The bacterium Helicobacter pylori (H. pylori) is a common gastric pathogen that colonizes the stomach lining, causing chronic gastritis, peptic ulcers, and increasing the risk of gastric cancer. Standard treatment involves antibiotics and acid-reducing medication, but rising antibiotic resistance has prompted the search for alternative therapies. Mastic gum, a natural resin with a long history of medicinal use, is being explored for its potential to combat this persistent gastric bacterium.
The Origin and Characteristics of Mastic Gum
Mastic gum is a natural, aromatic resin harvested from the Pistacia lentiscus tree, an evergreen shrub native to the Mediterranean region. The most studied variety is Pistacia lentiscus var. chia, which is cultivated on the Greek island of Chios. The resin, often called the “Tears of Chios,” is collected after making small incisions in the tree bark, allowing the sap to dry into brittle, translucent droplets.
Mastic gum has been used in traditional Greek medicine for over 2,500 years, primarily for treating gastrointestinal ailments like dyspepsia and peptic ulcers. Its composition includes over 120 different compounds. The active components are triterpenoids, such as isomasticadienolic acid and oleanolic acid, along with various essential oils.
Mastic Gum’s Mechanism Against H. pylori
Mastic gum’s action against H. pylori involves the direct antibacterial action of its triterpenoid components, particularly the acidic fraction. Laboratory studies show that compounds like isomasticadienolic acid possess a minimum bactericidal concentration capable of killing H. pylori. This antimicrobial effect stems from the resin’s ability to physically disrupt the bacterial cell structure.
Electron microscopy shows that exposure to mastic resin induces cellular fragmentation, morphological abnormalities, and “blebbing” in H. pylori cells, damaging the cell wall and membrane. H. pylori also uses the urease enzyme to survive the stomach’s acidic environment by creating a protective ammonia cloud. Mastic extracts may also inhibit the production of this urease enzyme, reducing the pathogen’s ability to colonize the stomach lining.
Scientific Support for H. pylori Eradication
Research into mastic gum’s efficacy in human patients has yielded mixed results. Early human trials indicated that mastic gum monotherapy, administered for 14 days, achieved eradication rates in a minority of patients, ranging from 31% to 38%. However, other small studies using high doses failed to eradicate the infection in any patient, highlighting the variability in results.
A recent randomized controlled trial suggested that mastic gum significantly improved eradication rates when used as an adjunct to the standard triple-drug regimen. Patients receiving the standard regimen plus mastic gum achieved a 92.2% eradication rate, substantially higher than the 63.3% rate achieved by the standard regimen alone. This suggests its greatest value may be in combination therapy, potentially helping to overcome antibiotic resistance. Some studies noted that combining mastic gum with a proton pump inhibitor (an acid-reducing drug) without antibiotics appeared ineffective, suggesting an acidic environment may be necessary for the resin’s compounds to be fully effective.
Practical Usage and Safety Considerations
Mastic gum is commercially available in capsules, powders, and as the traditional raw resin to be chewed. Dosages used in clinical trials for H. pylori eradication have varied widely, ranging from 350 mg three times daily up to 1 gram four times daily, typically lasting 14 days. A common dosage studied for general digestive support is 1 gram per day, often divided.
Mastic gum is generally well-tolerated, and clinical trials have not reported serious adverse events. Potential side effects are rare but may include mild digestive upset, such as stomach pain or nausea. Due to a lack of safety data, it should be avoided by pregnant or breastfeeding individuals and anyone with an allergy to Pistacia lentiscus. Because evidence for standalone treatment is inconsistent, and due to the serious nature of H. pylori infection, consultation with a healthcare provider is recommended before starting mastic gum.