This type of ulcer is life threatening due to the rapid bleeding it produces. The surface of the stomach and small intestine is coated with a protective layer of mucus, which can be eroded by stomach acid. The bleeding can occur due to various causes, including Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs.
NSAIDs
If you take NSAIDs regularly, you should be aware of the risks of hemorrhagic ulcers. These ulcers can be serious, and require immediate medical attention. NSAIDs may also lead to other gastrointestinal complications. Although the RR for serious GI complications with NSAID use is about three to five times greater than for people who don’t take NSAIDs. A multidisciplinary approach should be used to manage peptic ulcer bleeding.
NSAIDs can lead to bleeding in the duodenum, stomach, and large intestine. NSAIDs may cause diarrhea and vomiting. Taking them with food may improve tolerability, but taking them on an empty stomach can significantly increase the risk of ulcers. Even people without any symptoms of bleeding should take NSAIDs with food to lower their risk of developing ulcers. Warning signs include abdominal discomfort and bloody or black stools. Elderly patients may not experience these symptoms.
The increased risk of UGIB with NSAIDs is dose dependent and dose-dependent. Patients with a history of peptic ulcer and those who are older are at increased risk. The risk decreases after discontinuation of NSAID treatment. This increased risk of UGIB is seen in both men and women. NSAID use increases risk of UGIB in all age groups and is greater in elderly patients. Nonaspirin NSAID use is also associated with increased risk in patients with no ulcer history.
In addition to causing hemorrhagic ulcers, NSAID use can lead to other serious gastrointestinal problems, such as peptic ulcer disease and bleeding. It is estimated that one to two percent of NSAID users develop ulcers at some point during treatment.
Stress
If you have ever experienced the agony of an ulcer, you know how painful and uncomfortable it can be. Although minor ulcers can cause few symptoms, more severe ulcers can be very painful and lead to severe complications. Stress ulcers can cause so much pain that people are often unable to distinguish them from other types of illness, especially when they are accompanied by perforation or bleeding. In extreme cases, stress ulcers can be life-threatening.
Research has shown that mental and behavioral stress is a major cause of ulcers. In a recent study, a high level of psychological stress was associated with a greater risk of developing a gastric ulcer. This is because cortisol increases the secretion of pepsin and gastric acid. In addition, it negatively regulates the expression of COX-2 and induces lipocortins, which are inhibitors of phospholipase A2.
Fortunately, there are effective treatments for stress-induced ulcers. Most of them are based on the same basic principles as those used for other types of ulcers. The first goal of treatment is to decrease the acidity of the stomach, which allows the affected tissues to heal. This can be accomplished by using histamine blockers and proton pump inhibitors.
However, pharmacologic stress ulcer prophylaxis should only be used if patients have known risk factors. Pharmacologic treatment can be expensive and prolong the length of stay in the hospital. Early restoration of intravascular volume may also limit the severity of stress ulceration.
H. pylori infection
In order to diagnose H. pylori-related ulcers, your doctor may conduct an endoscopy. This type of examination uses a flexible camera and thin, lighted instrument to look inside your stomach and duodenum. A biopsy may also be taken, which helps your doctor determine whether the infection is causing your ulcer.
The bacteria attack the lining of the stomach, leaving part of the stomach exposed to acid. This causes stomach irritation, which leads to ulcers and sores. In some cases, the bacteria can even cause stomach cancer. About two-thirds of the world’s population is infected with the bacteria.
Once diagnosed, the infection is treated with antibiotics and acid suppression. If left untreated, the infection can recur. Treatment with antibiotics may be difficult, and a full course is required to clear the infection completely. Luckily, the most effective treatment involves several different types of antibiotics.
The infection can be transmitted from person to person. If you are infected, you should wash your hands after eating and after going to the bathroom. A combination of antibiotics and other drugs is most effective in treating H. pylori peptic ulcers.
In a study of 80 patients, H. pylori infection was identified in 80 of them. The patients were identical in terms of demographics and clinical parameters. A majority of the patients were also taking NSAIDs. However, no patients had a history of eradicating H. pylori from their digestive tract.