CHIOS, GREECE. Helicobacter pylori infections are common and are associated with indigestion, gastritis (inflammation of the stomach lining), peptic ulcer, and stomach cancer. In 1983 two Australian physicians discovered that the H. pylori bacterium can be permanently eradicated with a course of antibiotics and proton pump inhibitors (PPIs). Although the therapy is effective it does have side effects that many patients find intolerable. A group of Greek gastroenterologists now report that mastic gum (a natural resin excreted for the mastic bush) is effective in eradicating H. pylori. Their study involved 52 patients who suffered from H. pylori infection as diagnosed with upper gastrointestinal endoscopy and confirmed with a urea breath test (UBT). The patients were randomly assigned to receive one of four treatments:

• Group A � 350 mg mastic gum 3 times daily for 14 days;
• Group B � 1000 mg mastic gum 3 times daily for 14 days;
• Group C � 350 mg mastic gum 3 times daily + 20 mg pantoprazole (a PPI) for 14 days;
• Group D � 1 g amoxicillin + 500 mg clarithromycin + 20 mg pantoprazole twice daily for 10 days.

Five weeks after completion of the treatment UBT was repeated. This showed that 31% of group A, 39% of group B, and 92% of group D had achieved total eradication of H. pylori. None of those in group C achieved eradication. The researchers speculate that mastic gum requires an acidic environment to be effective and that the addition of a PPI is therefore counterproductive. They conclude that mastic gum may be a reasonable alternative for patients who are unable to tolerate the standard triple antibiotic therapy.

Dabos, KJ, et al. The effect of mastic gum on Helicobacter pylori. Phytomedicine, Vol. 17, 2010, pp. 296-99

Editor�s comment: For a discussion of the use of mastic gum in H. pylori eradication please see Conference Room Session 65. It is interesting that mastic gum may require an acidic environment to work effectively. If this is indeed the case, then combining mastic gum with betaine hydrochloride may result in more effective eradication in those with low stomach acid.