A stress ulcer is an inflamed, irritated area in the duodenum or the stomach that has been eaten away by gastric acids. It is not caused by the type of stress that occurs in everyday life, but instead by the stress of severe illness or trauma. Cushing’s ulcer and Curling’s ulcer are two kinds of stress ulcers. Both of these may be asymptomatic if the ulcer is small, but stress ulcers can be quite severe if they grow large or remain untreated.
Cushing’s ulcer is the often the result of some type of serious injury to the brain and is caused by an intercranial pressure. It can also occur as a complication from surgery or stroke. This type of stress ulcer may affect the esophagus as well as the stomach and duodenum. Cushing’s ulcer often produces no symptoms, although bleeding or perforations of the stomach or intestines may occur infrequently.
Curling’s ulcer occurs only in the duodenum and is an acute, peptic type of ulcer. It is usually a side effect of serious burns or other traumatic injury to the body. The shock from these medical conditions decreases the supply of blood to the gastric mucosa, which leads to the formation of this form of stress ulcer. Symptoms include loss of appetite, fatigue, nausea, or a gnawing pain below the breastbone which grows worse during the night. In the most serious cases, the ulcer patient may vomit blood.
Hospital patients who are recovering from serious illness are at risk for stress ulcers. Those who are in the hospital for an extended period or particularly in intensive care may be even more prone to them. They may suffer from either type of stress ulcer and are often given preventative medication while they are hospitalized.
Once an ulcer has been diagnosed, a doctor who specializes in gastroenterology may be recommended to take charge of stress ulcer treatment. Medication to suppress acid production is usually prescribed, and this is often all that is needed to ease ulcer symptoms. Antibiotics or antibacterial medication may also be prescribed, along with a special low acid diet. If left untreated, an ulcer can eat its way into the blood vessels, thereby causing blood to leach into the digestive tract.
Surgery may be required for larger ulcers. A vagotomy is one of the most common surgeries employed to treat serious ulcers. The vagus nerve is severed to prevent the brain from sending messages to the stomach. Another procedure, an antrectomy, may be performed to treat the worst stress ulcers. This involves removing a portion of the lower stomach that produces the hormone that causes that stomach to produce digestive juices.