Complications
Gastrointestinal bleeding is one of the most common complications of ulcers. This may manifest itself as vomiting fresh, bright red blood or passing bloody or tarry stools. Weakness, fatigue or, in the case of severe hemorrhage, loss of consciousness and shock also may result from bleeding ulcers. Ulcers always should be suspected when gastrointestinal bleeding occurs, even if there is no pain or other symptoms.
One serious complication is a perforated ulcer, which develops as acid deepens the ulcer and goes through the intestinal wall, spilling acid and bacteria into the abdominal cavity. This is always a medical emergency requiring immediate treatment, usually surgical. The pain is sudden, intense and steady, and even the slightest movement seems to increase it. The major danger is peritonitis, a severe infection of the abdominal cavity. A second danger is caused by excessive scarring or adhesions. Usually, however, this only occurs in older ulcers where several layers of scar tissue have had a chance to accumulate. Piled on one another, these may block the digestive tract.
Treatment of Ulcers
While some ulcers heal on their own, most patients require some sort of treatment. But recent important changes in the three major areas of ulcer therapy--diet, drugs and surgery--allow today's patients a freedom that would have been unimaginable to earlier generations of ulcer victims. In any case, ulcer patients who smoke should make every effort to stop. Avoidance of alcohol and aspirin, especially during a flare-up, also is recommended.
Diet
Milk and cream diets are still prescribed, as are small, frequent feedings of up to six meals a day. But today, these mainstays of dietary therapy are used much more judiciously than in the past. Since both seem to effectively relieve ulcer pain, they are routinely prescribed during flare-ups. But because there is no evidence that either actually promotes healing, once the pain has been relieved, patients are usually allowed to resume their normal diets.
