Do I have ulcers?

I recently I did a breath endoscopy and Helicobacter Pylori tests and had a general medical examination which showed I did not have ulcers. However, the other day I suffered a serious headache and vomited some blood. Could I have ulcers that were hiding?


Dear Anita,
The majority of peptic ulcers are caused by a germ Helicobacter Pylori and the rest mainly by painkillers of the type NSAIDs of which the darling Diclofenac is used by many Ugandans for diverse pains including a headache. NSAIDS can cause acute bleeding peptic ulcers resulting in vomiting blood.

Headache may be associated with vomiting (migraine headache) and if forceful, or prolonged, a crack inner lining, where the oesophagus meets the stomach may develop resulting in vomiting blood (Mallory Weis syndrome). This bleeding though may be associated with abdominal pain, stops on its own and may require no treatment but continued vomiting and headache may require being addressed.

Blood tests may be used to detect antibodies to H. pylori infections and if negative one may have never had infection or the infection is recent. If positive, this means that one may have been infected at some point in the past. H.Pylori antibody tests may remain positive even after successful eradication of the germ.

Breath tests for urea, a substance produced by H. Pylori to resist stomach acid if positive means active infection is present. Stool tests if positive for the germs antigen also indicate ongoing infection. But stool tests are also useful in indicating bleeding that may not be otherwise noticeable even when a victim looks at his own stool.

Whereas it was always believed that stress can cause ulcers, it is likely stress associated combined factors such as alcohol and consumption of painkillers on their own or in the presence of H. Pylori infection that may lead to ulcers.

Stress-induced gastritis, (stress- ulcer syndrome), can cause erosions in the inner lining of the stomach with some bleeding requiring proper diagnosis and treatment. This however is usually due to stress of another kind called physiological stress, like in severe burns or severe injuries, or being bedridden when there is reduced blood supply to the stomach causing the ulcers.

Can oral sex cause infections?

I enjoy oral sex but many times when I do it I get smelly fluids, itching and pain in the stomach. What safety measures can I take to avoid these issues?


Dear Nightingale,
Both men and women can use their mouth, lips or tongue to stimulate a partner’s genitals or in some people, the anus in what is called oral sex. Much as oral sex used to be taboo, today it is commonly used as foreplay for both men and women or especially in women to reach a climax without leading to penetrative sex and pregnancy.

Unfortunately, many people do not consider oral sex as sex, so they may take emotional or physical risks without even using protection. And because it involves sucking or licking the partner’s genitals (or anus), one is likely to come into contact with genital fluids or faeces risking many infections from the anus or sexually transmitted infections (STIs).

The STIs may include genital warts, genital herpes, chlamydia, gonorrhoea, hepatitis A, B or C, HIV/AIDS, syphilis and pubic lice affecting the men’s beards. This can especially happen if one gives rather than receives oral sex, one has cuts or sores in the mouth or is a woman in her period and one does not use protection.

Saliva on its own can disturb the vaginal environment leading to either bacterial vaginosis or vaginal candidiasis or both which can lead to a fish smelling vaginal discharge.

That said, infections can cause genital or abdominal pain, smelly vaginal fluids and itching but use of a dental dam to protect yourself during oral sex can be helpful. You can make one by cutting a condom into a rectangular shape and use it to protect his mouth.

You can also seek vaccination against HPV (cervical cancer) and hepatitis B apart from regularly and routinely checking for STIs, HIV and Hepatitis.

Best methods of family planning

I had an abortion two weeks ago and bled for three days. I also had sex two days after the bleeding stopped. Will I get pregnant again or can I take postinor which has failed to work before?


Dear Jackie,
An abortion is an expulsion of a pregnancy which is not yet viable (less than 28 weeks) though this varies with places. An abortion may be spontaneous or induced.

A woman who has had a miscarriage can be emotionally and physically traumatised and may need to delay getting pregnant again.

This, together with the fact that yours may have been an induced abortion, means that you need a method of family planning but not emergency contraceptionsuch as postinor or CIPLAs I pill.

Though it requires an experienced medical worker to insert, an Intra Uterine Contraceptive Device (IUCD) would suit you given that it will act as an emergency contraceptive up to five days backwards (since you have already had unprotected sex within five days) and continue to work up to 10 years or more until when you want to get pregnant again.

Though not all women will be fertile quickly after a miscarriage, a woman can ovulate and become pregnant just two weeks after a miscarriage, making it more pertinent to use an IUCD, which can act as an emergency contraceptive and be removed when she wants to get pregnant.

A woman may abort and get pregnant again even before she bleeds after an abortion and the bleeding after an abortion (or even that of the next month) is not usually a normal period to base on in determining safe days.

Will urine prevent HIV infection?

A while ago when gonorrhea was rampant, washing the vagina using one’s urine would prevent the gonorrhea because urine is acidic. Can one wash the vagina with urine to prevent HIV?


Dear Dorcus,
It is true Ugandans use urine to wash their private parts after sex in the hope that urine helps prevent STDs and HIV infections. The passage more than washing with urine was said to prevent STDs infecting through the urethra.

Other Ugandans quickly wash with soap and water to prevent even the dangerous HIV. Limiting the number of sexual partners, having sex with a partner with whom one has been checked for STDs and HIV, proper use of condoms and taking post exposure prophylaxis in case of HIV are important ways of preventing STDs and HIV infection.

Gonorrhea and some other STDs and HIV may infect one through the urethra and as such theoretically it may be helpful to pass urine after sex to clean up the urethral route of infection. However, passage of urine may not work 100 per cent in preventing the STDs and for HIV infection prevention by mere passage and washing with urine may be a very dangerous proposition.

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