Bleeding Ulcers
Peptic ulcers are open sores which are found in the digestive tract. When peptic ulcers are located inside the stomach, they are called gastric ulcers. When peptic ulcers are found in the upper part of the small intestine, they are called duodenal ulcers.
Some people are not even aware that they have an ulcer. Others have symptoms like heartburn and abdominal pain. Ulcers can become very dangerous if they perforate the gut or bleed heavily (also known as a hemorrhage).
What are the symptoms of an ulcer?
Ulcers don't always cause symptoms. In fact, only about one-quarter of people with ulcers experience symptoms. Some of these symptoms include:
- Abdominal pain (it is a pain or discomfort that is felt in the part of the trunk below the ribs and above the pelvis.)
- bloating or a feeling of fullness
- belching (it is the act of expelling air from the stomach through the mouth)
- heartburn
- nausea
- vomiting
Symptoms may be a little different for each person. In some cases, eating a meal can ease the pain. In others, eating only makes things worse.
An ulcer can bleed so slowly that the patient doesn't notice it. The first signs of a slow-bleeding ulcer are symptoms of anemia, which include:
An ulcer that is bleeding heavily may cause:
- stool that is black and sticky
- dark red or maroon-colored blood in your stool
- bloody vomit with the consistency of coffee grounds
Rapid bleeding from an ulcer is a life-threatening event. If the patient has these symptoms, seek immediate medical attention.
What causes ulcers?
There's a layer of mucus in the patient's digestive tract that helps protect the gut lining. When there's too much acid or not enough mucus, the acid erodes the surface of the patient's stomach or small intestine. The result is an open sore that can bleed.
Why this happens can't always be determined. The two most common causes are Helicobacter pylori and non-steroidal anti-inflammatory drugs.
What is the treatment for ulcers?
Ulcers are usually diagnosed after an upper GI endoscopy (EGD or esophagogastroduodenoscopy). An endoscope is a long flexible tube with a light and camera on the end. The tube is inserted into the patient's throat, then to the esophagus, stomach, and upper part of the small intestine.
The procedure is generally performed as an outpatient procedure, it allows the doctor to locate and identify problems in the stomach and upper intestine.
Bleeding ulcers must be addressed quickly, and treatment can start during the initial endoscopy. If bleeding from ulcers is found during the endoscopy, the doctor can:
- inject medication directly
- cauterize the ulcer to stop the bleeding
- clamp off the bleeding vessel
If the patient has an ulcer, he will be tested for H. pylori. This can be done using a tissue sample taken during the endoscopy. It can also be accomplished with noninvasive tests such as a stool sample or breath test.
If the patient is having the infection, antibiotics and other drugs can help fight the bacteria and ease symptoms. To be certain the patient gets rid of it, he must finish taking the medication as directed, even if his symptoms stop.
Ulcers are treated with acid-blocking drugs called proton pump inhibitors (PPIs) or H2 blockers. They can be taken orally, but if the patient has a bleeding ulcer, they can also be taken intravenously. Cameron ulcers are usually treated with PPIs, but sometimes surgery is needed to repair a hiatal hernia.
If the patient's ulcers are the result of taking too many NSAIDs, work with the doctor to find another medication to treat pain.
Over the counter antacids sometimes relieve symptoms. Ask the doctor if it's okay to take antacids.
What are the possible complications?
An untreated ulcer that swells or scars can block the patient's digestive tract. It can also perforate the patient's stomach or small intestine, infecting his abdominal cavity. That causes a condition known as peritonitis.
A bleeding ulcer can lead to anemia, bloody vomit, or bloody stools. A bleeding ulcer usually results in a hospital stay. Severe internal bleeding is life-threatening. Perforation or serious bleeding may require surgical intervention.