Peptic Ulcers - Complications

Complications

Most people with severe ulcers experience significant pain and sleeplessness, which can have a dramatic and adverse impact on the quality of life.

Complications of Peptic Ulcers

Peptic ulcers from either H. pylori or NSAIDs can be very serious if they progress to the point of hemorrhage or perforation of the stomach or duodenum. Of the people who get ulcers, up to 15% will experience some degree of bleeding, which can be life threatening in some cases. Ulcers that form where the small intestine joins the stomach can swell and scar, resulting in a narrowing or closing of the intestinal opening. In such cases, a patient will vomit the entire contents of the stomach and emergency procedures are necessary.

Complications of peptic ulcers cause an estimated 6,500 deaths each year. These figures, however, do not reflect the high number of deaths associated with NSAID use. Ulcers caused by NSAIDs are more likely to bleed than those caused by the bacteria H. pylori. NSAID-related bleeding and stomach problems may be responsible for 107,000 hospital admissions and 16,500 deaths each year.

Because there are usually no GI symptoms from NSAIDs until bleeding begins, doctors cannot predict which patients taking these drugs will develop bleeding. The risk for a poor outcome is highest in people who have had long-term bleeding from NSAIDs, blood clotting disorders, low systolic blood pressure, mental instability, or the presence of another serious, unstable medical condition. Populations at greatest risk are elderly patients and those with other serious conditions, such as heart problems.

Stomach Cancer and Other Conditions Association with H. pylori

H. pylori is specifically strongly associated certain cancers. And, although evidence is inconsistent, some studies have also linked it to a number of non-gastrointestinal illnesses as well.

Stomach Cancers. Stomach cancer, also called gastric cancer, is the second most common cause of cancer worldwide. In developing countries where the rate of H. pylori is very high, the risk of stomach cancer is six times higher than in America. An important 2001 study strongly supported previous work that found a causal link between H. pylori infection and stomach cancer. In the study, uninfected people did not develop stomach cancer. However, the stomach cancer rates for H. pylori-associated conditions were: 4.7% for nonulcer dyspepsia, 3.4% for gastric ulcers, and 2.2% of stomach polyps. Experts now suggest that H. pylori may be as carcinogenic in the stomach as cigarette smoking is in the lungs.