Ulcers are sores that can develop in the lining of the stomach, small intestine, or esophagus. An untreated ulcer can lead to serious complications. In this article, we will discuss what happens when an ulcer is not cured.
What is an ulcer?
An ulcer is a lesion that forms when there is a breakdown of the protective mucosal lining of the stomach, duodenum, or esophagus. Ulcers form when there is an increase in stomach acid production and a decrease in mucosal defense mechanisms.
There are several types of ulcers:
- Gastric ulcers – ulcers that form in the stomach
- Duodenal ulcers – ulcers that form in the first part of the small intestine (duodenum)
- Esophageal ulcers – ulcers that form in the esophagus
Some of the most common causes of ulcers include:
- Helicobacter pylori (H. pylori) infection – a bacteria that can damage the protective lining of the stomach and small intestine
- Non-steroidal anti-inflammatory drugs (NSAIDS) – medications like aspirin and ibuprofen
- Excess acid production
- Smoking
- Excessive alcohol consumption
- Stress
What happens when an ulcer is not treated?
When an ulcer is not properly treated, it can lead to a number of serious complications:
Bleeding
One of the most common and dangerous complications of an untreated ulcer is bleeding. Since ulcers form in damaged areas of tissue, they are prone to bleeding, especially as they grow larger and deeper.
Bleeding ulcers most often occur in the stomach and duodenum. The medical term for bleeding ulcers is hemorrhagic peptic ulcer disease. Symptoms of a bleeding ulcer include:
- Vomiting red or black blood
- Passing black tarry stools
- Feeling weak and dizzy
Bleeding ulcers require urgent medical care. Severe blood loss from an ulcer can be life-threatening.
Perforation
Another serious complication of untreated ulcers is perforation. This means a hole has formed in the wall of the stomach, small intestine, or esophagus.
When an ulcer perforates, the contents of the stomach or small intestine can leak into the abdominal cavity. This causes severe inflammation and infection, known as peritonitis.
An ulcer perforation is a medical emergency. Symptoms include:
- Sudden, severe abdominal pain
- Rigidity of the abdominal muscles
- Nausea and vomiting
- Fever
Perforated ulcers have a high risk of being fatal if not treated immediately with surgery.
Gastric Outlet Obstruction
Gastric outlet obstruction (GOO) occurs when a stomach ulcer grows and blocks the outlet from the stomach to the small intestine. When this happens, food and gastric juices cannot pass into the small intestine.
Symptoms of a gastric outlet obstruction include:
- Nausea and vomiting, especially after eating
- Abdominal bloating and fullness
- Weight loss
- Inability to tolerate solid foods
GOO requires hospitalization to insert a tube into the stomach that can decompress it. Surgery may also be needed to remove the blockage.
Iron Deficiency Anemia
Over time, bleeding from an ulcer can cause iron deficiency anemia. This happens when the body does not have enough iron to produce healthy red blood cells.
Symptoms of anemia include:
- Fatigue and weakness
- Shortness of breath
- Rapid heart rate
- Pale skin
- Dizziness or lightheadedness
Iron supplements and treatment for the underlying ulcer are needed to correct ulcer-induced anemia.
How are ulcers diagnosed?
There are several tests that can help diagnose an ulcer:
- Endoscopy – A procedure where a thin, flexible tube with a camera is inserted into the body to examine the digestive tract. This allows the doctor to visually inspect for ulcers.
- Biopsy – Taking a small sample of tissue to test for H. pylori infection.
- Stool test – Checking a stool sample for traces of blood or signs of H. pylori infection.
- Blood tests – Testing blood for anemia or signs of infection.
Once an ulcer is diagnosed, treatment can begin before serious complications have time to develop.
How are ulcers treated?
Treatment for ulcers focuses on reducing stomach acid production and protecting the ulcer from further damage so it can heal. Treatment options may include:
- Antibiotics – To kill H. pylori bacteria if present. Common combinations include amoxicillin, clarithromycin, and metronidazole.
- Proton pump inhibitors – Medications like omeprazole (Prilosec) and esomeprazole (Nexium) that reduce acid secretion.
- Histamine (H-2) blockers – Medications like ranitidine (Zantac) and famotidine (Pepcid) that reduce acid production.
- Cytoprotective agents – Medications like sucralfate that coat ulcers and promote healing.
- Antacids – To neutralize stomach acid.
Lifestyle changes are also an important part of ulcer treatment:
- Stop smoking
- Avoid triggers like alcohol, coffee, and spicy/fatty foods
- Eat small, frequent meals
With proper treatment, most ulcers can be cured in 4-8 weeks. Untreated ulcers may persist for years and lead to life-threatening complications.
When to see a doctor
See a doctor if you experience any symptoms of an ulcer, such as:
- Burning abdominal pain 1-3 hours after eating
- Nighttime abdominal pain that awakens you from sleep
- Nausea
- Bloating
- Unexplained weight loss
- Black, tarry stools
- Blood in vomit
Prompt evaluation and treatment can prevent an ulcer from worsening and causing serious harm.
Prevention
You can reduce your risk of developing ulcers by:
- Not smoking
- Limiting alcohol
- Avoiding NSAIDs when possible
- Reducing stress
- Eating a healthy, balanced diet
- Getting tested and treated for H. pylori if positive
Conclusion
Ulcers can lead to dangerous complications like bleeding, perforation, and obstruction if left untreated. Prompt medical care is essential. See a doctor for any possible ulcer symptoms before the condition can worsen. With treatment, most ulcers heal fully within a few weeks.