What Are the Most Common Ulcer Complications?

Ulcer disease is a common name for gastric ulcer and duodenal ulcer. It is named because ulcer formation is related to digestion of gastric acid / pepsin. Ulcer disease is a chronic disease that usually ranges from a few years to more than a decade or even decades. Its attacks are periodic, and the onset and remission phases alternate, and the abdominal pain has a certain regularity during the onset.

Basic Information

English name

ulcerdisease

Visiting department

Internal medicine

Common causes

Helicobacter pylori infection, poor diet, mental factors, drug stimulation

Common symptoms

Epigastric pain

Causes of ulcers

Helicobacter pylori infection

Helicobacter pylori is the main cause of gastrointestinal diseases, and gastric ulcers are no exception. Under the action of Helicobacter pylori, the damage mechanism of gastric mucosa and the protective mechanism are unbalanced, resulting in gastric mucosa being digested by gastric digestive juice itself.

2. Poor diet

After food enters the human body, the first thing that affects our stomach is when the patient eats improperly, uneven hunger and overeating, overeating, and cold stimulation can cause gastric juice secretion disorders, which can cause ulcers.

3. Mental factors

Gastrointestinal diseases are closely related to our mental state. When a patient is in a state of excessive tension or anxiety, it will cause the cerebral cortex to be overactive, which will cause gastrointestinal disorders and lead to disease.

4. Drug Stimulation

Many patients with gastric ulcers have a history of taking non-steroidal anti-inflammatory drugs before onset. These drugs can stimulate our gastric mucosa and cause damage to it, which can cause ulcers over time.

Clinical manifestations of ulcer

Abdominal pain, located below the xiphoid process (cardiac fossa) or around the midline of the upper abdomen, presents with burning, biting, or hunger dull pain, swelling, or dull pain. But sometimes it is limited to the lower thorax. The pain lasts for half an hour to three hours. The bursts of pain often go on and off, and after a few weeks of intermittent pain, there will be a short period of painlessness. Gastric ulcers usually cause pain within half an hour to two hours after a meal; duodenal ulcers begin to pain within two to four hours after a meal. The pain can be alleviated until the next meal and often occurs at night. This pain is related to diet and is often caused by hunger, medication, acidic foods or drinks. Pain can be relieved by eating, drinking, and taking alkaline foods such as steamed bread.

Ulcer examination

1. Gastroscopy and biopsy of gastric mucosa

Is the first choice for the diagnosis of peptic ulcer. Gastroscopy, can see round or oval stomach, flat bottom, neat edges of the ulcer. Pathological biopsy is used to distinguish benign and malignant ulcers.

2. X-ray barium meal inspection

(1) The shadow is a direct sign of ulcer. At the tangential position, the shadows protrude from the contour of the inner wall of the stomach and are papillary or semicircular; in the upright position, the shadows are round or oval, and their edges are smooth and neat.

(2) Mucosal pattern around the shadow: at the tangential position, the thin shadow of 1 to 2 mm is displayed at the junction of the shadow and the stomach, and it is found at the upper or lower edge of the shadow, or the entire edge of the shadow.

(3) "Narrow neck sign": at the tangential position, there is a 0.5 to 1 cm section narrower than the shadow of the shadow at the junction of the mouth and stomach cavity of the shadow, which is called "neck neck sign".

(4) "Necklace sign": There is a smooth thin line-shaped density reduction area at the mouth of the Yingying, such as a collar worn on the neck.

(5) "Sun halo sign" around the shadow: in the right position, there is a wide and narrow translucent band around the shadow, and the edges are smooth.

(6) Concentration of mucosal folds centered on the shadow; it is distributed radially, and its periphery gradually becomes thinner and disappears, which is another sign of chronic ulcers.

Ulcer diagnosis

Diagnosis can be made based on the cause, clinical manifestations, and laboratory tests.

Ulcer complications

Upper gastrointestinal bleeding, perforation, pyloric obstruction, and canceration are the four main complications of ulcer disease.

Upper gastrointestinal bleeding is the most common complication of ulcer disease. About one-third of patients have a history of bleeding. Among them, patients with duodenal ulcer are more likely to have bleeding than those with gastric ulcer. Black stools (tar-like stools or brown stools) or fecal occult blood tests are positive. Hemorrhage occurs when there is a large amount of bleeding and urgency, and then tar-like stools can appear.

When the ulcer lesion develops deep and penetrates the stomach wall or duodenal wall, perforation occurs. After perforation, the contents of the stomach and duodenum may penetrate into the abdominal cavity and cause acute diffuse peritonitis. Needs surgical repair.

The pylorus is located at the junction of the stomach and duodenum and is the exit of the stomach. Pyloric obstruction mostly occurs in the duodenal bulb or pyloric ulcer. Due to inflammation, congestion and edema of the tissue around the ulcer or repeated ulcer attacks, local scar formation and contraction narrow the pyloric discharge tract. It is manifested as fullness and discomfort in the upper abdomen, worsening after meals, frequent vomiting, and relief after vomiting. The vomit is undigested food.

A small number of gastric ulcers can become cancerous, while duodenal ulcers rarely become cancerous.

Ulcer Treatment

The treatment of ulcer disease should be combined with overall treatment and local treatment, combined with the root cause and the symptom, combined with drug therapy and diet regulation, combined with heart therapy and physical therapy. It should be done clinically: eliminate symptoms; promote ulcer healing; prevent complications; prevent recurrence of ulcers.

Cause treatment

Such as eradication of Helicobacter pylori, it is possible to completely treat ulcer disease, which is a major progress in the treatment of peptic ulcer.

2. Drug treatment

It can be divided into two categories: drugs that inhibit gastric acid secretion and drugs that protect gastric mucosa. They mainly play a role in relieving symptoms and promoting healing of ulcers. They are often used in combination with the treatment of H. pylori eradication.

3. H. pylori treatment

Commonly used quadruple / triple anti-helicobacter pylori therapy. Proton pump inhibitor PPI, (bismuth), 2 antibiotics taken twice, for 14 days

4. Drug-induced ulcers

Drugs that directly damage the gastric mucosa, such as non-steroidal anti-inflammatory drugs, should be discontinued immediately. If necessary, gastric mucosal protective agents and proton pump inhibitor PPI should be added.