If you usually experience belching or feel pain in the stomach whenever you swallow food, feel an urge to vomit most of the time, or have a poor appetite, chances are you could be risking peptic ulcers, as health experts explain.

Rene Tabaro, a senior Nutritionist and Dietician at Oshen King Faisal Hospital, Kigali says, peptic ulcers also known as gastric or stomach ulcer is a lesion of the mucosal lining of the upper gastrointestinal tract characterised by an imbalance between aggressive and protective factors of the mucosa, having H. pylori bacteria as the main etiologic factor.

He says, peptic ulcers are sores that develop in the lining of the stomach, lower oesophagus, or small intestine and are usually formed as a result of inflammation caused by the bacteria H. pylori, as well as from erosion from stomach acids.

According to Private Kamanzi, a dietician at Amazon Wellness Centre, Remera Gasabo District, there are three types of peptic ulcers and these include; gastric ulcers( these are ulcers that develop inside the stomach), and esophageal ulcers (ulcers that develop inside the oesophagus) and duodenal ulcers, (these are ulcers that develop in the upper section of the small intestines, called the duodenum).

Causes

Tabaro explains, when you eat, your stomach produces hydrochloric acid and an enzyme called pepsin that digests the food. The food is partially digested in the stomach and then moves on to the duodenum to continue the process.

He adds that peptic ulcers occur when the acid and enzyme overcome the defence mechanisms of the gastrointestinal tract and erode the mucosal wall.

Kamanzi notes that the cause of peptic ulcers could be through consuming contaminated food, alcoholic drinks, smoking, over feeding on spiced food, processed meat, sweetened drinks among others.

Signs and symptoms

For Tabaro, the most common symptom of peptic ulcers is abdominal pain, other symptoms include, nausea, vomiting, loss of appetite, loss of weight, he says.

He states, "Severe ulcers may cause bleeding in the stomach or duodenum. This bleeding can be fast or slow. Fast bleeding reveals itself in one of the following ways: anaemia, malnutrition, and if not treated can develop in to cancer.”

Tabaro explains that other common signs of a peptic ulcer may include; changes in appetite, unexplained weight loss, indigestion, vomiting and chest pain.

Treatment

Tabaro notes that the choice of treatment depends on whether or not the ulcer is caused by infection with H pylori. Correct diagnosis is key to whether a treatment works or not. If the bacteria are the cause, treatment focuses on killing the infection. Regardless of whether the bacteria are the cause, reducing acid in the stomach is another important focus of treatment.

The following treatments are recommended for ulcers; Lifestyle changes like quitting smoking, avoid alcohol, aspirin, acid-blocking medications, medications that protect the lining of the stomach and duodenum, he says.

Nutrition management

Tabaro states, it is important to eat a balanced diet with about 30 per cent of calories from healthy and omega-3 rich fats like olive oil, fatty fish, however, a diet that is too high in fat can worsen symptoms of an ulcer.

He says, eating enough proteins is necessary, while your ulcer is healing, aim for about 1.2 grams of protein per kilogram of your ideal body weight. The remainder of your calories should come from high fibre carbs like legumes, whole grains, fruits, and vegetables, a higher-fiber diet is associated with a lower risk of peptic ulcers.

Prevention

"H pylori bacteria are spread through the stools (faeces) of an infected person. The stool contaminates food or water (usually through poor personal hygiene).The bacteria in the stool make their way into the digestive tracts of people who consume this food or water. This is known as fecal-oral transmission and is a common way for infections to spread,” Tabaro notes.

He notes, it is imperative to avoid anti-inflammatory medication like, aspirin, no steroidal anti-inflammatory drugs (such as ibuprofen and naproxen), and newer anti-inflammatory medications (such as celecoxib), foods with high acid like lemons, oranges, but also too much alcohol, caffeine and cigarettes as they can worsen the peptic ulcers.

Tabaro urges one to protect themselves from infections, use caution with pain relievers, also consult a physician and feed on a balanced diet.

Kamanzi notes proper food hygiene should be a must, avoid eating while drinking, don’t eat cold or spicy food, as it might stimulate gastric acid that can affect the lining of the stomach.

He adds, meat should be cooked properly, and avoid reusing the same cooking oil.

Complication

Kamanzi says, peptic ulcers can block the passage of food through the digestive tract, causing you to become full easily, vomit and to lose weight through either swelling from inflammation or scarring.

He notes that it is not easy to treat peptic ulcers because helicobacter the bacteria that cause these ulcers is not easy to treat. Ulcers can even lead to death, bloating (swollen state caused by retention of fluid or gas), heart-burn and weight loss.

Tabaro states that peptic ulcers can lead to malnutrition because one might fail to get a balanced diet as they are limited to consuming certain foods.

editor@newtimesrwanda.com