Experts Raise Concern Over Misdiagnosis, Treatment of Ulcer Conditions in Nigeria

By Tolulope Oke

LAGOS — Health experts have raised concerns that millions of Nigerians suffering from persistent stomach pain may be receiving inappropriate treatment, as underlying causes of peptic ulcer disease remain largely undiagnosed.

According to gastroenterologists, many patients who present with symptoms such as burning abdominal pain are routinely treated with antacids without undergoing proper testing for Helicobacter pylori (H. pylori), a bacterium widely recognised as a leading cause of ulcers.

Peptic ulcer disease, which involves sores in the lining of the stomach or upper intestine, is one of the most common chronic conditions in Nigeria. Symptoms often include a burning sensation in the upper abdomen, particularly when the stomach is empty, and in some cases, pain that disrupts sleep.

Medical experts explain that H. pylori, a spiral-shaped bacterium that attacks the stomach lining, is responsible for a significant proportion of these cases. The World Health Organisation classified the bacterium as a Group 1 carcinogen in 1994, confirming its role in the development of stomach cancer.

A 2017 systematic review published in Gastroenterology, which analysed 184 studies across 73 countries, estimated Nigeria’s H. pylori infection rate at 87.7 percent of the adult population—one of the highest globally.

At such prevalence levels, experts say treating ulcers with acid-suppressing medication alone only provides temporary relief, as it does not address the underlying bacterial infection. While symptoms may subside, the infection often persists.

Concerns have also been raised about the effectiveness of standard antibiotic treatments. Studies conducted in clinical settings in Ibadan and Lagos have documented high resistance rates of H. pylori to commonly used antibiotics such as clarithromycin and metronidazole, in some cases reaching up to 100 percent.

This growing challenge has led to increased interest in alternative approaches, including plant-based therapies. Researchers note that certain medicinal plants have shown potential antibacterial activity against H. pylori.

For instance, a 2003 study published in the journal Helicobacter reported that lemongrass (Cymbopogon citratus), widely used in West Africa, demonstrated bactericidal effects against the organism, with no resistance observed during repeated exposure in laboratory conditions.

In recent years, some herbal formulations incorporating such plant compounds have gained attention. However, health professionals caution that while early findings and anecdotal reports may be promising, patients should prioritise treatments that are properly tested, regulated, and approved by relevant authorities such as the National Agency for Food and Drug Administration and Control (NAFDAC).

They emphasise the need for increased public awareness, improved diagnostic practices, and adherence to evidence-based treatment protocols to effectively manage ulcer-related conditions in Nigeria.

For many patients who continue to experience recurring symptoms despite treatment, experts say proper diagnosis—including testing for H. pylori—remains a critical first step toward effective care.