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Peptic Ulcers: The Silent Pandemic Among Young People

Peptic Ulcers: The Silent Pandemic Among Young People

By Canaan Arinda

On a random Saturday afternoon, Joan Ahesibwe, a third-year student at Makerere University is laying on her bed nursing yet another ulcers attack. She has just dropped by from the shops to buy another tin of Yoghurt, a remedy a friend recommended.

She has been struggling with what she calls ‘ulcers’; a medical concern that culminated in her first year after joining University. It started as just another urge to deworm, a stomach discomfort that refused to go away for days. Ahesibwe says swallowing deworming tablets couldn’t change anything.

She believes she suffers from ulcers even though she has never taken any test to confirm this. She has a couple of friends living with the same medical concern, but she wonders, how many more are out there?

She reaches out on her phone and posts a WhatsApp status; “I am on a survey, who else is struggling with ulcers?” and reassures potential respondents of the confidentiality.

Twenty-four hours on, her inbox is flooded with responses. That’s not a shock to her, however.  The actual surprise lies in the survey results.

Of over 120 people that viewed the status, 65 respond to her. A shocking 41 friends reply confirming to that they are struggling with a medical problem related to ulcers. If this sample is to go by, that’s well over half of respondents. The oldest respondent is 33 years, whereas the youngest is 19 years old.

Dr Ronald Mbiine, a gastrointestinal and endoscopic surgeon says the leading cause of ulcers is “poor lifestyle choices.”

This entails eating and drinking habits: The types of food we eat, the nature of spices used and the misuse of alcohol and spirits. Other aspects of lifestyle include the timing of meals and feeding patterns, he says.

“Another aspect of lifestyle is the fact that young people are increasingly having more stressful lives and this stress has been linked to the development of ulcers.

Similarly, changes in sleeping habits including sleep deprivation have been linked to the development of peptic ulcers,” Mbiine adds.

Sadly, a couple of patients walk into Dr Mbiine’s endoscopic department at Mulago National referral hospital in a ‘worse irreversible stage’.

Do ulcers actually kill?

Dr Josephant Jombwe says ulcers may cause gastrointestinal bleeding and progressively result into anaemia which refers to having a very low blood level. In other instances, the bleeding may be too severe that the person bleeds out to death. He says in such cases, this is a life-threatening emergency which, if not addressed urgently, invariably results into death.

He alternatively explains that ulcers may continue to dig into the stomach wall(flesh) such that they completely perforate the wall resulting into spillage of the highly acid gastric juice into the peritoneal cavity.

Simply put, the ulcer punctures the stomach or intestinal wall such that the acid in the stomach now spills into the abdomen. This results in a life-threatening emergency which needs urgent surgery to repair the perforation. If not addressed urgently, death can occur, he confirms.

Stomach cancer and Peptic ulcers

Stomach cancer is the presence of abnormal cancerous growths or wounds in the stomach while the peptic ulcers are wounds that develop in the stomach or duodenum (first part of the intestine).  Some forms of peptic ulcers if not treated adequately,

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can transform into stomach cancer according to Dr Mbiine.

He adds that there is a relationship in the causation of peptic ulcers and stomach cancer as when the causes of ulcers are not controlled, invariably the ulcers develop into stomach cancer. As an example, strong spirits and alcohol can cause ulcers while prolonged use has also been found to predispose to stomach cancer development. These two share close relationships regarding there causality with one being an effect of short-term exposure while the other (cancer) are result of long-term exposure, he adds.

Similarly, in the early stages, it’s impossible to distinguish the symptoms of stomach cancer from peptic ulcers as they are exactly the same. Dr Mbiine advises that it is for this reason that screening for gastric cancer is recommended among patients with persistent symptoms of dyspepsia (Peptic ulcers).

Early signs of peptic ulcers

Usually the presence of non-specific abdominal pain in the upper abdomen (epigastrium) that doesn’t seem to resolve may be an early indicator of potential peptic ulcers. The pain may be associated with other symptoms such as fullness, bloating, early satiety(satisfaction).

The persistence of these symptoms may be an early indicator of the development of peptic ulcers. In case the symptoms don’t resolve following the use of anti-acids should be a signal for the need to investigate these symptoms.

In such cases, its recommended that an endoscopy (Upper GIT endoscopy) is performed to confirm the presence of ulcers. Other diseases may have the same symptoms as peptic ulcers and hence the endoscopy confirms the cause of the symptoms.

The experts say out of Uganda’s population of about 45 million, they diagnose and treat at least 40,000 new cases of cancer each year and record at least 20,000 cancer-related deaths every year.  Of the top 10 cancers in Uganda, four of them occur in the gastrointestinal or digestive system that is the liver, esophagus, stomach and large intestines.

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