Ulcers!!

A non clear word indeed:

This a medical word which means wounds.

All wounds, whether on the skin, or the delicate covering in the mouth, inside the eyelids, the nose, the mouth, the intestines or the genital or urinary tract are medically called ulcers.

But to us Ugandans we informally use the “ulcer” word to mean wounds inside the stomach and the beginning of the intestines (duodenum).

Therefore, this post will be dealing with our Ugandan “ulcers”:

The real term for these stomach and duodenum wounds is Peptic Ulcers.

This can be further divided into:

·         Gastric ulcers: wounds inside the stomach.

·         Duodenal ulcers: wounds in the first part of the intestine (duodenum).

What you feel when you have ulcers:

Wound = Pain

The most common symptom is pain in the upper part of the abdomen close to the chest and mostly in the midline. This is because the stomach and the duodenum are located there.

But there are other organs located in the same place like the liver, pancreas, and gall bladder, which when diseased can cause pain.

That’s why the doctor will always bombard you with questions to characterize your pain. These questions help pinpoint which organ is the source of the pain.

Characterizing the ulcer pain!

One of the most important features of this ulcer pain is its relation to food.

·     Those with only gastric ulcers (ulcers in the stomach) tend to have their pain becoming worse the longer they take without eating. Eating food reduces the pain.  This becomes a recipe for obesity.

·         Those with duodenal ulcers tend to have their pain worsened on eating food.

·         Those with both have both types of pain, before and after.

As you already know, wounds are a nuisance, whether they are on the outside skin, or inside the stomach/duodenum.  It is even worse for the stomach/duodenal wounds because food interferes with healing and not feeding also interferes with healing.

That is why most people just get temporary relief when on ulcer treatment; they do not have the patience, and the discipline to go the whole way.

Ulcer treatment  that aims at achieving complete wound healing lasts between 1 month and 3 months.

Therefore, it is advisable not to develop the ulcers in the first place; this can be done by you just changing your lifestyle, especially the  feeding habits and avoiding stress.

There is no need of blaming the uclers on matooke, oranges, posho, beans, etc… these found the wound already there and just worsen the pain. Treat the wound and you will back to eating those “beans……..”

Diagnosing ulcers:

The test which confirms ulcers is Endoscopy. This is just a camera; the doctor is just extending the eye deep into your stomach. (some fiber-optic technology in use here.)

The purpose of endoscopy is to determine:

·         Whether the ulcers are both in the stomach and the duodenum

·         The size of the ulcers if present

·         The number of ulcers

·         The location of the ulcer with in the stomach

·      Whether you are lucky and you only have a bruise instead of a wound

·      Sometimes a tissue is taken to make sure it is not cancer causing the ulcer, especially in those with long standing pain

All these parameters determine the drugs to be given, and the duration of treatment including the needed lifestyle changes.

Note that: Endoscopy is not treatment, but a very important step therefore, it is advisable to carry out endoscopy before commencing treatment.

Just imagine a doctor starts you on treatment for 1 month (empirical treatment), yet the wound needs a 2 months course of treatment instead. This would be frustrating and you would even doubt whether the doctor knows what he is doing. This is one of the major reasons a person keeps moving from one doctor to another, or goes on to use alternative medicines (herbs) looking for a cure.

Availability and Cost of endoscopy:

Endoscopy is now available in almost all reputable hospitals in Kampala and  other Major Regional towns. 

This procedure is carried out by 2 types of specialized doctors: Gastroenterology Surgeons and physicians called Gastroenterologists, but in some hospitals, this is done by General Surgeons who have had further training in this skill.

The cost ranges from UGX 250k to 800k depending on the Hospital visited (k means 000)

Also, some insurance companies cover for this procedure depending on the agreement they made with your company.

Endoscopy done, problem found, what next?

This is where the rubber hits the road; there will be a lot of do’s and don'ts which you have to adhere to, all this done in the name of ensuring the wound heals and never comes back.

Lucky for me, not to make this blog longer that it is already, the same doctor who did the endoscopy, is also skilled to prescribe the treatment and to advise you.

You will also have regular weekly visits until the treatment is done.

Until next week…..

Chao

For those who do not know which hospital to visit to get further information, then please leave a comment or visit the contact page of www.ugandahospitals.com and send an email.