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What are the Most Common Ulcer Complications?

By Deborah Walker
Updated May 17, 2024
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Ulcer complications in the stomach and intestinal tract include bleeding, perforation, or intestinal blockage. Each of these issues may spawn further complications. Sometimes ulcer complications require surgery, but in other cases, medications may be all that is needed to get the ulcer problems under control. Mouth ulcers and diabetic foot ulcers can also pose serious complications.

Mild-to-severe internal bleeding can result if the ulcer damages blood vessels as it eats away at the lining of the stomach or small intestine. The amount of blood depends upon the size of the blood vessels that have been damaged. Bleeding can go undetected if the damaged blood vessels are small. If bleeding into the digestive tract continues unchecked, the patient will likely develop anemia. When the damage is done to larger blood vessels, internal bleeding can be severe, and immediate medical attention is normally required.

Other stomach ulcer complications include perforation and infection. In a perforated ulcer, which affects about 10 percent or less of cancer patients, the ulcer eats through the wall of the stomach or small intestine and allows the stomach contents to leak into the abdominal cavity. This can cause an infection known as peritonitis. A person with peritonitis typically will have sudden, sharp pains and need immediate hospitalization and surgery.

Intestinal blockage occurs in 5-8% of people with peptic ulcer complications. If an ulcer is located near the duodenum, which connects the stomach to the small intestine, swelling and/or scarring can occur. This leads to an intestinal blockage that prevents the stomach contents from moving through the digestive tract. The blockage will usually cause the patient to frequently vomit undigested food and cause a feeling of bloating and unexplained weight loss. Immediate hospitalization is likely for an intestinal blockage.

Treatment for an intestinal blockage depends upon the results of an endoscopy and what the doctor is able to see at the blockage site. If the blockage is the result of swelling, the patient will usually be given proton pump inhibitors or H2-receptor antagonists to reduce the swelling. As a general rule, surgery is not necessary.

If the blockage is due to scarring, especially if it is severe, the patient will need surgery to remove the scar tissue and avoid further ulcer complications. In mild cases, the surgery may be done through an endoscope inserted into the throat and down the digestive tract. After the scar tissue is removed, the stomach is reattached to the remaining, unscarred small intestine, and food can flow freely through the digest tract once again.

Mouth ulcers, diabetic foot ulcers and decubitus ulcers, also known as bed sores, are other complications. Mouth ulcers, although rare, put the patient at risk for bacterial infections. Diabetic foot ulcers require thorough cleaning and care and antibiotics to prevent an infection and gangrene from developing. If diabetic ulcer treatment does not work, the limb may need to be amputated as a last result. Immobile patients may develop bed sores that lead to ulcer complications of infection, gangrene, as well as a host of other health problems.

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