In Nigeria, almost everyone seems to "have ulcer." People blame hunger, blame stress, blame missing breakfast, and many self-treat for years with antacids bought at the chemist. But a true peptic ulcer is a real sore in the lining of your stomach or the first part of your small intestine, and the most common reason it keeps coming back is a bacterium called Helicobacter pylori (H. pylori) that lives in the stomach. The good news: with the right test and the right medicines, peptic ulcer treatment in Nigeria is very effective and often curative. This guide explains what actually works, and what to stop wasting money on.
What a peptic ulcer really is
A peptic ulcer is an open sore where stomach acid has eaten through the protective lining. When it sits in the stomach it is called a gastric ulcer; when it sits in the duodenum (the start of the small intestine) it is a duodenal ulcer. "Gastritis" is irritation of the lining without a deep sore, and many Nigerians use "ulcer" loosely to mean any burning stomach pain. The distinction matters because the treatment, and the seriousness, can differ. Most peptic ulcers are caused either by H. pylori infection or by regular use of painkillers known as NSAIDs (like ibuprofen, diclofenac, and aspirin), not simply by skipping meals.
Common symptoms
Ulcer symptoms can be vague, which is why people manage them for years without a proper diagnosis. The classic complaint is a burning or gnawing pain in the upper middle of the abdomen, often described as a "hunger pain."
- Burning upper-abdominal pain, sometimes worse at night or between meals
- Pain that eases briefly after eating or after taking antacids, then returns
- Bloating, belching, and feeling unusually full after a small meal
- Nausea, and sometimes vomiting
- Loss of appetite or unintentional weight loss
- Heartburn-like discomfort rising toward the chest
Danger signs — get help now
Go to the nearest hospital immediately, or call 112 or 199, if you have any of these: vomiting blood or material that looks like coffee grounds; black, tarry or sticky stools; sudden severe stomach pain that will not ease; fainting, dizziness or a racing heart; or being unable to keep down food or water. These can mean the ulcer is bleeding or has perforated, which is a medical emergency.
What actually causes ulcers
The two heavyweight causes are H. pylori and NSAID painkillers. H. pylori is spread mainly through contaminated food and water and close household contact, which is why it is so common across Nigeria. It weakens the stomach lining and lets acid cause damage. NSAIDs, very widely bought over the counter here for body pain, malaria aches, and period pain, do the same by another route. Smoking, heavy alcohol use, and untreated stress can worsen symptoms and slow healing. Spicy pepper soup and missed meals may trigger the pain you feel, but they are usually not the underlying cause, so cutting pepper alone will not heal a real ulcer.
Testing: stop guessing, get the H. pylori test
Because H. pylori drives so many ulcers, finding out whether you carry it changes everything about your treatment. The most practical tests available in Nigeria are a stool antigen test and a breath test, both of which detect active infection, and a blood antibody test, which is cheaper and widely offered but cannot tell a past infection from a current one. For people with alarm features, with new symptoms after age 50, or whose pain keeps returning, a doctor may recommend an endoscopy, where a thin camera looks directly at the ulcer. GoDoctor offers a home H. pylori test through our home lab service, so a phlebotomist or sample collection can come to you in Lagos, Abuja, Port Harcourt and other covered areas, with results reviewed by a doctor.
| Test | What it shows | Good to know |
|---|---|---|
| Stool antigen | Active, current infection | Reliable; pause PPIs and antibiotics before testing as advised |
| Breath test | Active, current infection | Accurate but not available everywhere |
| Blood antibody | Past or present exposure | Cheap and common, but cannot confirm current infection alone |
| Endoscopy | Direct view of the ulcer | For alarm signs, older age, or persistent symptoms |
Treatment and management that works
If H. pylori is found, the proven cure is a combination called triple or quadruple therapy: a proton pump inhibitor (PPI) such as omeprazole, esomeprazole or pantoprazole, taken together with two antibiotics for one to two weeks, sometimes with bismuth added. This is the part most people get wrong. Buying only omeprazole for a few days, then stopping when the pain eases, soothes the symptom but leaves the bacterium alive, so the ulcer returns. You must finish the full course exactly as prescribed, even after you feel better, and your doctor may arrange a repeat test about four weeks later to confirm the bacteria are cleared. Where NSAIDs caused the ulcer, the key step is to stop or change the painkiller, alongside a PPI to let the lining heal. Antacids and PPIs are available through GoDoctor's pharmacy, and we can deliver your full prescribed course to your door so you do not stop halfway.
- Take the complete antibiotic and PPI course — do not stop when pain improves
- Avoid NSAID painkillers like ibuprofen and diclofenac; ask a doctor about paracetamol as an alternative
- Cut down or stop smoking and heavy alcohol, which slow healing
- Eat regular meals and reduce foods that personally trigger your pain
- Return for a confirmation test after treatment if your doctor advises it
Prevention and reducing recurrence
Since H. pylori spreads through contaminated food and water, good hygiene helps: drink safe water, wash hands before eating and after the toilet, and wash fruits and vegetables properly. If your household has someone with confirmed infection, treating the person and following NAFDAC-registered medicines responsibly reduces reinfection risk. Avoid the habit of grabbing painkillers for every ache, and never take NSAIDs on an empty stomach over long periods without medical advice. Managing stress, sleeping well, and not smoking all support a healthier stomach lining.
When to see a doctor
See a doctor if you have had recurrent burning stomach pain for more than a couple of weeks, if antacids stop helping, if you are losing weight without trying, or if you have been self-medicating for ulcer for months. A proper diagnosis spares you years of treating the wrong thing. With GoDoctor you can speak to an MDCN-verified doctor online by video, audio or chat, get the right H. pylori test arranged, receive an e-prescription, and have your medicines delivered, all without leaving home. Remember: this article is for information and is not a diagnosis. Any of the danger signs above means go to the nearest hospital or call 112 or 199 straight away.
FAQ
Is ulcer caused by not eating on time? Skipping meals can trigger the burning pain you feel, but it is rarely the real cause. Most peptic ulcers come from H. pylori infection or regular painkiller (NSAID) use, which is why a test matters more than just changing your meal timing.
Can H. pylori be cured completely? Yes. With the correct combination of a PPI and two antibiotics taken for the full course, H. pylori is usually cleared and the ulcer heals. A follow-up test about four weeks later confirms the cure.
Why does my ulcer keep coming back? The most common reason is incomplete treatment — taking omeprazole alone, or stopping antibiotics early once the pain eases. Continued NSAID painkiller use, smoking, and reinfection are other causes. Completing the full prescribed course is the fix.
Do I need an endoscopy? Not always. Many people are managed well with an H. pylori test and medicines. An endoscopy is recommended if you have danger signs, are over 50 with new symptoms, or your pain keeps returning despite treatment — your doctor will advise.