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Stress Ulcer: How to Prevent and Treat Them

Stress Ulcer: How to Prevent and Treat Them

February 22, 2024
Stress Ulcer: How to Prevent and Treat Them

An ulcer develops when tissue in the mouth, esophagus, stomach, or other parts of the digestive system is injured. The area becomes inflamed and irritated causing a hole or sore. Ulcers in the stomach and intestinal tract pose a danger of bleeding, so they must be monitored. 

  • Stress ulcers: are seen in parts of the digestive tract like the esophagus, stomach, and intestine.
  • Peptic ulcers: are located in the stomach and the upper portion of the small intestine.
  • Mouth ulcers: can be discovered inside the lips, on the gums, or the tongue.

What is a stress ulcer?

Stress ulcers, also known as stress-related mucosal damage (SRMD), are superficial erosions or ulcers. A stress ulcer produces ulcers in the upper gastrointestinal system. These lesions harm the gastrointestinal lining. It can produce pain, burning sensations, and a higher risk of infection. The damage varies from moderate discomfort to major hemorrhage.

Stress ulcers differ from regular peptic ulcers, which are typically caused by bacterial infections or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen. 

What causes stress ulcers?

Stress ulcers are usually caused by physiological stress, such as:

  • severe illness
  • trauma
  • burns

They can also be caused by certain medications, such as:

  • corticosteroids
  • anticoagulants

What are the symptoms of stress ulcers?

Symptoms of stress ulcers can include:

  • abdominal pain
  • nausea
  • vomiting
  • blood in the stool
  • weakness

However, some people with stress ulcers may not have any symptoms, especially if the ulcers are small. If left untreated, stress ulcers can lead to serious complications, such as:

  • bleeding
  • perforation
  • infection

How to prevent stress ulcers?

Prevention is crucial in managing stress ulcers. If you are at risk of developing stress ulcers, your healthcare provider may recommend medication to reduce stomach acid, such as:

  • proton pump inhibitors (PPIs)
  • histamine-2 receptor antagonists (H2RAs)

They may also recommend avoiding NSAIDs and alcohol, which can increase the risk of stomach ulcers.

Stress ulcer prevention is particularly important for critically ill patients. In the past, stress ulcer prophylaxis was routinely given to all critically ill patients. 

However, recent guidelines recommend targeted prophylaxis based on the patient’s risk factors. This approach can reduce the risk of complications associated with unnecessary medication use.

How is stress ulcer treated?

Treatment of stress ulcers depends on the severity of the ulcers and the presence of any complications. 

  • For mild stress ulcers, medication to reduce stomach acid and protect the stomach lining may be sufficient. 
  • For more severe ulcers, hospitalization may be necessary.  Endoscopic procedures may also be required to stop bleeding or repair perforations.

In addition to medical treatment, lifestyle changes can also help manage stress ulcers, this includes:

  • Eating a healthy diet
  • Getting regular exercise
  • Managing stress through relaxation techniques, such as meditation.

It’s important to note that while stress can contribute to the development of stress ulcers, it’s not the only factor. Critical illness, injury, and certain medications can also play a significant role. Therefore, it’s crucial to work with your healthcare provider to identify and manage any risk factors.

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