DR ADE ODERINDE 
1. Fire! Fire!! Fire!!!
Fire in my breadbasket,
Unquenchable with water,
Flaming in my belly
2. Fire! Fire!! Fire!!!
Fire in my chest,
Far from a retardant’s reach,
My heart is on fire
3. Ethanol I gulp,
Tobacco I chew,
Intensified the agony becomes,
I’ve been set aglow within.
4. Hot pepper I guzzle,
Spiced plantain I gobble,
Bloated my stomach becomes,
I am burning up.
In the last few years, there’s been an upsurge in stomach related symptoms in Nigeria which has been ascribed to a new local alcoholic beverage in town. It was said to be a mixture of concentrated alcohol spiced with spicy herbs and alligator pepper!
The scene
Miss OPK walked into the consulting room clutching the upper part of the tummy, complaint was that of central upper abdomen pain. This symptom have been on and off over the last 3 years, usually brought on by hunger and her favorite (fried plantain), but relieved by milk. The most recent episode started 4 days prior to hospital visit.
This is classical of Peptic Ulcer Disease.
What it is
Peptic ulcers are sores that develop in the lining of the stomach, lower esophagus, or small intestine. They’re usually formed as a result of inflammation caused by the bacteria Helicobacter pylori, as well as from erosion from stomach acids. Most ulcers happen because of infection with the bacteria.
An ulcer in the stomach is known as a gastric ulcer while that in the first part of the intestines is known as a duodenal ulcer.
The offending bacteria
Helicobacter pylori (H. pylori) is a type of bacteria transmitted via contaminated food, water (or other drinks) or utensils. It’s more common in countries or communities that lack clean water or good sewage systems. It can also be picked up through contact with the saliva or other body fluids of infected people.
It was discovered in 1982 and has been found to be the cause of most ulcers. These germs can enter the body and live in the digestive tract. After many years, they can cause sores, called ulcers, in the lining of your stomach or the upper part of your small intestine.
Infection with H. pylori is common. About two-thirds of the world’s population has it in their bodies. For most people, it doesn’t cause ulcers or any other symptoms.
After H. pylori enters the body, it attacks the lining of the stomach, which usually protects one from the acid the body uses to digest food. Once the bacteria have done enough damage, acid can get through the lining, which leads to ulcers. These may bleed, cause infections, or keep food from moving through the digestive tract. Many people get H. pylori during childhood, but adults can get it too. The germs live in the body for years before symptoms start, but most people who have it will never get ulcers.
What gives it away
The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain or upper abdominal pain that improves with eating. With a gastric ulcer the pain may worsen with eating as gastric acid production is increased as food enters the stomach .
The pain is often described as a burning or dull ache. Other symptoms may include bloating, belching, farting, loss of appetite, nausea, vomiting, vomiting of blood or passage of dark stool (both could point to bleeding) weight loss (in gastric ulcer), water brash (rush of saliva after an episode of regurgitation to dilute the acid in esophagus ) and foul breath (halitosis).
Causes
Infection with H.pylori, some types of pain medications (non-steroidal anti-inflammatory drugs-NSAIDS), taking some other medications along with NSAIDS (such as such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors- SSRIs etc) can greatly increase the chance of developing ulcers. Though stress, spicy foods, alcohol, and smoking don’t cause ulcers, they can keep them from healing quickly or make it worse and intake of caffeine/coffee is also said to be less contributory.
The catch
A comprehensive history and examination followed by some tests.
1. Laboratory tests for H. pylori; This is to determine whether the bacterium H. pylori is present in the body. It can be detected using a blood, stool or breath test (Urea Breath Test-UBT) The breath test is the most accurate.
2. Endoscopy; A scope is used to examine the upper digestive system (endoscopy). If an ulcer is detected, small tissue samples (biopsy) may be removed for examination in a lab.
3. Upper GI series During the procedure, the client stands or sits in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the esophagus, stomach, and small intestine so the shapes of these organs can be seen more clearly on x-rays.
4. Computer Tomography (CT) scan; can help diagnose a peptic ulcer that has created a hole in the wall of the stomach or small intestine.
Negative outcomes
Gastrointestinal bleeding, perforation (leading to peritonitis), Anemia, Stomach (gastric) outlet obstruction and in the long term may lead to cancer.
Treatment
Drugs that reduce acid secretion and appropriate antibiotics to eradicate H. pylori.
Preventive measures
You can protect yourself from getting an H. pylori infection with the same steps you take to keep other germs at bay;
1. Basic hand washing hygiene after using the bathroom and before preparing or eating food.
2. Avoid food or water that’s not clean.
3.Do not eat anything that is not cooked thoroughly.
4. Avoid food served by people who are not hygienic.
Advice
Please visit a doctor as appropriate as other conditions (such as GERD; literally, heartburn) mimic peptic ulcer.
