Spike in peptic ulcer disease in pregnancy in a rural community of Enugu state, southeast Nigeria: is this an epidemic?


  • Emmanuel I. Umegbolu Outpatient Department, General Hospital Oji River, Enugu State, Nigeria




Spike, Epidemic, Multigravidae, Peptic ulcer, Pregnancy, Primgravidae


Background: Pregnancy is said to increase susceptibility to Helicobacter pylori (H. pylori) infection, probably due to decreased cell-mediated cytotoxic immune response. Despite this, evidence from epidemiological studies suggest an alleviation of peptic ulcer disease (PUD) during pregnancy. One study found the incidence of PUD among pregnant women to be as low as 0.005-0.03%. The present study aimed to determine the incidence of PUD in women who attended ante-natal clinic in Cottage Hospital Inyi, Oji River Local Government Area (LGA), Enugu State, in 2021.

Methods: This was a cross-sectional study conducted with 435 pregnant women, aged 18- 40 years in 2021 in Inyi, Oji River LGA of Enugu State, Southeast Nigeria. Through purposeful sampling, 57 women were selected. From each of these patients, a stool sample was collected and examined using immunochemical fecal occult blood test. A horizontal line on the test strip signified a positive result, while its absence negative result. Data were analysed as proportion and Chi- square using MaxStat (version 3.6) statistical software. P value ≤0.05 was considered significant.

Results: The incidence of PUD in the pregnant women was 13%; 4.8% in primigravidae, and 8.2% in multigravidae. The association between PUD and parity was not significant (p value =0.89).

Conclusions: The incidence of PUD in pregnancy (13%) was much higher than ever had been reported in the past, being slightly higher in multigravidae than primigravidae. Health education on lifestyle modification and environmental sanitation could help in tackling this problem.



Lanas A, Chan FKI. Peptic ulcer disease. Lancet. 2017;390:613-24.

Ford AC, Axon AT. Epidemiology of Helocobacter pylori infection and public health implications. Helicobacter. 2010;1:1-6

Hunt RH, Xiao SD, Megrand F, Leon-Barua R, Bazzoli F, van der Merwe, et al. Helicobacter pylori in developing countries. World Gastroenterology Organisation Global Guidelines. J Gastroint Liver Dis. 2011;20(30):299-304.

Lanciers S, Despinasse B, Mehta DI, Blecker U. Increased susceptibility to Helicobacter pylori infection in pregnancy. Infect Dis Obstet Gynaecol. 1999;7(4):195-8.

Chang J, Streitman D. Physiologic adaptations to pregnancy. Neurol Clin. 2012;30(3):781-9.

McKeena D, Watson P, Dornan J. Helicobacter pylori infection and dyspepsia in pregnancy. Am Coll Obstet Gynecol. 2003;102(4):845-9.

Baingana RK, Enyaru JK, Davidsson L. Helicobacter pylori infection in pregnant women in four districts of Uganda: role of geographic location, education and water resources. BMC Public Health. 2014;14:915.

Poveda GF, Carrillo KS, Monje ME, Cruz CA, Cancino AG. Helicobacter pylori infection and gastrointestinal symptoms on Chilean pregnant women. Rev Assoc Med Bras (1992). 2014;60(4):306-10.

Mansour GM, Nashaat EH. Role of Helicobacter pylori in the pathogenesis of hyperemesis gravidarum. Arch Gynaecol Obstet. 2011;284(4):843-7.

Nanbakhsh F, Mohaddesi H, Bahadory F, Amirfakhrian J, Mazloomi P. Comparison of Helicobacter pylori infection between pregnant women with hyperemesis gravidarum and controls. World Applied Sci J. 2013;28(12):1918-22.

Golalipour MJ, Sedehi M, Qorbani M. Does maternal Helicobacter pylori infection increase the risk of occurrence of neural tube defects in newborns in Northern Iran? Neurosciences. 2012;17(3):219-25.

Cardaropoli S, Rolfo A, Piazzese A, Ponzetto A, Todros T. Helicobacter pylori’s virulence and infection persistence define pre-eclampsia complicated by fetal growth retardation. World J Gastroenterol. 2011;17(47):5156-65.

Eslick GD, Yan P, Xia HH, Murray H, Spurrett B, Talley NJ. Foetal intrauterine growth restrictions with Helicobacter pylori infection. Aliment Pharmacol Ther. 2002;16(9):1677-82.

Cappell MS. Gastric and duodenal ulcers during pregnancy. Gastroenterol Clin North Am. 2003;32:263-308.

Essilifie P, Hussain M, Bolaji I. Perinatal duodenal ulcer in pregnancy- a rare cause of acute abdominal pain in pregnancy: a case report and literature review. Cas Rep Obstset Gynaecol. 2011;2011:263016.

Clark D, Tankel HI. Gastric acid and plasma histamine during pregnancy. Lancet. 1954;2:886-9.

Dunlap JJ, Patterson S. Focus on clinical assessment: peptic ulcer disease. Soc Gastroenterol Nurs. 2019;42(5):451-4.

Chung CS, Ching TH, Lee YC. A systematic approach for the diagnosis and treatment of idiopathic ulcers. Korean J Intern Med. 2015;30:559-70.

Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M et al. Perforated peptic ulcer. Lancet. 2015;386:1288-98.

Charpignon C, Lesgourgues B, Pariente A, Nahon S, Pelaquier A, Gatineau-Sailliant G, et al. Peptic ulcer disease: one in five is related to neither Helicobacter pylori nor aspirin/NSAID intake. Al Pharmacol Ther. 2013;38:946-54.

Chong SKF, Lou Q, Zollinger TW, Tolia V, Elitsur Y, Gold BD, et al. The sero-prevalence of Helicobacter pylori in a referral population of children in the United States. Am J Gastroenterol. 2003;98:2162-8.

Akhtar F, Shelton P, Dinh A. Peptic ulcer disease. In: Domino F, Baldor R, Golding J, Stephens M, eds. The 5-minute Clinical Consult. 27th edn. Philadelphia: Wolters Kluwer; 2019:748-749.




How to Cite

Umegbolu, E. I. (2022). Spike in peptic ulcer disease in pregnancy in a rural community of Enugu state, southeast Nigeria: is this an epidemic?. International Journal Of Community Medicine And Public Health, 9(12), 4359–4362. https://doi.org/10.18203/2394-6040.ijcmph20223192



Original Research Articles