According to statistics, with gastric ulcer bleeding occurs in about 5-15% of patients who have a similar disease. Basically, the intensity depends on the area of the lesion, and the well-being of the patient - on timely and correct assistance.
The consequences of such a complication can be severe, so it is very important to know for what reason the bleeding occurred, as well as how the first aid is provided to the patient.
Pathology Features
A stomach ulcer complicated by bleeding is a rather dangerous disease that causes significant discomfort. The intensity of the pathological process largely depends on the size of the affected vessel. The consequences of such a complication are quite serious, therefore, timely first aid and the appointment of subsequent treatment are important.
One of the causes of ulcerative bleeding can be problems with the cardiovascular system. In addition, it can be triggered by defects in a ulcerative neoplasm, which begins to develop after the use of glucocorticosteroids. As a result of the presence of various kinds of disorders, inflammatory and destructive processes begin to progress. This leads to the fact that there is a violation of capillary coagulation. Blood loss can come from arteries, veins, and also small blood vessels.
Forms and Degrees
With a stomach ulcer, bleeding can lead to hemorrhagic shock, which can be:
- compensated;
- subcompensated;
- decompensated;
- very heavy.
The pathological condition can be hidden and overt. Latent bleeding in the initial stages does not cause a deterioration in well-being. An obvious form is observed with lesions of a large vessel, while it is accompanied by nausea, vomiting with blood spots.
In addition, distinguish between arterial and venous bleeding. Arterial bleeding is characterized by the spread of erosion on the walls of blood vessels, and venous bleeding may be due to thrombosis.
Causes of occurrence
With gastric ulcer, bleeding mainly occurs due to damage to the walls of the stomach resulting from mechanical or chemical exposure. Other provoking factors include the following:
- physical stress;
- hypovitaminosis;
- changes in the emotional state;
- damage to the gastric walls at the cellular level.
Blood loss adversely affects the general condition of the body, exacerbating it. With significant blood loss, the heart rate increases, and there is a violation of the systemic circulation. Internal organs become swollen, which is fraught with the occurrence of a heart attack.
Key features
Basically, the occurrence of bleeding with a stomach ulcer occurs unexpectedly. The cause of this is damage to arteries or veins, and sometimes it can be a consequence of a long-discovered, but untimely resolved problem. Symptoms of bleeding with a stomach ulcer manifest themselves quite clearly, especially in the case of significant blood loss. With the occurrence of a hidden lesion, signs practically do not appear.
Among the most common symptoms of bleeding with gastric ulcer can be distinguished such as:
- the presence of bloody vomiting;
- feces of a dark color;
- painful sensations.
A sufficiently characteristic sign is vomiting with spotting or dark in color.
Dark colored stools are another sign that bleeding occurs with a stomach ulcer. Similar symptoms occur with significant loss of blood.
In acute gastric ulcer with bleeding, a number of signs are observed that can lead to hemorrhagic shock. Shortness of breath, pallor of the skin, weak pulse, and low blood pressure are also noted.
With a latent form, the symptoms may not be sufficiently expressed, so the patient may not notice them. Bleeding is mostly minor, but it is regularly repeated.
First aid
If there are signs of bleeding with a stomach ulcer, then you must definitely call an ambulance, and provide first aid to the patient before her arrival. First of all, you need to forbid him to move. It is best to lay the patient in a horizontal position on his back and put a bag of ice on his stomach before the doctors arrive.
You can additionally swallow a piece of ice, as the cold helps to stop bleeding. It is strictly forbidden to give the patient food and water. In the presence of acute or chronic ulcers with bleeding, the patient is transported only on a stretcher by experienced paramedics.
In almost all cases, the patient is hospitalized in the hospital, and in some cases in the intensive care unit.
Diagnostics
If the first signs of bleeding with a stomach ulcer appear, it is imperative to diagnose to accurately determine the presence of a problem. The main diagnostic method is endoscopy, which should be performed as soon as possible. Endoscopic examination is performed under general anesthesia.
In addition, special tests are prescribed to determine the presence of latent blood in the stool. Laboratory diagnostics is required to determine hemoglobin, the number of red blood cells, platelets, and blood coagulation time. In some cases, differential diagnosis may be required to exclude damage to other internal organs.
Treatment feature
If a stomach ulcer with bleeding has opened, then you should immediately consult a doctor for treatment. The main therapy is carried out in the hospital. Immediately after hospitalization, the patient is prescribed drugs that help reduce the risk of severe blood loss. For treatment, the management of “Vikasol” is indicated.
If the bleeding is strong enough, then the patient may be prescribed a blood transfusion. After the required volume is restored, additional therapy is required, aimed at the subsequent elimination of symptoms and the risk of subsequent bleeding.
In some cases, endoscopy is used for treatment. This method involves cauterization of a damaged vessel using electric current. A substance can also be injected into the vein that helps to clot and helps prevent subsequent bleeding.
If all of these methods do not produce any result, then surgical intervention may be indicated. This treatment involves resection of the stomach.
Drug therapy
Treatment of bleeding stomach ulcers with conservative therapy involves the use of colloidal and crystalloid solutions. To compensate for the lost blood, an injection of the required volume of reopoliglukin and polyglucin is required.
Means are also required to improve blood coagulation, in particular, such as platelet mass, fibrinogen, plasma, aminocaproic acid. Doctors also prescribe antibacterial agents, in particular, such as Tetracycline, Metranidozole, Clarithromycin. Then you need to take proton pump blockers (Omeprazole) and histamine receptors (Diazolin). In addition, antispasmodics are prescribed, for example, Spazmolgon, No-Shpa. This treatment is designed for 2 weeks.
Physiotherapeutic and endoscopic techniques
Physiotherapy plays a very important role in recovery. Properly selected physical exercises, laser therapy, magnetotherapy, as well as mineral water treatment for acute or chronic stomach ulcers with bleeding will speed up recovery and reduce the risk of relapse.
Recently, endoscopic therapy has gained great popularity. Among the most popular methods, it is necessary to highlight such as:
- laser coagulation;
- thermal electrode;
- bipolar coagulation;
- injection sclerotherapy;
- vascular clipping.
When using the thermocoagulation method, it is best to combine it with injectable endoscopic hemostasis. Vascular clipping helps to quickly stop bleeding, as well as prevent the likelihood of relapse. If endoscopic techniques have not yielded a positive result, the doctor may order an operation.
Surgical intervention
In many cases, with a stomach ulcer with bleeding, surgery is the only way to save the patient's life. The method of surgical intervention largely depends on the severity of the patient's condition and the localization of the ulcerative crater. The most popular method of surgery is resection of the stomach. This type of operation refers to organ-preserving, as well as quite simple and safe.
In debilitated patients, an alternative method of surgical intervention is suturing of the defect with vagotomy, as well as subsequent drainage of the wound. It should be noted that all these methods are not difficult and do not pose a particular risk, since there is no danger of vascular injury when they are carried out.
Dieting
In the case of bleeding with a stomach ulcer, nutrition after treatment plays a very important role, as this will prevent the occurrence of relapses. During the first 2-3 days, complete abstinence from food and drink is indicated. Thirst can be quenched by drinking a little water or a small piece of ice, which must be slowly absorbed in the mouth. After this, the patient can gradually introduce liquid food into the diet. In this case, you can consume:
- milk;
- raw eggs or soft-boiled eggs;
- jelly;
- semi-liquid jelly;
- juices.
During the recovery period, a sufficient amount of calories must be absorbed into the body, allowing to maintain vital activity. However, it is worth remembering that the food should be semi-liquid or in the form of mashed potatoes. From the diet you need to exclude alcohol, spicy, fatty and fried foods.
What could be dangerous
Like any other bleeding, such a pathology is very dangerous because the body loses a lot of blood, not having the opportunity to replenish it. With significant blood loss, above the permissible norm, the patient may die, so it is important to give him first aid and prescribe treatment as soon as possible. Particularly dangerous is bleeding, provoked by the defeat of large vessels, which leads to complications such as:
- cerebral edema;
- heart failure;
- intoxication of the body with toxins and blood decomposition products.
As a result of bleeding, organ failure syndrome can develop when many organs and systems are affected.
Prevention
Prevention of bleeding with gastric ulcer is mainly a regular balanced diet, abstinence from smoking and alcohol. In addition, it is important to conduct hardening and periodically undergo treatment in sanatoriums.