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A stress ulcer is a single or multiple mucosal defect usually caused by physiological (not psychological) stress which can become complicated by upper gastrointestinal bleeding. These ulcers can be caused by shock , sepsis , trauma or other conditions and are found in patients with chronic illnesses.
Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and rarer causes such as gastric cancer. The initial assessment includes measurement of the blood pressure and heart rate , as well as blood tests to determine the hemoglobin .
[1] [9] Sometimes in those with small amounts of bleeding no symptoms may be present. [1] Bleeding is typically divided into two main types: upper gastrointestinal bleeding and lower gastrointestinal bleeding. [2] Causes of upper GI bleeds include: peptic ulcer disease, esophageal varices due to liver cirrhosis and cancer, among others. [3]
There may be no symptoms but, when symptoms are present, the most common is upper abdominal pain (see dyspepsia). [1] Other possible symptoms include nausea and vomiting, bloating, loss of appetite and heartburn. [1] [2] Complications may include stomach bleeding, stomach ulcers, and stomach tumors. [1]
An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. [1] The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain, and upper abdominal pain that improves with eating. [1] With a gastric ulcer, the pain may worsen with eating. [7]
Melena is a form of blood in stool which refers to the dark black, tarry feces that are commonly associated with upper gastrointestinal bleeding. [1] The black color and characteristic strong odor are caused by hemoglobin in the blood being altered by digestive enzymes and intestinal bacteria.
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The drug Elmiron helps, for some patients, to prevent the formation of Hunner's ulcers by coating the bladder wall, thus making it harder for the acid in urine to irritate the bladder wall lining, which can lead to ulceration. Elmiron is a controversial medication within the interstitial cystitis community, with its efficacy questioned by many.