Yet Another Benefit of Mastic Is Discovered

Got Heartburn? Try Mastic!
If you have H. pylori, getting rid of it can help slow down your heartburn

ating good food is one of life's simple pleasures. Our gastronomical delights range from the juicy sweetness of a just-picked strawberry to the melt-in-your mouth goodness of oven-fresh bread to the lavish decadence of a traditional Thanksgiving Day feast. Yet for nearly 20 million Americans, the pleasures of food can be bittersweet, turning distinctly unpleasant in a very short time. That's because they suffer from gastroesophageal reflux disease (GERD), commonly referred to as heartburn.1


When the lower esophageal sphincter (LES) becomes "incompetent" (weak), the result is acid reflux, a form of regurgitation.

GERD is emerging as a major national health concern, as evidenced by the fact that omeprazole (Prilosec®), a drug that is used to treat heartburn by inhibiting the production of stomach acid, is the world's best-selling prescription medication.1 In fact, this single drug generates revenues of more than $4.6 billion per year. Clearly, a lot of people are anxious to alleviate the symptoms of GERD, which can include - in addition to the pain of heartburn - difficulty in swallowing, chronic cough, sore throat, hoarseness, and nocturnal wheezing. Severe cases can lead to complications in the esophagus, such as stricture (abnormal narrowing), bleeding, ulceration, and even perforation. Hospitalization or surgery may be required.

New research indicates that the presence of the pernicious bacterium Helicobacter pylori in the gastrointestinal tract may impair one's ability to recover from GERD. Eradication of H. pylori is therefore recommended. The conventional medical approach is to use a combination of prescription drugs that are effective but that have unpleasant side effects. A more natural method, which is also effective but which has virtually no side effects, is to use mastic, a resinous herbal product that has been used for millennia in the Mediterranean region as a food and chewing gum to alleviate the symptoms of stomach and intestinal disorders.

The smooth and efficient functioning of our digestive system relies on a combination of activities within the gastrointestinal tract. Mechanical digestion of our food begins with chewing but is carried out in earnest by a rhythmic churning action of the stomach. Meanwhile, chemical digestion begins mildly with saliva but "goes nuclear" with the action of hydrochloric acid and powerful digestive enzymes in the stomach.

These combined stomach processes produce a highly acidic, semiliquid mass called chyme (pronounced kime), which after several hours is passed slowly (squirt by squirt) into the duodenum, the first segment of the small intestine. It is there that most of the nutrients released by the stomach's digestive processes are absorbed into the bloodstream (by passing through the intestinal walls).

Each part of the gastrointestinal tract is specially designed for its particular function. The delicate epithelial cells that constitute the inner lining of the stomach, for example, are protected from the powerful acid/enzyme brew by a thick layer of mucus. The two neighboring parts, however - the esophagus and the duodenum - have no such protection. That is not usually a problem for the duodenum, which has a mechanism for neutralizing the acidity of the chyme it receives from the stomach. It is a big problem for the esophagus, however, which is not designed to deal with strong acids.

The esophagus is separated from the stomach by a circular group of muscles called the lower esophageal sphincter (LES). As soon as food passes through the esophagus into the stomach, the LES closes tightly and prevents the "reflux" (backflow) of chyme into the esophagus. In GERD, however, the LES does not close tightly enough, and chyme enters the esophagus, which can become painfully irritated or inflamed as a result. The LES, unfortunately, is not a muscle group you can keep well-toned through exercise - it is not under voluntary control.

The severity of GERD depends on the acidity of the chyme and the amount of time it spends in the esophagus. Not surprisingly, prolonged contact with especially acidic material will produce the severest symptoms. The principal one, heartburn, is called that simply because it's felt in the region of the heart. The pain is often mistaken, in fact, for that of an actual heart attack. (Unfortunately, the reverse mistake is also common, often with fatal results because treatment is not sought until it's too late.)

Although there are prescription and over-the-counter drugs to minimize the occurrence of GERD and to alleviate its symptoms, there is no completely effective treatment. But for some GERD victims - namely, those who also happen to be infected with H. pylori - there is a good way to slow down the recurrence of GERD episodes. That way is to eradicate the H. pylori infection.

Research published recently in the British medical journal The Lancet demonstrates that individuals infected with H. pylori suffer relapses of GERD much sooner, on average, than their uninfected peers.2 The research, which was conducted in Switzerland, involved 58 patients aged 18-75, all of whom had exhibited signs of GERD for a period of at least 4 weeks before the study began.

The patients were divided into three groups. Those in Group 1 (29 individuals) were H. pylori-negative and thus served as the controls. The remaining patients, all H. pylori-positive, were randomly assigned to one of the two other groups. The 13 individuals in Group 2 were treated with antibiotics to eradicate the bacterial infection, but the 16 individuals in Group 3 did not receive eradication therapy and thus retained their H. pylori infection throughout the study. All three groups, however, were treated identically for relief of their GERD symptoms: they received a daily dose of 30 mg of lansoprazole (Prevacid®) for 8 weeks. Lansoprazole, which is similar to omeprazole, is a proton pump inhibitor (PPI), a type of drug that reduces stomach acidity.

For GERD victims who are also
infected with H. pylori, there is a
good way to slow down the
recurrence of heartburn episodes:
eradicate the infection.

All the patients were monitored for the next 6 months to determine how they fared with respect to GERD symptoms. It was found that those who had never been infected with H. pylori (Group 1) fared the best: it took 110 days, on average, for the symptoms of GERD to return after the PPI treatment was stopped. Those patients who had had their H. pylori eradicated by antibiotics during the treatment phase of the study (Group 2) fared almost as well, with a relapse occurring in 100 days, on average. However, those with ongoing active H. pylori infections (Group 3) exhibited a much more unfavorable relapse time: their GERD symptoms returned in 54 days, on average, after the PPI treatment was stopped.

What Causes GERD? What Can One Do?
Gastroesophageal reflux disease can be caused or exacerbated by a number of factors. Any condition that places pressure on the lower esophageal sphincter or that increases the production of stomach acid is likely to increase the risk of GERD. Such factors include:
  • Being overweight, which likely causes increased pressure from the stomach to be exerted on the esophageal sphincter. Weight loss is often associated with improvement of GERD symptoms.
  • Smoking, which stimulates the production of excess stomach acid.
  • Muscle strain on the abdomen, e.g., from vomiting, straining at stool, heavy lifting, or frequent bending.
  • Ulcers and hernias, which may delay gastric emptying, making the chyme more acidic and prolonging the period of potential distress.

On a more positive note, it is encouraging to know that you can implement a number of lifestyle changes to decrease the severity of GERD symptoms.8 For example, you should:

  • Reduce the fat content of your diet, to speed gastric emptying.
  • Avoid foods that may aggravate your symptoms, such as citrus fruits and juices, tomatoes, coffee, and chocolate (sorry!).
  • Refrain from eating for 2–3 hours before bedtime, to minimize the amount of acid in your stomach when you're horizontal. (So don't lie down during that period either.)
  • Elevate your head and upper torso during sleep to relieve pressure on your esophageal sphincter. A more natural method than drugs for eradicating H. pylori is mastic.

Although the treatment used for H. pylori infections in this study was with antibiotics, the results would probably have been similar if mastic had been used instead. Because mastic is an effective H. pylori killer, its benefits extend far beyond those of GERD.

Once H. pylori takes up residence in the gastrointestinal tract, it can cause a variety of insults to your system. Not only does the infection upset the normal function of the stomach, but especially dense colonies of the bacteria can lead to gastritis. Gastritis is an inflammatory disease of the stomach lining, and localized erosion of this lining can result in stomach pain, bloating, nausea, and vomiting. In some cases, gastritis proceeds through a number of other phases and ultimately leads to stomach cancer.

Eradication of H. pylori helps to prevent gastritis and may also protect against the formation of precancerous growths called intestinal metaplasias.3 For example, Japanese researchers have demonstrated that 12-15 months after eradication of H. pylori, patients experienced an improvement in both intestinal metaplasia and glandular atrophy (a condition in which mucus- and acid-producing glands of the stomach gradually lose their function). Conversely, patients in whom H. pylori was not eradicated showed no significant improvement in either condition during the same time period.

A more natural method than drugs
for eradicating H. pylori is mastic.

Over 50% of the world’s population is predicted to be infected with H. pylori.4 In light of the fact that H. pylori is believed to promote chronic gastritis, gastric (stomach) ulcers, and duodenal ulcers, this is indeed a sobering statistic. (About 80% of all duodenal ulcers, e.g., are thought to be caused by H. pylori infection.5) Thus it is not surprising that eradication of H. pylori is encouraged by the National Institutes of Health as a method to treat peptic ulcers (ulcers of the stomach or duodenum).6

There is a variety of drugs on the market to wipe out bacterial colonies in your digestive tract. The treatment most widely employed is called "triple therapy" and typically consists of a cocktail of two antibiotics and a proton pump inhibitor. Although it works well, it has a significant disadvantage in addition to its unpleasant side effects: it is a nonselective therapy that destroys a wide range of beneficial bacteria as well as the harmful ones. Wouldn't it be nice if there were a more selective approach to eradicating H. pylori?

Fortunately, there is: it's the H. pylori killer mastic, which is derived from the stem and leaves of a Mediterranean evergreen tree (Pistacia lentiscus). Mastic also inhibits the growth of other potentially dangerous bacteria, such as Staphylococcus aureus, Escherichia coli, and Sarcina lutea, to protect the normal function of the digestive system.


  1. Reuters Health, New York, June 1, 2001.
  2. Schwizer W, Thumshirn M, Dent J, et al. Helicobacter pylori and symptomatic relapse of gastro-oesophageal reflux disease: a randomised controlled trial. Lancet 2001;357:1738-42.
  3. Ohkusa T, Fujiki K, Takashimizu I, et al. Improvement in atrophic gastritis and intestinal metaplasia in patients in whom Helicobacter pylori was eradicated. Ann Int Med 2001;134:380-6.
  4. Goodwin CS, Mendall MM, Nothfield TC. Helicobacter pylori infection. Lancet 1997;349:265-9.
  5. Peterson WL, Ciociola AA, Sykes DL, et al. Ranitidine bismuth citrate plus clarithromycin is effective for healing duodenal ulcers, eradicating H. pylori and reducing ulcer recurrence. Aliment Pharmacol Ther 1996;10:251-61.
  6. NIH Consensus Conference. Helicobacter pylori in peptic ulcer disease. NIH consensus development panel on Helicobacter pylori in peptic ulcer disease. JAMA 1994;272:65-9.
  7. Schempp CM, Pelz K, Wittmer A, et al. Antibacterial activity of hyperforin from St. John's wort, against multiresistant Staphylococcus aureus and gram-negative bacteria. Lancet 1999;353:2129.
  8. Mullick T, Richter JE. Chronic GERD. Strategies to relieve symptoms and manage complications. Geriatrics 2000;55:28-43.

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