When to call 911. Complications of peptic ulcer

Bleeding complicates the course of the disease, regardless of its duration. Sometimes it is the first manifestation of the so-called “dumb”, that is, asymptomatic ulcers. With heavy bleeding, vomiting occurs with an admixture of dark blood or “coffee grounds”, pallor of the skin, dizziness, even fainting of various durations. Over the next days, as a rule, low blood pressure is noted, the stool is liquid black. Hemoglobin may remain within normal limits. Massive bleeding can only be stopped in a hospital setting. Slight gastric bleeding can stop on its own, health is not impaired, its only sign is the color of feces in black. However, repeated bleeding depletes the patient, causing anemia (anemia). If you do not seek medical help on time, violations caused by hemoglobin deficiency can become irreversible – a person becomes disabled.

In the course of the course of peptic ulcer, in addition to bleeding, the following complications are possible: perforation, cicatricial narrowing of the pylorus.

Perforation, or perforation, ulcers

The most dramatic and dramatic complication of peptic ulcer disease. This is a violation of the integrity of the wall of the stomach or duodenum. As a result, the contents from the cavity of these organs flow into the abdominal cavity and cause peritonitis. Perforation (perforation) is usually observed in men during an exacerbation of the disease (usually in the spring-autumn period). Often develops after drinking alcohol, overfilling the stomach with food, excessive physical exertion, trauma. Sometimes ulcer perforation is the first manifestation of peptic ulcer, especially at a young age. The pains are very strong, sharp “dagger”, accompanied by signs of collapse: cold, sticky sweat, pallor of the skin, cooling of the extremities, thirst and dry mouth. Vomiting is rare. Blood pressure goes down. A few hours later, flatulence develops – bloating of the abdomen due to non-discharge of gases. After 2-5 hours, an imaginary improvement in well-being sets in: the pain subsides, the tense abdominal muscles relax. Visibility of well-being can drag on for up to a day. During this time, the patient develops peritonitis, and his condition begins to deteriorate rapidly. The doctor must be consulted in the first hours of the disease. Perforation of an ulcer into the abdominal cavity without surgical care ends within 3-4 days from the moment of its occurrence by the death of the patient due to diffuse purulent peritonitis.

Penetration of ulcers

The same perforation of the ulcer, but not in the abdominal cavity, but in the adjacent pancreas, omentum, intestinal loops, etc., when, as a result of inflammation, the wall of the stomach or duodenum fused with the surrounding organs. More common in men. Characteristic symptoms: nocturnal pain attacks in the epigastric region, often the pain is given to the back. Despite the most energetic therapy, the pain does not stop. Surgical treatment.

Obstruction of the pyloric stomach, or pyloric stenosis

It occurs as a result of scarring of an ulcer located in the pyloric canal or the initial part of the duodenum. Deformation and narrowing of the lumen after scarring of the ulcer leads to difficulty or complete cessation of food evacuation from the stomach.

An insignificant degree of narrowing of the pylorus is manifested by episodes of vomiting of food eaten, heaviness under the spoon for several hours after eating. As stenosis progresses, there is a constant delay in the portion of food in the stomach cavity and its distension, putrid odor from the mouth appears, patients complain of gurgling in the abdomen (the so-called “splash symptom”).

Over time, all types of metabolism are disrupted (fats, proteins, carbohydrates, salts, which leads to depletion).

Subphrenic Abscess

A rare complication of peptic ulcer disease, difficult to diagnose. It is an accumulation of pus between the diaphragm and the organs adjacent to it. It develops as a result of ulcer perforation or the spread of infection during an exacerbation of peptic ulcer disease in the lymphatic system of the stomach and duodenum. The main symptoms are pain in the right upper quadrant and above, often given to the right shoulder, fever. There is lethargy, general weakness, loss of appetite. In the blood, the number of leukocytes increases. If the abscess is not opened and the pus is not evacuated, then sepsis develops after 20-30 days.

I would like to warn readers of this article from the typical mistake of people who are studying “their” disease. It is possible that you will find signs of all ulcer complications at the same time. In this case, try to relax and remember the famous book of Jerome K. Jerome “Three in a boat, not counting the dog” – that chapter in which the author read a medical encyclopedia. If you had at least one complication at the moment, you would not read this book now, but would have waited for the doctor lying in bed.

So you can drink half a glass of warm milk and, with a clear conscience, continue reading.

local_offerevent_note November 19, 2019

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