The effectiveness of pharmacological treatment means that surgical operations due to gastric ulcers are rarely performed. This does not mean, however, that ulcers are no longer dangerous. Placed in the stomach or duodenum, they can lead to serious complications. And then, without a scalpel, there is no need to do. When do stomach ulcers make stomach surgery necessary?
Gastric ulcer surgeryis necessary when other, non-invasive treatments have failed.Peptic ulcer diseaseis characterized by the fact that its symptoms worsen in spring and autumn. People who, after eating a meal, have recurring pains in the upper abdomen, i.e. between the navel and ribs, and the pains resemble burning, burning, and sometimes a feeling of hunger, should not underestimate them in any way. It is assumed that if symptoms appear half an hour after eating, a stomach ulcer has developed. When two hours after a meal, ulcers are in the duodenum, because the food has already reached it, and the secreted digestive juices irritate the ulcer, which we feel as a nagging pain. With such symptoms, you need to see a doctor instead of swallowing more tablets.
Gastroscopy first, then pharmacotherapy
In order to find out which part of the gastrointestinal tract there are ulcers, a gastroscopy should be performed, which is a test that allows you to accurately assess the condition of the mucosa. It involves the insertion of a flexible tube terminated with a minicamera through the esophagus.
There is no reason to repeat the gastroscopy every year, because the examination is burdensome for the patient and not indifferent to his he alth.
The doctor examines the mucosa, and then uses special tools to take fragments of the diseased tissue from the ulcerated places. The samples are examined for neoplastic lesions and for the presence ofHelicobacter pylori , the bacteria that is the most common cause of ulcers. When the tests confirm the presence of bacteria, the patient takes two appropriately selected antibiotics and a protron pump blocker - a drug that reduces gastric acid secretion - for a week. For the treatment to be effective, it must be completed. It is a mistake to interrupt it when you feel better. Another gastroscopy can be done after the treatment is completed to see that the ulcer has healed.
Indication for surgery are complications
Successful pharmacotherapy resulted in resectionsdue to peptic ulcer disease ceased to be the main activity of surgeons. Currently, people with serious complications due to peptic ulcer disease come to the table. Operations are most often performed when there is bleeding from the ulcer. It happens that a haemorrhage may appear from even a small erosion.
If the bleeding is light, the first symptom will be tar-black stool. When the haemorrhage is massive, bloody diarrhea appears, often accompanied by fainting and vomiting with a gritty (like coffee grounds) content. Another complication that mainly affects tobacco smokers is a perforation in the stomach wall. This is a life-threatening condition as the contents in the stomach spill out into the abdominal cavity. Acute peritonitis develops rapidly. A characteristic symptom of perforation is the so-called plank, that is, very hard, belly. The patient knows exactly what time the perforation took place, because he felt extremely intense pain, like when stabbed with a knife. Another symptom is heat spreading over your belly. It is a consequence of the leakage of gastric acids in the abdominal cavity. Chemical peritonitis develops and the patient must urgently be on the operating table.
A serious risk for patients is stress ulcer, which is different from peptic ulcer. They arise, as the name suggests, under the influence of strong emotional tension. If we add an aspirin tablet to stress, swallowed to relieve a headache - ulcer guaranteed. This type of ulcer gives more complications such as massive bleeding and perforation in the stomach.
A less common complication of peptic ulcer disease is pyloric stenosis (the muscle ring that connects the stomach to the duodenum). It is manifested by vomiting and severe abdominal pain. After taking the photo in a standing position, you can see that the stomach is stretched so far that it occupies the entire inside of the abdomen. The reason for this is a significant narrowing of the pylorus, e.g. by a scar formed at the site of an ulcer. Here, too, a quick intervention of a surgeon is necessary.
Worth knowingNot every carrier of the bacteria gets sickIt is not true that everyone who becomes infected with Helicobacter pylori will develop an ulcer. It is estimated that as many as 80% of Poles are carriers of this bacterium, and about a quarter of them suffer from the disease. Most are young and middle-aged people, usually working hard, but there are also teenagers and children. One in ten adults suffer from peptic ulcers (stomach and duodenum). Men get sick three times more often than women. Almost everyone infected with the bacterium has (in various forms) gastritis, which is commonshows no symptoms.
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