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World J Gastrointest Pathophysiol. Feb 15, 2014; 5(1): 40-47
Published online Feb 15, 2014. doi: 10.4291/wjgp.v5.i1.40
Quality of healing of gastric ulcers: Natural products beyond acid suppression
Napapan Kangwan, Jong-Min Park, Eun-Hee Kim, Ki Baik Hahm
Napapan Kangwan, Jong-Min Park, Eun-Hee Kim, Ki Baik Hahm, CHA Cancer Prevention Research Center, CHA Cancer Institute, CHA University, Seoul 135-081, South Korea
Napapan Kangwan, Eun-Hee Kim, College of Pharmacy, CHA University, Pocheon 487-010, South Korea
Ki Baik Hahm, Department of Gastroenterology, CHA University Bundang Medical Center, Seongnam 463-828, South Korea
Author contributions: Kangwan N, Kim EH and Hahm KB contributed to the study design, data acquisition and analysis, and manuscript preparation; Park JM drafted and revised the article critically for important intellectual content; all the authors read and approved the final manuscript for publication.
Supported by The National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED) Grant (A102063) from the Ministry of Health and Welfare, South Korea
Correspondence to: Ki Baik Hahm, MD, PhD, AGAF, Professor, CHA Cancer Prevention Research Center, CHA Cancer Institute, CHA University, 605, Yoeksam1-dong, Gangnam-gu, Seoul 135-081, South Korea. hahmkb@cha.ac.kr
Telephone: +82-2-34682869 Fax: +82-2-34682649
Received: June 20, 2013
Revised: September 30, 2013
Accepted: October 17, 2013
Published online: February 15, 2014
Abstract

Gastric ulcer is a chronic disease featured with unexpected complications, including bleeding, stenosis and perforation, as well as a high incidence of recurrence. Clinical treatments for gastric ulcer have allowed the rapid development of potent anti-ulcer drugs during the last several decades. Gastric ulcer healing is successful with conventional treatments including H2-receptor antagonists, and proton pump inhibitors (PPIs) have been essential for ulcer healing and prevention of complications. Additionally, Helicobacter pylori eradication therapy is effective in reducing ulcer recurrence and leads to physiological changes in the gastric mucosa which affect the ulcer healing process. However, in spite of these advancements, some patients have suffered from recurrence or intractability in spite of continuous anti-ulcer therapy. A new concept of the quality of ulcer healing (QOUH) was initiated that considers the reconstruction of the mucosal structure and its function for preventing ulcer recurrence. Although several gastroprotection provided these achievements of the QOUH, which PPI or other acid suppressants did not accomplish, we found that gastroprotection that originated from natural products, such as a newer formulation from either Artemisia or S-allyl cysteine from garlic, were very effective in the QOUH, as well as improving clinical symptoms with fewer side effects. In this review, we will introduce the importance of the QOUH in ulcer healing and the achievements from natural products.

Keywords: Quality of ulcer healing, Natural products, Gastric ulcers, Acid suppression, S-allyl cysteine, Artemisia isopropanol extract

Core tip: Clinical treatments for gastric ulcer have allowed rapid development of potent anti-ulcer drugs, such as H2-receptor antagonists or proton pump inhibitors, which has been essential for ulcer healing and the prevention of complications. However, many patients have still suffered from recurrence or intractability in spite of continuous anti-ulcer therapy. The concept of the quality of ulcer healing is that we should consider the reconstruction of the mucosal structure and its function for preventing ulcer recurrence. In this review, we will introduce the importance of the quality of ulcer healing and the achievements from natural products.