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Complications Of Peptic Ulcers

NCLEX Test Question – Peptic Ulcer Disease

Left untreated, peptic ulcers can result in severe complications and emergencies.

  • Internal bleeding You can have bleeding in your stomach, esophagus, or duodenum when the ulcer opens a blood vessel. Ulcers can cause bleeding that occurs slowly over time or quickly, possibly resulting in hemorrhaging that can be life-threatening due to shock. Sometimes you may not notice a bleeding ulcer until you become anemic, a condition in which your body lacks red blood cells because of inadequate iron. This occurs when ulcers cause chronic, low-grade blood loss.
  • A hole, or perforation, in the stomach wall You can develop a perforated ulcer, which means it has eaten through your stomach or intestinal wall.
  • Obstruction This is when you have swelling or scarring related to your ulcer that is preventing your food from being digested properly.

The signs that you are having an ulcer emergency are:

  • Blood in stool
  • Blood in vomit or vomit that looks like coffee grounds
  • Increasing pain
  • Mental confusion
  • Severe abdominal distension

If you think you or someone you know is having an ulcer emergency, seek immediate medical attention.

Signs You May Have An Ulcer

    Did you know that stomach ulcers also called peptic ulcers affect at least 1 in 10 Americans over the course of their lives? And while stomach ulcers can be treated easily when caught early, lack of medical care can lead to serious complications.

    Understanding the signs of stomach ulcers is important in helping you get the treatment you need. At Prima Medicine in Fairfax and South Riding, Virginia, our care team has the experience and knowledge to diagnose and treat stomach ulcers. Weve curated this guide to help you recognize the warning signs of an ulcer and understand what you can do about it.

    What Laboratory Tests Help Diagnose Ulcerative Colitis

    Your doctor would conduct a few blood tests and a stool test to identify if the cause of your symptoms is ulcerative colitis or something else.

    Blood tests: A low red blood cell count and low hemoglobin level indicate that you have anemia, which is a symptom of ulcerative colitis.

    If you have ulcerative colitis, your blood test may show an increase in white blood cells, a low level of the protein albumin and an elevated C-reactive protein level.

    Stool test: Your stool test can let your doctor know if your symptoms are due to infections, such as gastroenteritis.

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    Will Surgery Cure A Peptic Ulcer

    Medical therapy works in most people with peptic ulcers. Sometimes, medical therapy does not work, or a person can’t take the therapy for some reason. Surgery is an alternative to medical therapy for these people.

    Surgical operations often used in peptic ulcers include the following:

    • Vagotomy: Cutting the vagus nerve, which transmits messages from the brain to the stomach, can reduce acid secretion. However, this can also interfere with other functions of the stomach. A newer operation cuts only the part of the nerve that affects acid secretion.
    • Antrectomy: This is often done in conjunction with a vagotomy. It involves removing the lower part of the stomach . This part of the stomach produces a hormone that increases production of stomach acid. Adjacent parts of the stomach may also be removed.
    • Pyloroplasty: This procedure also is sometimes done with vagotomy. It enlarges the opening between the stomach and duodenum to encourage passage of partially digested food. Once the food has passed, acid production normally stops.
    • Tying off an artery: If bleeding is a problem, cutting off the blood supply to the ulcer can stop the bleeding.

    What Causes An Ulcer

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    Most peptic ulcers are caused by:

    • bacteria called Helicobacter pylori infecting the stomach and upper intestine. They weaken the protective coating of the stomach and upper small intestine. Acid in the stomach then gets through to the sensitive lining underneath. Acid and bacteria irritate this lining, causing ulcers.
    • using nonsteroidal anti-inflammatory drugs , such as ibuprofen and aspirin. These medicines fight inflammation and help treat long-term, painful conditions like arthritis. If taken in high doses over a long period of time, NSAIDs can cause ulcers in some people.
    • smoking cigarettes. Smoking increases the risk of ulcers because nicotine causes the stomach to make more acid. Drinking a lot of alcohol each day for a period of time can also increase a person’s risk of ulcers. Over time, alcohol can wear down the lining of the stomach and intestines.

    Sometimes stress can help cause ulcers. Usually this happens only when a person has an illness involving severe emotional or physical stress. Any illness that makes it hard for the body to heal also can make someone more likely to get an ulcer.

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    What Tests Will Be Done To Diagnose A Peptic Ulcer

    Endoscopy. An upper endoscopy exam is expedient because allows healthcare providers to see inside your digestive tract and also take a tissue sample to analyze in the lab. The test is done by passing a thin tube with a tiny camera attached down your throat and into your stomach and duodenum. Youll have medication to numb your throat and help you relax during the test. Your healthcare provider may use the endoscope to take a tissue sample to test for signs of mucous damage, anemia, H. pylori infection or malignancy. If they take a sample, you wont feel it.

    Imaging tests. Imaging tests to look inside the stomach and small intestine include:

    • Upper GI series. An upper GI X-ray exam examines the stomach and duodenum through X-rays. Its less invasive than an endoscopy. For the X-ray, youll swallow a chalky fluid called barium, which will coat your esophagus, stomach and duodenum. The barium helps your digestive organs show up better in black and white images.
    • CT scan. Your healthcare provider might recommend a CT scan if they need to see your organs in more detail. A CT scan can show complications such as a perforation in the stomach or intestinal wall. For the test, youll lie on a table inside a scanner machine while X-rays are taken. You may drink or have an injection with contrast fluid to make your organs show up better in images.

    Tests for H. pylori. Your healthcare provider might want to test you separately for H. pylori infection. Tests may include:

    What Should I Do If I Think I Have A Stomach Ulcer

    Always seek medical care for a stomach ulcer. While you may be able to manage symptoms temporarily with over-the-counter medications, these wont heal the ulcer. You need to identify and treat the underlying cause. An untreated ulcer can lead to serious complications, even if your symptoms are mild. The major cause of stomach ulcers, H. pylori infection, can also lead to other complications.

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    How Are Ulcers Diagnosed

    Your healthcare provider may be able to make the diagnosis just by talking with you about your symptoms. If you develop an ulcer and youre not taking NSAIDs, the cause is likely an H. pylori infection. To confirm the diagnosis, youll need one of these tests:

    Endoscopy

    If you have severe symptoms, your provider may recommend an upper endoscopy to determine if you have an ulcer. In this procedure, the doctor inserts an endoscope through your throat and into your stomach to look for abnormalities.

    H. Pylori tests

    Tests for H. pylori are now widely used and your provider will tailor treatment to reduce your symptoms and kill the bacteria. A breath test is the easiest way to discover H. pylori. Your provider can also look for it with a blood or stool test, or by taking a sample during an upper endoscopy.

    Imaging tests

    Less frequently, imaging tests such as X-rays and CT scans are used to detect ulcers. You have to drink a specific liquid that coats the digestive tract and makes ulcers more visible to the imaging machines.

    How Do You Diagnose Ulcerative Colitis

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  • How Do You Diagnose Ulcerative Colitis? Center
  • It is OK to experience a bout of occasional abdominal cramps and diarrhea. However, if you have been experiencing these symptoms frequently, consult your doctor. It may be a sign of inflammatory bowel disease , such as ulcerative colitis.

    Your doctor will diagnose ulcerative colitis after looking at several factors, including your medical history, a physical exam and a series of medical tests. They will ask if anyone in your family has ulcerative colitis. They will also ask you about other signs and symptoms of ulcerative colitis, including

    In children, the condition can also affect their rate of growth.

    The symptoms of ulcerative colitis are not the same in each affected person. Nearly half of the affected people experience mild symptoms of the disease. The condition increases your risk of colorectal cancer. Hence, visiting your doctor and getting diagnosed and treated early is important.

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    What Imaging Tests Are Used In The Diagnosis Of Ulcerative Colitis

    If your laboratory reports are suggestive of inflammatory bowel disease , they will refer you to a gastroenterologist. A gastroenterologist is a doctor who specializes in treating digestive system disorders. The gastroenterologist will recommend that you undergo tests, such as sigmoidoscopy and colonoscopy. Each of the procedures requires you to take laxatives a night before to empty your colon.

    Sigmoidoscopy

    • A sigmoidoscopy involves the insertion of a flexible tube-like camera into the anus to view the inside of the rectum and lower part of the colon.
    • This procedure helps the doctor know the extent of inflammation and ulcers, if any, in the lower colon.
    • The procedure usually takes about 15 to 20 minutes and you can go home the same day.
    • If you have been given medicines that make you sleepy, you need to stay for a few hours at the clinic or hospital until the doctor allows you to go home.

    Colonoscopy

    X-rays or computed tomography scan

    • If your doctor wants to check if you have developed any complications of ulcerative colitis, they may order additional tests, such as a CT scan or X-ray of your abdomen. A CT scan uses strong radiation to get detailed images of the colon and other organs of your abdomen.

    How Do You Check For An Ulcer

    If you think you have peptic ulcer symptoms, visit your doctor. Theyll check your medical history and your symptoms. Theyll ask you about medicines you take, especially NSAIDs. Theyll do a physical exam to check for stomach pain and bloating. Theyll order some lab tests to check for ulcers.

    Peptic ulcer diagnosis can follow:

    Laboratory tests

    Your doctor will do lab tests for peptic ulcer diagnosis. They may measure gastrin levels in your blood. Gastrin is a hormone that helps release stomach acid or digestive juices.

    Theyll also check for H. pylori infection using these tests:

    • Urea breath test. Your doctor will ask you to drink a liquid containing urea a waste product formed when protein breaks down in your body. H. pylori bacteria convert urea into carbon dioxide, which is the gas you breathe out. Your doctor will collect your breath sample. If you have an H. pylori infection in your stomach, your breath will have higher levels of carbon dioxide.
    • Blood test. A blood test can help detect H. pylori infection.
    • Stool test. Doctors use a stool test to detect H. pylori infection. Theyll check if your stool sample has the bacteria.

    X-ray

    You may feel bloated and nauseous after the test. For a few days, you may have white or light-colored stools because of barium.

    Computerized tomography or CT scan

    Endoscopy

    Your doctor may use gastrointestinal endoscopy along with a biopsy to diagnose peptic ulcer disease. Endoscopy and biopsy are parts of the same procedure:

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    Testing For Peptic Ulcers

    Safe and effective tests are available to help your physician diagnose whether or not you have an ulcer. These include:

    • Endoscopy: During an endoscopy, a flexible tube with a light and video camera on the end is gently inserted into your mouth and passed into the stomach and duodenum .Ulcers in the stomach or duodenum can be seen in real time with the camera during the procedure. Biopsies can be taken during the endoscopy. This is the most accurate test for ulcers.
    • Upper Gastrointestinal X-ray: This is a special type of X-ray. To prepare for it, you will be asked to drink barium or a similar substance that outlines the inside of your esophagus , stomach and duodenum. Ulcers appear as defects in the barium that coats the lining of the stomach or duodenum. This test is not always accurate in showing ulcers, especially in children.

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    Home remedies and supplements, in this case, go hand in hand. Home remedies could provide instant relief from the pain and the symptoms. However, using the supplements on a long term basis could not only cure your stomach ulcer, but it could also promote digestive health, thereby preventing the occurrence of an ulcer.

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    Diagnosis Of A Stomach Ulcer

    Diagnosing a stomach ulcer is done using a range of methods, including:

    • Endoscopy a thin flexible tube is threaded down the oesophagus into the stomach under light anaesthesia. The endoscope is fitted with a small camera so the physician can see if there is an ulcer.
    • Barium meal a chalky liquid is drunk and an x-ray is performed, showing the stomach lining. These tests are less common nowadays, but may be useful where endoscopy is unavailable.
    • Biopsy a small tissue sample is taken during an endoscopy and tested in a laboratory. This biopsy should always be done if a gastric ulcer is found.
    • C14 breath test this checks for the presence of H. pylori. The bacteria convert urea into carbon dioxide. The test involves swallowing an amount of radioactive carbon and testing the air exhaled from the lungs. A non-radioactive test can be used for children and pregnant women.

    What Happens During H Pylori Testing

    There are different ways to test for H. pylori. Your health care provider may order one or more of the following types of tests.

    Blood test

    • Checks for antibodies to H. pylori
    • Test procedure:
    • A health care professional will take a blood sample from a vein in your arm, using a small needle.
    • After the needle is inserted, a small amount of blood will be collected into a test tube or vial.

    Breath test, also known as a urea breath test

    • Checks for infection by measuring certain substances in your breath
    • Test procedure:
    • You will provide a sample of your breath by breathing into a collection bag.
    • After that, you will swallow a pill or liquid containing a harmless radioactive material.
    • You will provide another sample of your breath.
    • Your provider will compare the two samples. If the second sample has higher than normal carbon dioxide levels, it is a sign of an H. pylori infection.

    Stool tests.Your provider may order a stool antigen or a stool culture test.

    Endoscopy. If other tests did not provide enough information for a diagnosis, your provider may order a procedure called an endoscopy. An endoscopy allows your provider to look at your esophagus , the lining of your stomach, and part of your small intestine. During the procedure:

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    What Is An Ulcer

    An ulcer is an open, painful sore. Peptic ulcers affect the stomach and the upper part of the small intestine, called the duodenum . Ulcers in the stomach are also called stomach ulcers or gastric ulcers. Those in the duodenum are also called duodenal ulcers.

    Peptic ulcers are common, but mostly affect adults. Most can be cured.

    When Should I See A Doctor If I Think I Have A Peptic Ulcer

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    • If you have burning pain in your upper stomach that is relieved by eating or taking antacids, call a health-care professional for an appointment. Don’t assume you have an ulcer. Certain other conditions can cause similar symptoms.
    • If you vomit blood or have other signs of gastrointestinal bleeding, go to an emergency department right away. Peptic ulcers can cause massive bleeding, which requires blood transfusion or surgery.
    • Severe abdominal pain suggests perforation or tearing of an ulcer. This is an emergency that may require surgery to fix a hole in your stomach.
    • Vomiting and abdominal pain also can be a sign of an obstruction, another complication of peptic ulcers. This also may require emergency surgery.

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    What Is Peptic Ulcer Disease

    Peptic ulcer disease is a condition in which painful sores or ulcers develop in the lining of the stomach or the first part of the small intestine . Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices. But many things can reduce this protective layer, allowing stomach acid to damage the tissue.

    What Happens During A Urea Breath Test

    The test involves firstly swallowing a special solution or capsule containing radioactively labelled urea. If there is an H. pylori infection, the urease from the bacteria will break down the urea, and the breakdown products will also be radioactively labelled.

    The second part of the test involves exhaling into a special bag, which is sealed and sent to a laboratory to be tested for radioactively labelled carbon dioxide. Labelled carbon dioxide will only be present if there is an H. pylori infection.

    The amount of radioactivity you are exposed to during a breath test is very low about the same as the amount we are exposed to naturally in one day of everyday life. However, there is a non-radioactive breath test that can be used in women of childbearing age and in children.

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