Peptic ulcers can cause some discomfort, but they are rarely life-threatening. That said, severe ulcers can sometimes lead to perforation and internal bleeding and require emergency surgery to prevent serious illness or death .
Approximately 25 million Americans develop at least one peptic ulcer in their lifetime, with an annual incidence of approximately 4.6 million cases. Ulcers can appear at any age, but they are rare in adolescents and even less common in children. Duodenal ulcers, which occur at the junction of the stomach and small intestine , usually first appear between the ages of 30 and 50 .
Stomach ulcers are more common in people over the age of 60. Although the duodenum is more common in men than women, stomach ulcers are more common in women than in men .
Symptoms and complications
Peptic ulcer symptoms can often be vague and present with pain or discomfort in the upper left corner of the abdomen, as well as heartburn, indigestion, nausea, and gas .
In some cases, complications can occur that lead to more serious symptoms. Overuse of non-steroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) is one example where bleeding from a peptic ulcer can progress from mild to severe .
Peptic ulcer disease causes three serious complications that may require emergency intervention:
- A perforation is an opening in the wall of the stomach or small intestine. A perforated ulcer is a serious condition in which an untreated ulcer can burn through the stomach wall, allowing digestive juices and food to seep into the peritoneum (abdomen). This can lead to peritonitis (inflammation of the intestinal wall) and sepsis (a serious reaction to an infection).
- Internal bleeding occurs when a blood vessel in the stomach or small intestine is damaged. This can lead to a drop in blood pressure and symptoms such as dizziness, weakness, pale skin, palpitations, and fainting. Some people experience bloody vomiting, while others develop melena (dark tarry stools).
- An intestinal blockage occurs when food cannot travel from the stomach to the duodenum (passage to the small intestine). Ulcers located at the end of the stomach can cause swelling and scarring, leading to intestinal strictures (narrowing or closing of the intestinal canal). Symptoms include severe abdominal pain, cramps, nausea, vomiting, constipation, and the inability to pass gas .
Ulcers form when the lining of the stomach or duodenum (known as the mucosa and submucosa) breaks. Small sores may not cause any symptoms, but large sores can cause severe bleeding.
Most ulcers occur in the first layer of the inner lining. If the ulcer collapses further, an opening may open through the intestines and cause a perforation. Piercing is always considered a medical emergency.
Despite the widespread belief that peptic ulcers are caused by spicy foods or stress, most peptic ulcers are caused by infection with the bacteria Helicobacter pylori ( H. pylori ) and can also occur with prolonged or excessive use. of NSAIDs .
Most ulcers can be treated with medications, including antibiotics . But in some cases, surgery may be required, including moxibustion, in which tissue is burned to close a bleeding blood vessel.
When to seek medical help
Most peptic ulcers are not urgently needed and can be treated on an outpatient basis. If a perforation, severe internal bleeding, or obstruction occurs, you may need immediate medical attention.
Warning signs of a medical emergency include:
- Vomiting blood
- Emetics similar to coffee grounds
- Heavy rectal bleeding and / or bloody stools
- Sudden, severe pain in the upper abdomen, with or without signs of bleeding.
- Clammy skin
- Fast heartbeat
If left untreated, intestinal perforation and internal bleeding can lead to shock , coma, multiple organ failure, and death;
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Perforation affects about five out of 100,000 people with peptic ulcers in the United States, while internal bleeding affects up to 57 out of 100,000 people with peptic ulcers. Both are responsible for the majority of deaths associated with peptic ulcer .
If you have any signs of these peptic ulcer complications, seek immediate help.