Peptic ulcer: complications
Most people with peptic ulcers (duodenal and gastric ulcers) are not overly troubled by them. For example, only half the people with duodenal ulcers have symptoms. Some ulcers may heal spontaneously, even without medication. However, if a person does not get medical treatment for their ulcer, serious complications can occur and the symptoms will reflect this. Complications of peptic ulcers include the following.
Haemorrhage (bleeding)
As an ulcer corrodes the wall of the stomach or duodenum, blood vessels can also be damaged, which causes bleeding. Ulcers can bleed without causing pain. If the damaged blood vessels are small, the blood may slowly seep into the digestive tract, leading a person to develop anaemia and feel weak, dizzy or tired. A bleeding ulcer may be found when a doctor carries out an endoscopy and the doctor will then cauterise the ulcer to stop it bleeding.
If the blood vessels are large, bleeding is faster. This is a more dangerous situation. The symptoms include weakness when standing up, vomiting blood or partly digested blood that looks like reddish brown coffee grinds, or fainting. Stools may be a black or dark red colour and ‘tar-like’ in consistency. Vomiting blood that resembles coffee grinds or passing black, tarry stools are important symptoms and you should see your doctor immediately if you develop these symptoms.
Initial treatment for bleeding ulcers may consist of the replacement of lost body fluids, however, if the bleeding is severe or persistent a blood transfusion may be needed.
Obstruction (pyloric stenosis)
Pyloric stenosis is the name doctors give to the condition where the valve at the bottom of the stomach that allows food to pass on to the duodenum becomes narrowed. This can be due to the build-up over time of scar tissue on ulcers that have formed at the junction of the stomach and the duodenum. This causes a blockage which interferes with the passage of the contents of the stomach into the intestine. Symptoms of this type of obstruction or blockage include increasing abdominal pain, repeated vomiting and a feeling of fullness or bloating. Surgery or endoscopy may be needed to ‘unblock’ the obstruction, although sometimes ulcer treatment will be enough.
Perforation
This is when the ulcer completely erodes (perforates) the stomach or duodenal wall. This causes the leaking of acidic gastric contents into the abdominal cavity and results in acute peritonitis (infection of the abdominal cavity). When perforation occurs, there is generally a sudden extreme abdominal pain that is worsened by any type of movement. The person will try to lie very still to avoid the pain. Perforation is a medical emergency. If it is not treated then shock can develop and it can be fatal. It needs immediate surgical treatment and intravenous antibiotics.
Always check with your doctor if you feel there are any unusual symptoms or changes associated with your ulcer.
Last Reviewed: 06 December 2001
