Update in the therapeutic role of Complementary and Alternative Medicine (CAM) in peptic ulcer

Peptic ulcer disease (PUD) is still a global health problem, and Helicobacter pylori infection is identified as the principal causative factor. While these are effective, the conventional pharmacological treatments are usually accompanied by side effects, the development of antibiotic resistance, and limited access in some cases. As a result, Complementary and Alternative Medicine (CAM) has become a promising complementary or alternative intervention for PUD. The objective of this systematic review was to assess the therapeutic value, safety, and constraints of CAM interventions for peptic ulcer disease. An extensive systematic review was performed using the PICO format and reported following guidelines, including Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Literature searches were conducted in multiple databases, including the Cochrane Library, Embase, MEDLINE, and the Complementary Medicine Database and included papers from 2000 to 2024. Herbal treatment, complementary medicine, and alternative medicine were the search terms. Available full-text studies had a focus primarily on CAM interventions for PUD. Data were tabulated and synthesized to summarize therapeutic mechanisms, safety profiles, and limitations of the studies. A total of 134 studies met the inclusion criteria, including randomized controlled trials (n ≈ 45), observational studies (n ≈ 30), systematic reviews and meta-analyses (n ≈ 20), and preclinical experimental studies (n ≈ 39). Herbal medicine was studied the most in CAM. There were agents such as Nigella sativa, licorice, turmeric, Aloe vera, and ginger, with gastroprotective, Antioxidant, and anti-H. Pylori effects. Probiotics and acupuncture were supportive, too. Compared to conventional therapies, CAM therapy caused fewer adverse effects. Some drawbacks included heterogeneity in herbal preparations, no standardized dosing, small patient populations, and limited large-scale clinical trials. In PUD management, CAM therapies, especially herbal medicines and probiotics, are of significant use as adjunctive drugs. Although both safety and affordability seem good, the overall evidence base is still moderate to low. Standardized preparations and good multicenter randomized controlled trials should be studied further to aid clinical utilization.