Thumbnail image of: Stomach and Duodenal Ulcer: Illustration

Perforated Ulcer

What is a perforated ulcer?

A perforated ulcer is a raw place or sore in the lining of the stomach or upper intestine that makes a hole through the tissue. Stomach acids that digest food, bacteria, and food may then move through the hole and into your belly. Blood vessels or other organs, such as your pancreas and liver, may be damaged. This could cause a life-threatening bleeding or infection.

What is the cause?

The lining of the stomach and intestine normally keeps these organs from being hurt by stomach acid and digestive juices. If this protective layer breaks down, stomach acids can damage the walls of your stomach or intestine and cause an ulcer. If the ulcer gets too big or too deep, it can make a hole in your stomach or intestine.

You may get an ulcer when:

  • You have bacteria called Helicobacter pylori (H. pylori). These bacteria are the most common cause of ulcers. When H. pylori bacteria infect the stomach or intestine, the infection can weaken the lining of these organs.
  • You regularly take nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin, ibuprofen, naproxen, or ketoprofen. These medicines irritate the lining of the stomach and upper intestine, making it easier for stomach acid to damage the lining.
  • Your stomach makes too much stomach acid.

What are the symptoms?

When an ulcer makes a hole in the wall of your stomach or intestine, the symptoms may come on very fast. Symptoms may include:

  • Sudden sharp belly pain that doesn’t go away
  • Vomit that is bloody or looks like coffee grounds
  • Weakness or feeling like you’re going to faint
  • Fever and chills

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

  • X-rays of your chest and belly
  • Blood tests
  • Urine tests
  • CT scan, which uses X-rays and a computer to show detailed pictures of the intestines
  • Endoscopy, which uses a slim, flexible, lighted tube passed through your mouth to look at your esophagus and stomach.

How is it treated?

You will stay at the hospital for treatment. You may be given emergency treatment for blood loss, and you will likely have surgery to close the hole.

A tube may be passed through your nose or mouth and down into your stomach. The tube may be used to give fluids or medicine or to help relieve pressure from air or fluids in your stomach and intestine.

Other treatments usually include:

  • Medicine to lower the acid in your stomach
  • Medicine that coats and protects the lining in your stomach and intestine from acid
  • Antibiotics to prevent or treat infection
  • Pain medicine

When you are able to eat again, you will have a liquid diet for 24 hours or longer. Then you will eat only soft foods until your stomach has healed enough for you to go back to your regular diet.

How can I take care of myself?

  • Take your medicines exactly as prescribed.
  • Follow the diet prescribed by your healthcare provider. Avoid any food or drink that seems to bother your stomach, such as spicy foods; acidic foods like oranges or tomatoes; and tea, coffee, and cola.
  • Avoid alcohol, cigarettes, and chewing tobacco because they slow the healing of ulcers. If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
  • Ask your provider if you should avoid NSAIDs and use acetaminophen for pain relief instead. If your provider says it’s OK to take these drugs, try taking them with food to help avoid irritating your stomach.
  • A healthy lifestyle may also help:
    • Try to get at least 7 to 9 hours of sleep each night.
    • Stay fit with the right kind of exercise for you.
    • Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example, take up a hobby, listen to music, watch movies, or take walks. Try deep breathing exercises when you feel stressed.
  • Ask your healthcare provider:
    • How and when you will hear your test results
    • How long it will take to recover
    • If there are activities you should avoid and when you can return to your normal activities
    • How to take care of yourself at home
    • What symptoms or problems you should watch for and what to do if you have them
  • Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-12-05
Last reviewed: 2014-12-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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