A peptic ulcer occurs when an open sore forms in the lining of the esophagus, stomach or duodenum—the upper portion of the small intestine. Substances that compromise the ability of the lining to repair itself, such as bacteria or medications, leave the cells vulnerable to damage by stomach acid. If left untreated, the ulcer can invade deeper into the wall of the stomach or intestine and damage a blood vessel, resulting in a bleeding ulcer. Bleeding ulcers can lead to additional complications such as anemia or perforations.
Cauterization
Doctors determine the presence of a bleeding ulcer using an endoscope, a long flexible tube inserted through the mouth and into the stomach to allow visualization of the stomach and intestinal walls. Upon locating the bleeding ulcer, doctors can use a heating device on the endoscope to cauterize the blood vessel and stop the bleeding.
Promote Clotting
Bleeding ulcers that involve larger blood vessels, and therefore larger amounts of blood, may require the use of a chemical to promote clotting. Using the endoscope, doctors inject the chemical directly into the blood vessel.
Histamine-2 Blockers
Because the stomach acid irritates the ulcer, reducing the amount of acid in the stomach helps to alleviate the symptoms of a bleeding ulcer. Histamine-2 blocker medications, such as cimetidine, famotidine, nizatidine or ranitidine, block the receptors that bind histamine-2—a chemical that stimulates the production of stomach acid.
Proton Pump Inhibitors
Proton pump inhibitors, such as omeprazole, lansoprazole and esomeprazole, bind to the gastric acid pumps in the stomach and prevent the secretion of stomach acid. Information provided by Consumer Reports Health indicates that proton pump inhibitors effectively treat ulcers by decreasing the level of stomach acid and therefore allowing the ulcers to heal.
Antibiotics
Over half of all peptic ulcers occur due to an infection by the bacterium Helicobacter pylori, according to the National Digestive Diseases Information Clearinghouse. The presence of the bacteria weakens the ability of the stomach lining to repair itself, making it vulnerable to damage by stomach acid. Therefore treating bleeding ulcers caused by the bacterial infection requires the use of antibiotics. In the United States doctors use several antibiotic therapies, including combinations of clarithromycin, amoxicillin, tetracylcine and metronidazole, as described by the National Digestive Diseases Information Clearinghouse.
Surgery
If all other treatments fail to heal the ulcers or if endoscopic methods cannot stop the bleeding, surgery may be necessary. The Merck Manual reports that today the other treatment methods produce such positive results, only ulcers with complications such as perforation or obstruction require the use of surgery.
