Peptic ulcers, or peptic ulcer disease (PUD) is a condition wherein ulcers are formed in the esophagus, stomach, and the duodenum lining. Esophagus is a muscular tube that carries the food and water we consume, to the stomach. Ulcers formed in this tube are known as esophageal ulcers. Ulcers formed in the stomach are known as gastric ulcers, and ulcers formed in the duodenum, which is the upper portion of the small intestine, are known as duodenal ulcers. Peptic ulcer disease is very common all across the globe, affecting approximately 4.6 million people every year, including both men and women. It is a very rare scenario when children and teenagers are affected by these ulcers.
Our digestive tract has a mucous membrane (mucosa), which is a lining that protects the tissues from the digestive juices and acids produced by the stomach. A damage to this lining can damage the tissues, thereby forming ulcers in the respective area. Unlike the common belief that an ulcer is an outcome of too much production of digestive acid in the stomach affecting the mucous lining, the fact is that an ulcer can form even in the presence of minimal acid.
The most common location of a peptic ulcer is the duodenum, whereas, ulcers in the esophagus are relatively rare. Research within the United States of America states that approximately 10% of the people are likely to develop a duodenal ulcer during their lifetime. Speaking of women, about 8%-11% women are likely to develop peptic ulcers at some point of time, the percentage of men under the risk being within the range of 11%-14%.
Symptoms
Not everyone will experience symptoms, or, the same kind of symptoms. However, ignoring peptic ulcer symptoms, if any, or not getting treated in time, may cause inflammation in the abdominal cavity. There may also be an obstruction and/or narrowing of the intestinal opening that can prevent food from leaving the stomach and entering the small intestine. These complications can be serious and life-threatening. Therefore, it is essential that one shouldn't ignore the warning signs, and consult a doctor as early as possible. Some noticeable symptoms include -
» Abdominal pain
This happens to be the most commonly observed symptom indicating the presence of peptic ulcers - be it in the stomach, duodenum, or the esophagus. Pain is mostly observed in the middle or upper abdomen, that may, at times, reach to the breastbone or the back. The pain usually arises while the stomach is empty (a few hours after eating). The intensity may vary from person to person, and so may the duration of the pain. While some people may experience it for a few minutes, others may endure it for hours. It is usually more prevalent in the night, or early in the morning. You may also notice that the pain might stay for several days, and then disappear suddenly. If the ulcer has developed to a point that it has perforated (made a hole) in the stomach, then this causes intense pain, wherein emergency surgical treatment may be needed.
» Heartburn
The gnawing abdominal pain is accompanied with a burning sensation in the chest. For example, if the stomach acid, due to some abnormality like gastroesophageal reflux disease (GERD), ends up entering the esophagus, it may cause heartburn. Another point to be noted is that peptic ulcers have been observed in people with GERD.
» Nausea and vomiting
For many people, vomiting relieves the intensity of the pain they experience. However, if one ends up vomiting blood, or if the vomit appears to be dark brown or black in color, then this is an alarming sign that may indicate internal bleeding caused by the ulcer. The vomit may also appear to be like coffee grains, which is nothing but the clotted blood. Immediate medical attention should be sought in this case.
» Indigestion
Indigestion is another common symptom of peptic ulcer that causes a burning sensation somewhere in the middle of the chest. It is often accompanied with burps, frequent hiccups, and abdominal bloating. The discomfort or uneasiness often disappears by taking an antacid.
» Unexpected weight loss
Peptic ulcers are nothing but sores in the lining of the stomach, esophagus, or the duodenum. These ulcers can cause swelling in the stomach, thereby preventing the food to pass on to the small intestine. Because the food is not completely digested, the person may feel full, thereby decreasing the food intake. This eventually ends up in weight loss, or loss of appetite.
» Blood in stool
If the feces is dark in color, appear to be tarry or bloody, then it calls for an emergency visit to the doctor. This is one of the most serious symptoms of peptic ulcer disease, which might indicate that the ulcer has perforated the wall of the stomach or duodenum. This is a critical condition and may require a surgery.
» Other symptoms
Other symptoms which may be observed include - fatigue, paleness, and hunger pangs. Peptic ulcers may also lead to anemia, which is a consequence of the slow internal bleeding at the site of the ulcer. The loss of blood accounts for lack of adequate amount of red blood cells, thereby making the person anemic.
It is very important to keep a track on your symptoms, especially when you suspect the presence of a peptic ulcer. Taking a note of important details like - the duration of the pain, the medications that you consume, the frequency of the pain - if there are any specific situations that flare or subside the pain, or if you have any history of gastrointestinal diseases, and so on, is important. Also, it is mandatory for you to tell your doctor about each and every symptom, even if you think it is irrelevant.
Causes
The root cause for ulcer formation is the tissue break out due to an imbalance between the digestive juices, acids, and protective mucous layer in the digestive tract. There are many factors that can disturb this balance. Some of them include -
» Helicobacter pylori
Almost 60% of gastric ulcers, and 90% of duodenal ulcers are caused because of the bacterium H. pylori. The reason behind this is the simple fact that almost 50% of the world's population is infected by this bacterium. H. pylori doesn't always cause problem, in fact, only 10%-15% of the infected population is prone to get ulcer disease. During an infection, H. pylori builds colonies in the mucosa, thereby damaging it in the process, leading to inflammation and swelling in the area. The bacterium releases an enzyme called urease, which neutralizes the hydrochloric acid (HCl), a gastric acid in the stomach. As a result the hormone gastrin releases more acid at frequent intervals of time which causes the erosion of mucosa, leading to the formation of ulcers.
» Non-steroidal anti-inflammatory drugs
Regular use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen can also affect the balance between stomach acid and mucosa. These medications suppress the body's natural mechanism for releasing protective mucus and acid-neutralizing bicarbonate which disrupts the normal acid production. NSAIDs cause peptic ulcers in people who frequently take such pain relievers, especially on an empty stomach. Painkillers should always be consumed with meals to avoid damage to the mucous layer.
» Smoking
Cigarette smoking can also become a contributing factor in the development of peptic ulcers. Smoking aggravates the development of peptic ulcers. Also, if you are on medications for the treatment of ulcers, then smoking slows down the process of healing. The risk of developing peptic ulcer increases through smoking if you are infected by the H. pylori bacteria.
» Other causes
If some members of the family have this condition, then it is likely to occur in the rest as well. This is not because of genetics, but because of the risk of being infected by the bacterium H. pylori.
Other causes include - Zollinger-Ellison syndrome in which tumors in the duodenum and pancreas release excessive amount of stomach acid causing peptic ulcers. Medications used to treat osteoporosis can also develop peptic ulcers.
There was a time when it was considered that stress, alcohol consumption, caffeine, aerated drinks, and spicy food can cause ulcer formation. However, these factors do not cause PUD but can contribute in aggravating the condition.
Diagnosis
After understanding your symptoms, the doctor would conduct some tests to confirm the presence of peptic ulcer disease. The following tests are done for diagnosis.
» H. pylori test
The doctors will need to confirm the presence of H. pylori in your body. For this, a sample of your blood or stool may be taken and sent to the laboratory for detecting the presence of the bacterium.
H. pylori may also be detected through a breath test. For this, you may be asked to drink a small amount of liquid containing urea. It has no taste or color. The urea enters the body and the bacterium breaks it down into water and carbon dioxide. Later on, you will be asked to blow your breath into a bag. This bag is sent to the laboratory to check for the levels of carbon dioxide, which if found elevated, indicate the presence of H. pylori.
» Endoscopy
This test is usually done on patients showing severe symptoms of PUD like vomiting, weight loss, difficulty in eating, etc. A hollow tube with cameras attached in it, known as an endoscope, is inserted into the mouth, thereby passing through the esophagus, stomach, and duodenum. The camera enables the doctors to see if there are any ulcers in the area. A small tissue sample may be collected for biopsy testing. The results would confirm the presence of ulcers.
» Upper gastrointestinal series (UGI series)
Also known as a barium swallow, this is a special type of X-ray, wherein you will be asked to drink a liquid containing barium. This substance coats the digestive tract and increases the contrast during X-ray, making the ulcers appear more visible.
Treatment
After determining the exact cause and condition of peptic ulcers, the doctor will suggest a treatment plan accordingly. For instance, your doctor may prescribe different medications if the ulcer is caused by pain relievers. Given below are the possible treatment options that are most likely to be prescribed by the doctor.
» Antibiotics: The bacterium H. pylori is known to cause peptic ulcers in a majority of cases. To kill this bacterium, the doctors are likely to prescribe a two-week course of antibiotics. These may include - amoxicillin, clarithromycin (Biaxin), metronidazole (Flagyl) and tetracycline.
» Acid blockers and antacids: It is not only important to kill the bacterium through antibiotics, but medications are also prescribed to reduce the level of acids in the digestive tract. Some drugs that are widely prescribed are Ranitidine (Zantac), Famotidine (Pepcid), Cimetidine or Tagamet. The use of antacids can provide rapid pain relief and neutralize existing stomach acid. These may also be included in your treatment plan.
» Medication to protect the mucosal lining of the stomach and small intestine: Sucralfate (Carafate), Misoprostol (Cytotec), and Bismuth Subsalicylate are a group of prescribed medication, known as cytoprotective agents, that protect the lining of your stomach and small intestine.
Periodic assessment and medical checkups help to keep a tab on the progress and elimination of ulcer from the body. If the ulcer symptoms persist even after following the prescribed medication, then there are chances that you may be suffering from refractory ulcers - peptic ulcers that don't heal. If that is the case, then your doctor will analyze the possibility of any other cause behind the ulcers, other than H. pylori or NSAIDs.
Your daily lifestyle plays a very important role in determining how healthy you are. Having discussed the causes and symptoms of peptic ulcers, you must have understood how important it is to follow a healthy lifestyle, not only for prevention, but also to enable faster healing. Eat a balanced diet, avoid smoking and drinking, avoid taking stress, and make sure that you control your consumption of painkillers. In case of any doubt, consult a doctor at the earliest and don't resort to self-diagnosis and self-medication.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.
Our digestive tract has a mucous membrane (mucosa), which is a lining that protects the tissues from the digestive juices and acids produced by the stomach. A damage to this lining can damage the tissues, thereby forming ulcers in the respective area. Unlike the common belief that an ulcer is an outcome of too much production of digestive acid in the stomach affecting the mucous lining, the fact is that an ulcer can form even in the presence of minimal acid.
The most common location of a peptic ulcer is the duodenum, whereas, ulcers in the esophagus are relatively rare. Research within the United States of America states that approximately 10% of the people are likely to develop a duodenal ulcer during their lifetime. Speaking of women, about 8%-11% women are likely to develop peptic ulcers at some point of time, the percentage of men under the risk being within the range of 11%-14%.
Symptoms
Not everyone will experience symptoms, or, the same kind of symptoms. However, ignoring peptic ulcer symptoms, if any, or not getting treated in time, may cause inflammation in the abdominal cavity. There may also be an obstruction and/or narrowing of the intestinal opening that can prevent food from leaving the stomach and entering the small intestine. These complications can be serious and life-threatening. Therefore, it is essential that one shouldn't ignore the warning signs, and consult a doctor as early as possible. Some noticeable symptoms include -
» Abdominal pain
This happens to be the most commonly observed symptom indicating the presence of peptic ulcers - be it in the stomach, duodenum, or the esophagus. Pain is mostly observed in the middle or upper abdomen, that may, at times, reach to the breastbone or the back. The pain usually arises while the stomach is empty (a few hours after eating). The intensity may vary from person to person, and so may the duration of the pain. While some people may experience it for a few minutes, others may endure it for hours. It is usually more prevalent in the night, or early in the morning. You may also notice that the pain might stay for several days, and then disappear suddenly. If the ulcer has developed to a point that it has perforated (made a hole) in the stomach, then this causes intense pain, wherein emergency surgical treatment may be needed.
» Heartburn
The gnawing abdominal pain is accompanied with a burning sensation in the chest. For example, if the stomach acid, due to some abnormality like gastroesophageal reflux disease (GERD), ends up entering the esophagus, it may cause heartburn. Another point to be noted is that peptic ulcers have been observed in people with GERD.
» Nausea and vomiting
For many people, vomiting relieves the intensity of the pain they experience. However, if one ends up vomiting blood, or if the vomit appears to be dark brown or black in color, then this is an alarming sign that may indicate internal bleeding caused by the ulcer. The vomit may also appear to be like coffee grains, which is nothing but the clotted blood. Immediate medical attention should be sought in this case.
» Indigestion
Indigestion is another common symptom of peptic ulcer that causes a burning sensation somewhere in the middle of the chest. It is often accompanied with burps, frequent hiccups, and abdominal bloating. The discomfort or uneasiness often disappears by taking an antacid.
» Unexpected weight loss
Peptic ulcers are nothing but sores in the lining of the stomach, esophagus, or the duodenum. These ulcers can cause swelling in the stomach, thereby preventing the food to pass on to the small intestine. Because the food is not completely digested, the person may feel full, thereby decreasing the food intake. This eventually ends up in weight loss, or loss of appetite.
» Blood in stool
If the feces is dark in color, appear to be tarry or bloody, then it calls for an emergency visit to the doctor. This is one of the most serious symptoms of peptic ulcer disease, which might indicate that the ulcer has perforated the wall of the stomach or duodenum. This is a critical condition and may require a surgery.
» Other symptoms
Other symptoms which may be observed include - fatigue, paleness, and hunger pangs. Peptic ulcers may also lead to anemia, which is a consequence of the slow internal bleeding at the site of the ulcer. The loss of blood accounts for lack of adequate amount of red blood cells, thereby making the person anemic.
It is very important to keep a track on your symptoms, especially when you suspect the presence of a peptic ulcer. Taking a note of important details like - the duration of the pain, the medications that you consume, the frequency of the pain - if there are any specific situations that flare or subside the pain, or if you have any history of gastrointestinal diseases, and so on, is important. Also, it is mandatory for you to tell your doctor about each and every symptom, even if you think it is irrelevant.
Causes
The root cause for ulcer formation is the tissue break out due to an imbalance between the digestive juices, acids, and protective mucous layer in the digestive tract. There are many factors that can disturb this balance. Some of them include -
» Helicobacter pylori
Almost 60% of gastric ulcers, and 90% of duodenal ulcers are caused because of the bacterium H. pylori. The reason behind this is the simple fact that almost 50% of the world's population is infected by this bacterium. H. pylori doesn't always cause problem, in fact, only 10%-15% of the infected population is prone to get ulcer disease. During an infection, H. pylori builds colonies in the mucosa, thereby damaging it in the process, leading to inflammation and swelling in the area. The bacterium releases an enzyme called urease, which neutralizes the hydrochloric acid (HCl), a gastric acid in the stomach. As a result the hormone gastrin releases more acid at frequent intervals of time which causes the erosion of mucosa, leading to the formation of ulcers.
» Non-steroidal anti-inflammatory drugs
Regular use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen can also affect the balance between stomach acid and mucosa. These medications suppress the body's natural mechanism for releasing protective mucus and acid-neutralizing bicarbonate which disrupts the normal acid production. NSAIDs cause peptic ulcers in people who frequently take such pain relievers, especially on an empty stomach. Painkillers should always be consumed with meals to avoid damage to the mucous layer.
» Smoking
Cigarette smoking can also become a contributing factor in the development of peptic ulcers. Smoking aggravates the development of peptic ulcers. Also, if you are on medications for the treatment of ulcers, then smoking slows down the process of healing. The risk of developing peptic ulcer increases through smoking if you are infected by the H. pylori bacteria.
» Other causes
If some members of the family have this condition, then it is likely to occur in the rest as well. This is not because of genetics, but because of the risk of being infected by the bacterium H. pylori.
Other causes include - Zollinger-Ellison syndrome in which tumors in the duodenum and pancreas release excessive amount of stomach acid causing peptic ulcers. Medications used to treat osteoporosis can also develop peptic ulcers.
There was a time when it was considered that stress, alcohol consumption, caffeine, aerated drinks, and spicy food can cause ulcer formation. However, these factors do not cause PUD but can contribute in aggravating the condition.
Diagnosis
After understanding your symptoms, the doctor would conduct some tests to confirm the presence of peptic ulcer disease. The following tests are done for diagnosis.
» H. pylori test
The doctors will need to confirm the presence of H. pylori in your body. For this, a sample of your blood or stool may be taken and sent to the laboratory for detecting the presence of the bacterium.
H. pylori may also be detected through a breath test. For this, you may be asked to drink a small amount of liquid containing urea. It has no taste or color. The urea enters the body and the bacterium breaks it down into water and carbon dioxide. Later on, you will be asked to blow your breath into a bag. This bag is sent to the laboratory to check for the levels of carbon dioxide, which if found elevated, indicate the presence of H. pylori.
» Endoscopy
This test is usually done on patients showing severe symptoms of PUD like vomiting, weight loss, difficulty in eating, etc. A hollow tube with cameras attached in it, known as an endoscope, is inserted into the mouth, thereby passing through the esophagus, stomach, and duodenum. The camera enables the doctors to see if there are any ulcers in the area. A small tissue sample may be collected for biopsy testing. The results would confirm the presence of ulcers.
» Upper gastrointestinal series (UGI series)
Also known as a barium swallow, this is a special type of X-ray, wherein you will be asked to drink a liquid containing barium. This substance coats the digestive tract and increases the contrast during X-ray, making the ulcers appear more visible.
Treatment
After determining the exact cause and condition of peptic ulcers, the doctor will suggest a treatment plan accordingly. For instance, your doctor may prescribe different medications if the ulcer is caused by pain relievers. Given below are the possible treatment options that are most likely to be prescribed by the doctor.
» Antibiotics: The bacterium H. pylori is known to cause peptic ulcers in a majority of cases. To kill this bacterium, the doctors are likely to prescribe a two-week course of antibiotics. These may include - amoxicillin, clarithromycin (Biaxin), metronidazole (Flagyl) and tetracycline.
» Acid blockers and antacids: It is not only important to kill the bacterium through antibiotics, but medications are also prescribed to reduce the level of acids in the digestive tract. Some drugs that are widely prescribed are Ranitidine (Zantac), Famotidine (Pepcid), Cimetidine or Tagamet. The use of antacids can provide rapid pain relief and neutralize existing stomach acid. These may also be included in your treatment plan.
» Medication to protect the mucosal lining of the stomach and small intestine: Sucralfate (Carafate), Misoprostol (Cytotec), and Bismuth Subsalicylate are a group of prescribed medication, known as cytoprotective agents, that protect the lining of your stomach and small intestine.
Periodic assessment and medical checkups help to keep a tab on the progress and elimination of ulcer from the body. If the ulcer symptoms persist even after following the prescribed medication, then there are chances that you may be suffering from refractory ulcers - peptic ulcers that don't heal. If that is the case, then your doctor will analyze the possibility of any other cause behind the ulcers, other than H. pylori or NSAIDs.
Your daily lifestyle plays a very important role in determining how healthy you are. Having discussed the causes and symptoms of peptic ulcers, you must have understood how important it is to follow a healthy lifestyle, not only for prevention, but also to enable faster healing. Eat a balanced diet, avoid smoking and drinking, avoid taking stress, and make sure that you control your consumption of painkillers. In case of any doubt, consult a doctor at the earliest and don't resort to self-diagnosis and self-medication.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.
I just want to note for folks, I have been fighting duidenal ulcer and gallstones since 2009, have been able to mostly prevent new gallstones with MSM and TMG and when an occasional one starts in, strong coffee is a gallbladder stimulator. Pops the gallstone out. However, I am still on Prilosec for the ulcer, cut down to 10 mg a day but trying to get off it. PPI's destroy mitochondria. That can cause chronic fatigue and arthritis. It's killing me. But also, if I forget my ppi, the ulcer kicks in and feels so very much similar to the gallstones. Very odd and frustrating
ReplyDeleteI am so grateful to the great Dr chukwu madufor curing my herpes disease,for 4 years i have been having hsv 1 and 2 which made me look so horrible, since i have been having this disease i have been in a complete agony weeping everyday, i have gone to several places trying to get a cure but nothing was change, i came to the internet one day and decided to look for help online and i saw different testimonies of lots of people around the world on how they have been cured from various diseases by Dr chukwu madu herbal home and i also decided to contact him through his whatsapp number and i told him i have been infected with hsv and he assure me that he will help me to get cured from my disease, i believed him and obeyed all his instruction that he gave to me, afterwards he prepare a cure for me and when i received it and started using it just as he has promised me, i was told i will be cured from my infections within two weeks if i follow as i was instructed and i did as i was told and after two weeks i went for check up and to my greatest surprise i was declared negative and i was still in doubt and i waited for another week and went for check up in another hospital in another city and i was still declared negative, that was how i was completely cured totally within 2 weeks of usage. and i know there are also people out there suffering from various infections, why not you contact DR.Chukwu madu and get cured, via: [dr.chukwumaduherbalhome@gmail.com]or watsapp on +2347030936239.
DeleteEl Dr. Akpu es realmente un hombre enviado por Dios que ha curado exitosamente a personas con VIH / SIDA, HSV, HPV, CÁNCER, FALLA RENAL, TIFIODIS, SÍFILIS, ETS, CONTADOR DE BAJO SPARM, ERECCIÓN SEMANAL, INFERTILIDAD, DIABETTING, HERPATTITIS, y muchos Enfermedades más graves lo contacté durante mis días cuando sufrí una gran pérdida después de que se confirmó que HERPES era positivo. Me sentí muy triste después de intentar tantas formas de curarme de la medicina inglesa, pero no me dieron signos negativos para mostrar mi resultado. Tuve que buscar hierbas en el sitio web, cuando descubrí las maravillas que habían estado curando a las personas. Fue como un sueño hecho realidad, tuve que probar su medicina contactando con él. Lo preparó y me lo envió a través del servicio DHl y funciona perfectamente para mí. Tenía mi resultado negativo de HSV ahora. Dios te bendiga por curarme de los 22 meses de esclavitud con herpes. Ahora amo las hierbas. El Dr. Akpu es un gran herbolario. Necesitas su dirección para que los enfermos sanen. dr.akpupowerherbscent@gmail.com teléfono o whatsapp +2348079594617
ReplyDeleteI was hospitalized with pneumonia and possible TB. I was scared too. Was this cancer?
ReplyDeleteI was finally allowed to go home. But had clinic visit a few days after.
The doctor wanted to discuss what was happening to me and that because my CD4 was down to 40 and viral load in excess of 330,000 copies, things were looking extremely tough for me in the coming months. I feared the worse. Was this the end for me. Was I going to die. Terrible fear took over. People with my diagnosis don't usually survive.
I had to take a whole month off work. Everyone was worried and wondered how I became so sick.
I had a close friend who came to the clinic with me and just supported me.
Fortunately my doctor was very positive and said it was going to be tough. But that I would survive.
Its now been 8 months since that all happened. Nothing positive to show up for my result, my friend told me about an Africa Herbalist who cured her Sis from Herpes, i was left with no choice i allowed her to contact the Herbalist and complaints for my cure. The Herbalist assured me I will be fine after taking his medicine. He did prepared it and sent it to me following the institutions applied, I became very happy cos I knew I was recovery with the Herbal Medicine, before I could finished the last bottle, I was convinced about my cure, and went for my test and all my results tested Negative.My health is back and my body is respond to treatment.
I'm hearing you. It isn't easy. Its freaking scary. I'm still fighting. And getting better each day.
My viral load now is undetectable. But my CD4 is still low.
I take each day now as a gift. I hey to look after my body. Mentally I'm still struggling. But I'm on the mend.
Stay strong. HIV, HSV, HPV CANCER, DIABETES ETC..ARE NO LONGER A DEATH SENTENCE.
I will be okay. And so will you. Life throws these things and challenges at us. To make us stronger.
Together we will overcome.
contact,
Odeyabangherbalhome@gmail.com
For Herbal remedy.
I am so grateful to the great Dr chukwu madufor curing my herpes disease,for 4 years i have been having hsv 1 and 2 which made me look so horrible, since i have been having this disease i have been in a complete agony weeping everyday, i have gone to several places trying to get a cure but nothing was change, i came to the internet one day and decided to look for help online and i saw different testimonies of lots of people around the world on how they have been cured from various diseases by Dr chukwu madu herbal home and i also decided to contact him through his whatsapp number and i told him i have been infected with hsv and he assure me that he will help me to get cured from my disease, i believed him and obeyed all his instruction that he gave to me, afterwards he prepare a cure for me and when i received it and started using it just as he has promised me, i was told i will be cured from my infections within two weeks if i follow as i was instructed and i did as i was told and after two weeks i went for check up and to my greatest surprise i was declared negative and i was still in doubt and i waited for another week and went for check up in another hospital in another city and i was still declared negative, that was how i was completely cured totally within 2 weeks of usage. and i know there are also people out there suffering from various infections, why not you contact DR.Chukwu madu and get cured, via: [dr.chukwumaduherbalhome@gmail.com]or watsapp on +2347030936239.
ReplyDelete