Ask the Doctor: What causes stomach ulcers?

Dear doctor,
What causes stomach ulcers? Tell me the difference between duodenal and peptic ulcers
Anonymous

Dear Anonymous,

A stomach ulcer is a wound found in the acidic areas of the alimentary canal, that is the stomach, duodenum (outlet to the stomach) and lower oesophagus (inlet to the stomach). They are called peptic ulcers, because the majority of them are caused by a germ infection (Helicobacter Pylori). The other major causes are painkiller drugs such as Aspirin or Diclofenac.

Peptic ulcers found in the stomach are known as gastric ulcers, in the duodenum, duodenal ulcers, and in the lower oesophagus, Gastro-Oesophageal Reflux Disease.

Apart from lifestyle changes like avoiding smoking and taking painkillers only when they are prescribed, treatment of peptic ulcers involves mainly checking for the helicobacter germ and eradicating it.

Sometimes I have periods after 32 days and other times, it is 25 days. Sometimes I bleed for three days, and other times for seven days. I have been told I need hormones to stabilise this. Shall I get pregnant in future? My husband has two children outside marriage. I am now taking supplements as advised so that I avoid hormones.
Restetuta Ssabakaki

Dear Restetuta,

Although the average cycle is 28 days, it is perfectly normal to have a cycle that is as short as 21 days or as long as 35 days, the cycle being controlled by hormones. Even in the same woman or among different women, the number of days may not always be the same, varying from two to seven days. A woman may have a set number of days for her periods but after childbirth or contraception, the days may change completely.

The brain sends hormones to the ovaries which also make the other hormones (oestrogens to build up the inner lining of the uterus and progesterone, produced after ovulation, to nurture the lining for the fertilised egg to implant in). A change in brain or the said hormone levels can affect the cycle or fertility. (Other hormones including those of the thyroid may also do the same).

In your case, it is likely that your hormones are normal and, barring other fertility problems, you are most likely to get pregnant as you wish.

When a doctor finds out that a woman may have menstruation and fertility problems due to abnormal hormone levels, the aim of treatment is to help restore the levels with eventual normalising of periods and fertility.

This can be done together with other ways to help boost your own or your husband’s fertility for better results. Taking the correct food supplements can boost fertility especially that of your husband but supplements taken alone without correcting the abnormal hormone levels may not lead to success in most women. Since a man can have children somewhere else and fail to have them with another, a woman may also have children with another man. You need to visit your doctor together with your husband even if he may have no fertility problems. He should give you psychological support because it is also a necessary booster of fertility.

Dear doctor,
In Uganda, today, more than ever before, parents are faced with a problem whereby toddlers may drink paraffin. As a parent, if my child took paraffin, what first aid should I give? Kenneth

Dear Kenneth,

In Uganda, paraffin (kerosene) is used for cooking and lighting. As such it will be found in many of our homes, whether they are rural or urban. Often times, toddlers or young children drink paraffin accidentally mistaking it for drinking water since it is usually stored in soda or beer bottles.Sometimes, the paraffin is given to them by others who also mistake it for drinking water.

Fortunately, in most accidental cases because of the strong smell and taste, only meagre amounts are taken. However, parents are always alarmed by the smell of paraffin (on the skin, clothes or breath) although they are mostly unaware of the amount taken having been away from the scene of the accident.

This alarm is helpful because the children are availed immediate attention. Even when the children have taken significant amounts of kerosene, they may not show symptoms immediately since kerosene is absorbed slowly in the stomach.
Paraffin can irritate the mouth, causing production of lots of saliva, and the throat, leading to a cough. Cough may also indicate paraffin entry into the lungs, which is a usual serious problem that can lead to pneumonia. Pneumonia may not only lead to cough but also difficulties in breathing and may be fatal.

Many parents give first aid of inducing vomiting, but they risk having the paraffin-laden vomit entering the lungs and causing fatal aspiration pneumonia.
The children apart from having a “new” cough, difficulty in breathing, irritability and nausea may also vomit due to kerosene irritating the stomach.

Since parents give first aid of milk or water to dilute the kerosene, which is commendable, care should be taken when giving these fluids in a child is who is already vomiting. Also the holding of the neck in a child who is vomiting that is commonly done may push the vomitus into the lungs and should therefore be avoided.

Regardless of whether a child has symptoms or not, a child suspected to have taken paraffin should be taken to a health facility to be checked out.

Dear doctor,
These days, when I cough I pass gas and as you know you cannot always prepare to cough. What can I do?
Adams Binshobeire

Dear Adams,

Cough, in many cases, comes automatically. Just like passing gas, cough follows contraction of the abdominal muscles resulting in pressure in the abdomen that suddenly pushes air out of the lungs and, for gas, out of the rectum.

If coughing and passing gas happen at the same time once in a while, this can be taken as normal. When it happens too often, it may be an indicator of too much gas in the tummy or failure to consciously control escape of gas. Too much gas may result from the type of diet (beans, vegetable, salads, dairy foods), constipation or peptic ulcers, among others, which have to be addressed. Flatus incontinence is likely in homosexuals or in advanced age, in men, while in women this may be related to too many or difficult deliveries.

Dear doctor,
Why is it that every time I am going to do exams I get asthma?
A. Bukirwa

Dear Bukirwa,
Stress can cause lots of anxiety and trigger attacks in those prone to asthma. The stress that accompanies examinations can also give asthma-like symptoms with difficulties in breathing and “induced” breath sounds that may be mistaken for the wheezing of asthma in what is called a conversion disorder (originally known as hysteria).

I do not know whether what you call asthma is self-diagnosis or if it is by a doctor in which case you require management of both stress and asthma. However you should be careful while using steroids for asthma because they can lead to mood swings which also trigger asthma. In cases of a conversion disorder, management of stress alone will take away the breathing symptoms as well as the disorder.
Stress that triggers asthma can be relieved by getting adequate sleep, eating right, exercising, and findings ways to relax even when faced with examinations.

Answers by Dr Vincent Karuhanga