Waquaruddin Ahmed, Ambreen Arif, Raheel Ather, Syed Ejaz Alam.
Comparison of healing of duodenal ulcer with herbal medicine versus allopathic medici.
Pak J Med Res Jan ;50(3):97-100.

Background: Proton pump inhibitors heal over 90% cases of duodenal ulcer but these are expensive. Many patients are reluctant to use allopathic treatment and therefore, use alternate herbal medicines to achieve the same results. There is no head to head comparison of the efficacy of herbal treatment with standard allopathic treatment available in the literature. Objectives: To compare the healing rates of duodenal ulcer using either herbal drugs (Andamali + Susi + Qarheen ) or allopathic medicines (proton pump inhibitor). Patients and Methods: Endoscopically diagnosed cases of duodenal ulcer were assigned to two groups where one group received herbal medicine and the other received proton pump inhibitor for 4 weeks (Clarithromycin and Amoxicillin were added for a week for Helicobacter pylori positive cases). Healing was checked on endoscopy at the completion of therapy. Complete blood count, liver function tests, urea and creatinine were done initially and at the end of therapy to see any adverse effects of the therapy. Other side effects were also noted during the study. Results: A total of 42 endoscopically proven cases of duodenal ulcer were included in the study, 22 patients received proton pump inhibitor (group A) and 20 received herbal medicine (group B). Seven cases (5 in group A and 2 in group B) were lost to follow up and were thus excluded from the study. Thirty-five cases (17 group A, 18 group B) completed the study. Out of these 35 cases, 29(82.85%) were males and 6(17.1%) females. Helicobacter pylori was present in 19(54.3%) cases (10 in group A and 9 in group B). After 4 weeks of therapy, 16(94%) cases healed with proton pump inhibitors and 13(72%) healed in herbal medicine group. The difference in healing rates was not significant. Using proton pump inhibitors along with 2 antibiotics in the Helicobacter pylori positive cases, 9 out of 10(90%) showed healing of ulcer, while 7 out of 9(78%) cases in herbal medicine group who were positive for Helicobacter pylori, but did not receive antibiotics also showed healing. Regarding adverse effects, bitter taste in mouth was reported in 5(29%) and diarrhea in 2(12%) patients, receiving triple regimen in group ‘A’ against only 2(11%) patients who had similar complaints with herbal medicine. No significant change was observed in the hematological and biochemical parameters like CP, LFTs, urea and creatinine from the baseline to the end of therapy in both groups. Conclusions: Healing of duodenal ulcer is almost similar with both herbal and standard allopathic drugs; however, adverse effects were more common with allopathic drugs. Policy message: Herbal medicine can be used to treat duodenal ulcer.

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