Understanding Peptic Ulcers and Heartburn

If you are reading this article, you probably have either of these conditions or know someone with one of them. The prevalence of peptic ulcer disease (PUD) stands at about 10% while that of gastroesophageal reflux disease (GERD), commonly known as heartburn ranges between 20-30%. As you can imagine, these are high numbers and they keep rising each year which can be attributed to several factors, most notably the changing dietary lifestyles among people. These conditions have taken a toll on many of us and the people around our lives, not knowing how we could prevent their recurrence or how we can help others avoid this condition.  But the good news is, with the right knowledge and habits, you can manage or even prevent them.

What is PUD and GERD?

PUD simply means you have sores on the stomach or duodenal lining. When the sore lies on the stomach wall it is known as gastric ulcer and when it is on the duodenal wall it is known as a duodenal ulcer. GERD, on the other hand, means there is a backflow of gastric contents, which contain hydrochloric acid from the stomach, into the esophagus. The contents irritate the lower part of the esophagus, causing the feeling of burning around the chest after eating; hence, the name heartburn.

Image of Peptic Ulcer Disease Courtesy: HealthDirect

Image depicting Gastroesophageal Reflux Disease

Causes

• PUD: Helicobacter pylori infection, use of non-steroidal anti-inflammatory drugs (e.g. ibuprofen, diclofenac, meloxicam, etc), excess physiological stress (e.g. post-surgery), and cigarette smoking.

• GERD: Weak lower esophageal sphincter, pregnancy, obesity, carbonated drinks, caffeine, and habits like sleeping immediately after eating a heavy meal.

Recognizing the Symptoms

• PUD Symptoms:

  • Burning stomach pain- this pain can either improve or worsen with eating.

  • Nausea, vomiting, bloating.

  • Blood in vomit or stool.

• GERD Symptoms:

  • Frequent heartburn.

  • Regurgitation of stomach acid.

  • Chronic cough, sore throat, difficulty swallowing.

  • A feeling of a mass in the throat.

Prevention Strategies

• Dietary Changes:

  • Eat smaller, balanced meals with fiber, fruits, and vegetables.

  • Avoid trigger foods: caffeine, fatty or spicy foods, chocolate, and acidic drinks.

• Healthy Habits:

  • Avoid lying down immediately after meals (wait at least 2-3 hours).

• Sleep on your left side.

• Elevate the head of the bed for GERD.

• Quit smoking and limit alcohol intake.

• Medications and Alternatives:

  • Limit NSAID use; opt for alternatives like paracetamol or take with protective medication like PPIs or antacids. Seek your doctor’s guidance on this.

  • Consult a doctor for PUD and GERD treatments like H2 blockers or PPIs if symptoms persist.

• Stress Management:

  • Practice relaxation techniques like meditation, yoga, or breathing exercises.

REMEMBER:

·       Take 1-2 hours before lying down after dinner.

·       Sleep on your left side.

·       Avoid trigger foods.

NOTE: These practices will go a long way to safeguard you from developing PUD and GERD, but you can still develop this condition due to Helicobacter pylori, which is a common habitant (normal flora) within the gut. In case of any of the above symptoms, please visit your doctor to advise accordingly.

The Wellness Doc