According to statistics, gastric ulcer bleeding occurs in approximately 5-15% of patients who have a similar disease. Basically, the intensity depends on the affected area, and the patient's well-being depends on the timely and correctly provided 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 exactly how the first aid is provided to the patient.
Features of pathology
A stomach ulcer complicated by bleeding is a rather dangerous disease that causes considerable 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, so timely first aid and subsequent treatment are important.
One of the causes of bleeding ulcers can be problems with the cardiovascular system. In addition, it can be provoked by defects in the ulcer.neoplasms that begin to develop after the use of glucocorticosteroids. As a result of the presence of various kinds of disorders, inflammatory-destructive processes begin to progress. This leads to the fact that there is a violation of capillary clotting. Blood loss can come from arteries, veins, and small blood vessels.
Forms and degrees
In stomach ulcers, bleeding can lead to hemorrhagic shock, which can be:
- compensated;
- subcompensated;
- decompensated;
- very heavy.
A pathological condition can be latent and overt. Hidden bleeding in the initial stages does not cause a deterioration in well-being. An explicit form is observed when a large vessel is damaged, while it is accompanied by nausea, vomiting with blood splashes.
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
In gastric ulcers, bleeding mainly occurs due to damage to the walls of the stomach resulting from mechanical or chemical effects. Other provoking factors include the following:
- physical strain;
- hypovitaminosis;
- swings in emotional state;
- damage to the gastric walls at the cellular level.
Blood loss adversely affects the general condition of the body, aggravatinghis. With significant blood loss, the heart rate increases, and there is also a violation of the systemic circulation. The internal organs become swollen, which is fraught with a heart attack.
Key Features
In general, the occurrence of bleeding in stomach ulcers occurs unexpectedly. The reason for this is damage to the arteries or veins, and sometimes it can be a consequence of a long-discovered, but untimely solved problem. Symptoms of bleeding with a stomach ulcer appear quite clearly, especially in the case of significant blood loss. With the course of a latent lesion, the signs practically do not appear.
Among the most common symptoms of bleeding from stomach ulcers are:
- presence of hematemesis;
- dark feces;
- pain.
Quite characteristic is bloody or dark-colored vomiting.
Dark-colored stools are considered another sign that a stomach ulcer is bleeding. Similar symptoms occur with significant blood loss.
In an acute gastric ulcer with bleeding, there are a number of signs that can lead to hemorrhagic shock. Shortness of breath, pallor of the skin, weak pulse, low blood pressure are also noted.
With a latent form, the signs may not be sufficiently expressed, so the patient may not notice them. Bleeding is mostly minor, but it is regularrepeats.
First aid
If there are signs of bleeding with a stomach ulcer, then it is imperative to call an ambulance, and the patient should be given first aid 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 an ice pack on his stomach before the arrival of the doctors.
You can additionally give a piece of ice to swallow, as the cold helps to stop the bleeding. It is strictly forbidden to give the patient food and water. In the presence of an acute or chronic ulcer with bleeding, the patient is transported only on a stretcher by experienced paramedics.
Almost in all cases, the patient is admitted to the hospital, and in some cases to the intensive care unit.
Diagnostics
If the first signs of bleeding appear with a stomach ulcer, it is imperative to conduct a diagnosis to accurately determine the presence of a problem. The main diagnostic method is endoscopy, which should be performed as soon as possible. Endoscopy 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, blood clotting time. In some cases, differential diagnosis may be required to rule out damage to other internal organs.
Feature of treatment
If a stomach ulcer has opened withbleeding, 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 administration of Vikasol is indicated.
If the bleeding is severe enough, the patient may be given 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 with an electric current. A substance may also be injected into the vein to help blood clot and help prevent future bleeding.
If all these methods have not brought any result, then surgery may be indicated. This treatment consists of gastric resection.
Drug therapy
Treatment of gastric ulcer with bleeding with the help of conservative therapy involves the use of colloid and crystalloid solutions. To compensate for the lost blood, an infusion of the required volume of rheopolyglucin and polyglucin is required.
Means to improve blood clotting are also required, in particular, such as platelet mass, fibrinogen, plasma, aminocaproic acid. Also doctorsprescribe antibacterial agents, in particular, such as "Tetracycline", "Metranidazole", "Clarithromycin". Then you need to take proton pump blockers ("Omeprazole") and histamine receptors ("Diazolin"). Additionally, antispasmodics are prescribed, for example, Spazmolgon, No-Shpa. This treatment is designed for 2 weeks.
Physiotherapy and endoscopic techniques
Physiotherapy plays a very important role in recovery. Properly selected physical exercises, laser therapy, magnetotherapy, as well as treatment with mineral waters of acute or chronic gastric ulcers with bleeding will speed up recovery and reduce the risk of relapse.
Recently, endoscopic therapy has become very popular. Among the most popular methods, it is necessary to highlight such as:
- laser coagulation;
- thermal electrode;
- bipolar coagulation;
- injection sclerotherapy;
- vascular clipping.
When applying the method of thermocoagulation, it is best to combine it with injection endoscopic hemostasis. Clipping of vessels helps to quickly stop bleeding, as well as prevent the likelihood of relapses. If endoscopic techniques did not bring a positive result, the doctor may prescribe an operation.
Surgery
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 depends largely on the severitythe patient's condition and localization of the ulcer crater. The most popular method of the operation is gastric resection. This type of operation is organ-preserving, and is also quite simple and safe.
In debilitated patients, an alternative method of surgical intervention is suturing the defect with vagotomy, as well as subsequent drainage of the wound. It should be noted that all these techniques are not difficult and do not pose a particular risk, since there is no danger of injury to the vessels during their implementation.
Dieting
In the event of bleeding from a stomach ulcer, nutrition after treatment plays a very important role, as this will prevent recurrence. During the first 2-3 days, complete abstinence from food and drink is shown. Thirst can be quenched by drinking some water or a small piece of ice, which must be slowly dissolved in the mouth. After that, the patient can gradually introduce liquid food into the diet. While you can consume:
- milk;
- raw or soft-boiled eggs;
- jelly;
- semi-liquid jelly;
- juices.
During the recovery period, the body must receive enough calories to support life. However, it is worth remembering that food should be semi-liquid or in the form of mashed potatoes. Alcoholic beverages, spicy, fatty and fried foods should be excluded from the diet.
What could be dangerous
Likeany other bleeding, such a pathology is very dangerous because the body loses a lot of blood, not being able 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. Especially dangerous is bleeding provoked by damage to 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 in gastric ulcers is mainly a regular balanced diet, abstinence from smoking and alcohol. In addition, it is important to harden and periodically undergo treatment in sanatoriums.
