By Michael Kanaabi Dollar
Due to a number of factors ranging from change in diet, change in life style and a more demanding (stressing) society in the key aspects of one’s well being, the incidence rate and prevalence of ulcers with in Uganda’s population is on the increase.
Estimates show that 10-15% of the entire country’s population may be suffering from one form of ulcers or another both known and unknown.
The age groups most affected are the adult population with peak prevalence noticed in the age group 30-50 years with the elderly that is 60 plus years also being greatly affected due to thinking stomach walls.
The numbers also show on average Stomach Ulcers affect men more than women with the ratios varying from 2:1 to 3:1 in various regions and countries across the globe.
Research also shows women are more likely to develop gastric Ulcers which affect the stomach lining itself while men more often present with duodenal Ulcers which mainly affect the duodenum on the upper side of one’s stomach.
On the other side though young children and adolescents are much less affected because they have thicker stomach wall linings.
The good news according to Julius Habumugisha a medical professional and CEO of Teamwork Homecare Services, a homebased medical care services provider, stomach Ulcers is a manageable condition that can be treated and cured if you seek professional medical intervention.
What are stomach ulcers?
According to Dr. Martin Opio, a Physician attached to Teamwork Homecare Services, ulcers are open sores that breakout on the inside of the stomach or duodenum (where the small intestine begins from).
These sores are triggered when the protective lining of the duodenum or stomach is damaged making it easy for digestive enzymes and stomach acids to irritate the surrounding tissues.
Dr. Opio notes that there are mainly 3 types of stomach ulcers the first being Gastric ulcers which affect the stomach lining, Esophageal ulcers which occur in the esophagus and Duodenal ulcers which attack the duodenum.
What are the Causes of Stomach Ulcers?
Helicobacter pylori commonly known as H-pylori is a bacterial infection that causes inflammation and ulcers or sores on the stomach lining.
Long term use of Nonsteroidal Anti-inflammatory drugs (NSAIDS) for example aspirin, naproxen and ibuprofen according to Dr. Opio can irritate and damage the stomach lining leading to gastric ulcers.
Excessive production of acid in the stomach which acid then erodes the stomach lining can lead to ulcers. “This can be triggered by high stress levels, excessive consumption of alcohol, smoking consistently over a long time, regular and continuous consumption of spicy and acidic foods among other factors” Dr.Opio says.
Genetic factors also may cause one to easily get stomach ulcers as some body types and genetic makeup of people is susceptible to stomach ulcers.
Having co-infections or underlying sicknesses in the body like Crohn’s disease, Ulcerative Colitis, Zollinger-Ellison syndrome according Dr. Lisa Nimusiima of Teamwork Homecare Services greatly increase the risk of one suffering from stomach ulcers.
Changes in specific hormonal levels and sudden fluctuations which occur during pregnancy and at the onset of menopause greatly affect digestion and may lead to one getting stomach ulcers.
As one’s age advances to 60 years and over, the stomach walls thin making one susceptible to stomach ulcers Dr. Nimusiima notes.
She also points out that regular and consistent consumption of unhealthy foods (poor diet) which includes a lot of sugar filled foods, processed foods and foods with unhealthy fat can lead to one suffering from stomach Ulcers.
Having low stomach acid levels can lead to overgrowth of bacteria in the small intestines which bacteria in turn facilities the onset of stomach ulcers.
Conditions such as gastroparesis and other gastrointestinal motility disorders also often lead to one getting stomach ulcers Dr. Nimusiima notes.
Medications such as anticoagulants and corticosteroids can also trigger the onset of stomach ulcers with continuous regular use.
Symptoms of Stomach Ulcers
Habumugisha says “Often times abdominal pain is the first symptom of stomach ulcers and it manifests with burning or gnawing pain in the upper abdomen usually getting worse at night.”
Ulcers victims also do experience bouts of nausea followed in most cases by vomiting of blood and coffee ground like materials.
Feeling uncomfortably full or gassy in the stomach which often results into bloating.
Habumugisha notes that ulcers victims tend to lose appetite as well and this reduced appetite manifests with their interest in food intake falling greatly because of the pain or discomfort they experience when food enters the stomach.
Weight loss may also be experienced due to difficulty in eating and a diminished appetite.
In severe cases one may experience bleeding, vomiting of blood and passing blood-stained or black tarry stool.
“Heart burn which manifests with a burning sensation in the throat and chest, indigestion which creates discomfort and burning in the upper abdomen is also a common Ulcers symptom” Habumugisha says.
Another symptom is reflux or regurgitation where by sour liquid or food returns to the mouth sometime after swallowing.
What underlying conditions may lead to stomach ulcers?
Besides helicobacter pylori which is the primary cause of ulcers, other conditions like Gastroesophageal Reflux Disease where by stomach acid flows back into the esophagus can be a precursor to stomach ulcers.
Dr. Opio says that liver diseases which increase production of acid in the stomach can result into stomach ulcers as well as Kidney diseases which create the same situation in the stomach.
Diabetes which results into high sugar levels being present in one’s blood may also result into stomach Ulcers according to Dr. Opio because these high sugar levels do damage the stomach lining.
If one has Crohn’s disease or ulcerative Colitis which may be referred to as inflammatory bowel syndrome, they will eventually develop ulcers.
In some rare cases Zollinger-Ellison syndrome a condition according to Julius Habumugisha a Medical Professional where the pancreas produces excess acid can also lead to Ulcers.
Habumugisha notes that having an underactive thyroid gland a condition known as Hypothyroidism may also lead to increased acid production and Ulcers.
Chronic Gastritis which is a form of continuous inflammation of the stomach lining, Gastroparesis a condition where stomach emptying or release of stool is delayed often because of neurological disorders or diabetes will lead to Ulcers too.
Raynaud’s phenomenon a condition that impedes blood flow to the stomach lining, Scleroderma a connective tissue disorder affecting the stomach lining and auto immune disorders like lupus and rheumatoid arthritis may also be a precursor for Stomach Ulcers according to Habumugisha.
What complications may result from stomach Ulcers?
A number of complications some very severe may result from one suffering from ulcers and not treating them in time.
As Ulcers develop, Dr Opio says “one is likely to experience bleeding if they are not treated properly and it can get severe even leading to shock death if neglected.”
Chronic bleeding as a result of stomach ulcers can lead to iron deficiency in the body.
Dr. Opio observes that Ulcers can also grow into a hole in the stomach or duodenum which makes way for bacteria to leak into the abdominal cavity. This situation may also lead to Peritonitis which is a life threating infection affecting the abdominal cavity.
There is obstruction of the food passage due to ulceration and scarring. This often times goes hand in hand with vomiting, nausea and abdominal pain.
Further bacterial infection of the ulcers leading to sepsis or abscesses.
Narrowing of the abdomen or duodenum may happen as result of scarring due to Ulcers.
Narrowing of the gastric outlet can also result from ulcers leading pain, nausea and vomiting on top of making the passing out of stool very difficult.
In some cases Dr. Opio observes that stomach cancer may develop from the growth of polyps (gastric polyps) on the stomach walls which usually come as a result of chronic Gastritis, and ulcers.
One can also become malnourished as a result of malabsorption of nutrients due to chronic ulcers.
Pancreatitis which is inflammation of the pancreas a life threatening condition may also develop as a result of one having chronic Ulcers.
Treatment and cure for stomach ulcers
The first line of treatment is taking recommended regimens of antibiotics to eradicate H. Pylori bacteria which primarily is the cause of ulcers according to Teamwork Homecare’s Dr. Lisa Nimusiima.
Taking Proton pump inhibitors (PPIs) which reduce stomach acid production and promote healing while reducing pain is also recommended.
Dr. Nimusiima says “One can use (H2) Histamine Blockers as medication to decrease acid production, relieving symptoms and leading to faster recovery.”
Antacids are also used in the treatment of ulcers to neutralize stomach acids and provide quick relief from Heartburn plus indigestion.
One can also use gastric protectants to protect the stomach lining, tame inflammation and make way for quicker healing.
In some cases Dr. Nimusiima points out that endoscopy may be required as part of the treatment for Ulcers. This procedure helps Doctors visualise the stomach lining, properly diagnose Ulcers and also may make way for the removal of damaged tissue.
Finally she says, “in severe cases of ulcers, one may have to undergo surgery to repair perforations, remove damaged tissue and relieve obstruction.”
It should be noted that once the right combination of antibiotics is prescribed, H.pylori can be completely eradicated in the body curing the ulcers and preventing future reoccurrence.
A number of natural remedies including licorice root, aloe vera, ginger and turmeric which contain anti inflammation properties, reduce nausea, soothe the stomach lining and calm the stomach can be used alongside recommended medications.
How do you prevent stomach ulcers?
A number of personal undertakings which generally rotate around adopting a more healthy lifestyle will help you prevent ulcers.
Medical professional and Teamwork Homecare Services CEO Julius Habumugisha says “Exercising regularly will improve your digestion and help you get rid of stress which both reduce your chances of getting Ulcers.”
Managing and working towards reducing stress which often comes with increased production of stomach acid will help prevent ulcers, this can be done through meditation and other activities according to Habumugisha.
This can also include ensuring you have enough sleep that is 7-8 hours a day, take regular breaks from work and practice relaxation techniques like deep breathing regularly.
Reducing on the consumption of alcohol which does irritate the stomach lining and quitting smoking can also help prevent stomach ulcers.
“Consuming a balanceded diet with whole unprocessed foods like lean proteins, whole grains and fruits can help keep ulcers away. Increasing fibre intake which does cut down on inflammation plus avoiding spicy, fatty or acidic foods that irritate the stomach lining is also a necessary intervention in the prevention of ulcers,” Habumugisha says.
He advises that taking probiotics can help maintain a healthy gut or stomach generally and also reduce inflammation.
Drinking plenty of water to avert dehydration and improve digestion is also a good preventive measures.
Avoiding the long term use of Nonsteroidal Anti-inflammatory drugs like ibuprofen and aspirin which are known to increase the risk of getting ulcers can also protect you.
Finally according to Habumugisha, getting tested for H. pylori if you have a family history of the infection or symptoms for early detection and better effective treatment can help prevent further complications and cure the condition completely.
Email: michaelkanaabi@gmail.com
