Treatment for Bleeding Ulcers

When a patient comes to the hospital with bleeding ulcers, in most cases, endoscopy is performed. This procedure is critical for all phases of bleeding ulcers, including diagnosis, determination of treatment options, and treatment itself.

In high-risk patients or those with evidence of bleeding, options include watchful waiting with medical treatments or surgery. The first critical steps for massive bleeding is to stabilize the patient and support vital functions with fluid replacement and possibly blood transfusions. People on NSAIDs should discontinue them if possible.

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Depending on the intensity of the bleeding, patients can be released from the hospital within a day or kept up to three days after endoscopy. Bleeding stops spontaneously in about 70% to 80% of people, but 30% of patients who come to the hospital for bleeding ulcers will need surgery. Endoscopy is the surgical procedure most often used for treating bleeding ulcers and for patients at high-risk for rebleeding. It is usually used in combination with medications, such as epinephrine and intravenous proton-pump inhibitors.

Between 10% to 20% of patients require more invasive procedures, usually major abdominal surgery. Such patients are usually bleeding.

Endoscopy for Treating or Preventing Bleeding Ulcers

Endoscopy is important for both diagnosing and treating bleeding ulcers. The doctor first places an endoscope (a thin, flexible plastic tube) into the patient's mouth and down the esophagus (food pipe) into the stomach.

Endoscopy Used for Diagnosing Bleeding Ulcers and Determining Risk for Rebleeding. Doctors are able to detect the signs of bleeding such as active spurting or oozing of blood from arteries. Endoscopy can also detect specific features in the ulcers referred to as stigmata, which indicate a higher or lower risk for rebleeding.