Pain After Every Meal: The Hidden Infection Millions of Nigerians Live With
Oluwafunbi Bello 
ABUJA, Nigeria – Misdiagnosed as diet or stress, a silent bacterial infection thrives in Nigeria’s water and sanitation crisis, leaving millions untreated. Oluwafunbi Bello, writes.
For years, Fashakin Kofoworola lived with a discomfort that was quiet, persistent, and easy to dismiss. It began as a burning sensation — a tightening in her stomach that followed meals — the kind many Nigerians casually attribute to “ulcer”, often blamed on pepper, irregular eating, or stress.
“I had symptoms for a while before I got diagnosed, things like stomach pain, burning sensation, and discomfort after eating,” she said. “At first, I didn’t think it was serious, so I delayed going to the hospital.”
But the pain did not go away.
When she eventually sought medical attention, the diagnosis revealed something far more complex: not just an ulcer, but an infection caused by Helicobacter pylori — a common yet often misunderstood bacterium that attacks the stomach lining and can persist for years undetected.
“When I eventually saw a doctor, I was told it was likely an ulcer and that I needed to avoid certain foods and take medication regularly,” she said. “The doctor explained that it wasn’t just about food or stress, but also an infection that needed proper treatment.”
Kofoworola’s Experience Is Not an Isolated Case
Across Nigeria, peptic ulcer disease remains a widespread and often misunderstood condition, affecting millions each year. Estimates in medical literature suggest that as many as four million Nigerians are diagnosed annually — a burden driven not only by H. pylori infection, but also by the widespread use of over-the-counter painkillers and the pressures of daily life.
Globally, H. pylori are believed to infect more than half of the world’s population, with a disproportionately higher burden in low- and middle-income countries where access to clean water, sanitation, and timely healthcare is limited.
Yet in Nigeria, the problem runs deeper than prevalence.
While many cases are treated as routine digestive discomfort, the underlying bacterial cause is frequently overlooked. The result is a cycle of misdiagnosis, incomplete treatment, and recurring infection — one that, in severe cases, can lead to life-threatening complications.
In an interview with Africa Health Report (AHR), pharmacist Ezema Bartholomew said many Nigerians approach ulcer treatment incorrectly from the outset.
“Not often, but the ones coming are always asking for antibiotics for treatment,” he said. “Some people, when they come for ulcer treatment, they prescribe for themselves — ‘I need omeprazole’ or ‘I need antacid’ — without proper diagnosis.”
He explained that treating H. pylori infection requires a precise combination of antibiotics, not guesswork.
“If you want to treat H. pylori, you go either with clarithromycin and amoxicillin or clarithromycin and metronidazole — you cannot take the three antibiotics at once,” he said. “Once H. pylori are confirmed, then proper medication like clarithromycin, amoxicillin, and omeprazole is prescribed.”
Such practices, he warned, not only delay proper treatment but can also contribute to recurring infections and potential drug resistance.
Back in Abuja, the pain still returns — sometimes quietly, sometimes sharp enough to disrupt the rhythm of Kofoworola’s day.
But now, she understands what lies beneath it.
What once seemed like a simple dietary issue is, in reality, part of a much larger public health problem — one tied not only to individual habits, but to the water she drinks, the sanitation systems around her, and the environment she cannot control.
“Living with an ulcer has affected my daily routine, especially my eating habits,” she said. “I have to be very mindful of what I eat and avoid foods that trigger the pain. It sometimes causes discomfort, but I’m used to it now.”
Across the country, millions of Nigerians share that quiet adjustment — shaping their lives around a condition they often do not fully understand, managing symptoms rather than addressing the root cause.
Yet the true burden is not just the pain after meals.
It is the silence surrounding it.
A silence sustained by misdiagnosis, limited awareness, incomplete treatment, and the everyday realities of unsafe water and poor sanitation — conditions that allow the infection to persist, largely unseen.
Until those systems change — until clean water becomes reliable, sanitation is prioritised, and awareness replaces assumption — the cycle will continue.
And for many Nigerians, the pain will keep returning.
Not just after meals, but as a reminder of a crisis that remains hidden in plain sight.
About the Author
Koko Maxwella 
Hussaini Ibrahim 