Peptic ulcer causes are changing, and so are the ways to prevent them.

While more than 90 per cent of patients with peptic ulcers used to be infected by H. pylori, the prevalence now ranges from 50 to 75 per cent.

It is continuing to decrease in developed countries due in part to widespread anti-H. pylori therapy in both primary practice and the hospital setting, and the improvement of socio-economic and living conditions, says Dr Chuah Sai Wei, Consultant, ​ Department of Gastroenterology & Hepatology, Singapore General Hospital (SGH), a member of the ​ SingHealth group. However, the prevalence of H. pylori infection remains high in the elderly and in less developed countries.

“No one knows for sure how H. pylori is transmitted, although researchers believe that it may be spread through contaminated food or water; or through contact with the stool or vomit of an infected person. H. pylori has also been found in the saliva of some infected people, which means infection could be spread through direct contact with saliva,” adds Dr Chuah.

In the absence of definitive evidence on how H. pylori spreads, prevention is difficult. The usual advice, says Dr Chuah, is to wash your hands with soap and water after using the bathroom and before eating, to eat food that has been washed well and cooked properly, and to only drink water from clean, safe sources.

Peptic ulcers: What are the recommended lifestyle changes

• Stop smoking: Smokers are more likely to get ulcers. In addition, these ulcers prove more difficult to treat and have a higher recurrence rate.
• Moderate your alcohol intake: In high concentrations, alcohol damages the gastric mucosa and stimulates acid secretion. Alcohol abuse also appears to interfere with ulcer healing.

Ref: T12