The highly concentrated acid produced by the stomach is quite capable of burning a hole through the tissue of the stomach and duodenum (part of the small intestine). That it usually does not do so is a tribute to the effectiveness of the methods that the body uses to protect itself. However, sometimes these protective mechanisms fail, and the ever-present acid begins to produce an ulcer.

Ulcer pain is caused by stomach acid coming into contact with unprotected tissue. Eating generally decreases ulcer pain temporarily because food neutralizes the acid. As soon as the food begins to be digested, the pain returns.

Conventional medical treatment for ulcers has gone through a slow revolution. A few decades ago, the prescribed response to ulcers was a bland diet—one low in spices and high in dairy products, which were believed to coat the stomach. However, eventually it was discovered that spicy foods are innocent and that milk itself is somewhat ulcer forming! The only other option at that time was surgery.

Next came antacids containing magnesium and aluminum. However, these were seldom strong enough to allow the ulcer to heal fully. Ulcer treatment took a big step forward with the development of Tagamet (cimetidine), followed by Zantac (ranitidine), Pepcid (famotidine), and others. These H2-blocking drugs dramatically lower the stomach's production of acid. Later, a new class of even more potent acid suppressors appeared, the proton-pump inhibitors, led by Prilosec (omeprazole).

When stomach acid is suppressed, ulcer pain rapidly diminishes and the ulcer heals. For a time, these drugs were regarded as the definitive answer to ulcers. This early enthusiasm began to fade when it became clear that ulcers frequently returned after the drugs were stopped. In the late 1980s, a new explanation for this problem began to surface. First regarded as a wacky theory, it has now become the accepted explanation.

We now believe that ulcers are caused by the bacteria Helicobacter pylori. Apparently, this previously ignored organism has the capacity to infect the stomach and, by so doing, weaken the stomach lining. When antibiotics to killH. pylori are combined with stomach acid suppressants ulcers are far more likely to go away and stay away. However, it isn’t easy to kill H. pylori; antibiotic treatment is not always successful, and it has side effects. Friendly bacteria (probiotics) may help this treatment work better.

Probiotics are bacteria that are healthy for you. The most famous probiotic is Lactobacillus acidophilus, found in yogurt. There are many other probiotics, as well.

Evidence suggests that various probiotics in the Lactobacillus family can inhibit the growth of H. pylori.24-27,51 While this effect does not appear to be strong enough for probiotic treatment to eradicate H. pylorion its own, preliminary studies, including several small, double-blind trials, suggest that probiotics may help standard antibiotic therapy work better, reducing side effects, and improving the rate of eradication.24-25,28-32,41-42,44,48,49,50,52,53

For more information, including dosage and safety issues, see the full Probiotic article.