When Peptic Ulcers Bleed

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Ulcers usually aren't dangerous, but if they bleed, they can become a problem.
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Ulcers are usually not life-threatening. However, a bleeding ulcer or the more advanced peptic ulcer hemorrhage can be dangerous, so learning how to spot the warning signs is important to protect your well-being.

Origins of a Bleeding Ulcer

Ulcers are sores that can occur in the lining of your stomach, in which case they're called gastric ulcers, or at the top of your small intestine, in which case they're called duodenal ulcers, according to the American College of Gastroenterology.

The bacteria Helicobacter pylori (H. pylori) and the overuse of nonsteroidal anti-inflammatory drugs (NSAIDs) are common causes of such ulcers, according to the Mayo Clinic. The inner lining of your stomach is protected by a coating of mucus, but both H. pylori and NSAIDs can break down that coating, leaving the lining exposed to the acids that occur normally within your digestive system. Ulcers caused by this acid are called peptic ulcers.

Stress, anxiety and spicy foods do not lead to ulcers, though they can make any symptoms that you're experiencing feel worse.

Though many people don't have symptoms with a peptic ulcer, when they occur they may include pain or a burning sensation in the chest and abdomen, bloating, burping and nausea. With prompt treatment, ulcers can be successfully healed, and the progression to a bleeding ulcer may be prevented. So don't ignore the early signs of an ulcer, like pain in your upper abdomen or the feeling of bloating, warns the American College of Gastroenterology.

Read more: What Can I Eat and Drink With a Peptic Ulcer?

Signs of a Bleeding Ulcer

"Bleeding ulcers happen when an ulcer erodes into a blood vessel in the stomach lining," says Patricia Raymond, MD, a gastroenterologist with Sentara Princess Anne Hospital in Virginia Beach. Minor bleeding is not usually serious and can go unnoticed, but once detected it should be treated.

In many people, signs of a bleeding ulcer don't occur until the blood loss is advanced and causes anemia, according to the American College of Gastroenterology. Anemia results when you don't have enough healthy red blood cells to carry the needed amount of oxygen to your body's tissues. That's why people with bleeding ulcers may look pale, get quickly out of breath during exertion, especially exercise, and feel extremely tired, the college explains.

Signs of even more serious bleeding are vomiting red blood or brown blood resembling coffee grounds or having stools that are dark black and sticky, it adds. If you experience any of these symptoms, seek emergency medical care.

Treatment for bleeding peptic ulcers as well as early stage peptic ulcers typically starts with medications. When an ulcer fails to heal, it's often because medications aren't being taken properly or the patient is regularly using tobacco or still taking NSAIDs, according to the Mayo Clinic. In rare cases, an ulcer will fail to heal because someone has another condition, like Zollinger-Ellison syndrome or Crohn's disease, it says.

People who smoke cigarettes, drink alcohol, have a history of aspirin or antiplatelet use or a history of peptic ulcers should be extra careful. Although these factors do not alone cause ulcers, they can make them worse and difficult to heal, according to Mayo.

Read more: Foods to Avoid When You Have a Stomach Ulcer

What Is a Peptic Ulcer Hemorrhage?

A severely bleeding ulcer is known as a peptic ulcer hemorrhage. For some people, an ulcer that has bled significantly can be treated during an upper endoscopy, according to the American College of Gastroenterology.

For this procedure, a gastroenterologist uses a thin tube with a light and camera to examine the upper digestive tract and can inject medications, burn a bleeding vessel shut or clamp off a bleeding vessel. However, not all ulcers can be treated this way. Occasionally, ulcers may require more serious surgeries, such as a gastrectomy, which involves removal of part of the stomach.

Remember, if you suspect that you may have a peptic ulcer, seek medical attention. The quicker you address the ulcer, the easier it may be to treat. And if you have any signs of a bleeding peptic ulcer, get immediate attention.

Is This an Emergency?

To reduce the risk of spreading COVID-19 infections, it is best to call your doctor before leaving the house if you are experiencing a high fever, shortness of breath or another, more serious symptom.
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