THE INCREASING INCIDENCE OF ULCER IN ABA

The increasing incidence of peptic ulcer disease in Aba metropolis is very worrisome. Hardly does a day pass in many hospitals without any case of peptic ulcer disease.

Of recent, about one quarter of patients that show up in Out patient Department is peptic ulcer disease giving a prevalence rate of about 25% as against the general prevalence rate in Nigeria which is about 12 to 14% which is comparable to the prevalence rate in America, about 10%

One is therefore worried why this sudden increase in prevalence rate of peptic ulcer in Aba against the general population. Before we look at the causes of ulcer and why there is increase in incidence of ulcer in Aba, let us understand the meaning of peptic ulcer disease otherwise known as PUD.

Definition
Peptic ulcer disease may be defined as the ersion of the mucosal lining of the stomach or the duodenum leading to the formation of ulcer(sore) [source]@nokas
It occurs as a result of secretion of pepsin or gastric acid. It may also occur in the oesophagus (food passage)

Causes of peptic ulcer disease
Once there's imbalance between protective forces (the mucosal lining of the stomach) and the aggressive forces(gastric acid and pepsin), ulcer is bound to occur. What are these factors that disrupt this balance?

• Non Steroidal Anti Inflammatory Drugs (NSAIDs)
  NSAIDs are common over the counter (OTC) drugs used in the treatment of pains, arthritis, inflammation and some cases of fever such as rheumatoid fever etc.

The abuse of these drugs are the major reasons why there is increase in the incidence of peptic ulcer disease in Aba. Self medication is the major cause of peptic ulcers. No group of drugs have been abused as much as the NSAIDs.

Individuals make prescriptions for
themselves and combine several drugs of the same class upto six tablets. With these quantities of drugs the protective factors are overwhelmed leading to ulceration.

Some individuals combine these drugs with prednisolone which also has the capacity to erode the gastrointestinal tract.

• Helicobacter pylori
  This is the only bacteria (micro organism) implicated in peptic ulcers.
  Helicobacter pylori together with NSAIDs account for about 75% of cases of PUD

Again self medication contributes largely
to the deteriorating condition of ulcers.

• Stress
  Stress is another cause of peptic ulcers. It could be physical, mental or emotional stress. It is even worse when the individual is stressed with empty stomach. I'm not sure of any city that is constantly under stress than Aba.

There's no light, no water, no road; and people move long distance pushing trucks of water. The intimidating presence of security agents in every corner keep the inhabitants perpetually under emotional stress and trauma.

Harassment from revenue agents , innumerable task forces and tauts cause so much distress to the people leading to upsurge of adrenaline; release of pepsin and hydrochloric acid with attendant mucosal damage.

• Cigarette Smoking
  Cigarette smoking reduces the immune system and elicits inflammatory reaction in the gastrointestinal tract to cause ulceration.

• Alcohol intake
  Alcohol like Cigarette Smoking weakens the immune system and throws the system open to many diseases including ulcer

• Gastric cancer
  Prolonged un treated Helicobacter pylori may progress to cancer with the development of ulcer.

• Family history
  Peptic ulcers may sometimes run in families.

Symptoms and signs of Ulcer

• Epigastric pain
  This is pain that occurs in the depression between the junction of the chest wall and the abdominal wall
• Abdominal pain
  This is described as gnawing in character ( constant ache
• Belching
  Releasing gas through thy mouth
• Flatulence
  Releasing gas through the anus
• Abdominal fullness
• Nausea and vomiting
• Malaena - Dark tarried stool ( coffee coloured)
• Weakness
• Malaise. - Feeling of unwell

Complications of ulcer

• Bleeding
• Anaemia
• Gastric perforation
• Septicemia
• Shock
• Gastric cancer
• Gastric Outlet obstruction

Management of Ulcer
The management of Ulcer is divided into three:

1. Lifestyle modification: Stop Cigarette Smoking and alcohol intake
2. Eradication of Helicobacter Pyloric using a combination of proton pump inhibitors and two antibiotics.
3. Ulcer healing using the antacids and the H2 Receptor blockers

Conclusion
Do yourself favour, avoid self medication.
If you must self medicate, look for the list of drugs that have the potential to cause ulcer and avoid them
As much as possible, stay away from stress
Treatment of ulcer must be complete, at least six weeks.