A peptic ulcer is an open sore that develops on the inner lining of the stomach or the upper part of the small intestine, known as the duodenum. These ulcers arise when the protective mucous layer, which typically shields the digestive tract from corrosive stomach acids and digestive enzymes, becomes weakened. The most frequent causes of peptic ulcers include infection with the bacterium Helicobacter pylori (H. pylori) and the prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs). Ignoring peptic ulcers can lead to several severe health complications.
Internal Bleeding
Internal bleeding is a common and severe complication of an untreated ulcer. As an ulcer deepens, it can erode into nearby blood vessels, causing bleeding that ranges from slow, chronic blood loss to acute, life-threatening hemorrhages.
Slow bleeding often leads to symptoms of anemia, such as pale skin, persistent fatigue, weakness, and lightheadedness. More significant bleeding can produce noticeable signs like black, tarry stools (melena), which result from digested blood. Vomiting blood (hematemesis) may appear bright red or resemble dark coffee grounds, indicating the blood has been partially digested by stomach acid. Severe blood loss is a medical emergency that requires immediate attention, potentially leading to a significant drop in blood pressure and rapid heart rate.
Perforation and Peritonitis
An ulcer can erode completely through the wall of the stomach or small intestine, creating a perforation. This is a critical and life-threatening event, allowing digestive contents, including stomach acid, partially digested food, and bacteria, to leak into the abdominal cavity. This leakage triggers a widespread infection and inflammation of the abdominal lining, a condition called peritonitis.
Peritonitis causes sudden, severe abdominal pain, often described as a “dagger” pain, which may spread across the abdomen. The abdomen can become rigid and tender to the touch, and other symptoms include fever, a rapid heartbeat, and signs of shock. Immediate surgical intervention is necessary to close the perforation and clear the infection, as peritonitis carries a high mortality rate if left untreated.
Gastric Outlet Obstruction
Chronic inflammation, swelling, and scarring from an untreated ulcer can lead to gastric outlet obstruction. This condition occurs when the passage connecting the stomach to the small intestine (the pylorus) becomes narrowed or blocked, preventing food from moving into the small intestine. The blockage hinders proper digestion and nutrient absorption.
Individuals with gastric outlet obstruction often experience persistent vomiting, which may include undigested food. Other symptoms include feeling full after consuming a small amount of food, unexplained weight loss, and recurring abdominal pain. This obstruction can lead to dehydration, electrolyte imbalances, and malnutrition, typically requiring medical intervention to clear the blockage.
Increased Risk of Gastric Cancer
Certain types of untreated ulcers, particularly those caused by chronic H. pylori infection, are associated with an increased risk of gastric (stomach) cancer over time. The H. pylori bacterium can cause long-standing inflammation and damage to the stomach lining. This continuous cycle of inflammation and healing can eventually lead to genetic mistakes in cells, increasing the likelihood of cancerous changes.
While not all H. pylori infections or ulcers will progress to cancer, the infection is recognized as the strongest known risk factor for gastric cancer. Eradicating H. pylori infection can significantly reduce this risk, emphasizing the importance of diagnosing and treating the underlying cause of ulcers.