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Peptic Ulcers

Peptic Ulcers

Stomach ache is a common symptom most people experience at least once in their lives. In fact, it is one of the reasons why people go to their doctors for a medical checkup. Stomach ulcer or peptic ulcer disease is a major cause of abdominal Pain- which can be extremely painful.

Peptic ulcers are open sores or wounds that develop on the lining of the stomach. These ulcers may also affect the small intestine.

In Uganda the annual mortality stands at 3.31 1 per 100,000 while for greater East-Sub Saharan Africa it stands at 5.4 per 100,000 people. For men, the deadliness of peptic ulcer disease in Uganda peaks at age 80+.

Individuals with the illness may experience a wide range of symptoms and the condition may lead to serious complications if it’s left untreated.

In this issue Dr. Gerald Opio a gastro enterologist at Aga khan hospital addresses some of your common questions and myths on peptic ulcers.

What are the common causes of ulcers?

Peptic ulcers are as a result of an injury or a wound to the food pipe (oesophagus), stomach and the intestines.

The two most common causes of peptic ulcers are: Infections caused by a bacterium called Helicobacter pylori and fungal infection like candida of the gut as well as chronic use of drugs like pain killers (aspirin, diclofenac, ibuprofen, mefenemic acid, iron supplements, antibiotics like doxycycline and cancer chemotherapeutic drugs).

Other predisposing factors include chronic use of herbal remedies, alcohol misuse and cigarette smoking.

What are the general signs and symptoms of peptic ulcers?

Dr. Opio who also works at Nakasero and Mulago hospital says people usually come in with complaints of abdominal Pain, discomfort, burning, fullness in the upper abdomen and sometimes chest pain. These symptoms are usually experienced for weeks and or months. However, they can present as an acute exacerbation (worsening of symptoms).

These symptoms may indicate a problem in the esophagus (food pipe), stomach, and duodenum. However, it may also indicate that you have heart disease, respiratory problem, or a problem in your liver or pancreas.

As such, your doctor needs to take a detailed history and physical examination to make sure you have only gastrointestinal problem and not a heart or respiratory problem.

How can ulcers be diagnosed?

According to Doctor Opio, the best way to diagnose ulcers is by performing an endoscopy. An endoscopy is a test that allows your doctor to look inside your food-pipe or gullet (esophagus), stomach and the rest of the small intestine.

Your Doctor may recommend laboratory tests for H. pylori bacterium to determine whether the bacterium is present in your body. He or she may look for it using a blood, stool or breath test.

Also, Upper gastrointestinal series sometimes called a barium swallow can be done.

Are there ways of reducing the risk of Peptic Ulcers?

Yes, the risk can be reduced by living a healthy lifestyle which involves avoiding alcohol and smoking, exercising regularly, avoiding excessive use of herbs and pain killers and also having a healthy diet.

Is there any special diet for people with peptic ulcer disease?

There is no conclusive evidence that dietary restrictions and bland diets play a role in ulcer healing. However, since coffee stimulates gastric acid secretion and alcohol can cause gastritis, moderation in alcohol and coffee consumption is recommended.

What is a healthy diet?

  • Fruits, vegetables, legumes (e.g. lentils, beans), nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat, brown rice).
  • At least 400 g (5 portions) of fruits and vegetables a day. Potatoes, sweet potatoes, cassava and other starchy roots are not classified as fruits or vegetables.
  • Avoid most free sugars. These are added to foods or drinks by the manufacturer, cook or consumer, and can also be found in sugars naturally present in honey, syrups, processed fruit juices and fruit juice concentrates.
  • Unsaturated fats (e.g. found in fish, avocado, nuts, sunflower, canola and olive oils) are preferable to saturated fats (e.g. found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard) (3). Industrial trans fats (found in processed food, fast food, snack food, fried food, frozen pizza, pies, cookies, margarines and spreads) are not part of a healthy diet.
  • Less than 5 g of salt (equivalent to approximately 1 teaspoon) per day (6) and use iodized salt.

What are the complications of peptic ulcers?

  • There are several complications that can occur as a result of peptic ulcers. One of them is poor quality of life due to pain, gastrointestinal bleeding, blockage due to healing ulcer and stomach cancer

What is the prognosis for a person with peptic ulcer disease?

With modern treatment, people with ulcer disease can lead normal lives without lifestyle changes or dietary restrictions. Cigarette smokers have been found to have more complications from ulcers and treatment failure. Eradication of the bacteria H. pylori not only heals ulcers but also prevents the recurrence of ulcer disease.

What are the Myths around Ulcers?

Skipping meals causes ulcers

A lot of Ugandans believe that skipping meals results in peptic ulcers. If anyone is seen skipping a meal therefore, well-meaning family members or friends will tell them to desist from this bad practice lest they end up with peptic ulcers. But can skipping meals result in peptic ulcers?

“No,” Dr Gerald Opio says. “Skipping or failure to take meals on time will only aggravate [existent] peptic ulcers.”

Peptic ulcers result from the weakening of the mucous coating of the stomach and duodenum resulting in acid irritating the stomach or duodenal lining. An H. Pylori infection or non-steroidal anti-inflammatory drugs cause this weakening. Skipping or failure to take one’s meals will only exacerbate peptic ulcers, and not cause them.

Stress is a common cause of ulcers

Stress, like skipping meals, only exacerbates peptic ulcers. Dr. Opio says that only in rare cases will stress cause ulcers.

Ulcers are incurable

Various doctors and online medical resources say peptic ulcers are curable. If their cause is identified, they can be successfully treated and cured by removing the cause.

By Jubilee Insurance