Complications of peptic ulcer
Complications of peptic ulcer may include bleeding, perforation, penetration, or obstruction.
Bleeding
Peptic ulcers sometimes bleed.
- Sometimes an ulcer may involve just the surface lining of the digestive tract. The person may then have a slow but constant loss of blood into the digestive tract. Over time, anemia may develop because of this slow blood loss.
- If ulcers become larger and extend deeper into the digestive tract lining, they may damage large blood vessels, resulting in sudden, serious bleeding into the intestinal tract. This can be very dangerous. Without prompt medical treatment to stop the bleeding, a person could bleed to death. Blood transfusions often are needed when serious bleeding occurs.
Nearly half of all cases of sudden (not long-term) bleeding from the upper gastrointestinal tract are caused by peptic ulcers. In the United States each year, there are about 150,000 cases of hospitalization due to bleeding peptic ulcers. Treatment with endoscopy can control bleeding in nearly all cases.1
If you are vomiting blood and/or material that looks like coffee grounds, or if you have stools that are black, look like tar, or are maroon or bloody, see a doctor immediately. The chances of successfully treating your ulcer are best if you see a doctor when you first notice any bleeding.
Perforation
Perforation occurs when an ulcer eats through the wall of the stomach or intestine into the abdominal cavity.
- Although perforation is a much less frequent complication than bleeding, it is still a significant problem in people with unsuspected or untreated peptic ulcers.
- As people use more nonsteroidal anti-inflammatory drugs (NSAIDs), the incidence of perforation is increasing.2
- When perforation occurs, partially digested food, bacteria, and enzymes from the digestive tract may spill into the belly cavity, causing inflammation and infection (peritonitis).
- Peritonitis usually causes sudden and severe pain. Treatment usually requires urgent hospitalization and surgery.
Penetration
If another abdominal organ blocks the perforation, stomach contents may not spill into the abdominal cavity. This is called penetration. It may increase pain without causing peritonitis.
In rare cases, an ulcer can create an abnormal hole, or connection, between the stomach and another nearby part of the body. This happens when the ulcer burrows through the wall of the stomach or intestine and, instead of opening into the abdominal cavity, penetrates into an adjacent organ such as the small intestine, colon, or pancreatic duct. This connecting structure is called a fistula.
In many cases, fistulas caused by ulcers can heal with treatment of the ulcer. Sometimes surgery may be needed to close the fistula.
Obstruction
Ulcers in the upper small intestine (duodenum) or in the valve between the stomach and small intestine (pylorus) can cause the digestive tract to become narrow or close off completely. This condition is called obstruction. Obstruction:
- May be caused by a peptic ulcer, but the number of obstructions caused by peptic ulcers is less than it used to be.1
- Can prevent food from leaving the stomach and entering the intestines.
- May cause a person to have belching, bloating, fullness, discomfort, or vomiting. If the condition continues, a person may lose weight and develop other problems.
Treatment with medicines may be used to reduce inflammation, which sometimes improves the symptoms. If medicines do not help after a few days, surgery may be needed to correct the problem.
| Author: | Monica Rhodes | Last Updated: January 7, 2008 |
| Medical Review: | Kathleen Romito, MD - Family Medicine Andrew H. Soll, MD - Gastroenterology | |
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