A peptic ulcer is an open sore on the inner lining of the stomach, upper small intestine (duodenum), or esophagus. These sores form when the protective lining is damaged, allowing digestive acids to erode the tissue. While many ulcers are managed with medication and lifestyle adjustments, certain complications require immediate medical attention.
Common Ulcer Symptoms
Most peptic ulcers present with uncomfortable symptoms that do not signal an immediate emergency. A common indicator is a burning or gnawing pain in the upper abdomen, often felt between meals or at night. This discomfort may temporarily improve after eating or taking antacids.
Other frequent symptoms include bloating, fullness after eating small amounts, belching, and heartburn. Nausea and vomiting can also occur. These symptoms, while bothersome, suggest the ulcer can be addressed with a primary care physician.
Critical Signs for Emergency Care
Certain ulcer symptoms are serious and require immediate emergency medical evaluation. Severe, sudden, or spreading abdominal pain can indicate a perforated ulcer, where the sore has created a hole through the stomach or intestine wall. This allows digestive contents to leak into the abdominal cavity, which is a medical emergency. Movement, coughing, or sneezing may worsen this pain.
Evidence of gastrointestinal bleeding is another critical sign. This can manifest as vomiting blood, appearing bright red or resembling “coffee grounds” due to partially digested blood. Blood in the stool, appearing black and tarry (melena) or dark red, indicates upper digestive tract bleeding. Severe internal bleeding can lead to signs of shock, such as dizziness, lightheadedness, or fainting.
Shock symptoms also include a rapid heart rate, low blood pressure, and cool, clammy, or pale skin. Difficulty breathing or shortness of breath can also signal significant blood loss. Any combination of these indicators necessitates an immediate emergency room visit for assessment and intervention.
What Happens During an ER Visit
Upon arrival at the emergency room for suspected ulcer complications, medical professionals conduct a thorough assessment. This typically includes a physical examination and diagnostic tests. Blood tests are often performed to check for anemia, indicating blood loss, or signs of infection.
Imaging studies like X-rays or CT scans may identify perforation or internal damage. If stable, an upper endoscopy might be performed, where a flexible tube with a camera visualizes the ulcer directly and can stop bleeding. Initial treatments may involve intravenous fluids for dehydration or low blood pressure, and blood transfusions for significant blood loss. Medications to reduce stomach acid can also be administered. In cases of perforation or uncontrolled bleeding, emergency surgery may be necessary.
When to Seek Non-Emergency Medical Attention
While some ulcer symptoms demand immediate emergency care, many do not. If you experience persistent, but not severe, abdominal pain that does not resolve with over-the-counter remedies, visit your primary care doctor. Chronic heartburn, frequent nausea, or general discomfort without critical emergency signs should also prompt a medical consultation.
These symptoms suggest an underlying ulcer requiring proper diagnosis and management. A healthcare provider can determine the ulcer’s cause, such as Helicobacter pylori infection or NSAID use, and prescribe appropriate treatment. Addressing these symptoms promptly can help prevent more serious complications.