by Lauren Beyenhof

Created on: June 02, 2009   Last Updated: June 03, 2009

According to the Merck Manual of Medical Information, 1 in 10 people will develop an ulcer at some point. An ulcer is typically defined as a sore located somewhere in the lining of the stomach. Ulcers develop where there is excess stomach acid and too much pepsin (a digestive enzyme) in the stomach. Causes of ulcers range from trauma to stress, and the symptoms are usually a steady pain accompanied by a feeling of burning in the stomach. Some ulcers have no symptoms at all and go undetected until a complication arises.

The complications of peptic ulcers include penetration, perforation, bleeding and obstruction. These problems can become life-threatening rather quickly, so it's important to get the right diagnosis for an ulcer.

An ulcer is said to be penetrating when it breaks through the muscular wall of the stomach. Sometimes they can also break through the lining of the first segment of small intestine called the duodenum. When penetration occurs, the ulcer begins to affect nearby organs such as the pancreas or liver causing tremendous pain that reaches even beyond the affected area. When drugs are ineffective in healing the penetration, surgery may be required.

Another example of a complication of peptic ulcers is perforation. This means that an ulcer on the front of the duodenum burns through the lining resulting in an open space in the abdomen. Again, this complication is accompanied by extreme pain as it spreads. The pain tends to become more intense and uncomfortable when a person changes position or tries to take in a deep breath. A doctor can identify a perforation simply by pressing on the abdomen and watching to see whether the person is in pain once the pressure is released. People who are prone to perforation from an ulcer include those who are taking corticosteroids such as prednisone. Without treatment, a perforation can cause a person to go into shock. Treating the condition involves emergency surgery followed by weeks of intravenous antibiotics.

A bleeding ulcer is generally not painful. A person with a bleeding ulcer may vomit blood or have blackened, bloody bowel movements as a result. In order to treat a bleeding ulcer, a doctor must perform an endoscopy in order to detect the source of the bleeding. When the site of the ulcer is found, the typical treatment is to cauterize it. However, if the doctor cannot find the source of the bleed, treatment with medication is utilized. Additionally, the patient is encouraged to avoid eating so as to let the site heal on its own. Surgery is a last resort for a bleeding ulcer.

Obstructions caused by ulcers are often the result of repeated flare-ups from an ongoing problem. As the tissue surrounding an ulcer becomes inflamed, it can cause scarring. Eventually so much scar tissue develops that food cannot pass from the stomach into the small intestine. The result is frequent vomiting, bloating and decreased appetite. The danger of having an obstruction is that over time it can cause weight loss, dehydration and an imbalance of essential chemicals in the body. Obstructions can be treated simply by treating the ulcer, but in some cases endoscopy and surgery are needed.

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