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Bleeding Ulcer - An Insight

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4 min read


Internal bleeding is the most frequent side effect of stomach ulcers. It may occur when an ulcer forms at the location of a blood vessel.

Written by

Dr. Palak Jain

Medically reviewed by

Dr. Anshul Varshney

Published At May 17, 2024
Reviewed AtMay 17, 2024


An ulcer is a sore that takes longer to heal. Bleeding may occur if an ulcer forms near a blood vessel. As it might result in fatalities and rapid blood loss, excessive ulcer bleeding is a medical emergency. The stomach, the small intestine immediately below the stomach, or the esophagus (food pipe) above the stomach can all develop peptic ulcers. Peptic ulcers might bleed on occasion. These are known as bleeding ulcers by medical professionals. Hemorrhaging, or severe bleeding, can be fatal. In most cases, the little bleeding from an ulcer is not as dangerous and could go undetected. But it still has to be treated.

What Is Bleeding Ulcer?

Food and digestive juices can combine in the stomach like a mixing bowl to start the process of digestion. However, the stomach lining is shielded from the corrosive effects of digesting enzymes. Pain and inflammation could arise if this lining is compromised. The duodenum's lining, the small intestine's first segment, or the stomach may bleed if the inflammation worsens. The patient may not notice the bleeding or get help.

What Causes Bleeding Ulcers?

There are various causes of bleeding ulcers. Among the most typical reasons are:

1. Helicobacter Pylori

Helicobacter pylori, or H. pylori, is frequently found in the stomachs of those who suffer from stomach ulcers. Stomach ulcers do not always result from this particular strain of bacteria. This bacteria can erode the unique mucous layer that coats the stomach and small intestine, bringing stomach acid through and eroding the tissue.

2. Anti-inflammatory nonsteroidal Medications (NSAIDs)

Regular use of nonsteroidal anti-inflammatory medications, including Aspirin, Naproxen, or Ibuprofen, might also increase the risk of ulcer development. NSAIDs lessen the natural mucous layer that shields the stomach from its acid, even though they can aid with pain, fever, and inflammation. Particularly if NSAIDs are taken frequently, this may result in ulcers. The following factors increase the chance of an NSAID-induced ulcer:

Take more of a dosage than usual

  • Take them too often.

  • Consume alcohol.

  • Elderly.

  • Utilize corticosteroids.

  • History of ulcers.

3. Rare Tumours

Tumors that produce gastrin hormone result from a rare illness called Zollinger-Ellison syndrome. This causes ulcers because the stomach releases a lot of acid.

What Are the Symptoms Associated With Bleeding Ulcers?

Some people never exhibit symptoms, which makes diagnosing peptic ulcers challenging. Symptoms are frequently very apparent to those who do experience them. Some symptoms are:

  • Upper abdominal pain may worsen after eating or when the stomach is empty.

  • Feeling full or bloated.

  • Nausea.

  • Vomiting.

When a peptic ulcer starts to bleed, a person could experience:

  • Dark, sticky, bloody stools.

  • Vomit that resembles coffee grounds or has blood in it.

  • Fainting or losing consciousness.

  • Anyone experiencing any of these symptoms ought to immediately get emergency medical attention. If a serious bleeding ulcer is not treated, it might lead to severe bleeding, possibly even death.

An ulcer can bleed so slowly that no one notices. Anaemia symptoms, such as the following, are the initial indicators of a slow-bleeding ulcer:

  • Light-colored skin.

  • Breathing difficulties during physical exertion.

  • Low energy weariness.

  • Dizziness (it is a word for a variety of feelings, like being lightheaded, dizzy, weak, or unstable).

How to Diagnose Bleeding Ulcer?

1. Blood Examination

Blood tests can be used by doctors to look for indications of an H. pylori infection or issues related to peptic ulcers.

2. A Urea Breath Test

It is one tool that doctors use to monitor for H. pylori infections.

3. Stool Tests

Stool tests are one way that doctors can screen for H. pylori infection.

4. Upper Gastrointestinal Endoscopy

To confirm the diagnosis of a peptic ulcer and investigate its cause, physicians may prescribe an upper gastrointestinal endoscopy. During an upper gastrointestinal endoscopy, a physician views the lining of the upper GI tract, which includes the stomach, duodenum, and esophagus, using an endoscope, a flexible tube equipped with a camera.

What Are The Treatment Modalities Used To Treat Bleeding Ulcers?

The following medications are used as first-line therapy for NSAID-induced ulcers:

  • H2 blockers that stop the stomach from acid production, including Famotidine.

  • Proton pump inhibitors (PPI), which lessen stomach acid production and safeguard the stomach lining, are products like Omeprazole and Omeprazole plus sodium bicarbonate.

  • Antacids.

  • Medications such as Sucralfate shield the lining of the stomach and small intestine.

A doctor will also prescribe medications to eradicate H. pylori bacteria in the digestive tract if it is the cause of the ulcer. Doctors may occasionally need to address severe bleeding as well.

They can deal with this issue by:

  • Immediately inject medicine into the ulcer.

  • Applying heat treatment to the ulcer.

  • Applying metal clips to the blood vessel.

  • Carrying out surgery.

  • Stop the bleeding by cauterizing the ulcer.

Eating these foods may help combat the ulcer-causing bacteria in addition to taking the antibiotics and acid-blocking drugs that your doctor has prescribed for the treatment of ulcers:

  • Blueberries, raspberries, strawberries, radishes, and cauliflower.

  • Cherries.

  • Chilli peppers.

  • Carrots.

  • Leafy greens like kale and spinach that are high in probiotics, such as kombucha, yogurt, kefir, miso, and sauerkraut.

A blood transfusion might be necessary for therapy in situations where the bleeding is severe.

When an ulcer does not stop bleeding and is bleeding heavily, medical professionals usually operate on it. If the ulcer has eaten away at the tissue, one might require surgery if the stomach lining or small intestine breaks.

What Are the Possible Complications?

Treatment of peptic ulcers as soon as possible is the best defense against complications, especially those that are bleeding. Some issues may develop if the individual with ulcers does not seek treatment, including:

  • Severe Internal Bleeding: This is a medical emergency since it can cause hemorrhaging.

  • Perforation - A perforation occurs when the stomach lining tears apart. This uncommon and serious consequence can infect the lining of the abdomen with stomach bacteria, causing peritonitis.

  • Gastric Outlet Obstruction - When food cannot pass through a scarred or enlarged stomach ulcer, it is called gastric outlet obstruction.


It is important to pay attention to symptoms such as bleeding ulcers. Untreated ulcers can cause severe bleeding or a hole in the stomach's lining tissue. Fortunately, bleeding ulcers can be cured with treatment. A medical professional could advise surgery if extreme bleeding does not cease or slow down with treatment. With the right care, an ulcer can be cured, and major consequences can be avoided. Urethritis, however, frequently returns. For example, someone may get another ulcer if they keep using NSAIDs daily.

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Dr. Anshul Varshney
Dr. Anshul Varshney

Internal Medicine


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