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Nigerian influencer Enioluwa Adeoluwa recently revealed on social media that his ulcer had recurred despite his regular eating habits. On July 30, Enioluwa took to X (formerly Twitter) to share his surprise at the diagnosis, considering he consumes food frequently.
He wrote, “The most shocking news of 2024 is my Doctor saying my ulcer has recurred. How??? Forget content. I eat like a fooooool.” The post quickly went viral, garnering over 1.9 million views, 493 reposts, and more than 7,000 likes.
The revelation led many users on X to question the common beliefs surrounding the causes of ulcers. One user, Sweetest~girl (@Ojoma321), commented, “You’re not eating the right food.” Another, Dammie (@dat_fine_dammy), shared a similar experience, stating, “The exact same thing happened to me. Never had ulcer, and now at 36… madam you have a chronic ulcer, me? That eats 7 times a day?”
Adding to the conversation, Amme (@abbeyb2k) questioned the notion that ulcers are solely caused by not eating regularly. “They actually made us believe that it’s when you don’t eat that you end up having an ulcer. Truth be told, I could stay all day without eating anything… and I don’t even have an ulcer. So I’m not sure it’s by not eating,” Amme wrote.
Winifred (@Winifunds) further contributed by stating, “They’re not necessarily caused by not eating.”
The ongoing discussions have highlighted the need for a deeper understanding of ulcer causes, and many users are now seeking clarification from experts.
What is ulcer?
The latest data by the World Health Organization in 2020, published by worldlifeexpectancy.com, says Peptic Ulcer disease has caused 5,846 deaths in Nigeria, making up 0.39% of all deaths in the country. When adjusted for age, this means that about 7 out of every 100,000 people in Nigeria died from this disease, placing Nigeria 31st in the world for peptic ulcer-related deaths.
Peptic ulcers, open sores that develop in the lining of the stomach or the upper portion of the small intestine (duodenum) are a common yet serious gastrointestinal condition. According to the Cleveland Clinic, these ulcers result from erosion penetrating through all three layers of the mucous lining. Stomach ulcers account for about 20% of all peptic ulcers, while duodenal ulcers make up the remaining 80%.
According to Penn Medicine, Peptic ulcers arise when there is an imbalance between the digestive juices produced by the stomach and the protective factors in the stomach’s lining. One of the leading causes of stomach ulcers is the bacterium Helicobacter pylori, which can weaken the stomach’s defence mechanisms.
Treating ulcers caused by this bacterium typically includes acid-suppressing medications and antibiotics to eliminate the infection.
According to the National Institute of Health, excessive alcohol consumption, the regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen, smoking, and exposure to high-stress levels increase the risk of developing peptic ulcers. Additionally, a rare condition known as Zollinger-Ellison syndrome can lead to excessive acid production in the stomach, further contributing to the formation of ulcers. The primary symptom of a peptic ulcer is a burning or gnawing pain in the stomach.
Is not eating regularly the only cause of ulcers?
Enioluwa’s post focused on his experience of eating frequently and still developing an ulcer. DUBAWA created a poll on its WhatsApp Channel to gauge public opinion on this topic. The survey included five response options, allowing participants to share their thoughts on whether they believe irregular eating habits cause ulcers. The survey results provide insight into how people perceive the relationship between eating frequency and the development of ulcers.
Graphical representation of responses from DUBAWA Survey. Source: Juliet Buna
A total of 2,768 respondents participated in the survey. The responses were categorised as follows:
- 974 respondents, representing 35.2% of the total, believe that not eating enough causes ulcers
- 367 respondents, representing 13.3%, think that stress and lifestyle causes ulcers
- 485 respondents, representing 17.5% of the total, believe bacterial infection causes ulcers
- 562 respondents, representing 20.3% of the total, think that all the mentioned causes (combined causes) contribute to ulcers
- 380 respondents, representing 13.7% of the total, are unsure or do not know what causes ulcers
Here’s an analysis of the survey data on the perceived causes of ulcers:
- The most common belief among respondents is that not eating enough causes ulcers, with 35.2% of the respondents holding this view.
2. Second Most Common Belief: 20.3% of respondents believe that all factors combined (not eating enough, stress/lifestyle, and bacterial infection) can cause ulcers.
3. Bacterial Infection Awareness: Only 17.5% of respondents attribute ulcers primarily to bacterial infection (which aligns with medical understanding, as Helicobacter pylori bacteria cause many ulcers).
4. Uncertainty Among Respondents: 13.7% of respondents admitted that they don’t know what causes ulcers.
5. Stress and Lifestyle: A relatively smaller portion, 13.3%, believes that stress and lifestyle are the primary causes of ulcers.
Conclusively, the survey reveals a need for more awareness regarding the actual medical causes of ulcers, with many attributing it to not eating enough. This indicates a gap in public knowledge that could be addressed through education about the true causes of ulcers, particularly the role of bacterial infections.
According to Outpost Health, peptic ulcers are not directly caused by irregular eating habits. However, such habits can create an environment that facilitates the growth and proliferation of these harmful bacteria, thereby increasing the risk of developing peptic ulcers.
Expert speaks
A medical doctor at Trinity Hospital, Ibadan, Dr Abiodun Aworuwa, emphasised that poor diet is not the only factor contributing to the development of ulcers. Dr Aworuwa highlighted that various factors can lead to the condition, including bacterial infections, medication, stress, and lifestyle choices.
“It is not only inadequate food that can contribute to ulcers,” Dr Aworuwa stated. “We have several factors that can lead to ulcers, not just when someone is not eating properly. Some people are well-nourished and even overweight and still suffer from ulcers. This clearly shows that it’s not just about poor diet.”
He further pointed out that emotional and physical stress was also a significant factor. “Stress can increase acid production, leading to ulcers,” Dr Aworuwa said. “Excessive smoking and alcohol consumption have also been linked to the development of ulcers.”
He also noted that genetics and age can affect the likelihood of developing ulcers. “If there’s a family history of ulcers, or if someone is older, they may be at a higher risk, regardless of their diet.”
When asked whether ulcers have a cure, Dr Aworuwa responded affirmatively. “Yes, ulcers can be cured if the patient follows the prescribed treatment plan diligently,” he confirmed. “Once the cause is identified and addressed, and the patient adheres to the treatment plan, they can be completely free from ulcers.”
Also speaking, a dental surgeon at the Federal Medical Centre (FMC) in Owo, Ondo State, Dr Adeyemi Tunde, referenced recent discussions, such as those by popular health influencer Aproko Doctor, who mentioned that Helicobacter pylori can be transmitted through kissing. “There’s truth in that,” Dr Tunde confirmed. “Research has shown a correlation between the presence of Helicobacter pylori in the stomach and its presence in the mouth, particularly on the teeth. Once the bacteria enter the stomach, they reproduce uncontrollably and produce enzymes that accelerate the breakdown of the stomach lining.”
In addition to bacterial infection, Dr Tunde highlighted the role of certain medications in inducing ulcers. “Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, diclofenac, and ibuprofen have been linked to triggering episodes of ulcers,” he said. “For instance, if someone with an existing ulcer takes these medications, it can worsen their condition. That’s why we advise patients with ulcers to avoid these drugs.”
Dr Tunde also pointed out that other factors, including rare diseases such as Crohn’s disease, stress from acute illness, hormonal changes, viral infections, and certain therapies like chemotherapy, can also lead to ulcer formation.
Regarding symptoms, Dr Tunde explained the different presentations of gastric and duodenal ulcers. “For peptic ulcer disease, the most common symptom is epigastric abdominal pain. With a gastric ulcer, this pain is typically felt before eating. When the stomach is empty, it signals to the brain that it’s hungry, producing digestive juices mixed with hydrochloric acid (HCL). Without food to digest, these juices begin to corrode the stomach lining, causing injury and pain.”
He added, “In contrast, duodenal ulcer pain usually occurs after eating. When food enters the duodenum, enzymes like trypsinogen are released, along with bicarbonate, to aid digestion. However, these enzymes can also act on the duodenal mucosa, causing pain.”
According to Dr Tunde, other symptoms of ulcers include bloating, vomiting, nausea, and, in severe cases, bleeding in the gastrointestinal (GI) tract. “Upper GI bleeding may present with blood-stained or dark-coloured stool and can lead to weight loss,” he noted.
Conclusion
The development of ulcers can be influenced by various factors, and understanding these factors is crucial for effective prevention and management. According to experts, bacterial infections, particularly Helicobacter pylori, play a significant role in the onset of ulcers. Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), and certain lifestyle choices, including smoking and alcohol consumption, can exacerbate the condition. Stress, genetic predispositions, and age further contribute to the risk of developing ulcers. Additionally, behaviours such as kissing may also play a part in the transmission of ulcer-causing bacteria. In rare cases, specific diseases may trigger the formation of ulcers.
The researcher produced this article per the DUBAWA 2024 Kwame KariKari Fellowship, in partnership with Crest 91.1FM, Ibadan, and News Verifier Africa, to facilitate the ethos of “truth” in journalism and enhance media literacy in the country.
