Peptic ulcers commonly referred to as “ulcers” are wounds that develop on the inside lining of lower part of the esophagus (gullet), stomach and the upper portion of your small intestine. The annual mortality rate per 100,000 people from peptic ulcer disease in Uganda has decreased by 32.8% since 1990, an average of 1.4% a year.

Peptic ulcers include: Gastric ulcers that occur on the inside of the stomach and Duodenal ulcers that occur on the inside of the upper portion of your small intestine (duodenum)

The most common causes of peptic ulcers are infection with a germ called Helicobacter pylori (H. pylori) and long-term use aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) painkillers e.g. paracetamol (panadol), diclofenac and ibuprofen. Smoking, stress and  eating spicy foods do not cause peptic ulcers but they highly predisposes one to getting ulcers or make symptoms worse.

Symptoms may include; burning stomach pain, feeling of stomach fullness, bloating or belching, fatty food intolerance, heartburn or nausea (feeling like vomiting)

The most common peptic ulcer symptom is burning stomach pain. Stomach acid makes the pain worse, as does having an empty stomach. The pain can often be relieved by eating certain foods that neutralize stomach acid or by taking an acid-reducing medication, but then it may come back. The pain may be worse between meals and at night. Nearly three-quarters of people with peptic ulcers don’t have symptoms.

Less often, ulcers may cause severe signs or symptoms such as: vomiting or vomiting blood — which may appear red or black, dark blood in faeces, or stools that are black or tarry, feeling faint, unexplained weight loss or appetite changes

Left untreated, peptic ulcers can result in complications such as; Internal bleeding, Infection and intestinal obstruction.

In order to diagnose this disease, the doctor first takes a medical history and performs a physical exam. You then may need to undergo diagnostic tests, such as: specific blood tests, x-ray or ultrasound imaging of abdominal organs and direct visualization of the stomach by use of a tube inserted through the mouth and pushed into the stomach (endoscopy)

Treatment for peptic ulcers depends on the cause. Usually treatment will involve killing the H. pylori bacterium using antibiotics, drugs that neutralize or reduce stomach acid production, reducing use of aspirin and similar pain medications.

Peptic ulcers that don’t heal with treatment are called refractory ulcers. There are many reasons why an ulcer may fail to heal, including: abnormal acid production by the stomach, new H.pylori infection, stomach cancer or continued exposure to the risk factors mentioned above.

Treatment for refractory ulcers generally involves eliminating factors that may interfere with healing, along with using different antibiotics.

If you have a serious complication from an ulcer, such as acute bleeding or a perforation, you may require surgery. However, surgery is needed far less often than previously because of the many effective medications now available.