Bleeding stomach ulcers, also known as peptic ulcers, stem from a variety of factors, such as consuming nonsteroidal anti-inflammatories and aspirin, excessive alcohol intake and experiencing high amounts of stress on a daily basis. According to "Medical-Surgical Nursing," 80 percent of peptic ulcers occur in the duodenum, which pertains to the uppermost part of the small intestine in people aged 30 to 60 years. However, 15 percent of peptic ulcers occur in the stomach in people aged 50 and over.
Causes of Bleeding Ulcers
Bleeding ulcers usually occur from untreated peptic ulcers. Peptic ulcers, which consist of open wounds within the stomach lining or the duodenum, may bleed if the wound extends deeper into the lining of the affected region. Peptic ulcers can develop from a variety of factors other than consuming excessive amounts of ibuprofen and aspirin. A bacterial infection called Helicobacter pylori, according to the MayoClinic, can irritate the lining of the stomach, thereby creating an ulcer. Helicobacter pylori usually spread through kissing, eating contaminated food and drinking contaminated water, according to the MayoClinic. Other causes of peptic ulcer development are eating spicy food on a regular basis, smoking and taking biphosphonates, such as Fosamax, to treat osteoporosis, reports the MayoClinic.
Symptoms of Bleeding Ulcers
Most symptoms of ulcers involve abdominal pain. Symptoms of peptic ulcers vary according to their severity and location. If the ulcers form in the stomach, symptoms may include abdominal pain occurring 30 minutes to an hour following a meal, notes "Medical-Surgical Nursing." Duodenal ulcers cause abdominal pain two to three hours following a meal and also occur in the middle of the night, disturbing the victim's sleep. If the stomach ulcer bleeds, symptoms may include vomiting a coffee-ground appearing substance or having dark and tarry bowel movements, which are a medical emergency, according to the MayoClinic. Bleeding ulcers may lead to anemia, which may warrant blood transfusions.
Complications of Bleeding Ulcers
Although duodenal ulcers do not usually lead to bleeding, perforation may occur, whereas the open wound within the inner lining of the duodenal mucosa penetrates through its entire wall and causing spillage into the abdominal cavity. Once perforation occurs, it becomes a medical emergency and must be treated immediately. A painfully rigid and distended, boardlike abdomen indicates perforation, notes, "Medical-Surgical Nursing." Perforation can lead to peritonitis within a few hours, which is an infection within the abdominal cavity. Peritonitis is evidenced by a fever in the presence of abdominal pain and abdominal distention.
Diagnostic Testing
A physician, likely a gastroenterologist, performs a series of tests to determine the best treatment plan. Using a scope with a camera attachment, the gastroenterologist inserts this tool orally until he reaches the duodenum. Once inside, he's checking for ulcers and performing biopsies to determine its cause. Also, he would order blood tests to check for anemia and stool studies to check for blood, according to the MayoClinic. If the gastroenterologist sees a bleeding ulcer, he may apply a heat probe to the area, which is called cautery, so that a clot would form, thereby stopping the bleeding.
Treatment of Ulcer
In the meantime, while waiting for the results of the biopsies and other tests performed, the gastroenterologist would prescribe proton pump inhibitors such as Prilosec to reduce the production of acid. Prilosec helps the peptic ulcer to heal. If biopsies revealed a presence of Helicobacter pylori, the doctor would prescribe two antibiotics to be taken simultaneously, such as clarithromycin and amoxicillin, with a proton pump inhibitor for about two weeks, notes MayoClinic.
References
- "Medical-Surgical Nursing: Volume 2, 10th Edition"; Suzanne Smeltzer, RN EdD, and Brenda Bare, RN, MSN; 2004
- MayoClinic.com: Peptic ulcer
