help us, may actually be providing the environment in which the real pathogens – the viruses, can flourish.  The antibiotic may actually kill the bacteria and release the bacteriophage.  So the answer to the question ‘what is the true cause’ is viruses – both non phages and phages -  aided by doctor or self administered pharmaceuticals.

Fungal infections

So far we have only found the cause to be a fungal infection in immunocompromised patients, and the patients were immunocompromised as a result of being administered immunosuppressants:

Pharmaceuticals

First we will take a look at eHealthme and the statistics they have collected in the USA from doctor submitted Adverse drug reports to the FDA and SEDA.  The links should take you to the condition.  We have had problems with the eHealthme site reorganising and breaking the links we have set up, so if the link does not work, use the symptom charts on their site to find the symptom.  Then scroll down until you find the section 'Drugs that could cause'.

• Heartburn - the drugs can be found by following this LINK.  As of Dec 2016, 1,200 drugs were implicated in causing heartburn

• GERD - the drugs implicated in causing GERD can be found by following this LINK.  As of Dec 2016, 1,200 drugs were implicated in causing heartburn

• Peptic ulcer - the drugs implicated in causing peptic ulcer can be found by following this LINK . As of Dec 2016, 2,000 drugs were implicated in causing heartburn

• Indigestion - the drugs implicated in causing indigestion can be found by following this LINK.  As of Dec 2016, 2,150 drugs were implicated in causing indigestion

The following chart shows the trend for pharmaceuticals having caused indigestion, from eHealthme.

As we can see from the above sections on viruses, bacteria and so on, three major classes of pharmaceuticals are implicated, but there others:

• Immunosuppressants – including asthma medication
• Antibiotics
• Antacids and heartburn treatments

In addition, as we we can see from looking at the eHealthme website statistics, NSAIDs are also significant contributors.

And a significant source of problems come from osteoporosis treatments, beta blockers, benzodiazepines, statins, anti-depressants and so on.  And we also have the ‘cholesterol’ attacking drugs.

Parasites

The following case study does not actually prove that either parasites or bacteria are the cause, but it shows some interesting statistical correlations.  It also shows how far these organisms can spread if the immune response of the stomach is in any way compromised:

Many different sorts of parasites are implicated we have not listed them all, but here is another example:

 

Treatments

So what causes an upset stomach? Well, as we have seen it may be a bacteria, but is more likely to be viruses, fungi, toxins – a pathogen in other words. What do we want our stomach to do in this case? 
The answer is to secrete as much acid as possible so that the pathogen is killed or disabled.  We may get temporary discomfort, but on the whole, better to suffer a bit of discomfort than to have the pathogen enter the body.  So the treatment is to grin and bear it.

What else can cause an upset stomach – so called GERD gastric acid reflux, when the stomach contents regurgitate, or even when you just get heartburn or indigestion?

Well another cause can be food intolerance, so the obvious answer here is to get yourself tested for any allergens – any, as they will all do the same thing.  The body thinks it is being poisoned so it tries to either make you sick, or creates a lot of acid to try to get rid of it through the intestines.  Quick throughput.

Anything else?  Indeed yes – stress.

Stress of all sorts invokes the sympathetic nervous system – the flight or fight response.  People get upset stomachs from fear, loneliness, grief, panic, and depression.  Unable to cope, at a very low ebb their sympathetic nervous system is working overtime to help them flea, but sadly the ‘threat’ cannot in many case be flown from that easily.

Indigestion means just that, the body cannot digest its food because we are so stressed it has gone into 'lack of activity' mode.  It is not too much acid, the body under stress is not actually secreting any, so we have lack of digestion, which feels like a big lump in our stomachs that lasts for a very long time and gives us pain.

And what do we find if we take a look at the statistics for just one drug - Nexium, used to supposedly treat heartburn? The top conditions involved for these people, according to the eHealthme web site were:

1. Pain (97 people, 23.15%)
2. Depression (87 people, 20.76%)

So the answer is clearly to solve the stress problem, the sadness, the loneliness, the hurt.  There are all sorts of kindly ways of helping the lonely, the fearful, the grief stricken and the depressed and they do not involve and should not involve pharmaceuticals.  They need to involve people helping people.

References and further reading

• Am J Gastroenterol. 2000 Sep;95(9):2171-6.  Herpes simplex virus esophagitis in the immunocompetent host: an overview.  Ramanathan J1, Rammouni M, Baran J Jr, Khatib R.
• Hepatol Int. 2010 Jul 1;4(3):585-93. doi: 10.1007/s12072-010-9184-4.  Increased incidence of gastroesophageal reflux disease in patients with chronic hepatitis B virus infection.  Hsu CS, Wang CC, Wang PC, Lin HH, Tseng TC, Chen CH, Su WC, Liu CJ, Chen CL, Lai MY, Chen PJ, Chen DS, Kao JH.
• EMBO Rep. 2006 Oct; 7(10): 956–960. doi:  10.1038/sj.embor.7400812  PMCID: PMC1618379; Science and Society Viewpoint Who are we? Indigenous microbes and the ecology of human diseases - Martin J Blaser, Frederick H. King Professor of Internal Medicine, the Chair of the Department of Medicine and a Professor of Microbiology at New York University School of Medicine, New York, USA. martin.blaser@med.nyu.edu
• Blaser M (2011). "Antibiotic overuse: Stop the killing of beneficial bacteria". Nature 476 (7361): 393–4. doi:10.1038/476393a. PMID 21866137
• Salama N. R.; et al. (2013). "Life in the human stomach: persistence strategies of the bacterial pathogen Helicobacter pylori". Nature Reviews Microbiology 11: 385–399. doi:10.1038/nrmicro3016
• Blaser MJ, Chen Y, Reibman J (May 2008). "Does Helicobacter pylori protect against asthma and allergy?". Gut 57 (5): 561–7. doi:10.1136/gut.2007.133462. PMID 18194986.
• Chen Y, Blaser MJ (August 2008). "Helicobacter pylori colonization is inversely associated with childhood asthma". J. Infect. Dis. 198 (4): 553–60. doi:10.1086/590158. PMID 18598192
• Helicobacter. 2015 Nov 27. doi: 10.1111/hel.12282. [Epub ahead of print]  The Presence of Phage Orthologous Genes in Helicobacter pylori Correlates with the Presence of the Virulence Factors CagA and VacA.  Kyrillos A1, Arora G1, Murray B1, Rosenwald AG1.  1Department of Biology, Georgetown University, Washington, DC, USA.
• Ann Allergy Asthma Immunol. 1997 Oct;79(4):333-8.  Esophageal candidiasis as a complication of inhaled corticosteroids.  Simon MR1, Houser WL, Smith KA, Long PM.  1Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA.
• Ann Saudi Med. 1995 Mar;15(2):140-2.  Squamous papilloma of the esophagus - a clinicopathologic study of 10 cases and review of the literature.  Al-Sohaibani MO1, Al-Rashed RS.
• Appl Environ Microbiol. 2013 May;79(10):3176-84. doi: 10.1128/AEM.03530-12. Epub 2013 Mar 8.  Characterization of Helicobacter pylori bacteriophage KHP30.  Uchiyama J1, Takeuchi H, Kato S, Gamoh K, Takemura-Uchiyama I, Ujihara T, Daibata M, Matsuzaki S.
• Eksp Klin Gastroenterol. 2010;(6):30-4.  [Gastrointestinal giardiasis associated with Helicobacter pylori].  [Article in Russian] - Isaeva GSh, Efimova NG.
• Ulus Travma Acil Cerrahi Derg. 2011 Jan;17(1):90-2.  Gastric perforation caused by Strongyloides stercoralis: a case report.  Oztürk G1, Aydınlı B, Celebi F, Gürsan N.  1Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey. gurkanoztrk@yahoo.com
• PLoS One. 2013 Jun 12;8(6):e65996. doi: 10.1371/journal.pone.0065996. Print 2013.  No association of coffee consumption with gastric ulcer, duodenal ulcer, reflux esophagitis, and non-erosive reflux disease: a cross-sectional study of 8,013 healthy subjects in Japan.  Shimamoto T1, Yamamichi N, Kodashima S, Takahashi Y, Fujishiro M, Oka M, Mitsushima T, Koike K.
• Korean J Parasitol. 2015 Feb;53(1):95-9. doi: 10.3347/kjp.2015.53.1.95. Epub 2015 Feb 27.  Comorbid gastric adenocarcinoma and gastric and duodenal Strongyloides stercoralis infection: a case report.  Seo AN1, Goo YK2, Chung DI2, Hong Y2, Kwon O3, Bae HI1.
• J Virol. 2012 Oct;86(20):11400-1.  Complete genome sequences of two Helicobacter pylori bacteriophages isolated from Japanese patients.  Uchiyama J1, Takeuchi H, Kato S, Takemura-Uchiyama I, Ujihara T, Daibata M, Matsuzaki S. 1Department of Microbiology and Infection, Kochi University, Kochi, Japan.
• J Med Virol. 2015 Jun;87(6):1041-5. doi: 10.1002/jmv.24152. Epub 2015 Mar 16.  Human cytomegalovirus induced pseudotumor of upper gastrointestinal tract mucosa: effects of long-term chronic disease?  Reggiani Bonetti L1, Barresi V, Bertani A, Maccio L, Palmiere C.

Related observations

Healing observations

• Angelica - The Healing power of herbs – Ceres Esplan 019720
• Anise tea - The Healing power of herbs – Ceres Esplan 019733
• Anti-ulcerogenic activity of some plants used in folk medicine of Pinarbasi (Kayseri, Turkey) 020741
• Antiulcerogenic action of ethanolic extract of the resin from Virola surinamensis Warb. (Myristicaceae) 018286
• Bees – Lectures by Rudolf Steiner - Too much honey upsets the acid/alkaline balance 020914
• Bingen, Hildegard of - Licorice 022698
• Carum copticum L.: A Herbal Medicine with Various Pharmacological Effects - Gastrointestinal effects 027882
• Chili peppers, migraine and pain 005752
• Culpepper's Complete Herbal on Celery 012442
• Culpepper's Complete Herbal on Great and Lesser Burnet 020743
• Culpepper's Complete Herbal on Heal-all [Self-heal] 018269
• Culpepper's Complete Herbal on White Willow 020521
• Cumin and diabetes 005583
• D-Limonene: safety and clinical applications 020764
• Dandelion and its healing potential 006776
• Dr Duke's list of Antibacterial activity for the Dog Rose 018094
• Dr Duke's list of biological activities for Vitamin C 017880
• Dr Duke's list of chemicals and activity for the Shallot 017969
• Dr Duke's list of Chemicals and their Biological Activities in Pilocarpus microphyllus 018158
• Dr Duke's list of Plants and chemicals with AntiGERD activity 020765
• Dr Duke's list of Plants with Antiheartburn Activity 019973
• Dr Duke's list of Plants with Antihelicobacter activity 018402
• Dr Duke's plants to help with acid reflux 010317
• Dr Franz Morell – The Mora Concept - Diagnosing a milk allergy 012280
• Gastroprotective mechanisms of Citrus lemon (Rutaceae) essential oil and its majority compounds limonene and β-pinene 016782
• Goodheart, George - On the Acid-Alkaline balance 011173
• Healing actions of essential oils from Citrus aurantium and d-limonene in the gastric mucosa: the roles of VEGF, PCNA, and COX-2 in cell proliferation 016784
• Heartburn, ulcers and plants 006253
• Limonene: safety and clinical applications. 016777
• Meadowsweet tisane 019459
• Mrs Grieve on Acorus calamus 027980
• Mrs Grieve on Almonds 020768
• Mrs Grieve on Angelica 020900
• Mrs Grieve on Anise 016641
• Mrs Grieve on Anise (Star) 021027
• Mrs Grieve on Apples 016642
• Mrs Grieve on Avens 019740
• Mrs Grieve on Barberry bark and root exract 008092
• Mrs Grieve on Carrots and Parsnips 005539
• Mrs Grieve on Chamomile 016793
• Mrs Grieve on Cinnamon 005549
• Mrs Grieve on Cloves 005550
• Mrs Grieve on Elecampane 019928
• Mrs Grieve on Evening Primrose 012147
• Mrs Grieve on Juniper berries 005566
• Mrs Grieve on Mint 005541
• Mrs Grieve on Peppermint 005542
• Pelley, William Dudley - Seven Minutes in Eternity With Their Aftermath 07 027242
• Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon 017632
• Probiotics and prebiotics - pros and cons 006251
• Propolis and dementia 005336
• Sauerkraut, ulcers and stomach problems 006249
• Terminalia catappa L.: a medicinal plant from the Caribbean pharmacopeia with anti-Helicobacter pylori and antiulcer action in experimental rodent models 021404
• The Healing Power of Sleep 026790
• Thirty days of Fernet Branca: An experiment in healthy living 012770
• Tirrukural, the - Book 2 from Medicine 022858
• Turmeric, ulcers and stomach cancer 005577
• Water and ulcers 008351

Hallucination

• Arthrotec 018013
• Carafate 018169
• Common Drugs May Cause Cognitive Problems 021361
• Cytotec 018838
• Dexilant 018863
• Glycopyrrolate 019092
• Kapidex 019232
• Metoclopramide 019525
• Misoprostol 019539
• Pamine 019828
• Pepto bismuth associated neurotoxicity: A rare side effect of a commonly used medication 020777
• Prevpac 019859
• Robinul 020010
• Vignoli, Tito - Sees flames and stars 005967

Wisdom, Inspiration, Divine love & Bliss

• Bees – Lectures by Rudolf Steiner - Too much honey upsets the acid/alkaline balance 020914
• Comenius - Didactica Magna - Eat well, sleep long 020656
• Tirrukural, the - Book 2 from Medicine 022858

Enlightenment

Kundalini, Ecstasy, Moksha, Nirvana and Annihilation

• I had an impulse to go on my knees, there in the road beneath the stars 021660

In time

Synaesthesia, Pure or enhanced perception, Inter composer communication, Vision, Dream, Perception recall, Exploring group perception

• I had an impulse to go on my knees, there in the road beneath the stars 021660
• Pelley, William Dudley - Seven Minutes in Eternity With Their Aftermath 07 027242

Other observations

• Bismuth Toxicity, Often Mild, Can Result in Severe Poisonings 029512