Perforation of gastric - duodenal ulcer: Dangerous complications of peptic ulcer disease

The article was professionally consulted by a Gastroenterologist, Department of Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

Peptic ulcer disease is a disease caused by an imbalance between factors that attack and protect the gastrointestinal mucosa. If the disease is not detected and treated properly, it can turn into dangerous complications.

Peptic ulcer disease, if not detected and treated early, can progress and cause life-threatening complications such as:
Gastrointestinal bleeding: Bleeding or bleeding ulcers often occurs vigorously, may appear suddenly or after the patient uses substances that irritate the gastrointestinal mucosa such as drinking alcohol, using anti-inflammatory drugs ... with the expression of vomiting fresh blood, walking In addition to black stools, blood pressure drops... Gastrointestinal - Duodenal perforation: The patient appears to have severe abdominal pain, stabbing pain, the abdomen is as hard as wood, accompanied by vomiting, sweating, cold hands and feet. Pyloric stenosis: Peptic ulcer is the cause of pyloric stenosis, with symptoms such as slow digestion, pain in the stomach, vomiting food from a previous meal.... Cancer: Gastric ulcer can can lead to stomach cancer, regularly visit the doctor to detect the progression of the disease early.

Perforated ulcer is a serious and serious complication of peptic ulcer disease. If not diagnosed and treated promptly, this complication can be life-threatening.

It can occur at any age, most commonly the working age. It is more common in men than in women, possibly due to a diet rich in alcohol, smoking, etc.

Clinical signs: Sudden severe pain in the epigastrium, constant pain, making the patient not dare to breathe. The patient's abdomen becomes as hard as wood. Hours later, if left untreated, the patient's pain spreads to the entire abdomen.
Due to gastric juice overflowing into the peritoneal cavity, the patient shows signs of shock such as: rapid pulse, low blood pressure, sweating, pale face, shallow breathing, a few hours after signs of shock subside, the patient can see the body. increased temperature due to peritonitis.
Subclinical: X-ray shows signs of crescent below the diaphragm. However, in the cases of small perforation, the hole was sealed without seeing the image of the crescent below the diaphragm.
Increasing the rate of having air on X-ray film can be done through gastric tube inflation, simple and safe procedure, making the diagnosis more accurate
If X-ray is not visible, the method can be used Laparoscopy for diagnosis and treatment.

On the background of a patient with a history of peptic ulcer disease, the presence of the above clinical and laboratory signs requires urgent diagnosis and treatment. As a surgical emergency, there is no indication for conservative treatment, treatment requires surgery.
Surgery must be performed as soon as possible. If patients are operated before 12 hours, the mortality rate is about 0-0.5%, after 12 hours it is 15%, and if it is later than 24 hours in elderly patients, the mortality rate is up to 30%.

Ulcerative colitis can be treated stably with drugs in combination with a reasonable diet and lifestyle. Early treatment of the disease avoids unfortunate complications that endanger the patient's health and life.

When there are signs of illness, patients go to medical facilities to examine and determine the cause of the disease. Do not arbitrarily use drugs without the guidance of medical staff.
The drugs used include:
Antibiotics to kill HP according to the protocol of the Ministry of Health when HP is positive. Drugs that neutralize gastric acid. Drugs that reduce gastric acid secretion: H2 receptor blockers or proton pump inhibitors.

In addition to complying with medication use, changing the diet and lifestyle helps to improve the disease.
Follow a healthy diet: Eat in moderation, don't skip meals, don't eat too full, don't let your stomach get too hungry, split meals. Do not use beverages that stimulate the stomach such as wine, beer, coffee, carbonated water... Do not eat sour, spicy foods Eat fruits, green vegetables and whole grains Avoid food late at night, get enough sleep.

Do not exercise or exercise much after eating. Rest for at least 30 minutes after eating. Regular exercise avoids stress, reduces anxiety, helps to relax. Eat foods that are easy to digest, soft, avoid foods that are too hard. After treatment, the patient should be re-examined to assess the condition of the disease. Regularly check periodically to detect abnormal changes of the disease or disease recurrence.
Peptic ulcer disease seems simple but can cause life-threatening complications. Perforated peptic ulcer is a very dangerous complication of the disease, with a high mortality rate if detected and treated late. To avoid unnecessary complications as soon as symptoms appear, the patient should go to the doctor to detect and treat the disease early.