Any disease that does not cure or does not follow all the doctor’s recommendations can lead to serious complications. Currently, a large percentage of the population suffers from diseases of the digestive tract, among them gastritis and ulcers occupy one of the first places. One of the complications of these pathologies is perforated gastric and duodenal ulcers, the symptoms and treatment of these pathologies will be discussed later.
What is perforation?
Such a pathology is a consequence of a complication of peptic ulcer, which can occur for various reasons, but all of them can lead to the formation of a through hole in a hollow organ. It can be either the stomach or any part of the intestine.
As a result of the formation of perforation, the entire contents of the stomach or intestine together with the contents and enzymes enters the abdominal cavity and begins to corrode it. Infectious agents do not remain indifferent, and in response to such an event, an inflammatory process develops, which is called peritonitis.
This is a serious situation that requires immediate medical attention. Most often, such a complication occurs in a strong half of humanity, with a peak in occurrence in the spring and autumn.
Causes of perforation in the stomach
There are several reasons that can lead to a perforated ulcer, among them the main place is:
- Frequent inflammatory processes in the stomach.
- Physical activity that leads to an increase in intra-abdominal pressure.
- Large amounts of food.
- Negligent diet.
- Stressful situations.
- Aspirin use or glucocorticoid therapy.
The presence of inflammation in the mucous membrane can lead to a perforated ulcer, its symptoms can be visited by the patient. It is imperative to regularly undergo an examination and follow the doctor's recommendations.
Causes of duodenal ulcer
Most often, the causes of ulcers of this organ lie in problems with the stomach. If you do not take any measures to eliminate the inflammatory process in it, then it will necessarily spread to the duodenum.
Causes may also include:
- Alcoholism.
- Gallbladder disease, chronic appendicitis.
- Helicobacter pylori bacteria infection.
It must be borne in mind that perforated duodenal ulcer occurs much more often than stomach.
Symptoms of a perforated ulcer
When the patient worsens the disease, it is always manifested by pain, vomiting, all this most often occurs after eating. At the time of perforation, the perforated ulcer has symptoms in the form of a sharp “dagger” pain that cannot be tolerated. The patient tries to pull his legs to his chest to reduce it.
At this moment, there is also an increase in signs of intoxication of the body as a result of the ingress of all that is in the stomach into the abdominal cavity. The skin becomes pale, cold sweat appears , blood pressure decreases and the heart begins to beat more often.
In the development of this pathology, several stages are distinguished:
- Shock stage. It is just characterized by unbearable sharp pains that can give to the right side of the back. Because of this, it is difficult to breathe, the muscles become very hard and tense.
- Imaginary improvement. At this time, and this is approximately a few hours after the onset of all pains, the condition improves slightly, a perforated ulcer reduces its symptoms. Weakness appears, pressure remains low, muscles relax slightly, and it becomes easier to breathe. Body temperature usually rises during this period, flatulence occurs, patients familiar with this condition should no longer confuse it with poisoning or flu. One cannot do without ambulance during this period.
- After 12 hours, symptoms of peritonitis already appear: dry mouth, abdominal pain. It should be noted that the signs of peritonitis are always the same, regardless of the reason that provoked it. It is possible to suspect that this happened against the background of perforation of a stomach or intestinal ulcer only on the basis of the existing diagnosis.
Peritonitis can be caused by appendicitis, pancreatitis, but in any case, if such a pathology is suspected, urgent hospitalization is necessary. A dangerous situation is when a developing ulcer shows almost no signs. The patient may ignore the symptoms of perforation that has arisen, but simply try to relieve the pain with homemade improvised drugs and painkillers, and this is already life-threatening.
Bowel ulcer symptoms
If perforation of the duodenum 12 is observed, then the signs may be as follows:
- Acute pain in the left hypochondrium, which can give to the neck and collarbone.
- Vomiting, most often it happens only once.
- Becomes a "disk-like stomach."
- Cold sweat and a blue tinge of the mucous membranes appear.
Just as with perforation of the stomach, the perforated ulcer of the duodenum 12, the symptoms of which we are considering, leads to the fact that at the second stage of development, signs immediately begin to appear that the contents of the intestine enter the abdominal cavity. Tachycardia, fever, severe pain are vivid witnesses of the development of peritonitis. In this condition, urgent surgeons need help.
Perforation Diagnostics
Since the perforated ulcer of the stomach and duodenum, the symptoms are pronounced in the first stage, and patients, as a rule, are admitted to a medical institution in the second, the history of the disease is the basis for making the correct diagnosis. In addition, additional studies are required:
- X-ray, which will show the presence of free gas, if there is perforation.
- Ultrasound reveals the onset of inflammation in the abdominal cavity and the presence of fluid.
- Sometimes FGDS is used to identify the exact localization of the pathology, but there is a risk of gas entering the abdominal cavity, so special care must be taken.
- If the case is severe, and the perforated duodenal ulcer has blurred symptoms, then a laparoscopy is performed.
- A blood test will also show elevated ESR, a high level of stab leukocytes and a decrease in hemoglobin.
Only after confirmation of the assumptions about the presence of perforation will surgery be performed.
First aid for perforated ulcer
The formation of perforations in the stomach or intestines is very dangerous for human life, which is why at the first suspicions of such a condition, it is necessary to call an ambulance. During transportation, a patient in serious condition is injected with drugs to maintain blood pressure, inhaled with oxygen, and given pain medication.
It is not advisable to use narcotic analgesics during this period, since they violate the patient’s consciousness and lubricate clinical manifestations, which makes it difficult to make a correct diagnosis.
Perforated ulcer treatment
Perforated intestinal ulcer symptoms are almost the same as perforation of the stomach, they are also united by the fact that only surgeons can cope with this condition. Surgery should be performed as early as possible, because at a later stage this may be pointless.
If the situation requires it, then all the manipulations are carried out in the intensive care unit. Before the operation, the probe and catheter are inserted into the bladder, and the surgery itself is performed under general anesthesia.
The surgeon makes an incision and examines the cavity of the stomach or intestine, detects perforation, and then the question is solved, how to eliminate it. There are several options for this:
- You can close the hole.
- In some cases, part of the stomach is removed along with perforation.
- Excision of an ulcer and vagotomy.
Most often, surgeons know from their experience that suturing is not a 100% guarantee of a complete cure, relapses often occur. Therefore, this method of combating perforation is resorted to in situations with severe peritonitis or in the presence of pathology in young people whose stresses are the cause of this condition.
In most other cases, ulcer excision or gastrectomy are more effective .
Both before excision or suturing, and after surgery, a complete sanitation of the cavity is carried out and several drains are installed.
We examined the topic: "Perforated ulcer symptoms and treatment." First aid in this situation is very important, but most often its meaning lies in the speedy hospitalization of the patient.
Complications after surgery and a prognosis for the future
Among all the complications of the postoperative process are the following:
- The development of an abscess in the abdominal cavity.
- Pneumonia.
- If the seams are made poorly, then this is fraught with repeated perforation and the formation of peritonitis and sepsis.
- It is very rarely possible to disturb the movement of food through the esophagus into the stomach due to the narrowing of the input sphincter.
If a perforated ulcer is detected in time, the symptoms are eliminated and all necessary measures are taken to eliminate the pathology, then the prognosis is most often favorable. With all the recommendations of the doctor and diet, you can lead a normal lifestyle.
Alternative treatment of ulcers
If the disease has gone too far and perforation has formed, then alternative methods of therapy will no longer have any effect. But after the surgical intervention, along with the standard course of treatment, it is quite possible to apply the recommendations of traditional healers.
Here are a few recipes that can help reduce the acidity of your gastric juice to prevent relapse:
- Mix the juice of two lemons with 0.5 liters of honey and with the same volume of olive oil. Ready-made medicine to use 1 tbsp. l before meals 3 times a day for a month.
- Grind 250 grams of aloe leaves in a meat grinder, add 250 grams of honey and heat the mixture to 50 degrees, then add half a liter of red wine. All this is insisted in a dark place for 7 days, and then you can take a tablespoon 3 times a day for an hour before eating. The duration of such treatment is 3 weeks.
It must be remembered that traditional medicine can be effective in the initial stages of ulcer development, and if there is a perforation, it makes no sense.
How to prevent relapse of perforation
In order to prevent a recurrence of a perforated ulcer, it is necessary to regularly conduct anti-relapse therapy, which includes:
- Compliance with diet. As a prophylaxis, patients are encouraged to follow diet No. 1, especially during periods of possible exacerbation of the disease.
- Taking the necessary medicines. The attending physician will definitely give recommendations on this matter.
- Physiotherapy. They give remarkable results in combination with proper nutrition and medication.
- Periodic spa treatment.
Diseases of the gastrointestinal tract can bring a lot of trouble to its owner. If you do not adhere to strict food restrictions, abuse bad habits, and undergo frequent stresses, you may not be surprised that the ulcer will again express itself with its unpleasant symptoms. Take care of yourself and your health; you cannot buy it for any money.