Surgery is usually considered the last option in treating peptic ulcers, when all other methods fail to cure the condition.
Peptic ulcers have become more common with the changing lifestyle and dietary habits. These ulcers can develop in the lower part of the esophagus, stomach, and duodenum. While duodenal ulcers are the most common ones, esophageal ulcers are very rare. Peptic ulcers are commonly known as stomach ulcers and include gastric (ulcers in the stomach), duodenal and esophageal ulcers.
Peptic Ulcers – Symptoms and Causes
Peptic ulcer causes include regular smoking, excessive consumption of alcohol, stress, regular intake of certain drugs, helicobacter pylori infection, etc. The last two causes are more common, when compared to others. Abdominal pain is the most common symptom of peptic ulcer. It is described as a sharp, gnawing pain, that may develop on any location that lies between the belly button and the lower ribs. While gastric ulcer worsens the abdominal pain after consuming food, in case of duodenal ulcers, the same happens if the stomach is empty. Other symptoms include, nausea or vomiting, bloating and fullness, etc. Severe symptoms include bloody or tarry stools, blood in the vomit, and anemia.
How are Peptic Ulcers Treated
The treatment for peptic ulcers may differ from one person to another. The course of treatment is decided by the physician, after assessing the condition of the patient. Diagnosis is usually done with the help of endoscopy. Helicobacter pylori test and barium enema may also be conducted as part of the diagnosis. Mild to moderate ulcers are often treated with medication, like antacids, anti-inflammatory agents, etc. In case of bacterial infection, antibiotics are also prescribed. Even proton pump inhibitors and H2 blockers are used for this purpose. Switching to a stomach ulcer diet, along with medication may prove beneficial. In most cases, the ulcers heal with proper medication and diet control. However, some people may not respond to medication, resulting in worsening of the condition. In some other cases, complications that necessitate surgical intervention may arise.
Peptic Ulcer Treatment – Surgery
Surgery is performed as the last option, when all other treatment methods fail, or in emergency situations like bleeding or perforation of ulcers or obstruction. Surgery is performed either to remove the ulcers that do not heal, or to reduce the acid in the stomach, or as an emergency measure. Basically, three forms of stomach ulcer surgery are performed. They include vagotomy, antrectomy, and pyloroplasty.
- VAGOTOMY is a surgical procedure, wherein the vagus nerve, which is responsible for transmission of messages from the brain to the stomach, is severed. This surgery aims at reducing acid secretion in the stomach, but various side effects may develop due to this procedure. The patient may experience constant and severe abdominal pain, vomiting, diarrhea, etc. In some people, vagotomy affects stomach emptying too. In order to rectify these problems, a newer version of this surgery has been introduced, and in this procedure, only those parts of the vagus nerve, that regulate the acid secretion in the stomach, are cut off. This procedure is associated with minimal side effects, and do not affect stomach emptying.
- Another peptic ulcer surgery is ANTRECTOMY, which removes the antrum, that is the lower part of the stomach. Antrum is responsible for producing the hormone that induces the stomach to secrete digestive juices. By removing the antrum, the acid production in the stomach is reduced. Even the areas lying near the antrum are removed, so as to block the production of pepsin. In most cases, vagotomy is also performed, along with antrectomy.
- PYLOROPLASTY is a surgery that aims at enlarging the pylorus, the passage from the stomach to the duodenum, which is the first part of the small intestine. The pylorus that is widened through surgery, enables free flow of the contents of the stomach to the small intestine. In this case too, vagotomy is done.
The surgical procedures mentioned above are measures to control and treat stomach ulcers. Nowadays, endoscopic treatment is preferred to peptic ulcer surgery. Bleeding ulcers may be cauterized or injected with medication (for healing), using the endoscope. Even some of the perforations and obstructions can be rectified through endoscopy. In some cases of peritonitis caused by perforated ulcers, open surgery may be needed. In order to avoid complications and surgery, it is always better to diagnose and treat peptic ulcers at the earliest.
Disclaimer: This article is for informational purposes only, and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.