U is for ULCERS

I literally had no idea what to write about for the letter “U” until this morning, and I’m so glad with what I finally came up with – ulcers. Ulcers as we all know are open sores on either the external or internal surface of the body. They are breaks in the skin or mucous membranes that fail to heal. Just like obstruction, ulcers can affect many parts of the human body and each of them difficult to treat. Some are cancerous though many aren’t. Today, I’d like to focus on peptic ulcers.

Ulcers can be found in the mouth, I remember growing up and having those tiny, painful aphthous ulcers and taking vitamin C tabs to treat. They can also be found on the legs, seen in many people with poorly controlled diabetes mellitus, hypertension, trauma (seen too many of those). They can be found on the buttocks in many bedridden people. Ulcers can also be in the stomach and intestines, those are the peptic ulcers. Let’s go study a bit.

Peptic ulcers occur when the gastric fluid (acidic) corrode the mucous membranes of the stomach or intestines. They are usually caused by starvation (watch out those of you who are trying to loose weight the unhealthy way). They can also be caused by a bacterial called Helicobacter pylori. Some drugs like NSAIDs – pain relievers (diclofenac, ibuprofen, piroxicam) can both cause and worsen it. It can also be aggravated by eating peppery and oily foods.

The mistake is that many people think the treatment is in the medications alone ( I learnt that the hard way). For most of my patients, I use the 80/20 rule; 80% of the treatment is dependent on the patient and 20% on the doctor. Look at it this way, It is my job to make the diagnosis, prescribe the medications and educate the patient, but if the patient does follow the instructions, then they’d never get better, would they?

Also, chewing gum and sweets all the time in place of food is so wrong. The glucose in sweets and gums is too miniature for the acid produced, and most of the time we are just swallowing our saliva. A lot of stuff triggers the production of acid in the stomach in preparation for the digestive process. These triggers could be smell of food, taste of the food, chewing, e.t.c. When the acid finally sees no food, it digests the stomach walls (that's protein too).

To effectively get rid of the ulcers, you have to make some sacrifices;

• Eat healthy foods regularly, small portions is better than no portion.
• Eat at the right time. You can’t be eating breakfast at 11am, it’s now brunch.
• Avoid peppery and oily foods.
• Avoid fasting, but you can still pray (only the living can serve God).
• Avoid any form of painkillers except paracetamol and use those with caution
• Inform your doctors about your condition even if you are visiting for a different reason.
• Finally take your ulcer medicines as prescribed.

Ulcers have complications and they are scarier than been called fat, or been deviant. These complications include;

• Gastro-intestinal bleeding: usually results from the ulcer corroding a blood vessel on its path. I have seen people bleed internally to death because of this. Some have been caught on time and successfully managed conservatively, and some ended up in surgery with little chance of survival.
• Perforation: Here the ulcer eats up the wall of the stomach or intestine to the other side and the gastric contents (bile, acid e.t.c.) are emptied on the rest of the internal organs. They have to go through surgery to survive, if caught.
• Penetration: The ulcer eats up the intestine and starts to eat into an adjacent organ usually the liver or spleen.
• Malignant: Some become cancerous. Now that’s just bad news.

So there you have it on ulcers. Have you ever had any type of ulcer before? Share your story/experiences.