What Dies A Stomach Ulcer Feel Like – The gastrointestinal tract consists of the stomach, small intestine, and large intestine. A perforation, or hole, can develop in the wall of the gastrointestinal tract. This condition is called gastrointestinal perforation.
Gastrointestinal perforation is a painful condition that can lead to further health complications, so emergency surgery is often required.
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This article looks at the causes and symptoms of gastrointestinal perforation. It also covers complications, diagnosis, treatment, and when to see a doctor.
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A gastrointestinal perforation is a hole in the wall of the gastrointestinal tract. Other names for the condition include:
A hole in the large intestine, also known as the lower intestine, occurs less often. Researchers estimate that perforations of the lower intestine affect only 4 out of 100,000 people in the European population.
A perforation can force the contents of the stomach, small intestine or large intestine into the abdominal cavity. Bacteria will also be able to enter, which can lead to a condition called peritonitis, which is life-threatening and requires immediate treatment.
Peritonitis is inflammation of the peritoneum, the thin layer of tissue that lines the abdomen. If left untreated, peritonitis can lead to blood poisoning or sepsis. Sepsis can lead to organ failure.
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Therefore, people with gastrointestinal perforation need emergency medical attention. Intestinal perforations are the most common surgical emergency that occurs worldwide.
The main symptoms of gastrointestinal perforation are severe abdominal pain and tenderness. The abdomen may protrude or feel hard to the touch.
If the hole is in a person’s stomach or small intestine, the pain usually comes on suddenly, but if the hole is in the large intestine, the pain may come on gradually. Either way, once the pain starts, it’s likely to be constant.
The pain can get worse when the person moves or if there is pressure on the abdomen. However, it may decrease if they lie down.
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If people experience any of the symptoms of gastrointestinal perforation or peritonitis, they should see a doctor right away.
Most cases of gastrointestinal perforation require emergency treatment. The situation is especially urgent if a person has symptoms of sepsis, which is life-threatening.
This usually involves an exploratory laparotomy. The surgeon will open up the person’s abdomen and repair any holes in the gastrointestinal tract.
They will also remove any substance from the person’s stomach, small intestine, or large intestine that is now in the abdomen. This helps treat peritonitis and prevent sepsis.
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For some people, part of the intestine may need to be removed. As a result, a person may need a colostomy or ileostomy. These procedures allow the contents of the person’s intestines to be collected in a bag that attaches to the abdomen.
On rare occasions, a gastrointestinal perforation can heal on its own without the need for surgery. If this happens, a course of antibiotics may be the only treatment.
Possible complications of gastrointestinal perforation include internal bleeding and sepsis. Abdominal abscesses or permanent damage to the intestines can lead to gastrointestinal perforations. It could also die on part of the uterus.
Sometimes a person’s wound can fail after surgery or it can become infected. Certain lifestyle factors can increase this risk, including smoking, heavy alcohol consumption, and obesity.
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Gastrointestinal perforation is a serious condition with many different causes, some of which are more preventable than others.
If a person has any of the diseases that could lead to gastrointestinal perforation, he should follow the treatment plan recommended by his doctor. This reduces the risk of developing the condition.
The size of the hole and the length of time before treatment can determine how successfully surgeons can repair the piercing. This, in turn, will affect recovery.
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When I first saw Ms. Lee, 43, in the emergency room, she already had all the signs and symptoms of peptic ulcer disease (PUD), which is characterized by painful ulcers in the lining of the stomach or duodenum.
She suffered from severe abdominal pain and went into septic shock, a life-threatening condition that occurs when blood pressure drops to a dangerously low level after an infection.
Her upper abdomen was tight and hard, and tests indicated she had a perforated peptic ulcer or hole in her stomach.
This means that bacteria in the stomach and intestinal contents can make their way into the abdominal cavity and then enter the bloodstream, causing a serious infection that can be fatal if left untreated. She needed immediate surgery to save her life.
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Ms Lee is one of an ever-growing group of people with the same ‘chronic condition of urbanity’ – also known as a peptic ulcer, although hers is an extreme case as complications of bleeding and perforation are rare in cases of PUD.
Many of the patients I see have non-specific symptoms such as upper abdominal discomfort, bloating or belching. While it can happen to anyone, middle-aged people, like Ms. Lee, are more prone to peptic ulcers because they tend to neglect their health due to busy schedules.
Those experiencing recurring symptoms such as upper abdominal pain, bloating, and belching should have an endoscopic evaluation of their upper gastrointestinal tract to check for the presence of a bacteria called Helicobacter Pylori. This bacterium has been linked to PUD and stomach cancer. However, about 80% of infected people have no symptoms. Dr. Sujith Wijerathne
A clear example is Ms. Lee, a mother of three school-going children and a wife to a jet-setting husband.
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She adored her three children, she was especially attentive to how housework was done, and she took care of just about anything and everything under the sun. This, coupled with her anxious nature and perfectionist streak, made her very tense and paranoid. It is what some people call the “kancheong spider”.
There were clues to her condition as she had frequent stomach pains, including several episodes of severe abdominal discomfort. Each time, she self-medicated with pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, but the pain remained.
However, because she has a high threshold for pain and discomfort, she has chosen to put family first and her health last.
I see more working young adults, some with young children, putting work, family or family commitments before health. They skip meals or eat irregularly and don’t always eat enough.
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Some even hit the gym on an empty stomach to stay slim and look good. Others drink and smoke to cope with stress.
These aggravating sacrifices aren’t really worth it because PUD can creep in over time and, if left untreated, can lead to serious consequences.
The problem is often not treated with pain relievers such as NSAIDs. In fact, they can even make the pain worse. Acute pain always comes back because these drugs only treat the symptoms, not the cause.
Those experiencing recurring symptoms such as upper abdominal pain, bloating and belching should have an endoscopic evaluation of their upper gastrointestinal tract to check for the presence of a bacteria called Helicobacter Pylori. This bacterium has been linked to PUD and stomach cancer. However, about 80% of infected people have no symptoms.
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Miss Lee underwent a two hour lock picking operation during which I repaired a 1cm hole in her duodenum (the first part of the small intestine). There was a lot of pus and stomach contents coming out of the pulley.
After the surgery, she was placed on a liquid diet (she went back to a normal diet after three days) and a course of antibiotics to treat the bacteria responsible for PUD.
At follow-up, I explained to Ms. Lee that she would need to adjust her lifestyle because the condition could recur.
Stress is a frequently cited anecdotal cause of gastritis and ulcers. Stress from anxiety and related disorders can contribute to PUD. So I referred Ms. Lee to a psychologist at Alexandra Hospital.
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She has since adjusted her routine and is doing well. When I saw her at my clinic recently, she also seemed much happier.
My advice to PUD patients is to stop smoking and drinking and have regular meals as skipping meals can make the condition worse.
Choose balanced and healthy foods with less fat, acidity and spiciness. Avoid foods that can irritate the stomach, such as fried and spicy foods, caffeine, carbonated drinks, citrus juices, and alcohol.
Dr Sujith Wijerathne is a Consultant Associate at General Surgical Services Alexandra
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