Herbal Treatment of Peptic Ulcer: Guilty or Innocent

Normally there is a balance between the protective factors (e.g. mucus, bicarbonate, prostaglandins, nitric oxide and normal blood flow) and aggressive factors (e.g. acid plus pepsin, active oxidants, leukotrienes, endothelins, bile or exogenous factors including nonsteroidal anti-inflammatory drugs). Peptic ulcer develops when aggressive factors overcome the protective mechanisms (Borrelli & Izzo, 2000). Helicobacter pylori, nonsteroidal anti-inflammatory drugs and acid-pepsin hypersecretion are the major factors that disrupt this equilibrium. There is other type classified as idiopathic and may be related to defective mucosal defence mechanisms due to tobacco use, psychological stress (stress gastritis), rapid gastric emptying or genetics (Calam & Baron, 2001). Drug treatment of peptic ulcers is targeted at either counteracting aggressive factors or stimulating the mucosal defences (Tepperman & Jacobson, 1994). The ideal aims of treatment of peptic ulcer disease are to relieve pain, heal the ulcer and delay ulcer recurrence (Borrelli & Izzo, 2000).