How Do You Know if Your Stomach Ulcer Is Bleeding

Peptic ulcer

Ulcer - peptic; Ulcer - duodenal; Ulcer - gastric; Duodenal ulcer; Gastric ulcer; Dyspepsia - ulcers; Bleeding ulcer; Gastrointestinal haemorrhage - peptic ulcer; Gastrointestinal hemorrhage - peptic ulcer; M.I. drain - peptic ulcer; H. pylori - peptic ulcer; Helicobacter pylori - peptic ulcer

A peptic ulcer is an open sore or raw area in the lining of the stomach or intestine.

In that location are 2 types of peptic ulcers:

• Gastric ulcer -- occurs in the stomach
• Duodenal ulcer -- occurs in the get-go part of the pocket-sized intestine

Peptic ulcers may atomic number 82 to emergency situations. Severe intestinal pain with or without evidence of bleeding may indicate a perforation of the ulcer through the tum or duodenum. Vomiting of a substance that resembles coffee grounds, or the presence of blackness tarry stools, may betoken serious bleeding.

The procedure chosen gastroscopy involves the placing of an endoscope (a pocket-sized flexible tube with a camera and lite) into the tummy and duodenum to search for abnormalities. Tissue samples may exist obtained to bank check for H pylori bacteria, a cause of many peptic ulcers. An actively bleeding ulcer may besides be cauterized (blood vessels are sealed with a burning tool) during a gastroscopy procedure.

A peptic ulcer is an open sore or raw area in the lining of the tum (gastric) or the upper part of the pocket-size intestine (duodenal).

A major cause of peptic ulcer, although far less mutual than H.pylori or NSAIDS, is Zollinger-Ellison syndrome. A big corporeality of excess acid is produced in response to the overproduction of the hormone gastrin, which in turn is caused by tumors on the pancreas or duodenum. These tumors are ordinarily malignant, must exist removed and acrid production suppressed to save the recurrence of the ulcers.

An ulcer is a crater-like lesion on the skin or mucous membrane acquired by an inflammatory, infectious, or cancerous status. To avoid irritating an ulcer a person can try eliminating certain substances from their nutrition such every bit caffeine, alcohol, aspirin, and avoid smoking. Patients can take certain medicines to suppress the acid in the stomach causing the the erosion of the breadbasket lining. Endoscopic therapy tin can be used to stop bleeding from the ulcer.

If you've got stomach pain and nausea, any number of gastrointestinal issues could be to blame. When these symptoms don't go away, 1 possibility is that you have a peptic ulcer. Let'south talk about peptic ulcers. A peptic ulcer is a defect in the lining of your breadbasket or the offset office of your small-scale intestine, the duodenum. When the defect is in your breadbasket, it's called a gastric ulcer. A defect in your duodenum is called a duodenal ulcer. Your stomach is filled with strong acid, which breaks downwardly and digests the foods you eat. If yous've ever seen a potent acrid at work, you lot know that it starts to burn away anything it touches. That'due south why your stomach and intestines are equipped with a special lining to protect them. Only if that lining breaks downward for whatsoever reason, acids tin can first eating their way through. When acids burn a hole all the way through the breadbasket or duodenum, it'south called a perforation, and that's a medical emergency. You may joke that your boss is giving you an ulcer, and it's possible that stress does play some part in ulcers. More likely, your ulcer is caused by a stomach infection with a type of bacteria called H. pylori. Other common ulcer risks include smoking cigarettes, drinking a lot of alcohol, or regularly using NSAID pain relievers like aspirin and ibuprofen. If the ulcer is pocket-sized, you may have no idea that yous have information technology because in that location are no symptoms. Larger ulcers can cause abdominal pain, a feeling of fullness in the stomach, and nausea. If you have any of these ongoing symptoms, your doctor will wait inside your GI tract to meet what'due south going on. One style to do this is with an upper endoscopy, a thin tube with a camera on i terminate that takes pictures equally it moves through your stomach and modest intestine. A lower GI is a serial of x-rays that are taken after you lot drink a radioactive substance called barium. Your doctor will also examination y'all for the H. pylori bacteria that may be causing your ulcer. Treatment for peptic ulcers works in two ways. If yous have an H. pylori infection, you'll have a medication regimen to impale the bacteria. Y'all'll likewise get a medicine called a proton pump inhibitor, such as Prilosec or Prevacid, which reduces the corporeality of acrid in your tum. Endeavor to avoid taking NSAID pain relievers for long periods of time, especially if you have a trouble with H. pylori. Use Tylenol instead. If yous practice accept to have NSAIDs, also have an acid-blocking drug to protect your sensitive stomach. Also avoid tobacco smile and backlog alcohol. Follow your doctor'south instructions carefully for treating a peptic ulcer. If you don't follow your treatment as directed, your ulcer could come up back. Call your doctor right away if yous have abrupt tum hurting, y'all're sweating a lot or feeling confused, or your stomach feels hard to the bear upon. These could be signs of a serious ulcer complication that needs immediate medical assistance.

Causes

Commonly, the lining of the stomach and pocket-sized intestines tin can protect itself against strong stomach acids. Only if the lining breaks down, the result may be:

• Bloated and inflamed tissue (gastritis)
• An ulcer

Most ulcers occur in the first layer of the inner lining. A hole in the stomach or duodenum is called a perforation. This is a medical emergency.

The almost mutual cause of ulcers is infection of the tummy past bacteria called Helicobacter pylori (H pylori). Near people with peptic ulcers have these bacteria living in their digestive tract. Yet, many people who have these bacteria in their tummy practice not develop an ulcer.

The following factors enhance your risk for peptic ulcers:

• Drinking too much alcohol
• Regular utilize of aspirin, ibuprofen, naproxen, or other nonsteroidal anti-inflammatory drugs (NSAIDs)
• Smoking cigarettes or chewing tobacco
• Being very sick, such every bit being on a breathing machine
• Radiation treatments
• Stress

A rare condition, called Zollinger-Ellison syndrome, causes stomach and duodenal ulcers.

Symptoms

Pocket-size ulcers may non cause any symptoms. Some ulcers tin can cause serious haemorrhage.

Intestinal hurting (oftentimes in the upper mid-abdomen) is a common symptom. The pain can differ from person to person. Some people have no pain.

Pain occurs:

• In the upper abdomen
• At night and wakes you up
• When you feel an empty stomach, oft one to 3 hours subsequently a meal

Other symptoms include:

• Feeling of fullness and problems drinking as much fluid as usual
• Nausea
• Vomiting
• Bloody or dark, tarry stools
• Chest pain
• Fatigue
• Airsickness, possibly encarmine
• Weight loss
• Ongoing heartburn

Exams and Tests

To detect an ulcer, you may need a examination chosen an upper endoscopy (EGD).

• This is a exam to check the lining of the food pipe, breadbasket, and kickoff part of the small intestine.
• It is done with a small camera (flexible endoscope) that is inserted downwards the throat.
• This exam about frequently requires sedation given through a vein.
• In some cases, a smaller endoscope may be used that is passed into the tum through the nose. This does not require sedation.

EGD is done on most people when peptic ulcers are suspected or when you lot accept:

• Low blood count (anemia)
• Problem swallowing
• Bloody vomit
• Encarmine or dark and tarry-looking stools
• Lost weight without trying
• Other findings that enhance a business for cancer in the stomach

Testing for H pylori is too needed. This may be done by biopsy of the stomach during endoscopy, with a stool test, or by a urea breath test.

Other tests y'all may have include:

• Hemoglobin claret test to bank check for anemia
• Stool occult claret test to examination for claret in your stool

Sometimes, you may demand a test called an upper GI serial. A series of 10-rays are taken after you lot potable a thick substance called barium. This does not require sedation.

Handling

Your health care provider volition recommend medicines to heal your ulcer and prevent a relapse. The medicines volition:

• Kill the H pylori bacteria, if nowadays.
• Reduce acid levels in the stomach. These include H2 blockers such as ranitidine (Zantac), or a proton pump inhibitor (PPI) such as pantoprozole.

Take all of your medicines equally yous have been told. Other changes in your lifestyle can likewise help.

If you accept a peptic ulcer with an H pylori infection, the standard treatment uses different combinations of the following medicines for 7 to 14 days:

• Two different antibiotics to kill H pylori.
• PPIs such as omeprazole (Prilosec), lansoprazole (Prevacid), or esomeprazole (Nexium).
• Bismuth (the main ingredient in Pepto-Bismol) may be added to aid kill the bacteria.

You will likely need to take a PPI for 8 weeks if:

• You take an ulcer without an H pylori infection.
• Your ulcer is caused by taking aspirin or NSAIDs.

Your provider may also prescribe this type of medicine regularly if you continue taking aspirin or NSAIDs for other health conditions.

Other medicines used for ulcers are:

• Misoprostol, a medicine that may help prevent ulcers in people who take NSAIDs on a regular ground
• Medicines that protect the tissue lining, such as sucralfate

If a peptic ulcer bleeds a lot, an EGD may be needed to stop the haemorrhage. Methods used to stop the haemorrhage include:

• Injecting medicine in the ulcer
• Applying metallic clips or heat therapy to the ulcer

Surgery may be needed if:

• Haemorrhage cannot exist stopped with an EGD
• The ulcer has caused a tear

Outlook (Prognosis)

Peptic ulcers tend to come dorsum if untreated. There is a good chance that the H pylori infection will be cured if yous take your medicines and follow your provider's advice. You will be much less likely to become some other ulcer.

Possible Complications

Complications may include:

• Astringent claret loss
• Scarring from an ulcer may make it harder for the breadbasket to empty
• Perforation or hole of the stomach and intestines

When to Contact a Medical Professional

Get medical assistance correct away if you lot:

• Develop sudden, sharp abdominal hurting
• Have a rigid, hard abdomen that is tender to bear upon
• Have symptoms of shock, such equally fainting, excessive sweating, or defoliation
• Vomit claret or take blood in your stool (especially if information technology is maroon or dark, tarry blackness)

Contact your provider if:

• You feel dizzy or empty-headed.
• You have ulcer symptoms.

Prevention

Avert aspirin, ibuprofen, naproxen, and other NSAIDs. Try acetaminophen instead. If you must have such medicines, talk to your provider showtime. Your provider may:

• Test you for H pylori before you take these medicines
• Ask you to take PPIs or an H2 acid blocker
• Prescribe a medicine called misoprostol

The post-obit lifestyle changes may assistance prevent peptic ulcers:

• DO Not smoke or chew tobacco.
• Avoid booze.

References

Chan FKL, Lau JYW. Peptic ulcer disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran'due south Gastrointestinal and Liver Affliction. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 53.

Cover TL, Blaser MJ. Helicobacter pylori and other gastric Helicobacter species. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett'south Principles and Do of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 217.

Lanas A, Chan FKL. Peptic ulcer disease. Lancet. 2017;390(10094):613-624. PMID: 28242110 pubmed.ncbi.nlm.nih.gov/28242110/.

Version Info

Last reviewed on: v/27/2020

Reviewed by: Jenifer Chiliad. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Internal review and update on 08/26/2021 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.Thou. Editorial team.

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Source: https://www.mountsinai.org/health-library/diseases-conditions/peptic-ulcer