184 | id == 184
184 | category_id == 16
184 | category_order == 13
184 | category_name == Gut Health
184 | category_color == #C47AC0
184 | slug == CYP2C19-Peptic-Ulcers
184 | title == Can This Gene Increase Your Risk of Peptic Ulcers? (CYP2C19)
184 | meta_description == The CYP2C19 gene encodes an enzyme that breaks down drugs and is associated with peptic ulcers. Learn where your variant stands
184 | summary == <p style="text-align:justify"><strong>The CYP2C19 gene encodes an enzyme that breaks down many clinical drugs. A highly active variant of this gene has been associated with peptic ulcers. Read on to learn if your variant increases your risk of this condition.</strong></p>
184 | overall_score_text == Peptic Ulcer Score (based on CYP2C19 gene)
184 | image == https://sd-selfdecode-assets-prod.s3.amazonaws.com/blog/background/CYP2C8--Gut-Inflammation-Ulcers---all-chips.jpg
184 | author_id == 12
184 | author_name == Carlos Tello
184 | author_title == PhD
184 | author_order == 55
184 | author_photo == https://sd-selfdecode-assets-prod.s3.amazonaws.com/blog/author-photo/CarlosTello.webp
184 | author_intro == <p><strong>Carlos received his PhD and MS from the Universidad de Sevilla.</strong></p>    <p>Carlos spent 9 years in the laboratory investigating mineral transport in plants. He then started working as a freelancer, mainly in science writing, editing, and consulting. Carlos is passionate about learning the mechanisms behind biological processes and communicating science to both academic and non-academic audiences. He strongly believes that scientific literacy is crucial to maintain a healthy lifestyle and avoid falling for scams.</p>
184 | author_social_media_name == linkedin
184 | author_social_media_icon == https://sd-selfdecode-assets-prod.s3.amazonaws.com/blog/social-icon/linkedin.png
184 | author_social_order == 1
184 | author_social_link == https://www.linkedin.com/in/carlos-tello-lacal-b946b4a7/
184 | reviewer == None
184 | medical_reviewer_id == 11
184 | medical_reviewer_name == Puya Yazdi
184 | medical_reviewer_title == MD
184 | publish_date == 2020
184 | publish_date == 5
184 | publish_date == 13
184 | avg_rating == 5.0
184 | tags_id == 429
184 | tags_name == CYP2C19 Gene
184 | tags_id == 431
184 | tags_name == Drugs
184 | tags_id == 432
184 | tags_name == H. pylori
184 | tags_id == 140
184 | tags_name == Metabolism
184 | tags_id == 430
184 | tags_name == Peptic Ulcers
184 | tags_id == 433
184 | tags_name == Proton Pump Inhibitors
184 | permissions_favorite == False
184 | permissions_rate == False
184 | content_article == <p><em><span style="font-weight: 400;">This article is for informational purposes only. None of the information here should be taken as medical advice. If you suspect you may have peptic ulcers, seek medical help immediately. </span></em><em><span style="font-weight: 400;">Keep in mind that these results are based on association studies, which are correlative and aren&rsquo;t necessarily causative. In addition, any single genetic variant will typically contribute only a small proportion to the overall risk of the condition, and non-genetic factors play a large role in developing a condition as well. Therefore, just because you have one of these genotypes does not necessarily mean you are at increased risk of developing this condition!</span></em></p> <h2><strong>What Is the <em>CYP2C19 </em>Gene?</strong></h2> <p><span style="font-weight: 400;">The </span><a href="../../gene/CYP2C19/"><em><span style="font-weight: 400;">CYP2C19 </span></em><span style="font-weight: 400;">gene</span></a><span style="font-weight: 400;"> encodes a member of the </span><a href="https://selfhacked.com/blog/cyp-enzymes-interact-supplements-related-genes/"><span style="font-weight: 400;">cytochrome P450</span></a><span style="font-weight: 400;"> family. These enzymes are involved in the breakdown and elimination of most toxins and drugs from the body. </span><a href="https://selfhacked.com/blog/cyp2c19/"><span style="font-weight: 400;">CYP2C19 </span></a><span style="font-weight: 400;">is mostly found in the liver and metabolizes ~10% of clinical drugs, including [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164225/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/27199033"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]:</span></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Antidepressants (such as citalopram, </span><a href="https://www.selfhacked.com/blog/escitalopram/"><span style="font-weight: 400;">escitalopram</span></a><span style="font-weight: 400;">, sertraline, imipramine, and </span><a href="https://selfhacked.com/blog/amitriptyline-elavil/"><span style="font-weight: 400;">amitriptyline</span></a><span style="font-weight: 400;">) [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4512908/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/29136336"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/19884907"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/30452773"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Proton pump inhibitors (such as </span><a href="https://www.selfhacked.com/blog/omeprazole/"><span style="font-weight: 400;">omeprazole</span></a><span style="font-weight: 400;">, esomeprazole, pantoprazole, and rabeprazole) [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2432489/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/32227647"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3419350/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/25495411"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Anti-</span><a href="https://selfhacked.com/blog/natural-treatments-anxiety/"><span style="font-weight: 400;">anxiety</span></a><span style="font-weight: 400;"> drugs (such as diazepam and phenazepam) [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/28520370"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/30325732"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Blood thinners (such as clopidogrel, prasugrel, and warfarin) [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121225/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/23257377"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/27356304"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Antimalarial drugs (such as progunail and primaquine) [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045938/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/30706164"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Antifungals (voriconazole) [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391994/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Antipsychotics (clozapine) [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/28664816"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Anti-seizure medication (phenytoin) [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/32216088"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Immunosuppressants (leflunomide) [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580556/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Methadone [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/27199033"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><a href="https://selfhacked.com/blog/mdma-2/"><span style="font-weight: 400;">MDMA</span></a><span style="font-weight: 400;"> (ecstasy) [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/28117133"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> </ul> <p><span style="font-weight: 400;">Variants in the </span><em><span style="font-weight: 400;">CYP2C19 </span></em><span style="font-weight: 400;">gene may alter the rate at which these drugs are broken down. An elevated CYP2C19 activity may reduce the effectiveness of the treatment (by speeding up drug clearance) but also increase it if the drug needs to be broken down to become active, as is the case for clopidogrel.&nbsp;</span></p> <p><span style="font-weight: 400;">CYP2C19 is also involved in the metabolism of substances naturally produced in the body. For instance, it breaks down </span><a href="https://www.selfhacked.com/blog/arachidonic-acid/"><span style="font-weight: 400;">arachidonic acid</span></a><span style="font-weight: 400;"> into different epoxyeicosatrienoic acids (EETs). These molecules are involved in blood pressure regulation, blood vessel formation, and inflammation [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/19505190"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/14636671"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/17872966"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/11773611"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">This enzyme can also break down female sex hormones (estrogens), which may explain why variants with increased activity reduce the risk of breast cancer and endometriosis [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/16537715"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/19415745"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/18521743"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4150687/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Finally, its expression in the fetal brain suggests a potential role in brain development [</span><a href="https://www.futuremedicine.com/doi/full/10.2217/pgs.14.151"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;"><span style="font-weight: 400;">The </span><em><span style="font-weight: 400;">CYP2C19 </span></em><span style="font-weight: 400;">encodes an enzyme that breaks down many clinical drugs and some substances naturally produced in the body.</span></span></p> <h2><strong><em>CYP2C19 </em>Variants and Peptic Ulcers</strong></h2> <h3><strong>What Are Peptic Ulcers?</strong></h3> <p><span style="font-weight: 400;">Peptic ulcers are open sores in the lining of the upper digestive tract. They are most common in the lining of the stomach (gastric ulcers), though they can also emerge in the esophagus or small intestine [</span><a href="https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/definition-facts"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/books/NBK534792/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952291/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/books/NBK538326/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">The most common causes of peptic ulcers are NSAIDs and </span><a href="https://selfhacked.com/blog/h-pylori-part-1/"><em><span style="font-weight: 400;">H. pylori</span></em></a><span style="font-weight: 400;"> infection. They may also be caused by other medications (such as steroids and bisphosphonates) and rare diseases like Zollinger-Ellison syndrome, cystic fibrosis, and </span><a href="https://selfhacked.com/blog/hyperparathyroidism/"><span style="font-weight: 400;">hyperparathyroidism</span></a><span style="font-weight: 400;"> [</span><a href="https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/definition-facts"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/books/NBK534792/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952291/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/books/NBK538326/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <h3><strong>High CYP2C19 Activity May Increase the Risk of Peptic Ulcers</strong></h3> <p><span style="font-weight: 400;">There's a few potential hypotheses about why variations in CYP2C19 are associated with ulcers.</span></p> <p><span style="font-weight: 400;">Researchers have speculated that the effect could be due to [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/23267857"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]:</span></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Increased breakdown of proton pump inhibitors (leading to reduced protection of the stomach lining)</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Altered arachidonic acid metabolism (thus increasing inflammation and </span><a href="https://selfhacked.com/blog/oxidative-stress-101/"><span style="font-weight: 400;">oxidative stress</span></a><span style="font-weight: 400;">)</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Increased breakdown of estrogens (which seem to protect from peptic ulcers)</span></li> </ul> <p><span style="font-weight: 400;">Therefore, inhibiting this enzyme could be a good way to counteract the negative genetic effects that these variants have on ulcers.</span></p> <p><span style="font-weight: 400;">In addition, several studies have associated this variant with a faster breakdown and clearance of proton pump inhibitors. This may reduce ulcer healing and </span><em><span style="font-weight: 400;">H. pylori</span></em><span style="font-weight: 400;"> eradication by failing to lower stomach acids [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5628683/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932617/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266903/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/25495411"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2432489/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/22873740"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/28884817"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/30859680"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/20376628"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <h3><strong>Role of the rs12248560 Polymorphism</strong></h3> <p><span style="font-weight: 400;">The </span><a href="../../snp/rs12248560/"><span style="font-weight: 400;">rs12248560</span></a><span style="font-weight: 400;"> polymorphism, also known as CYP2C19*17, is located in the region that controls gene expression (the </span><em><span style="font-weight: 400;">promoter</span></em><span style="font-weight: 400;">). Its minor allele &lsquo;T&rsquo; is associated with increased gene expression and protein activity [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357098/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829691/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">In a British study of over 1,200 people in which variants of genes encoding different cytochromes were tested, the minor allele of rs12248560 was the only one associated with an increased incidence of peptic ulcers [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/23267857"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].&nbsp;</span></p> <p><span style="background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;"><span style="font-weight: 400;">Peptic ulcers are open sores in the lining of the stomach, esophagus, or small intestine. A </span><em><span style="font-weight: 400;">CYP2C19 </span></em><span style="font-weight: 400;">variant with higher activity is associated with an increased incidence of peptic ulcers and may impair their healing.</span></span></p> <h2><strong>Your <em>CYP2C19 </em>Results for Peptic Ulcers</strong></h2> <p>*9667647540254687*</p> <p>&nbsp;</p> <h3><strong>SNP Summary and Table</strong></h3> <p><strong>Primary SNP: </strong><strong><em>CYP2C19 </em></strong><strong>rs12248560&nbsp;</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;C&rsquo; = Normal risk of peptic ulcers.</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;T&rsquo; = Increased risk of peptic ulcers.</span></li> </ul> <h4><strong>Population Frequency</strong></h4> <p><span style="font-weight: 400;">The &lsquo;C&rsquo; allele is clearly the most abundant one. 72% of the world population carries two copies of this variant versus only 3% of &lsquo;TT&rsquo;.</span></p> <p><span style="font-weight: 400;">The &lsquo;T&rsquo; allele is more common in people with African and European ancestry (41% of carriers in each case) but almost non-existent in East Asian descendants.</span></p> <p>*1009104940735015*</p> <p>&nbsp;</p> <h2><strong>Strategies that May Improve Your Peptic Ulcers</strong></h2> <p>*7925740921949496*</p> <p>&nbsp;</p> <p><em><span style="font-weight: 400;">You may try the complementary approaches listed below if you and your doctor determine that they could be appropriate for you. Discuss the strategies listed here with your doctor. Remember that none of them should ever be done in place of what your doctor recommends or prescribes.</span></em></p> <h3><strong>Diet</strong></h3> <h4><strong>Dietary Polyphenols</strong></h4> <p><span style="font-weight: 400;">Multiple studies have found that certain dietary polyphenols conferred protection against peptic ulcers. </span><a href="https://www.selfhacked.com/blog/quercetin-22-scientifically-proven-benefits-quercetin/"><span style="font-weight: 400;">Quercetin</span></a><span style="font-weight: 400;">, a common flavonoid found in many fruits and vegetables, appears to protect the lining of the digestive tract by suppressing acid secretion and has been shown to inhibit CYP2C19 [</span><a href="https://pubchem.ncbi.nlm.nih.gov/compound/Quercetin"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253827/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/25196644"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Some of the foods richest in quercetin include leafy green vegetables, red grapes, and berries.</span></p> <p><span style="font-weight: 400;">Other polyphenols may protect the lining of the digestive tract by stimulating blood flow or preventing the release of </span><a href="http://selfhacked.com/blog/histamine/"><span style="font-weight: 400;">histamine</span></a><span style="font-weight: 400;">. Still others scavenge free radicals, inhibit oxidizing enzymes, and stimulate the body&rsquo;s antioxidant defense mechanisms [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253827/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458761/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3178942/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Food polyphenols proven to inhibit CYP2C19 include:</span></p> <ul> <li style="font-weight: 400;"><a href="https://selfhacked.com/blog/top-15-scientific-health-benefits-of-resveratrol-with-references/"><span style="font-weight: 400;">Resveratrol</span></a><span style="font-weight: 400;"> (found in red wine, dark chocolate, berries, and peanuts) [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/30979536"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Caffeic acid (found in sunflower seeds, apple sauce, apricots, prunes, and some herbs and spices) [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/25196644"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Bergamottin (found in </span><a href="https://selfhacked.com/blog/grapefruit/"><span style="font-weight: 400;">grapefruit</span></a><span style="font-weight: 400;"> juice) [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/30979536"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Diosmetin (found in the peel of citrus fruits) [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/28867436"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Naringenin (found in citrus fruits, tart cherries, tomatoes, dark chocolate, and beans) [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252466/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> <li style="font-weight: 400;"><a href="https://www.selfhacked.com/blog/green-tea/"><span style="font-weight: 400;">Epigallocatechin</span></a><span style="font-weight: 400;"> gallate (found mainly in </span><a href="http://selfhacked.com/blog/green-tea/"><span style="font-weight: 400;">green tea</span></a><span style="font-weight: 400;">) [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/11470492"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/23268924"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]</span></li> </ul> <h4><strong>Garlic</strong></h4> <p><a href="https://selfhacked.com/blog/garlic-health-benefits/"><span style="font-weight: 400;">Garlic</span></a><span style="font-weight: 400;"> is a hotly debated complementary approach for ulcers. In a recent meta-analysis, its active compound allicin improved healing rate and remission of the symptoms when used as an add-on therapy in case of </span><em><span style="font-weight: 400;">H. pylori</span></em><span style="font-weight: 400;"> infection with ulcers [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815797/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">However, the authors of this analysis noted that the evidence was still relatively weak and in need of further investigation.</span></p> <p><span style="font-weight: 400;">This compound also inhibited overactive CYP2C19 variants, thus delaying the clearance of the proton pump inhibitor omeprazole, in a small trial on 18 people [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/19172254"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Garlic can be irritating on the stomach, so caution is advised if you already have ulcers.</span></p> <h4><strong>Chilli Peppers</strong></h4> <p><span style="font-weight: 400;">Some documents and guidelines advise against eating chili peppers if you have ulcers, but a surprising amount of research has suggested that </span><a href="http://selfhacked.com/blog/capsaicin/"><span style="font-weight: 400;">capsaicin</span></a><span style="font-weight: 400;">, the active ingredient in chili, could actually be beneficial [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477151/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273101/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6272969/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Capsaicin inhibits the growth of </span><em><span style="font-weight: 400;">H. pylori</span></em><span style="font-weight: 400;"> bacteria, which may explain why people given chili powder healed more quickly than their peers in a study of 50 ulcer patients [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1441892/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">This compound prevents stomach ulcers in animals, and may also help heal existing ones. It inhibits stomach acid secretions, reduces acidity, promotes mucus secretion, and stimulates blood flow in the stomach [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/16621751"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">In a study in rats, capsaicin inhibited CYP2C19 and other enzymes from the same family [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/25678312"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">We advise caution with capsaicin if you already have stomach ulcers, because it can also irritate the stomach.</span></p> <h4><strong>Cruciferous Vegetables</strong></h4> <p><span style="font-weight: 400;">Extracts from cruciferous vegetables such as kale and cabbage prevented the development of ulcers in different animal models by stimulating the production of mucus and lowering stomach acids [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/21986229"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/22147134"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177631/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Their active compound </span><a href="http://selfhacked.com/blog/panacea-benefits-broccoli-sprouts-sulforaphane/"><span style="font-weight: 400;">sulforaphane</span></a><span style="font-weight: 400;"> inhibited </span><em><span style="font-weight: 400;">H. pylori</span></em><span style="font-weight: 400;">&nbsp; infections and activity in human, animal, and cell-based studies [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047973/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/19349290"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465045/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC124299/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4618678/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">In </span><em><span style="font-weight: 400;">H. pylori</span></em><span style="font-weight: 400;">-infected type 2 diabetic patients, broccoli sprout powder, in addition to standard triple therapy, considerably improved </span><em><span style="font-weight: 400;">H. pylori</span></em><span style="font-weight: 400;"> eradication. It also improved markers of heart health in these subjects [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060758/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Rats fed with kale showed a reduced activity of CYP2C19 and other proteins from the same family (measured as increased blood levels of drugs broken down by these enzymes), suggesting it may help people with the overactive variant [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/22975634"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">Eating a diet rich in polyphenols and cruciferous vegetables helps prevent peptic ulcers and may reduce CYP2C19 activity. Garlic and chilli peppers may also help, but people with existing ulcers should be cautious due to their potential to irritate the stomach.</span></p> <h3><strong>Lifestyle</strong></h3> <h4><strong>Stress Management</strong></h4> <p><span style="font-weight: 400;">Most doctors and researchers agree that psychological stress and peptic ulcers are closely linked. In fact, a cohort study of 17,525 Danish adults found that people under high stress were more than twice as likely as people under low stress to develop ulcers [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/15082877"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126869/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Anxiety disorders, personality disorders, and panic disorders have also been directly linked to peptic ulcers. One study further found that alcohol or </span><a href="https://selfhacked.com/blog/28-proven-health-benefits-nicotine-4-potential-risks/"><span style="font-weight: 400;">nicotine</span></a><span style="font-weight: 400;"> dependence exacerbated the connection between anxiety and ulcers; that is, people with anxiety disorders who were also dependent on alcohol or nicotine were even more likely to have ulcers [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572011/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340907/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">A large body of research suggests that managing stress is very important for healing peptic ulcers. Some researchers have recommended the inclusion of cognitive behavioral therapies and other psychological strategies to help manage family, job, economic, and workload problems [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3613748/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Studies in humans and mice have associated high CYP2C19 activity with anxiety and </span><a href="https://selfhacked.com/blog/natural-treatments-depression/"><span style="font-weight: 400;">depression</span></a><span style="font-weight: 400;">, possibly because it reduces the volume and function of a brain region involved in these disorders (the hippocampus). However, a recent human study couldn&rsquo;t find this association [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/27895323"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/20468063"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031638/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/32315880"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">People with overactive </span><em><span style="font-weight: 400;">CYP2C19 </span></em><span style="font-weight: 400;">variants may break down anti-anxiety and antidepressant drugs faster, potentially making the treatment less effective [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/28520370"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/30325732"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4512908/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/29136336"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/19884907"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/30452773"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">The close link between peptic ulcers and psychological stress has been studied extensively. CYP2C19 activity may also worsen anxiety disorders and interfere with their treatment.</span></p> <h3><strong>Supplements</strong></h3> <h4><strong>Black Cumin</strong></h4> <p><span style="font-weight: 400;">In a study of 88 patients with indigestion positive for </span><em><span style="font-weight: 400;">H. pylori</span></em><span style="font-weight: 400;">, </span><a href="http://selfhacked.com/blog/top-28-scientific-benefits-of-the-panacea-black-cumin-seed-nigella-sativa/"><span style="font-weight: 400;">black seed</span></a><span style="font-weight: 400;"> helped eradicate the bacteria and symptoms. A minimal dose of 2 g of the seeds (in combination with omeprazole) was effective and comparable to standard triple antibiotic therapy, while both lower and higher doses were less efficient [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003218/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Some studies suggest that it may also help protect the stomach lining from damage and ulcers, mostly based on findings from animal studies [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702918/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://scholar.google.com/scholar_lookup?journal=Int+J+Pharma+Bio+Sci&amp;title=Gastroprotective+activity+of+ethanolic+extract+of+Trachyspermum+ammi+fruit&amp;author=S+Ramaswamy&amp;author=S+Sengottuvelu&amp;author=S+Haja+Sherief&amp;author=S+Jaikumar&amp;author=R+Saravanan&amp;volume=1&amp;publication_year=2010&amp;pages=1-15&amp;"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Black cumin seed protected the stomach lining from the harmful effects of alcohol in rats. The oils also prevented gut damage [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/16240107"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/22571716"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Its active compound thymoquinone showed moderate CYP2C19 inhibition in an enzymatic assay [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5822518/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <h4><strong>Ginger</strong></h4> <p><a href="https://selfhacked.com/blog/scientifically-proven-health-benefits-of-ginger/"><span style="font-weight: 400;">Ginger</span></a><span style="font-weight: 400;"> increased protective </span><a href="https://selfhacked.com/blog/prostaglandins/"><span style="font-weight: 400;">prostaglandins</span></a><span style="font-weight: 400;"> in the stomach lining in 43 osteoarthritis patients who used NSAIDs long-term. Ginger could potentially be useful in people who developed ulcers from NSAIDs, but further clinical trials are needed [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/22784345"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">In cellular studies, antioxidants in ginger (such as the flavonoids gallic and cinnamic acid) blocked the growth of stomach-ulcer-causing </span><em><span style="font-weight: 400;">H. pylori</span></em><span style="font-weight: 400;">, mainly by fighting free radicals [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/17295419"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136331/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Ginger extract reduced the drug-metabolizing activity of CYP2C19 in the lab [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/23346764"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <h4><strong>Licorice Root</strong></h4> <p><a href="https://selfhacked.com/blog/licorice/"><span style="font-weight: 400;">Licorice</span></a><span style="font-weight: 400;"> was a good adjunctive treatment to standard clarithromycin triple therapy in the treatment of </span><em><span style="font-weight: 400;">H. pylori</span></em><span style="font-weight: 400;"> in a clinical trial on 120 people and increased the eradication rate by about 20% [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/27614124"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Licorice extract and its component licochalcone A inhibited CYP2C19 and other enzymes from the same family in the lab [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656517/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/26100226"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;"><span style="font-weight: 400;">Preliminary research suggests that black seed oil, ginger, and licorice root may help with peptic ulcers mainly by helping eradicate </span><em><span style="font-weight: 400;">H. pylori</span></em><span style="font-weight: 400;">. Some of their components inhibited CYP2C19 activity.</span></span></p>
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184 | content_learn_more_9667647540254687_text == Based on the variants we looked at, your CYP2C19 gene variant is somehow associated with an increased risk of peptic ulcers. However, this doesn’t necessarily reflect your potential risk of this condition — just one gene related to it. A healthy diet, stress management, and some supplements may help. Keep reading to find out more.
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rsIDs = rs12248560
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