A stomach ulcer, like a mouth ulcer, is a crater-like area where the upper layer of the stomach lining is missing. But it is much larger than a mouth ulcer, and a far more serious problem. The main symptom is a burning pain that extends across the chest and upper abdomen. The pain lasts for between half an hour and three hours, and episodes of pain tend to come and go.
No one is sure what causes stomach ulcers, but the acid that the stomach produces to help in digestion may be a factor – if there is an eroded or inflamed area in the stomach lining, then the acid could begin to break it down. A tendency to suffer from stomach ulcers runs in some families. Smoking, drinking too much alcohol and taking aspirin and similar painkillers (see p322) can all contribute to the development of a stomach ulcer. So can stress, particularly if this means hurried, irregular or unrelaxed meal-times.
Whether food intolerance can ever produce stomach ulcers is a controversial issue. Certainly, there are case-histories of patients with persistent or recurring stomach ulcers who have recovered remarkably well on an elimination diet. However, these people are probably a minority of all patients with this problem. What might arouse suspicion is if the symptoms get substantially worse during the conventional treatment. Such treatment relies heavily on milk, as a safe, bland food. For anyone who is sensitive to milk, this sort of diet will make matters worse.
The presence of allergic symptoms, such as asthma, hay-fever or urticaria, makes it more likely that a stomach ulcer is due to food sensitivity. Some patients of this type (atopics), who also have stomach or duodenal ulcers, turn out to have high IgE levels for certain foods. Objective evidence that foods are causing their ulcers comes from direct observation of the stomach lining in contact with a few drops of food extract. This can be achieved by lowering an observation tube into the stomach, a method that has been developed by a Polish allergist, Dr Bogdan Romanski. Dr Romanski reports that inflammation occurs rapidly in the stomach lining where the food extract touches it – the action of stomach acid on such inflamed areas is the likely cause of ulceration. A drug that prevents mast cells from reacting, sodium cromoglycate, is an effective treatment for these people. All this points to the ulcers being produced by IgE antibodies and mast cells – in other words, being truly allergic. At present, however, stomach and duodenal ulcers are not generally accepted as a possible symptom of food allergy, which is why they are dealt with here.
There is little doubt that psychosomatic factors play a part in stomach ulcers, even where there is some other underlying cause. Research has shown that by learning to relax, patients can reduce the likelihood of their ulcer recurring after treatment.