To 20th-Century man, the peptic ulcer is almost a cliche.
In countless situation comedies, cartoons, parodies and nightclub routines the ulcer has appeared as the demon that sends the over-stressed, overworked, tyrannized office worker straight to the refrigerator for a tall glass of buttermilk.
But medical researchers at UC Irvine say they believe that they know precisely what prevents--and may cure--ulcers; and the traditional panaceas are nowhere on the list.
According to Dr. Daniel Hollander, chief of the division of gastroenterology at the California College of Medicine at UCI, a long vacation won't do it because stress isn't to blame. Milk won't, either. In fact, milk probably will make the burning pain worse. Gobbling antacids will only relieve the pain temporarily.
What the sufferer with the fiery stomach probably could use, said Hollander, is a salad with light Italian dressing.
If the oil used in the dressing is processed from vegetables, said Hollander, it will trigger a chemical conversion process in the body that produces a hormone-like compound that protects the stomach lining against ulceration. Ulceration of the stomach lining can be caused by, among other things, aspirin, alcohol, bile acids and other irritants, Hollander said.
Hollander and another researcher, Dr. Andrzej Tarnawski, a UCI professor of medicine and head of the division of gastroenterology at Veterans Hospital in Long Beach, are, Hollander said, the first researchers to discover that the essential fatty acids found in most vegetable oils could prevent the formation of ulcers in the stomachs of animals.
The findings of their three-year study were published in the March issue of GUT, the journal of the British Society of Gastroenterology.
Linoleic acid, which is found in safflower, corn, cottonseed, sunflower seed, soy and sesame oils (but not olive oil), is needed for the synthesis in the body of arachidonic acid, another essential fatty acid that is converted by the body into compounds called prostaglandins, Hollander said. It is the prostaglandins, he said, that not only help prevent ulcerations of the stomach lining from forming, they appear to help heal existing ulcers.
Conversely, Hollander said, an absence of prostaglandins appears to be a principal cause of ulcers.
"The biggest cause," he said, "seems to be genetic predisposition, something that can be passed from parents to children. Also, some people's bodies may not be able to use the essential fatty acids to generate prostaglandins. Others may have an inadequate dietary intake of the essential fatty acids."
Today, Hollander said, about 10% of Americans suffer some degree of stomach ulceration, most of it slight.
"Less than 10% of those people with ulcers get to the point where it's life threatening," he said, "but when you consider how many that is in the United States, the number is pretty high."
What does not cause ulcers, he said, is stress.
"It seems like people who have ulcer disease and undergo stress find that the disease recurs," Hollander said, "but that will happen with other diseases, too. Stress alone won't cause the disease."
Also, he said, milk, often considered a reliever of the burning pain of ulcers, actually can make the problem worse because the calcium found in it can stimulate the production of acid that can further irritate the inflamed stomach lining.
Shift From Animal Fats
Hollander said he and Tarnawski believe that Americans' shift from the consumption of animal fats to vegetable oils since the 1920s is responsible for the large drop in mortality from ulcer disease in the last five decades.
In 1921, Hollander said, 40 out of every 1 million American men in their 50s died as a result of ulcer disease. In 1976, only seven per million died. Hollander said this data was compared to the consumption of essential fatty acids found in vegetable oils, which has increased by 200% in the United States since 1909.
Hollander and Tarnawski conclude in their report that "the marked increase in the dietary availability of essential fatty acids could be responsible at least in part for the marked decrease in the incidence and virulence of peptic ulcer disease."
"There's been a switch in the Western world in the last few decades away from animal fats that are found in things like butter, cream, whole milk, lard and some meats," said Hollander. "We think it's because of economics on one hand because vegetable oils are cheaper to make and also because organizations like the American Heart Assn. have been pushing for avoidance of animal fats and cholesterol in people's diets."
Perhaps the greatest ingestible enemy of the ulcer sufferer, Hollander said, is alcohol. It is pure alcohol, in fact, that he and Tarnawski used as an irritant to the stomach lining of rats during their research.
Experiments on Humans
And the two doctors, he added, have begun similar experiments on human volunteers with no ulcer disease, spraying small amounts of alcohol directly on the stomach lining through a tube called a gastroscope that is inserted through the mouth.
"I think we're going to find that essential fatty acids can cure existing ulcer disease," Hollander said.
And it is possible, he said, that "within two or three years" a pill may be produced that contains the essential fatty acids needed to produce prostaglandins for people with recurrent ulcers.
"Until then, though," Hollander said, "the best thing to do is to eat a normal, well-rounded diet. That should contain enough vegetable oils naturally to do the job for most people."