Peptic Ulcer

There are two main types, each with a slightly different location and pain pattern.

• Gastric ulcer
  this forms in the wall of the stomach itself. Pain tends to occur during or shortly after eating, as food stimulates acid production directly against the damaged lining. Some patients find that eating makes symptoms worse rather than better.
• Duodenal ulcer
  this develops in the duodenum, the first section of the small intestine, a short distance beyond the stomach. It is actually the more common of the two in our patient population. A characteristic pattern is relief immediately after eating, followed by a return of pain two to three hours later, once the stomach has emptied and the acid buffer is gone.
• Oesophageal ulcer
  Oesophageal ulcers form in the lower part of the oesophagus, where the lining meets repeated acid exposure. They are less common than gastric or duodenal ulcers, but we do see them.

Neither pattern is entirely reliable as a diagnostic marker - some patients experience symptoms that do not fit neatly into either category, and a significant number feel very little until a complication develops. This is precisely why we encourage early evaluation rather than prolonged self-management. Our team offers the best duodenal, oesophageal, and gastric ulcer treatment options in Uganda.

Several factors come together to make peptic ulcer disease particularly prevalent. Understanding these is important - both for managing an existing ulcer and for protecting those who have not yet developed one.

• Helicobacter pylori infection is the single most significant cause.
• Prolonged use of NSAIDs and non-prescribed painkillers is the second major driver.
• Long gaps between meals are extremely common, as they cause acidity.
• Smoking and tobacco use impair blood flow to the stomach lining and significantly slow healing in existing ulcers.
• Chronic stress does not cause ulcers directly, but worsens symptoms and undermines recovery.

Many patients live with mild symptoms for months before seeking evaluation. Some can wait for a scheduled appointment. Others need same-day attention. It is important to know the difference.

• Burning or gnawing upper abdominal pain, typically between the navel and lower chest, which may ease briefly after eating or taking antacids
• Pain that returns two to three hours after a meal, particularly characteristic of duodenal ulcers
• Nausea, especially in the morning or shortly after eating
• Feeling full quickly, even after a small amount of food, or persistent bloating after meals
• Reduced appetite and gradual, unintended weight loss over weeks
• Black or tarry stools - this indicates bleeding in the upper digestive tract and requires same-day evaluation, even without acute pain
• Vomiting blood, or material that resembles dark coffee grounds - this is a medical emergency
• Persistent, unexplained fatigue that may indicate anaemia from slow ongoing blood loss

If you or a family member is experiencing any of the extreme symptoms, seek emergency medical care. UMC Victoria Hospital offers the best peptic and stomach ulcer treatment in Uganda.

The investigations we recommend from there depend on age, symptom duration, and whether any alarm features are present.

• Upper GI endoscopy is our most reliable investigation. It allows direct visualization of the stomach and duodenum, confirms the presence and size of any ulcer, and allows biopsy samples to be taken - to confirm H. pylori infection and, critically, to rule out malignancy in gastric ulcers.
• The urea breath test is a non-invasive, accurate method for detecting H. pylori without requiring endoscopy. We use this selectively for younger patients without alarm features.
• The stool antigen test provides another non-invasive option for H. pylori detection, particularly where breath testing is not immediately available.
• A full blood count helps assess whether anaemia is present - an important indicator of slow or ongoing bleeding from the ulcer site.

Treatment is guided by the underlying cause. It includes:

• Proton pump inhibitors (PPIs) reduce stomach acid and allow the ulcer to heal. Most patients take these for four to eight weeks, depending on ulcer size and location.
• Triple therapy for H. pylori combines a proton pump inhibitor with two antibiotics - typically clarithromycin and amoxicillin - for 10 to 14 days. Completing the full course is essential. Stopping early leads to treatment failure and antibiotic resistance over time.
• Stopping or reducing NSAIDs is a necessary step when these medications have contributed to the ulcer. Where ongoing pain relief is still needed, we will discuss alternatives that are less harmful to the stomach lining.
• Antacids and H2 blockers may be used alongside primary treatment to provide faster symptom relief in the initial days.
• Repeat endoscopy is recommended after treatment for gastric ulcers, specifically, to confirm healing and ensure no malignancy was missed on the initial examination.

No specific food causes peptic ulcers, but certain habits make symptoms significantly worse and slow healing. Eat smaller meals at regular intervals - roughly every three to four hours - rather than one or two large meals with long gaps between them. During the active treatment period, reduce or avoid very spicy food, excessive tea or coffee, carbonated drinks, and fried or heavily oiled food. These will not cause the ulcer, but they aggravate an inflamed lining and delay recovery.

Peptic ulcer disease is highly treatable when identified early. Our gastroenterologists provide the most advanced peptic ulcer treatment in Kampala at UMC Victoria Hospital.

• Experienced gastroenterologists and internal medicine specialists working together under one roof, with the ability to manage both straightforward and complex presentations
• Advanced endoscopy facilities for accurate diagnosis, H. pylori confirmation, biopsy, and post-treatment follow-up
• Root-cause diagnosis rather than symptom suppression - we identify what is driving the ulcer and tailor treatment accordingly
• Structured, evidence-based care informed by an understanding of the health realities specific to Uganda and the wider East African region