Peptic Ulcer (cont.)
What are ulcer complications?
Patients with ulcers generally function quite comfortably.
Some ulcers
probably heal even without medications. Therefore, the major
problems
resulting from ulcers are related to ulcer complications.
Complications
include ulcer bleeding, ulcer perforation, and gastric
obstruction.
Patients with ulcer bleeding may report
black tarry stools
(melena),
weakness, a sense of passing out upon standing (orthostatic
syncope), and
vomiting blood (hematemesis). Initial treatment involves rapid
replacement
of lost body fluids intravenously. Patients with persistent or
severe
bleeding may require blood transfusions. An upper endoscopy is
performed
to establish the site of bleeding and to stop active ulcer
bleeding with
the aid of heated instruments.
Ulcer perforation leads to the leakage of gastric contents
into the
abdominal (peritoneal) cavity, resulting in acute peritonitis
(infection
of the abdominal cavity). These patients report a sudden onset
of extreme
abdominal pain, which is worsened by any type of motion.
Abdominal muscles
become rigid and board-like. Urgent surgery is usually
required.
Patients with gastric obstruction often report increasing
abdominal
pain, vomiting of undigested or partially digested food,
diminished
appetite, and weight loss. The obstruction usually occurs at or
near the
pyloric canal. The pyloric canal is a naturally narrow part of
the stomach
as it joins the upper part of the small intestine called the
duodenum.
Upper endoscopy is useful in establishing the diagnosis and
excluding
gastric cancer as the cause of the obstruction. In some
patients, gastric
obstruction can be relieved with tube suction of the stomach
contents for
72 hours, along with intravenous anti-ulcer medications, such as
cimetidine (Tagamet) and ranitidine (Zantac). Patients with
persistent
obstruction require surgery.
Next: What treatments are available for peptic ulcers? »
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