Ibrahim had been having epigastric pain for 5 months — always better after eating, which convinced him it was hunger. A test for H. pylori and an abdominal assessment at Mascot Healthcare diagnosed peptic ulcer disease. Treatment resolved symptoms completely.
Secondary school teacher, Mushin. 5-month history of epigastric pain.
Peptic Ulcer DiseaseIbrahim had been buying Ranimax (ranitidine) from a roadside drug seller each morning for five months. It helped for a few hours. By afternoon the burning was back. He had told his wife he had 'ulcer symptoms' but had never attended a clinic.
The night pain was the symptom that finally pushed him to attend. He had woken at 2am on three consecutive nights with the same burning sensation, and antacids were providing less relief than they had initially.
At Mascot Healthcare, The attending doctor asked whether the pain was better or worse with food. 'Better with food,' Ibrahim said. 'That's the duodenal ulcer pattern,' the doctor replied. He explained that most peptic ulcers are caused by H. pylori — a bacterial infection — not by stress or spicy food.
The pattern of PUD pain is distinctive — but easily confused with hunger, especially when food relieves it temporarily.
Central upper abdominal burning, 30–60 minutes after meals or on an empty stomach.
Classic PUD pattern — the pain eases briefly when food buffers the acid.
Acid production peaks at night; waking with epigastric pain is characteristic of duodenal ulcer.
Postprandial nausea without vomiting — present most days.
Functional dyspepsia component — common alongside ulcer disease.
Antacids and H2-blockers (like ranitidine) are acid-suppressing agents that relieve ulcer symptoms but do not treat the underlying cause. If the ulcer is caused by H. pylori — as approximately 80–90% of duodenal ulcers in Nigeria are — acid suppression alone is temporary management, not cure.
Ibrahim had been symptomatic for 5 months on antacids. Without H. pylori eradication, the ulcer would continue to recur indefinitely — and carried a small but real risk of bleeding or perforation over time.
H. pylori stool antigen test at Mascot Healthcare: positive. An abdominal examination found epigastric tenderness without guarding or rebound — no features of perforation. Full blood count was performed: no anaemia, which would have suggested occult GI bleeding.
The doctor explained the diagnosis: 'You have a peptic ulcer, and it is caused by a bacterial infection called H. pylori. We can eradicate it with a specific combination of antibiotics and acid suppression — and once eradicated, the ulcer heals and the pain goes.'
H. pylori stool antigen test: positive. Clinical presentation consistent with duodenal ulcer (pain pattern, night symptoms, relief with food). FBC: no anaemia. Diagnosis: H. pylori-positive peptic ulcer disease.
A 2-week combination treatment course to clear the H. pylori infection (an acid-suppressing medication together with two other medicines). Advised to avoid anti-inflammatory painkillers, alcohol, and frequent coffee. Soft diet for 2 weeks. Follow-up H. pylori test at 4 weeks post-treatment.
Repeat H. pylori stool antigen at 4 weeks after completing eradication therapy (minimum 4 weeks after last antibiotic dose). Symptomatic review at 2 weeks.
Ibrahim was asymptomatic by day 10 of treatment. The night pain resolved by day 4. Repeat H. pylori test at 4 weeks: negative — eradication confirmed. He has had no recurrence in the 6 months since.
Peptic ulcer disease in Nigeria is largely driven by H. pylori infection — affecting an estimated 70–80% of the adult population and most duodenal ulcer cases. The 'stress ulcer' narrative is largely outdated; stress may exacerbate symptoms but the primary driver is bacterial.
Clearing H. pylori with a short combination treatment course results in ulcer healing and cessation of recurrence in the vast majority of patients. An antacid taken daily for months costs more over time than a one-off course that treats the underlying infection.
Burning epigastric pain — especially if better with food, worse at night, or recurrent on antacids — should be assessed for H. pylori. A stool antigen test at Mascot Healthcare costs ₦3,500. The treatment is a short course that cures the underlying infection.
Walk in to Mascot Healthcare, Akoka — same-day consultation, transparent pricing, 4.9★ rated.