May 2007: Cranberry, Helicobacter, and Ulcers
Although many factors contribute to the development of ]]>peptic ulcers]]> (ulcers of the stomach or duodenum), their underlying cause is infection with the bacterium Helicobacter pylori . Powerful stomach acid suppressants decrease pain and reduce ulcer size, but no matter, once they are stopped the ulcers commonly recur. To accomplish a permanent cure, it may be necessary to eliminate the underlying infection with H pylori .
Unfortunately, H pylori , is a tough bug to kill. Combination treatment with multiple drugs is required. However, even this may fail to eradicate it. Some research hints that ]]>cranberry juice]]> may help.
Cranberry juice is best known as a treatment for ]]>bladder infections]]> . It is thought to work by preventing adhesion of bacteria to the bladder. Preliminary evidence suggests that cranberry might similarly help prevent the adhesion of H pylori to the stomach wall. In theory, this could enhance the effectiveness of drug treatment by making it more difficult for the bacteria to “hide” in the tissue of the stomach wall.
A ninety day, double-blind, placebo-controlled study performed in China tested the effects of daily consumption of cranberry juice on individuals who were already infected with helicobacter (but who didn’t necessarily have ulcers). The results indicated that use of cranberry significantly decreased levels of H pylori in the stomach, presumably by causing some of the detached bacteria to be “washed away.”
However, while this was a promising finding, it did not directly address treatment or prevention of ulcers.
A more practical study was published in May 2007. This double-blind trial of 177 people with ulcers evaluated the use of cranberry as a support to standard therapy. All participants were given one week of treatment with a common triple-drug cocktail used to eradicate H pylori : omeprazole, amoxicillin, and clarithromycin (OAC). They were additionally given either placebo or cranberry juice during the week of OAC and continuing for two weeks afterwards. Researchers also looked at a third group attending the same clinic and who received only OAC.
The results were somewhat promising. In the study group at large, OAC plus cranberry was no more effective than OAC plus placebo or OAC alone. However, among female participants in the study, use of cranberry was associated with a significantly increased rate of helicobacter eradication as compared to placebo or no treatment.
Does this mean that women undergoing ulcer treatment may benefit from cranberry? Perhaps, but not necessarily. When a treatment fails to produce benefit in the entire group studied, researchers may, after the fact, go on a hunt for a subgroup who did benefit. The laws of chance alone ensure that they can almost always find one. Therefore, it is not clear whether cranberry actually did provide benefit, or whether this finding was merely a statistical fluke.
Burger O, Ofek I, Tabak M, et al. A high molecular mass constituent of cranberry juice inhibits Helicobacter pylori adhesion to human gastric mucus. FEMS Immunol Med Microbiol . 2000;29:295-301.
Shmuely H, Yahav J, Samra Z, et al. Effect of cranberry juice on eradication of Helicobacter pylori in patients treated with antibiotics and a proton pump inhibitor. Mol Nutr Food Res . 2007 May 9 [Epub ahead of print].
Zhang L, Ma J, Pan K, et al. Efficacy of cranberry juice on Helicobacter pylori infection: a double-blind, randomized placebo-controlled trial. Helicobacter . 2005;10:139-45.
Last reviewed by ]]>Steven Bratman, MD]]>
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