Perforated Duodenal Ulcer Symptoms and Treatment Options
A peptic ulcer is a sore that affects the lining of various tissues within the digestive system. One of the most common places that they occur is the duodenum, which is the upper region of the small intestine. Aptly named of course, an ulcer that is found in this region is referred to a duodenal ulcer. WebMD points out that while previously considered to be caused by stress and spicy foods, a bacterium known as H Pylori is most often to blame along with overuse of nonprescription pain relievers. Typical peptic ulcer symptoms include heartburn, abdominal discomfort and stomach bloating.
Most commonly, the symptoms of a peptic ulcer include heartburn like sensations, vomiting and nausea and abdominal pain. In the case of a gastric ulcer, which is one that is found in the stomach as opposed to the higher duodenum, symptoms may also include changes in stool color and indigestion like symptoms. These other location specific ulcers can also be caused by tumors of the cells in the stomach that produce acid, known as gastrinomas.
A perforated duodenal ulcer can occur when symptoms have gone unchecked and the condition has gone untreated. The condition is characterized by a hole in the wall of the duodenum (in the case of this particular type of peptic ulcer although the perforation occurs elsewhere for other forms). A perforated ulcer is an extremely serious medical condition. When the perforated ulcer appears, the hole that is created can allow for food and digestive liquids to leak out into the cavity of the abdomen, which can be a medical emergency. Among digestive disorders, a perforation that allows the seeping of intestinal matter into the sterile area outside can be one of the most serious, and also can be life threatening.
In most cases, the predominant symptoms of a perforated duodenal ulcer are intense pain and discomfort. The National Center for Biotechnology Information notes that this pain is very sudden and in the abdominal region in most cases. While the pain may first appear as precisely located, as symptoms persist, the pain seems to become more generalized across the torso area. Typically, those affected are in too much pain to move, walk or bend over. Obviously, this is the first clue that health care providers use in diagnosis.
X-Rays of the chest are often used to identify a perforated duodenal ulcer. These can be used to spot air that is trapped under the diaphragm. In addition, other diagnostic tools include temperature measurement as elevated fevers are common and blood pressure monitoring because a drop in blood pressure is not uncommon for the affected.
Treatment for a perforated duodenal ulcer is most often surgery. While surgery is not always or even frequently used in the management of peptic ulcers, it is often the selected course of treatment for just about all kinds once perforated. And therefore many times, a perforated gastric ulcer will be treated similarly to one that has appeared in the duodenum.
There are a few types of surgery considered as practical for the management of a perforated duodenal ulcer. Laparoscopic surgery is one of the most popular choices because it results more comfortable recovery time, with patients encountering less pain. Patch closures, installed via a procedure called conservative surgery, has been making a comeback among medical professionals because of the newly discovered information about the relationship of H. Pylori and its role in ulcer formation. Emergency surgery via immediate definitive means is less common procedure because it is riskier to the patient.
Aftercare following surgery for the perforation involves typically a combination of medicines used to reduce stomach acid which can contribute to discomfort. And, treatment of H. Pylori is also often considered for therapy following. Common medications used for this purpose include Bismuth, Amoxycillin and Tetracycline, as explained by The National Center for Biotechnology Information.
Lifestyle changes following perforation are also sometimes considered. While a special duodenal ulcer diet is no longer considered necessary by medical professionals, it may help to relieve some symptoms if food and beverages tended to be triggers for the peptic ulcer prior to perforation. And, quitting smoking, losing weight and reducing the use of anti-inflammatory drugs are all worthwhile lifestyle improvements to help healing and also to help reduce the chances of recurrent events.