Peptic Ulcer Surgery

Peptic ulcers have become more common with the changing lifestyle and dietary habits. These ulcers can develop in the lower part of the esophagus, stomach and duodenum. While, duodenal ulcers are the most common ones, esophageal ulcers are very rare. Peptic ulcers are commonly known as stomach ulcers and include gastric (ulcers in the stomach), duodenal and esophageal ulcers.

Peptic Ulcers - Symptoms and Causes

Peptic ulcer causes include regular smoking, excessive consumption of alcohol, stress, regular intake of certain drugs, helicobacter pylori infection, etc. The last two causes are more common, when compared to others. As far as the peptic ulcer disease symptoms are concerned, abdominal pain is experienced by almost all peptic ulcer patients. It is described as a sharp, gnawing pain that may develop on any location that lies between the belly button and the lower ribs. While gastric ulcer worsens the abdominal pain after consuming food, in case of duodenal ulcers, the same happens if the stomach is empty. Other peptic ulcer symptoms include, nausea or vomiting, bloating and fullness, etc. Severe symptoms include bloody or tarry stools, blood in the vomit, anemia, etc.

How are Peptic Ulcers Treated

The treatment for stomach ulcers may differ from one person to another. The course of treatment is decided by the doctor, after assessing the condition of the patient. Stomach ulcer diagnosis is usually done with the help of endoscopy. Even a helicobacter pylori test and barium enema may be conducted as part of the diagnosis. Mild to moderate ulcers are often treated with medication. Stomach ulcer medication include antacids, anti-inflammatory agents, etc. In case of bacterial infection, antibiotics are also prescribed. Even proton pump inhibitors and H2 blockers are used for this purpose. Switching to a stomach ulcer diet along with medication prove beneficial. In most cases, the ulcers heal with the above said medication and diet control. However, some people may not respond to medication, resulting in worsening of the condition. In some other cases, complications that necessitate peptic ulcer surgery may arise.

Peptic Ulcer Treatment - Surgery

Surgery is performed as the last option, when all other treatment methods fail or in emergency situations like bleeding or perforation of ulcers or obstruction. Surgery is performed either to remove the ulcers that do not heal or to reduce the acid in the stomach or as emergency peptic ulcer disease treatment measures. Basically, three forms of stomach ulcer surgery are performed for treating ulcers. This include vagotomy, antrectomy and pyloroplasty.

• VAGOTOMY is a surgical procedure, wherein the vagus nerve, which is responsible for transmission of messages from the brain to the stomach is severed. This surgery aims at reducing acid secretion in the stomach, but, various side effects are found to happen due to this procedure. The patient may experience constant and severe abdominal pain, vomiting, diarrhea, etc. In some people, vagotomy affects the stomach emptying too. In order to rectify these problems, a newer version of this surgery has been introduced and in this procedure, only those parts of the vagus nerve that regulate the acid secretion in the stomach are cut off. This procedure is found to produce minimal side effects, but, do not affect stomach emptying.
• Another peptic ulcer surgery is ANTRECTOMY, which removes the antrum that is the lower part of the stomach. Antrum is responsible for producing the hormone that induces the stomach to secrete digestive juices. By removing the antrum, the acid production in the stomach is reduced. Even the areas lying near the antrum are removed, so as to block the production of pepsin. In most cases, vagotomy is also performed, along with antrectomy.
• PYLOROPLASTY is a surgery that aims at enlarging the pylorus, the passage from the stomach to the duodenum, which is the first part of the small intestine. The pylorus that is widened through surgery enables the free flow of the contents of the stomach to the small intestine. In this case too, vagotomy is done.

Most of the above said surgeries are measures to control and treat stomach ulcers. Nowadays, most of the bleeding ulcers too are treated without surgery, as the treatment is provided through the endoscope. Bleeding ulcers may be cauterized or injected with medication (for healing) through the endoscope and thus peptic ulcer surgery is avoided. Even some of the perforations and obstructions can be rectified during the endoscopy. However, in some cases of peritonitis caused by perforated ulcer, surgery may be needed. So, to avoid complications and surgery, it is always better to diagnose and treat peptic ulcers at the earliest.