Complications of stomach ulcers are rare, but can be very serious.
The main complications are:
- internal bleeding
- perforation - the lining of the stomach splits open
- gastric outlet obstruction - the stomach ulcer obstructs the normal passage of food through your digestive system
Internal bleeding's the most common complication of stomach ulcers. It can occur when an ulcer develops at the site of a blood vessel.
The bleeding can either be slow and long-term, or rapid and severe.
Slow, long-term bleeding
Slow, long-term bleeding can lead to anaemia.
Symptoms of anaemia include:
- pale skin
- heart palpitations (noticeable heartbeats)
You should visit your GP if you have persistent symptoms of anaemia. If they think you have a stomach ulcer, they may refer you to a gastroenterologist for an examination and treatment.
More about anaemia
Contact your GP or the NHS 24 111 service immediately if you have symptoms of more severe bleeding, including:
- you're vomiting blood – the blood can appear bright red or have a dark brown, grainy appearance like coffee grounds
- you're passing dark, sticky, tar-like stools
Stopping severe bleeding
An endoscopy will be used to identify the cause of the bleeding. Treatment can be given during the endoscopy to stop the bleeding.
- specialised procedures carried out under X-ray guidance are used to stop bleeding ulcers
- surgery is needed to repair the affected blood vessel
Blood transfusions may also be needed to replace the blood you've lost.
Perforations are a rarer complication of stomach ulcers. This is when the lining of the stomach splits open.
This can be very serious because it lets the bacteria that live in your stomach escape and infect the lining of your abdomen (peritoneum). This is known as peritonitis.
In peritonitis, an infection can rapidly spread into the blood (sepsis) before spreading to other organs. This carries the risk of multiple organ failure, and can be fatal if left untreated.
The most common symptom of peritonitis is sudden abdominal pain, which gets steadily worse. If you have this type of pain, contact your GP or the NHS 24 111 service immediately
Peritonitis is a medical emergency that requires hospital admission. In some cases, surgery may be needed.
Gastric outlet obstruction
In some cases, an inflamed (swollen) or scarred stomach ulcer can obstruct the normal passage of food through your digestive system. This is called a gastric outlet obstruction.
- vomiting large amounts of undigested food
- a constant feeling of bloating or fullness
- feeling more full than usual after eating less food
- unexplained weight loss
Treating a gastric outlet obstruction
An endoscopy can be used to confirm the obstruction.
If the obstruction's caused by inflammation, proton pump inhibitors (PPIs) or H2-receptor antagonists can be used to reduce stomach acid levels until the swelling goes down.
If the obstruction's caused by scar tissue, surgery may be needed. This can involve passing a small balloon through an endoscope and inflating it to widen the site of the obstruction.