…Why ulcers rate is high in Nigeria
By Suleiman Tajudeen
… Continued from last week
CITIZENS COMPASS— …Peptic ulcer occurs from an imbalance between “aggressive” and “defensive” forces in the gut lining.
Main causes:
Helicobacter pylori infection – primary cause. Damages the mucosa and triggers inflammation.
NSAID abuse: Painkillers like ibuprofen, diclofenac. Found in 37.5% of perforated ulcer cases and was the most common risk factor for PPU in Lagos.
Herbal remedies / “agbo” – abuse of local herbal concoctions for body pains is a notable risk factor.
Lifestyle: Smoking, alcohol, stress, “dry fasting” – fasting without water.
Poor sanitation + poor health education: worsens H. pylori spread.
Other risk factors for pressure ulcers: Prolonged immobility, diabetes, poor nutrition, incontinence, ageing.
Certain disease conditions can cause ulcers
Effects / Complications
Symptoms: Epigastric pain, bloating, nausea.
Severe complications: Bleeding, gastric outlet obstruction,
Perforation: It is life-threatening and a leading cause of secondary peritonitis.
Surgery: Perforated ulcer often needs emergency surgery like Graham’s patch. Hospitals stay a median of 13 days.
Other impacts: Chronic ulcers cause delayed healing, septicemia, and mortality. Pressure ulcers increase hospital stay and cost. Buruli ulcer: 82.9% needed surgery and had movement limitations.
Prevention
Get tested and treated for H. pylori early.
Rational drug use: Avoid self-medication with NSAIDs. Use with food or under a doctor’s guidance.
Health education: Knowledge about causes and prevention is poor – only 0.3% knew H. pylori causes PUD in one student study. pylori causes PUD in one student study.
Dietary changes: Reported by 56.7% of patients. Avoid spicy food, irregular meals, alcohol, and smoking.
For pressure ulcers: Repositioning, good nutrition, skin care. Health staff should prescribe preventive techniques.
Avoid foods that can trigger/worsen the symptoms
Management
Diagnosis: Non-invasive – urea breath test, stool antigen. Invasive – endoscopy with biopsy. Urea breath test is most widely available in some areas.
Medical treatment:
Antibiotics + Proton Pump Inhibitors PPIs – standard for H. pylori. In Owerri, 84.4% used PPIs, 77.8% used antibiotics.
Antacids were used by 28.4%.
Surgical treatment: For perforation or bleeding. Modified Graham’s patch is common.
Eradication therapy for H. pylori is given to all perforated ulcer patients in some centers.
References
Ndububa, D. A., & Adeyemi, O. J. (n.d.). Peptic ulcer disease in Nigeria. Journal of the Obafemi Awolowo University Medical Students’ Association.
Etonyeaku, A. C., Agbakwuru, E. A., Akinkuolie, A. A., Omotola, C. A., Talabi, A. O., Olasode, B. J., & Ojo, E. O. (2013). A five-year review of perforated peptic ulcer disease in Irrua, Nigeria. _PMC_. https://pmc.ncbi.nlm.nih.gov/
Umeh, C. (2018). _Prevalence and management behaviour of individuals with peptic ulcer due to Helicobacter pylori in Owerri West Local Government Area, Imo State, Nigeria. _ Federal University of Technology Owerri (FUTO) Repository. https://repository.futo.edu.ng/
For questions or medical consultations, contact Dr. Suleiman Tajudeen, CEO and Director of Clinical Psychology, Clear Mind Psychological Consult, Km 15, Badagry Expressway, Ojo, Lagos. +234 803 402 4457
