November 17 was World Ulcer Prevention Day. To avert the condition, medical experts advised early breakfast, at least by 10am. The same goes for lunch and dinner, which should also be eaten promptly.
Physicians explained that ulcer is an open sore on an external or internal surface of the body, caused by a break in the skin or mucous membrane, which has failed to heal. Ulcers range from small, painful sores in the mouth to bedsores and serious lesions of the stomach or intestine.
Public Health Physician with Save the Children International, Dr. Olutosin Adeoye, said causes of stomach ulcers include, an infection with the bacterium helicobacter pylori (H.Pylori), long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin ibuprofen, or naproxen, a rare condition known as zollinger-ellison syndrome, which can cause stomach and intestinal ulcers by increasing the body’s production of acid. He said: “This syndrome is suspected to cause less than one per cent of all peptic ulcers. To prevent the spread of bacteria that might cause stomach ulcer, wash your hands with soap and water regularly. Also, be sure to properly clean all of your food and to cook thoroughly.
“To prevent ulcers caused by NSAIDs, people should stop using these medications (if possible) or limit their use. If you need to take NSAIDs, be sure to follow the recommended dosage and avoid alcohol while taking these medications. It is important to always take these medications with food and adequate liquids. Eating a healthful diet can benefit your intestinal tract and overall health. In general, it’s a good idea to eat a diet with lots of fruits, vegetables and fibre.”
Explaining that a number of symptoms are associated with stomach ulcers, Adeoye said severity of the symptoms depends on severity of the ulcer. “The most common symptom is a burning sensation or pain in the middle of your abdomen between your chest and belly button. Typically, the pain will be more intense, when your stomach is empty, and it can last for a few minutes to several hours.
“Other common signs and symptoms of ulcers include, dull pains in the stomach, weight loss, not wanting to eat because of pain, nausea or vomiting, bloating, feeling easily full, burping or acid reflux and burning sensation in the chest. See your doctor, if you have any symptoms of stomach ulcer. Even though discomfort may be mild, ulcers can worsen, if they are not treated. Bleeding ulcers can become life-threatening.”
Adeoye said diagnosis and treatment of stomach ulcer depend on the symptoms of the patient and severity of the ulcer. He said: “To diagnose stomach ulcer, your doctor will review your medical history along with your symptoms and any prescription or over-the-counter medications you’re taking. To rule out H. pylori infection, a blood, stool, or breath test may be ordered. With a breath test, you’ll be instructed to drink a clear liquid and breathe into a bag, which is then sealed. If H. pylori is present, the breath sample will contain higher-than-normal levels of carbon dioxide.”
Dr. Shakirat Gold-Olufadi, Senior Registrar, Dermatology, Genitourinary Medicine and Rheumatology Unit, Lagos University Teaching Hospital (LUTH), said mouth ulcer refers to a break in the tissue of the mouth, which can be external or internal. She said: “The external ones usually occur in the angle of the mouth or lips, while the internal ones can occur on the tongue, the lining of the cheeks or palate. They usually appear in the form of sores, which may be red, yellow or gray in colour and may appear swollen. They are usually painful, but can be painless in some cases. The causes of mouth ulcerations are numerous. However, they are usually harmless in most cases.
“Causes of mouth ulcers may range from infectious, inflammatory, autoimmune or cancerous causes. Some commonly encountered causes of mouth ulcers include, canker sores or apthous sores. This is one of the commonest causes of mouth ulcers and most individuals would experience this at one time or other in their life. They are commonly associated with nutritional deficiencies form Vitamin B12, folic acid, riboflavin, zinc and iron deficiency.
“They may also be associated with such systemic diseases as gastrointestinal disease like Crohn’s disease or coeliac, where there may be problem with absorption of vitamins. In some cases, the cause is not known. Some individuals may also have recurrent apthous ulceration.
“There is also cold sore, which bears close similarity to canker sores. It is caused by herpes virus, especially type 1, but may also be caused by type 2 herpes virus. It commonly starts as a blister on the lips, which may be single or multiple and ruptures to leave mouth sores. This may also be associated with recurrence and is a contagious cause of mouth sore.
“Trauma may cause mouth sore, if there is accidental biting of the lining of the mouth when chewing. Autoimmune diseases are diseases characterised by formation of antibodies, which are fighting against some specific components of the individual’s body. Examples of connective tissue disease, which may cause mouth ulceration include, systemic Lupus erythematosus (SLE), and behcet’s disease. These are associated with other symptoms of the disease, such as joint pains, hair loss, and specific skin rashes in the case of SLE and recurrent genital ulceration in the case of behcet’s disease.”
Olufadi said treatment of most cases of mouth ulceration are usually self-limiting and resolve in one to two weeks. More sinister causes, such as cancer in the oral mucosa, may run a protracted course and will require expert management by oral surgeons or physicians, depending on the cause.
“Prevention of mouth ulcers will include eating a balanced diet with fruits and vegetables, good oral hygiene such as brushing twice daily, use of mouth wash, and chewing slowly while eating to avoid trauma.
“Avoidance of intimate contact, such as kissing an individual with cold sores to reduce the risk of transmission is also advisable. In cases not resolving in two weeks or recurrent cases, or those associated with systemic symptoms, it is necessary to see an oral care doctor for proper evaluation and management.”