March 29, 2006:- Dear Reader, "My daughter suffers greatly with an esophageal ulcer. Can you recommend anything that will help?"

After receiving that request from an HSI member named Vern, I discovered that esophageal ulcers are often associated with excess stomach acid. As long-time readers know, HSI Panelist Allan Spreen, M.D., has occasionally offered tips on how to manage excess acid in the gastrointestinal (GI) tract without resorting to powerful antacid drugs. So I checked in with Dr. Spreen and he offered a plan that will hopefully provide Vern's daughter (and others) with welcome relief.


Six up

Here are Dr. Spreen's six steps for addressing an esophageal ulcer:

1. First, of course, you need to track down the cause of the ulcer, if possible. An aspirin stuck in the esophagus, for example, can do the job nicely, as can some other drugs. Esophageal ulcers are not common, so the cause may be unusual.

2. If no known cause presents, a Heidelburg gastrogram might be in order (all of this should be monitored by a health care practitioner knowledgeable in nutrient therapeutics). That's a capsule/transmitter that's swallowed to show the acidity of the GI tract at different points. If the acidity is low (i.e., high pH), digestive enzymes could be in order, to cause the G-E sphincter (the trap door between the stomach and the esophagus) to tighten (it loosens if there's inadequate acid).

3. L. acidophilus powder should be used pretty heavily, in my opinion. The liquid variety is okay, but it tastes pretty bad. Capsules can be opened, squeezing the powder onto the tongue and letting the saliva (and minimal water) take it down. It has a non-acid-neutralizing protective effect.

4. Dissolving De-Glycerrhizinated Licorice (DGL) can help. Hopefully she likes licorice, because that's what it tastes like.

5. I haven't tried Potter's Acidosis for this, but it might be worthwhile. This herbal formula is a traditional remedy that relieves acid indigestion.

6. If a known cause is unavailable, a close examination of the diet is in order. All soft drinks (especially those with phosphoric acid), refined sugars and flours, and artificial agents need to go. A food diary and a good nutritionist (experienced in nutrient therapies...RD's are not usually well-versed here) would be most helpful.

Six...and then some

I have a few notes to add to Dr. Spreen's six tips.

Acidophilus is available at most health food stores and through many Internet sources. Dr. Spreen recommends refrigerated varieties in capsules or powdered form. And he adds: "They should be measured in billions (with a 'B') of cfu (colony-forming units)."

The DGL brand recommended by Dr. Spreen is made by Enzymatic Therapy (www.enzy.com). He suggests that patients chew or suck on a tablet 20 minutes before eating.

Potter's Acidosis is an herbal product that includes meadowsweet (an antacid and anti-inflammatory), medicinal vegetable charcoal (excess acid neutralizer), and rhubarb (an astringent and digestive aid). It's made in England and is somewhat difficult to find in the U.S. You can get more information at the web site for Academy Health (www.academyhealth.com).

Vern states that his daughter suffers greatly from her esophageal ulcer, so I assume she's already under a doctor's care. Before trying any of these natural treatments she should discuss their use with her doctor or a health care professional. In step 2 above Dr. Spreen notes the importance of monitoring by a health care practitioner knowledgeable in nutrient therapeutics. You can find doctors like these who practice in your area by searching the web site for the American College for Advancement in Medicine (www.acam.org ), or the web site for the International College of Integrative Medicine (www.icimed.com ).

To Your Good Health, Jenny Thompson