Ulcers: An Old Cure

Last Editorial Review: 1/30/2005

Can ancient oils serve as modern-day medicine?

By Charles Downey
WebMD Feature

May 29, 2000 -- To raise funds for his famous expedition, Christopher Columbus reportedly promised he would bring back four precious commodities: gold, spices, cotton, and mastic.

Gold? Of course. Spices? Certainly. But mastic? Mastic oil comes from the sap of a rare cousin of the pistachio tree. In ancient times, doctors, including Hippocrates and Galen, prized it for its ability to cure stomach ulcers and gum disease.

Now researchers are beginning to confirm that mastic kills Helicobacter pylori, the bacterium responsible for most ulcers in the stomach and small intestine. Prompted by this finding, in March 2000, a British pharmaceutical company began marketing this ancient remedy in capsule form.

Out of Favor

Until recently, mastic was hard to find because the bushy Pistacia lentiscus tree grew only on the island of Chios, Homer's legendary birthplace in the central Aegean, seven miles off the coast of Turkey. For centuries, people of the Mediterranean have cooked with the tree's oil and chewed gum made from its resin to freshen their breath and soothe stomach pains. But it long ago fell out of favor with Western doctors.

"Mastic disappeared from medicine for many centuries because when universities were established, pharmacological knowledge was not included," says John Riddle, PhD, professor of history at North Carolina State University. "Learned men of the time did not trust folk cures based on herbs."

But in 1982 the discovery that H. pylori causes most ulcers in the stomach and small intestine spurred a search for new treatments. Middle Eastern doctors who remembered the ancient remedy decided to test mastic scientifically.

In one such study, reported in the September-October 1984 issue of Clinical Experiments in Pharmacological Physiology, researchers assigned 38 patients with duodenal (intestinal)ulcers to two groups. One group took a gram a day of mastic and the other group took a placebo. Of those taking the mastic, 70% healed, compared with only 22% of the patients taking the placebo. Patients reported no side effects, and further experiments showed that mastic can kill H. pylori in test tubes.

Now John Atherton, MD, a gastroenterologist at Nottingham University, England, is testing mastic in patients known to be infected with H. pylori. "There are a handful of scientific papers from the Middle East showing how mastic cures ulcers and reduces heartburn," says Atherton. "But there are no good studies from the U.S. or from Britain. (And) we want to see if mastic works by killing the bacterium H. pylori or by some other protective action on the stomach."

Some researchers think mastic may ease ulcer symptoms by stimulating the stomach to thicken the lining of mucus that shields it from acid.

The treatment is still virtually unknown in the United States. "We have not heard of that yet," says Jennifer Rittman, communications director for the American College of Gastroenterology. The British herbal products company Goldshield Healthcare sells mastic in British pharmacies under the trade name Mastika and plans to sell the treatment to U.S. customers through its web site (http://www.mastika.com). The company is marketing mastic as a food supplement because the research is so preliminary that neither the British nor the U.S. government have approved it as a medicine.

A Bargain Treatment

Little research has tested mastic's long-reputed power to fight gum disease; scientists have focused on its potential as an ulcer treatment because ulcers can be deadly, H. pylori increases the risk of gastric cancer, and the standard antibiotic treatments are expensive.

"My hope for mastic is that it will provide more ulcer cures in poor Third World countries where as many as 90% of people are infected [with H. pylori]," says Dlawer Ala'Aldeen, MD, Nottingham University professor of clinical microbiology. "The best antibiotic ulcer treatments can cost the equivalent of several months' income for some families in Africa."

A course of treatment with mastic for ulcers -- four to eight 250-milligram capsules a day for four weeks -- costs about $30. The out-of-pocket cost for a course of antibiotics for ulcers is about $100.

Not only are antibiotics more expensive than mastic, they often cause side effects. And H. pylori is becoming resistant to metronidazole, the current first-choice antibiotic for ulcers in many poor nations. So far, no one has tested mastic and antibiotics head-to-head to see which is most effective for ulcers.

Farmers on Chios are doing well selling mastic where most Pistacia lentiscus still grow, but a few trees have already been planted elsewhere in Mediterranean climes, according to a Goldshield Healthcare spokesperson.

Riddle thinks the story of mastic's revival offers a lesson that other researchers should study. "If today's pharmaceutical firms would read more of the ancient Greek, Roman, and Egyptian medical texts, they may not have to constantly reinvent the wheel," he says. "We could have had mastic much sooner."

Charles Downey writes frequently about medicine and early childhood development for The New York Times Syndicate. He has also written for Reader's Digest, Playboy, McCall's, Woman's Day, and Boys' Life.

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