According to statistics, 10% of people with peptic ulcers experience gastric bleeding, the intensity of which is influenced by the size of the affected vessels. This condition is characterized by suddenness, and experts do not note a connection with the severity of the disease. Bleeding from a stomach ulcer is often the first sign of a disease of this digestive organ. Sometimes it is the result ineffective treatment. In both cases, a bleeding stomach ulcer is dangerous condition requiring medical attention.

An ulcer in the stomach may be complicated by bleeding

Ulcerative bleeding can have both obvious and hidden forms. In the first situation, the cause of the condition is the damaged integrity of the artery, in the second - a small vessel. Venous involvement is much less common.

A bleeding ulcer due to stomach disease has following symptoms associated with the severity of blood loss:

• dizziness;
• muscle weakness;
• darkening of the eyes;
• hypotension;
• pale face;
• vomiting dark masses;
• blood clots in stool;
• oliguria.

When bleeding occurs, a change in heartbeat is observed

A stomach ulcer with duodenal bleeding is characterized by the appearance of tarry stools and the manifestation of an anemic state. At the same time painful sensations may stop due to increased leukocytosis. A little later, hyperthermia develops.

An open gastric ulcer poses a great danger to the elderly, who, due to hardening of the vessels, lack their ability to contract, which makes hemostasis impossible.

In the presence of callous disease, when the ulcer has opened, the bleeding does not stop on its own, since the affected mucous membranes containing scar tissue do not have the ability to regenerate. In such cases, blood is released from the ulcer until surgery is performed.

Against the background of bleeding, an increase in body temperature occurs

The acute form of peptic ulcer is characterized by intermittent bleeding, but even in this case, a referral to a specialist is required, since in case of serious blood loss only resuscitation measures can save the patient.

The danger of an open ulcer

In the case when a stomach ulcer opens, acute pain begins after eating, which leads to the person completely refusing to eat. The result is serious exhaustion, blood loss in which leads to severe weakness and dystrophy.

In a situation where a person has an ulcer and profuse bleeding begins, blood loss occurs very rapidly. In this case, symptoms develop:

• hypovolemic shock;
• swelling of the meninges;
• acute dysfunction of the liver and heart;
• intoxication.

The opening of bleeding may be accompanied by symptoms of cerebral edema

In this condition, when the functions of many organs are impaired, the risk of death is quite high.

Therapy for ulcer bleeding

Treatment of a bleeding stomach ulcer is usually carried out conservatively. Even with independent process hemostasis, professional help should not be neglected, since in the absence of therapy, relapses almost always occur. A bleeding stomach ulcer requires hospitalization, which includes bed rest and a ban on eating and drinking water.

First of all, the attending physician prescribes the patient the drug Vikasol in the form of injections, a course of drips with epsilon-aminocaproic acid. This therapy is aimed at stopping bleeding.

Inpatient treatment is necessary in case of bleeding

If the ulcer is accompanied by massive blood loss, a transfusion with red blood cells is performed. When the patient’s condition has stabilized, the patient is monitored to determine signs of ongoing bleeding.

Before treating a bleeding ulcer, its location is determined. If the lower part of the esophagus is affected, a special catheter with a balloon is inserted into it through the patient’s mouth. The balloon then begins to inflate to create pressure at the site of the damaged vessel. There is another healing method, which consists in acting on damaged tissue by special means.

Helps cure bleeding endoscopic method, in which a vessel is cauterized using an electric current. Also injected into a vein medicine, which enhances blood clotting.

The operation is necessary in particularly difficult cases

What to do if none of the above methods gave the desired effect? In this situation, specialists resort to surgical intervention.

Diet for open ulcers

One of the components effective therapy is a diet that requires the strictest restrictions. A diet for a bleeding stomach ulcer involves an absolute refusal of liquid and food on the first day. At extreme thirst the patient is given water (several teaspoons) or ice for resorption. Subsequently, meals include raw eggs, milk, jelly, liquid jelly.

Experts have come to the conclusion that if there is an open process with bleeding, prolonged hunger is contraindicated, since the secreted gastric juice worsens the condition of the mucous membrane. The body must receive the required number of calories, mineral salts, vitamins, proteins. In this case, the food should be liquid.

Therapy for peptic ulcer disease includes diet

What diet should you follow in the following days? A little later, you can add a soufflé of cottage cheese, meat, vegetable purees, crushed cereals, steamed cutlets, and butter to your diet. When a patient has an ulcer and bleeding begins, under complete ban includes all spicy foods, alcoholic drinks, smoked foods, and fried foods.

First aid

If a person shows signs of internal bleeding, help is necessary. First of all, you need to call a medical team. The patient should lie on his back and try not to move. If possible, experts advise applying ice to the abdomen to reduce the effects of blood loss. During this time, it is forbidden to drink or eat food. medicines, rinse the stomach.

If possible, the patient should be kept conscious; for this purpose, ammonia. It is also not recommended to get to the hospital on your own; this can lead to increased bleeding.

If bleeding occurs, you should call ambulance and put it on your stomach cold compress or ice

It is forbidden to treat an open ulcer at home; this can be extremely dangerous. It is important to know that even if you feel better and stop bleeding, the disease should be treated under the supervision of doctors. It is necessary to call emergency help if bloody vomiting, stool with bloody components, acute pain in the stomach, development of shortness of breath, tachycardia, sharp decline pressure.

About the symptoms and treatment of stomach ulcers we'll talk in the video:

In some patients with erosive lesions of the stomach, ulcerative bleeding is possible, the severity of which depends on how large the vessel is damaged. It may open unexpectedly, regardless of the size and location of the defect.

Sometimes vessel damage is detected for the first time, and in some cases the cause is an ineffectively treated bleeding ulcer.

Hemorrhage from an ulcer is always life-threatening, so medical assistance is necessary to eliminate it. Even if the bleeding stops spontaneously, it may resume after a certain period of time.

Symptoms of open bleeding

With hidden hemorrhage, signs are almost completely absent. The patient’s well-being practically does not suffer; there may be a slight decrease in performance and weakness.

At prolonged bleeding symptoms may occur oxygen starvation tissues: dizziness, pallor, headache, shortness of breath, palpitations. There may be a decrease in blood pressure when sitting or standing.

To ensure that the disease is detected in a timely manner and does not progress to a more severe stage, emetics and feces, as well as gastric juice to carry out the Gregersen reaction, which makes it possible to detect traces of blood in samples.

Average blood loss

In case of blood loss average size(from 16 to 20%) the patient’s extremities become cold, the face becomes pale, diuresis decreases, and the heart rate increases even at rest.

In addition, the following symptoms are noted:

• tremor and dizziness;
• blood in saliva after reflux or vomiting;
• increased sweating;
• hypothermia;
• photophobia;
• signs of dehydration.

Obvious bleeding from a stomach ulcer is characterized by pronounced signs. Such hemorrhage can be recognized by hematomesis (vomiting with blood) and melena (black stool).

Massive bleeding

With large blood loss (from 21 to 30%), the symptoms of a bleeding stomach ulcer can be determined by a strong heartbeat, shortness of breath and sharp fall pressure. In this case, the body is not able to independently replenish blood loss, but the consequences of severe hemorrhagic shock are still reversible. Patients with such signs of ulcer bleeding usually become unhealthy agitated, irritable and restless.

Bleeding ulcers have a very high mortality rate, up to half of the cases. Symptoms of massive bleeding (more than 30%) are characterized by severe pallor skin, unconsciousness, thready pulse and increased sweating. Pressure is most often impossible to determine. If the patient is not provided with emergency medical care, the patient’s condition worsens and becomes irreversible.

Causes of bleeding from ulcers

There are many reasons for bleeding from a stomach ulcer.

The following negative factors are of greatest importance:

• Associated infection.
• Mechanical damage to the surface of the ulcer, for example, during FGDS.
• Excessive physical activity during an acute process.
• Inadequate healing effect therapy, incorrectly chosen tactics.
• Taking illicit foods, alcohol or medications such as NSAIDs.
• Failure to provide first aid during an exacerbation.

It is important to adhere to a properly selected diet, since due to its absence or errors in nutrition, hemorrhage can also occur.

Danger of ulcers with hemorrhage

Any hemorrhage, massive or mild, is extremely dangerous for the patient’s life. Profuse bleeding can cause the death of a patient in a few hours, and an ulcer that bleeds slightly for a long time, imperceptibly leads to the patient’s decline.

Hemorrhage is a typical complication of gastric ulcer. In this case, the erased form of the disease passes into active stage. The patient suffers severe pain after eating, therefore, begins to avoid consuming any food, which leads to exhaustion of the body. In addition, blood loss further weakens the patient, causing weight loss, feeling unwell and weakness.

With an ulcer with profuse bleeding, damage to large vessels occurs, so the patient may lose most of the blood in the first half of an hour.

This condition can cause multiple organ failure syndrome:

• swelling of the meninges;
• hypovolemic shock;
• pressure drop;
• heart and liver failure;
• intoxication with decomposed blood.

A bleeding stomach ulcer can cause a condition that is practically incompatible with life. In this case, there is a high probability of death, so if signs of hemorrhage appear, you should immediately seek help. medical assistance.

Medical nutrition

The most important component of effective therapy is diet for bleeding stomach ulcers. It involves abstaining from eating and drinking for the first 2-3 days. You can periodically quench your thirst slightly with a piece of ice or a spoon of water. After this period of time, the patient is allowed to give some liquid food.

Nutrition for stomach ulcers with bleeding should include:

• raw and soft-boiled eggs;
• milk and cream;
• oatmeal or milk jelly;
• not too thick jelly;
• sweet diluted juices.

Proper nutrition does not encourage fasting for more than 3 days. Even if the ulcer is acute and bleeding, it is necessary to ensure that the patient receives enough calories, as well as proteins, fats, carbohydrates, minerals and vitamins. In addition, mechanical, chemical and thermal protection of the mucous membrane is necessary, so the consistency of the food should be semi-liquid, the taste neutral, and the temperature warm.

Gradually the diet expands and includes:

• mashed potatoes and carrots;
• meat and curd soufflés;
• slimy pureed soups;
• steamed meat and fish meatballs;
• boiled mashed porridge;
• butter;
• cocoa and tea with milk;
• rosehip decoction and compote.

With this form of the disease, alcoholic drinks, coffee, spicy and sour foods are strictly excluded. Dietary ration should be discussed and agreed upon with a specialist who is aware of all the intricacies of therapy. He will recommend the optimal set of products that will contribute to effective treatment.

If drug treatment and diet do not help or are inappropriate, surgical intervention is necessary. Resection or suturing of the stomach, treatment of which in this case occurs only under general anesthesia, is carried out using endoscopic equipment.

Sometimes there is a need for open surgery with longitudinal section abdominal wall. After surgical intervention The patient is prescribed strict bed rest, massive supportive therapy and parenteral nutrition.

Treatment of ulcers with hemorrhage

The assumption that a patient has developed a bleeding stomach ulcer excludes examination in a clinic, since it is a reason for urgent hospitalization in surgical hospital. In this case, there is a huge risk of increased blood loss, so the patient must stay in bed and refrain from eating in the first days (hereinafter referred to as diet).

Compensation for blood loss and the prescription of drugs to help stop hemorrhage are indicated:

• blood and plasma products;
• aminocaproic acid;
• vikasol;
• calcium chloride;
• atropine.

Conservative treatment is indicated for older people with general diseases. It is also carried out for mild to moderate hemorrhages.

There are methods for endoscopic stopping of hemorrhage:

• Mechanical - applying a clip, alloying, and also the use of gluing.
• Injection - administration of sclerosants, adrenaline, novocaine, saline solution.
• Thermal – laser coagulation, thermocoagulation, radiofrequency coagulation and thermal probe.

Indication for surgical treatment is an open defect with massive blood loss, regardless of the type of ulcer, recurrent and continuous with usual treatment bleeding, addition of other complications of the disease. The choice of surgery is determined by the location of the defect and the severity of the pathology. The doctor may recommend excision or suturing of the vessels at the bottom of the ulceration.

With hemorrhage consists of careful attention to your health and contact a specialist if you experience the slightest symptoms stomach lesions. And also in medical examination on the recommendation of a doctor and examination with the appointment of adequate treatment.

According to statistics, approximately 5-15% of patients with a similar disease may experience bleeding. As a rule, the intensity depends on the size of the affected vessel, and the patient’s condition depends on the correct medical care provided. The consequences of such a complication can be the most terrifying, so it is important to know what to do if bleeding suddenly occurs due to a stomach ulcer.

Usually this process occurs unexpectedly. In some cases, the cause is a violation of the integrity of a vein or artery, and sometimes it is the consequences of a long-discovered but unresolved problem in a timely manner.

If a bleeding stomach ulcer occurs, the symptoms can be quite vivid, especially in the case of obvious bleeding. If we're talking about about a latent state, then the signs may be blurred (that is, a critical state is not observed).
So what are the most frequent symptoms any bleeding that occurred?

• bloody vomiting;
• dark-colored stool;
• sensation of acute blood loss, pain.

Vomiting blood is usually characteristic of a stomach ulcer, and extremely rarely - duodenum. It may be noted that the color of the vomit may resemble coffee grounds due to the fact that hemoglobin is converted into hematin.

Vomiting blood is characteristic of the immediate bleeding, but may occur some time after it. If the process in the stomach and duodenum proceeds too quickly, scarlet color may predominate in the vomit.

Dark-colored stool (melena) is another sign that a gastric ulcer is bleeding. This symptom occurs when blood loss is more than 80-200 ml.
Melena is characterized by stool with a mushy, black consistency. Typically, such changes are associated with the fact that the hemoglobin of the spilled blood has a dark tint and a shiny surface. Typically, this symptom is characteristic of massive bleeding from the stomach. It should also be noted that there may be reflux of blood into the duodenum. In some cases, scarlet-colored stools are observed due to the fact that the bleeding becomes very intense.

With acute blood loss, a number of symptoms occur that can lead to hemorrhagic shock. There is also pallor of the skin, shortness of breath, muffled heart sounds, weak pulse, low blood pressure. Dry wheezing in the chest, cough, and the development of pulmonary edema are also possible, which is also characteristic of bleeding from stomach and duodenal ulcers.

At hidden forms symptoms may be minor and therefore not noticed by the patient. Bleeding is usually small and regularly repeated, but the extent of the problem becomes noticeable only when chronic form turns into acute.

Why is it dangerous?

Like any open bleeding, this complication It is dangerous because the body loses blood without being able to replenish it. For losses over permissible norm the patient may die, so it is necessary to provide assistance to the patient and prescribe treatment in as soon as possible. The patient’s further life activity and his general condition depend on the correctness of the doctors’ actions aimed at eliminating the symptoms of bleeding due to gastric and duodenal ulcers.

First aid

If dangerous signs appear, it is necessary to take measures to maximize quick fix bleeding to prevent sad consequences. Since the main function of recovery satisfactory condition Doctors take it upon themselves to help the patient only temporarily. To do this, it is important to do the following:

• provide the patient with complete rest;
• It is advisable to place the patient on a flat surface;
• Do not feed or give liquid under any circumstances;
• for symptoms of bleeding, it is recommended to apply cold to the abdominal area;
• Do not rinse the stomach or give any medications;
• try to keep the patient conscious until the ambulance arrives (to do this, moisten a cotton swab with ammonia).

Video “Symptoms of gastrointestinal bleeding”

How to treat

Any obvious bleeding from a stomach or duodenal ulcer should be a reason to consult a doctor, so the main treatment takes place in the hospital. Immediately after hospitalization, the patient is prescribed hemostatic drugs, which can help reduce the risk of blood loss. As a rule, for treatment, injections of Vikasol, a chloride solution are administered, and droppers are made based on epsilon-aminocaproic acid.

If blood loss from a stomach and duodenal ulcer is severe enough, the patient may receive a blood transfusion. After the required volume has been restored, therapy aimed at eliminating further symptoms and the risk of subsequent bleeding. Very often, the method of treating an ulcer depends on where exactly it is located.

If the erosion is in the lower esophagus, a balloon catheter is inserted there. It swells, creating pressure on the area of ​​the damaged vessel. It is also possible that dangerous outbreak uses a special chemical to prevent inflammation and fibrosis.

There are often cases when endoscopy is used to treat gastric and duodenal ulcers. This method consists of cauterizing a vessel that is damaged using electric current. A substance is also injected into the vein to clot the blood, preventing further bleeding.

If all methods have been tried, but symptoms persist, doctors resort to surgical intervention. This treatment consists of resection of the stomach - partial or complete, in order to prevent subsequent bleeding. The operation is performed in a hospital, after which the patient must follow the regimen prescribed by doctors.

Nutrition of the patient

To avoid relapses and to restore the mucous membrane of the stomach and duodenum, it is important for the patient to adhere to a diet. Immediately after acute bleeding, you must refuse food. Quench your thirst with small pieces of ice or a few spoons of water. Two days after intensive treatment, the patient can be given no large number liquid food.

When the “crisis” has passed, the patient returns to good nutrition, however, he is prescribed the following products:

• soft-boiled eggs;
• jelly;
• steamed cutlets or fish;
• slimy soups;
• porridge;
• mashed potatoes;
• unsweetened tea;
• lean white meat;
• meatballs;
• dried fruit compotes.

When treating a stomach ulcer, the following are completely excluded from the patient’s diet:

• spicy and fatty foods;
• pickles, smoked meats;
• sour juices, fruits;
• legumes;
• vegetables with an irritating effect (radish, radish);
• fatty sweets, cakes, pastries, baked goods;
• alcohol.

To ensure that a bleeding ulcer does not cause many problems in the patient’s life, it is necessary to consult a doctor in a timely manner, and then the treatment will be successful and the consequences will be minimal.

Video “Stomach bleeding with ulcers”

What to do if gastrointestinal tract Has there been heavy bleeding? Find out how to cope with the disease in the video.

If a bleeding ulcer of the stomach or duodenum has opened, then immediate medical attention to the patient is required. This complication of peptic ulcer disease manifests itself in pronounced pain syndrome, dark-colored vomit and tarry feces. A complicated form of bleeding ulcer requires emergency surgery on the stomach. With minor blood loss, it is possible to manage with conservative therapeutic measures.

Why does blood appear?

Acute or chronic peptic ulcer stomach (GSD), complicated infectious pathologies often leads to bleeding varying degrees.

Other negative factors can also affect the appearance of a bleeding ulcer:

• mechanical trauma to the upper part of the ulcerated mucous membrane;
• reinforced physical activity at acute course illness;
• wrong conservative treatment ulcers;
• use of unauthorized food products, alcoholic drinks and sodas;
• taking certain medications;
• untimely provision of first aid in case of acute form peptic ulcer.

Characteristic symptoms

Vomit contains blood.

A bleeding gastric ulcer with hidden small hemorrhage may not manifest itself in any way. clear signs. The patient's condition remains the same, with only slight weakness and decreased ability to work. If significant gastric bleeding occurs, then symptoms of tissue oxygen starvation occur. The manifestation of a bleeding peptic ulcer is accompanied by dizziness, pale skin, shortness of breath, and rapid heartbeat. The table shows signs characteristic of different degrees of the disease.

Type of bleeding	Amount of blood loss, %	Symptoms
Average	16-20	Cold hands and feet
		Pale face
		Decreased number of urinations
		Rapid heartbeat even at rest
		Tremor of limbs and dizziness
		Bloody impurities in saliva after vomiting
		Increased sweat production
		Fear of light
		Dehydration
		Black stool
Big	21-30	Strong heartbeat
		Shortness of breath even without exertion
		A sharp drop in blood pressure
		Pathological agitation and increased irritability
Massive	More than 30	Pallor of the epidermis
		Loss of consciousness
		Thready pulse and excessive sweating
		Inability to determine blood pressure
		Development of hemorrhagic shock

How to determine: diagnostics

The study will determine the condition of the gastrointestinal tract with high accuracy.

If it occurs internal bleeding with a stomach ulcer, a comprehensive diagnostic examination. If there is a violation, immediately contact a gastroenterologist, who will study the anamnesis and diagnose accurate diagnosis. Upon examination, pathological pallor of the skin and a decrease in its tension will be noticeable. The patient's blood tests reveal low hemoglobin and reduced quantity red blood cells An open blood ulcer requires the following diagnostic procedures:

• Esophagogastroduodenoscopy. It is always performed when there is suspicion of ulcer bleeding. The procedure is not performed only on patients in agony. During the procedure, the causes of the bleeding ulcer are visualized.
• CT and MRI.
• Ultrasound diagnostics.

What to do and how to treat?

Drug treatment

Treatment requires integrated approach under the supervision of a gastroenterologist.

Bleeding ulcers can be treated with pharmaceutical drugs which help stop bleeding. Doctors prescribe the following medications to patients:

• Aminocaproic acid. Helps reduce the intensity of resorption of formed blood clots. The medicine is injected into the vein using a dropper.
• "Dicynon." It is prescribed to activate the formation of thromboplastin in the bloodstream, which promotes blood clotting.
• Calcium chloride or gluconate. Calcium ions combine with oxygen to influence the formation blood clot. After using the drug, permeability decreases vascular walls, after which they contract better and gastric ulcer bleeding stops.
• Vitamin K. Improves the synthesis of components of the blood coagulation system, but the effect does not occur immediately, but a day after administration.
• Fresh frozen plasma. A natural complex remedy that includes a complex of coagulation factors. It is injected dropwise into the vein to stop bleeding.
• "Cryoprecipitate." Contains plasma and other necessary clotting substances that are effective for bleeding stomach ulcers.

Any medicine at peptic ulcer disease should be prescribed by a doctor, since self-administration of pharmaceuticals can lead to increased bleeding and irreparable consequences.

Diet food

Boiled or steamed food is allowed.

To prevent internal bleeding from peptic ulcers from occurring and becoming complicated, it is necessary to follow a special diet. In the first days after an exacerbation, the patient is advised to fast and not eat anything. You can quench your thirst by eating a small piece of ice or drinking 2-3 tablespoons of water. 2 days after intensive care You can take some food in liquid form. For a bleeding ulcer, food includes the following foods:

• soft-boiled eggs;
• jelly;
• steamed cutlets;
• soups with a slimy consistency;
• porridge;
• mashed potatoes;
• tea without sugar;
• lean white meat;
• dried fruit compote.

For peptic ulcers accompanied by bleeding, exclude the following foods from the diet:

• spicy, salty and fatty foods;
• smoked meats;
• sour fruits;
• legumes;
• vegetables that are irritating to the gastric mucosa;
• fatty cream products;
• alcoholic drinks.

Published: May 27, 2015 at 5:36 pm

According to statistics, 5-15% of patients suffering from erosion of the gastric mucosa sooner or later develop ulcerative bleeding, the intensity of which directly depends on the size of the damaged vessel. It occurs suddenly, regardless of the degree and severity of the pathology. In some cases, a violation of the integrity of a vein or artery becomes the first sign of a peptic ulcer, in others it is a consequence of a problem that has long been discovered, but ineffectively solved. In any case, bleeding from an ulcer is very dangerous, so professional help from doctors is always required to eliminate it. Even if the blood stops flowing for some period, then after a few hours or, at most, a day, the process resumes again.

Ulcerative gastric bleeding is divided into hidden and obvious. In the first case, the integrity of a small vessel is damaged, in the second - major artery. And most often it is the eroded artery that causes internal bleeding in a stomach ulcer. Much less often, the pathology is venous in nature.

Bleeding from a gastric ulcer cannot be predicted based on the localization of erosive formations, as well as the gender or age of the patient. That is, it cannot be said that if the erosive focus is located in a certain place, then internal bleeding will definitely occur with an ulcer. Likewise, it makes no difference whether the patient is a man or a woman, or how old he is. However, older people with an existing complication are included in special group risk, since independent hemostasis is practically impossible for them, even for short periods of time. This is primarily due to the sclerosis of blood vessels and their loss natural ability to spasms. And incessant gastric ulcer bleeding poses a serious threat to human life.

If there is a chronic callous peptic ulcer, the bleeding will also not stop on its own even after short time, since scar formation forms at the site of damage to the mucous membrane connective tissue, which lacks the ability to regenerate. For this reason open wounds remain gaping until appropriate treatment is carried out conservative therapy or surgical treatment. But in case of acute gastric ulcer, the bleeding is usually intermittent, but this does not mean that you can hesitate to see a doctor. Failure to provide medical care in a timely manner results in significant loss of life. required liquid, and the first degree of severity of the patient’s condition very quickly develops into the fourth, when a person can be saved only through resuscitation measures, and even then not always. In addition, even a small and intermittent bleeding gastric ulcer, if repeated for a long time, provokes the development iron deficiency anemia, aggravating the problem and making it difficult general treatment patient.

Why is a peptic ulcer complicated by bleeding dangerous?

In fact, bleeding itself is a complication of peptic ulcer disease. In other words, a sluggish or so-called erased pathology turns into an aggressive form. A person experiences sharp pain after eating, which is why he simply begins to be afraid to take any food. As a result, exhaustion of the body develops, which, combined with blood loss, leads to weakness, lethargy and weight loss.

The most dangerous is gastric ulcer, complicated by profuse bleeding. In this case, they are affected large vessels, so within literally half an hour a person loses a large amount of blood. And this is already threatening:

• hypovolemic shock;
• orthostatic hypotension;
• heart failure;
• acute liver failure;
• cerebral edema;
• intoxication by decomposition products (hydrolysis) of blood entering the intestines.

Thus, a stomach ulcer, complicated by bleeding, can cause MODS (multiple organ failure syndrome), in which the body is practically unable to maintain its vital functions. In these cases the percentage is very high deaths Therefore, if you identify symptoms indicating an erosive violation of the integrity of a vein or artery in the stomach, you must seek help from a gastroenterologist as soon as possible.

How to recognize the symptoms of a bleeding ulcer?

With hidden (small) ulcer bleeding, symptoms are almost always absent. General condition the patient is satisfactory and the person does not feel any changes in well-being. However, prolonged effusion may cause slight dizziness, fatigue and pallor. Particular attention should be paid to changes in blood pressure, which decreases when a person stands or sits. In order to detect the problem in time and prevent it from developing into a more severe overt form, it is necessary to periodically undergo tests for the Gregersen laboratory test, which allows you to detect even very small particles of blood in gastric juice, feces, urine and vomit.

For obvious bleeding with a stomach ulcer, the symptoms are always pronounced. They are recognized by such signs as bloody vomiting (hematomesis) and tarry stool (melena).

With average blood loss (15-25%), the patient’s face turns pale, the limbs become cold, the volume of urine excreted decreases, and the heartbeat increases significantly even when the person does not experience any physical exertion.

Symptoms of a bleeding ulcer with significant blood loss (25-45%) are recognized by a sharp drop in blood pressure, the appearance of tachycardia and shortness of breath. The body cannot independently replenish the lost blood volume, but in this state we can still talk about the reversibility of severe decompensated hemorrhagic shock. People with similar signs patients with ulcerative bleeding, as a rule, do not lose consciousness, but, on the contrary, become restless and irritable, and are in a state of very noticeable unhealthy agitation.

If, with a bleeding stomach ulcer, the loss is 50% or more, the symptoms are expressed in the absence of consciousness, sudden paleness of the skin, the appearance of sticky and cold sweat, and a thread-like pulse. In most cases blood pressure impossible to measure. If in this condition the patient does not receive urgent medical care, then the pathology becomes irreversible and the person dies.

How is ulcer bleeding treated?

Treatment of bleeding gastric ulcers in 80% of cases occurs conservative methods without performing an operation. There are frequent cases of spontaneous hemostasis, but this is no reason to ignore contacting a doctor, since without professional help there is an almost 100 percent chance of a quick relapse. Only literate therapeutic actions can lead to lasting positive results.

In all cases, treatment of gastric ulcers with bleeding includes hospitalization of the patient, strict instructions bed rest, prohibition on taking food and water. On initial stage As a rule, injections of Vikasol, a chloride solution are administered, and droppers of epsilon-aminocaproic acid are also placed. All these actions are aimed at achieving a hemostatic effect.

In case of intense bleeding of a gastric ulcer, treatment involves transfusion of red blood cells, which avoids an excessive increase in the volume of blood volume. After volume restoration, the patient is closely monitored to identify symptoms indicating continued bleeding.

In many ways, the method of treating a bleeding ulcer depends on its location. If this lower section esophagus, a balloon catheter is inserted into it through the mouth. After this, the balloon is inflated to create a certain pressure in the area of ​​the damaged vessel. Another technique involves applying a special treatment to the problem area. chemical substance, causing fibrosis and inflammation of the vein.

IN modern medicine Endoscopic therapy is widely used. And treatment of bleeding from a stomach ulcer is no exception. The damaged vessel is cauterized by applying an electric current, or a substance that causes blood clotting is injected into the vein. In the event that all of the above measures do not give the expected effect, a bleeding stomach ulcer is treated with surgery.

Diet and nutrition for bleeding stomach ulcers

One of the most important factors successful treatment is proper nutrition with a bleeding stomach ulcer. During the first 2-3 days there is complete abstinence from drinking and food. Only thirst can be quenched with a few teaspoons of water or a small piece of ice, which must be dissolved in the mouth. After 48 hours, the patient is given a small amount of liquid food. So, a diet for ulcer bleeding may include:

• milk;
• cream;
• raw or soft-boiled eggs, in which the protein is in a semi-liquid state;
• thin jelly;
• jelly;
• juices, etc.

IN lately Many experts have completely abandoned long-term fasting. In their opinion, if a stomach ulcer is complicated by bleeding, the diet should ensure that the body receives a sufficient amount of calories that support vital functions, as well as fats, proteins, carbohydrates, vitamins and salts. The only condition is that the food must be liquid or pureed. In addition to the above products, this diet for bleeding stomach ulcers includes:

• curd or meat soufflés;
• pureed vegetable soups, cooked in a mucous decoction;
• mashed porridge;
• fish or meat balls;
• steamed cutlets;
• mashed potatoes;
• dumplings;
• butter;
• tea and cocoa;
• fruit compotes;
• sugar;
• rosehip decoction, etc.

Naturally excluded from the diet alcoholic drinks and spicy irritating foods. Thus, a diet for stomach ulcers and bleeding is not a strict ban on all foods without exception. The main thing is to coordinate the patient’s diet with the attending physician, who will recommend certain edible products that do not harm the body and do not interfere with effective treatment.

What to do if a stomach ulcer is bleeding?

For ulcer bleeding urgent Care is the main condition not only for maintaining health, but also life. First of all, the patient must be completely immobilized, that is, placed in a horizontal position on his back, and an ambulance must be immediately called. Within first aid It is recommended to apply some kind of ice container to your stomach. You can also give a small piece of ice to swallow, as the cold will stop the bleeding. It is strictly forbidden to take water or food or move independently. Transportation of a person with this complication is carried out only on a stretcher.

In a hospital setting, complex therapeutic measures are carried out, including endoscopic hemostasis for ulcerative bleeding, which can be:

• medicinal (blocking the focus with vasoconstrictor, hemostatic, coagulating drugs, oil, sclerosing and physiological solutions);
• physical (thermal, electrical or laser).

Surgery for bleeding gastric ulcers is performed as a last resort, when all possibilities of therapy and endoscopy have been exhausted, but the result has not been achieved.

Modern treatment completely eliminates this dangerous pathology, virtually eliminating relapse or any complications. The consequences of bleeding gastric ulcers can be irreversible only in case of delay in seeking medical help or due to underestimation of the severity of the patient's condition.