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Deglycyrrhizinated Liquorice Extract
As early as the 1940’s therehas been suggestion that the components of licorice extract have therapeutic effects in the treatment of ulcers (Revers 1948). The interest in licorice was increased two-fold in 1962 (Doll, Hill Hutton and Underwood, 1962) with the synthesis and clinical application of carbenoxolone, an active glycoside extracted from glycyrrhizic acid present in liquorice. The discovery of carbenoxolone activity marked a significant advance in the treatment of gastric ulcer by means other than antacid activity. Unfortunately, the use of this licorice derivative resulted in complications in water retention and electrolyte imbalance manifesting as oedema, heartburn, congestive cardiac failure, and headaches (Molhuysen, Gerbrandy, de vries, de Jong, Renstia, Turner and Borst, 1950). These findings led to intense study of the clinical applications of licorice extract with glyccirhizinic acid removed (also called DGL licorice extract). The findings from the subsequent studies were quite controversial.
Several studies performed in the 1960’s claimed quite significant effects regarding DGL licorice extract (Tewari and Trembalowicz 1968; Turpie, Runcie, Thomson, 1969; Gassman and Foster, 1963; Russell and Dickie, 1968). A trial of 54 patients showed “good results for [DGL licorice]” treatment in patients with both gastric and duodenal ulcers. In as little as two weeks gastric ulcer craters were extensively reduced and a spamolytic effect was seen . Duodenal ulcer symptom relief was also noted. A concurrent study exhibited an accelerated rate of healing in patients with gastric ulcers when treated with DGL licorice extract to a “significant degree”(Turpie , 1969). In addition, these studies as well as others (Feldman, 1971; Engqvist, 1973) have shown no adverse side effects that are associated with carbenoxolone. Even after four weeks of treatment signs of pitting oedema, hypokalemia, and increased blood pressure were absent (Tewari 1969).
DGL is indicated in the use of ulcer treatment. Iits level of safety and previous findings make it an interesting material that may have a place in clinical practice.
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