What is a stress ulcer?

A stress ulcer is a swollen and irritated area in the duodenum or stomach that has been eaten away by gastric acids. It is not caused by the kind of stress that occurs in everyday life, but by the stress of serious illness or trauma. Cushing's ulcer and Curling ulcer are two types of stress ulcers. Both can be asymptomatic if the ulcer is small, but stress ulcers can be quite serious if they get larger or are left untreated.

Cushing's ulcer is often the result of some kind of serious injury to the brain and is caused by pressure between the skull. It can also occur as a complication of surgery or stroke. This type of stress ulcer can affect the esophagus, stomach, and duodenum. Cushing's ulcer often causes no symptoms, although bleeding or perforation of the stomach or intestines may occur infrequently.

Curling ulcer occurs only in the duodenum and is a type of acute peptic ulcer. It is usually a side effect of severe burns or other traumatic injuries to the body. The shock of these medical conditions decreases the blood supply to the gastric mucosa, leading to the formation of this form of stress ulcer. Symptoms include loss of appetite, fatigue, nausea, or persistent pain below the breastbone that is worse at night. In the most severe cases, the ulcer patient may vomit blood.

Hospital patients recovering from serious illness are at risk for stress ulcers. Those who are in hospital for a long period of time or particularly in intensive care may be even more prone to them. They can get any type of stress ulcer and are often given preventative medications while hospitalized.

Once an ulcer is diagnosed, a doctor specializing in gastroenterology may be referred to take care of stress ulcer treatment. Medications are usually prescribed to suppress acid production, and this is often all that is needed to relieve ulcer symptoms. Antibiotics or antibacterial medications may also be prescribed, along with a special low-acid diet. If left untreated, an ulcer can penetrate blood vessels, causing blood to leak into the digestive tract.

Surgery may be required for larger ulcers. A vagotomy is one of the most common surgeries used to treat severe ulcers. The vagus nerve is cut to prevent the brain from sending messages to the stomach. Another procedure, an antrectomy, can be done to treat the worst stress ulcers. This involves removing a portion of the lower stomach that produces the hormone that causes the stomach to produce digestive juices.

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