Many Nigerians believe that skipping meals or eating spicy food is what causes stomach ulcers. But health experts say the main cause is the bacterium called Helicobacter pylori (H. pylori), and the awareness of how it spreads and its long-term risks is key to early treatment and prevention.
H. pylori infects the stomach and can remain undetected for years in many people. In some people, it causes inflammation and damage to the stomach lining, leading to pain, ulcers, and in severe cases, cancer.
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“A lot of people still think ulcers are mostly caused by stress or fasting,” said Ganiyat Oyeleke, a Consultant Gastroenterologist and Hepatologist at the Lagos University Teaching Hospital. “But most peptic ulcers are caused by H. pylori infection.”
According to Mrs Oyeleke, H. pylori has special features that help it survive beneath the protective mucus lining of the stomach.
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Its presence causes inflammation and destroys cells that normally suppress acid production, leading to increased gastric acid. This acid, in turn, damages the stomach lining and causes ulcers.
While physiological stress from severe burns, infections, or brain injury can cause what is known as a stress ulcer, this is less common.
“Skipping meals may aggravate ulcer symptoms, but it is not the main cause,” she explained.
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How it spreads
H. pylori infection is common worldwide and is often acquired through contact with contaminated food, water, or saliva.
“H. pylori is acquired by ingesting food and water contaminated by stool or from the saliva of an infected person getting into the mouth of an uninfected person,” Mrs Oyeleke said.
“The infection can be prevented by personal hygiene such as hand washing, good toilet habits, adequate refuse and sewage disposal, and provision of potable water.”
The World Health Organisation’s International Agency for Research on Cancer (IARC) classifies H. pylori as a carcinogen due to its role in causing gastric cancer and other serious gastrointestinal diseases.
Diagnosis, treatment
In Nigeria, the infection can be diagnosed through several methods. These include a blood test to detect antibodies, a stool test to find antigens, “a specific breath test,” and laboratory analysis of stomach biopsies taken during endoscopy.
Mrs Oyeleke said there are specific combinations of medicines which are taken for a specific period to eradicate the bacteria.
She noted that the infection is curable if well-treated.
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Treatment usually involves a combination of antibiotics and medications that reduce stomach acid, allowing the stomach lining to heal.
Symptoms of H. pylori-related ulcers include burning stomach pain, bloating, nausea, and frequent burping. In some cases, complications like bleeding, weight loss, or vomiting blood may occur.
Long term risks
One of the most concerning aspects of untreated H. pylori infection is its potential to cause life-threatening diseases.
Mrs Oyeleke said the long-term complications of H. pylori infection in the upper gastrointestinal tract are chronic gastritis, peptic (gastric and duodenal) ulcers, gastric cancer, and a specific type of lymphoma in the stomach known as mucosa-associated lymphoid tissue lymphoma.
She said it has also been linked with stroke in the brain, heart attack, iron deficiency anaemia, and a few other conditions.
The National Cancer Institute also confirms that chronic H. pylori infection can lead to long-lasting inflammation, which may evolve into atrophic gastritis and even stomach cancer.
Preventing spread
Good hygiene and safe water access remain the most effective ways to reduce transmission, especially in areas where the infection is common.
Mrs Oyeleke encourages regular handwashing, proper food handling, and early medical attention for symptoms.
“The infection can be prevented by personal hygiene (hand washing), good toilet habits, adequate refuse and sewage disposal, other good environmental hygiene practices, adequate potable water and adequate treatment of infected persons,” she said.
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