| HOME REMEDY: The bitter taste of Triphala generally fails to elicit a happy expression
Sailesh Kumar, a 23-year-old BPO employee, often complains of severe abdominal pain and indigestion. So does 20-year-old Zinnia Khan, a second-year student at a Calcutta college. Sailesh and Zinnia represent the growing number of cases of gastric disorders in Calcutta.
The statistics really make for grim reading. Nearly 30 per cent of the people coming to Calcutta Medical College’s outpatients’ department (OPD) complain of gastric disorders such as peptic ulcers, says Dr Prabir Banerjee, head of the gastroenterology department at the hospital.
A peptic ulcer is a sore on the lining of the stomach or the duodenum, which is the beginning of the small intestine. These ulcers, however, are non-malignant in nature. According to doctors, peptic ulcers are very common these days and almost everyone suffers from such a problem at some point of time. Dr Manoj Aggarwal, consultant gastro enterologist at Belle Vue Clinic, Calcutta, says that the increase in the number of gastric disorders is linked to the changing lifestyle of the city’s dwellers. “Though people have become more health conscious, sometimes they still eat food rich in fats. Also, the growing trend of smoking, chewing pan masala and alcohol consumption takes its toll. In fact, a majority of the patients complaining of peptic ulcers has a history of smoking and alcohol consumption,” Dr Aggarwal observes. Dr Banerjee adds that a peptic ulcer can be caused by long-term consumption of non-steroidal anti-inflammatory agents (NSAIDs) like aspirin and ibuprofen. “However, the condition can be controlled by medication and lifestyle modification,” he says.
Another cause of peptic ulcers is Helicobacter pyroli infection. H. pylori is a spiral-shaped bacteria that weakens the protective mucous coating of the stomach and the duodenum. This allows acid secreted by the gastro-intestinal lining to seep into the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause a sore or ulcer. H. pylori is able to survive in the stomach acid because it secretes enzymes that neutralise the acid. This mechanism allows H. pylori to make its way to the “safe” area — the protective mucous lining. Once there, the bacterium’s spiral shape helps it burrow through the lining.
In India, H. pylori infection is generally caused by poor hygienic conditions and by drinking contaminated water, especially in the slums and in rural areas. Tobacco addiction and the use of toothpastes or toothpowders containing tobacco can also trigger off peptic ulcers among the poor.
• Abdominal discomfort. This is usually a dull, gnawing ache that comes and goes for several days or weeks. It occurs two to three hours after meals. It occurs in the middle of the night (when the stomach is empty) and only eating food or antacid medications brings relief.
• Weight loss.
• Poor appetite.
• Nausea and vomiting.
• Bleeding from ulcers (in advanced cases).
After taking into account the symptoms, most doctors opt for an endoscopy to reach a definitive diagnosis. During an endoscopy, a thin, lighted tube with a tiny camera at the end (endoscope) is inserted into the mouth of a patient. It is then guided to the stomach and duodenum. This enables the doctor to observe the lining of the esophagus, stomach and duodenum, take photos of ulcers or remove a tiny piece of the tissue for biopsy. If an ulcer is bleeding, the doctor can use the endoscope to inject drugs that promote clotting or to guide a heat probe that cauterises the ulcer.
Doctors may also opt for other medical tests to detect the presence of H. pylori. In such cases, doctors recommend certain drugs that kill the bacteria, reduce stomach acid and protect the stomach lining. While antibiotics are generally used to kill the bacteria, certain drugs like H2 blockers and proton pump inhibitors are prescribed to reduce acid production, says Dr Banerjee. He explains that H2 blockers suppress the production of histamine (a compound that stimulates acid secretion). On the other hand, proton pump inhibitors halt the mechanism that pumps acid into the stomach. Moreover, Bismuth subsalicylate, a type of drug, is used to protect the stomach lining and also kill H. pylori bacteria.
However, certain precautions can help a person avert such a condition. These are:
• Modifying your lifestyle and dietary habits.
• Maintaining hygiene. This is important because H. pylori can be transmitted from person to person through close contact.
• Washing your hands after using the toilet and before eating.
• Thinking before popping painkillers, as they may render more damage to your gastric lining.
• Avoiding alcohol, pan masala and cigarettes.
• Going for morning walks, yoga classes or exercising regularly.
• These tips will certainly reduce one’s chances of contracting ulcers. After all, a stitch in time saves nine.