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What are the complications of peptic ulcers?

Patients with ulcers generally function quite comfortably. Some ulcers probably heal even without medications (though they probably recur as well). Therefore, the major problems resulting from ulcers are related to ulcer complications. Complications include bleeding, perforation, and obstruction of emptying of the stomach.

Patients with bleeding ulcers may report passage of black tarry stools (melena), weakness, a sense of passing out upon standing (orthostatic syncope), and vomiting blood (hematemesis). Initial treatment involves rapid replacement of fluids. Patients with persistent or severe bleeding may require blood transfusions. An endoscopy is performed to establish the site of bleeding and to stop active ulcer bleeding with the aid of specialized endoscopic instruments.

Perforation through the stomach leads to the leakage of stomach 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 usually is required. A duodenal ulcer that has perforated can burrow into adjacent organs such as the pancreas or behind the abdomen and into the back. An esophageal ulcer that perforates can cause severe inflammation of the tissues that surround it (mediastinitis).

If an ulcer occurs in the narrow outlet from the stomach, it can obstruct the flow of stomach contents into the duodenum. Duodenal ulcers sometimes also may obstruct the flow of intestinal contents. Patients with 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 pylorus of the stomach. Endoscopy is useful in establishing the diagnosis of obstruction from an ulcer and excluding gastric cancer as the cause of the obstruction. In some patients, gastric obstruction can be relieved by suction of the stomach contents with a tube for 72 hours, along with intravenous anti-ulcer medications, such as cimetidine (Tagamet) and ranitidine (Zantac). Patients with persistent obstruction require surgery.

Return to Peptic Ulcer (Stomach Ulcer)

See what others are saying

Comment from: Deern, 45-54 Female (Patient) Published: May 10

I have peptic ulcers from NSAIDs and aspirin; pain so bad in lower back above kidney, up to front ribs on the right side. I cannot take proton pump inhibitors (PPI) because of low functioning gallbladder that causes me more intense pain, PPIs make it stop functioning. I used PPI until I couldn't take gallbladder pain. Now I am taking Zantac 150 twice daily and Mylanta liquid. I'm lots better, the pain in my side back area was mistaken for kidney infection and that delayed therapy. It is weird how ulcers in duodenum can cause such pain but it can. Terrible 3 months.

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Comment from: wvhawk, 75 or over Male (Patient) Published: March 19

I have lumbar pain (degenerative discs), and found ibuprofen was the best pain reliever. When pain got worse my doctor prescribed etodolac, 3 times a day. The side effect of having it 3 times was too much so I took either 1 or 2 a day (12 hours apart) depending on pain. I then developed occasional difficulty in swallowing (usually meat). An EGD was performed. Results: non-bleeding ulcers were found in esophagus, stomach, and duodenum bulb, and irritation in the linings. Cause was NSAIDs. PPI (proton pump inhibitor) was prescribed. I am well on the way to healing.

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Comment from: mouser, 55-64 Male (Patient) Published: October 15

I was suffering with severe chest pains and GERD like symptoms for over 2 months. Pain would wake me in the middle of the night. I finally tried eating the Greek yogurt one night out of desperation. The intense chest pains disappeared within minutes and I slept great till the morning. Finally I went in to urgent care and had really high blood pressure so I was sent later to the cardiac clinic to rule out heart troubles. But the attending doctor at urgent care said it sounded like peptic ulcer and gave me Protonix to try. It worked wonders. Now I am trying to kill the bacteria which is likely causing the troubles, H. pylori. I'm taking colloidal silver and Pepto-Bismol along with probiotics and digestive enzymes. Will let you know if that works.

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