Why Surgery Is Necessary for Stomach Ulcers

Stomach ulcers, especially superficial or newly developed ones, often do not require surgical intervention. However, there are specific situations where surgery becomes essential to protect the patient's health and prevent life-threatening complications.

Severe Gastrointestinal Bleeding

One of the most serious complications of stomach ulcers is gastrointestinal bleeding. When an ulcer erodes into a blood vessel, it can cause significant internal bleeding. In cases where this leads to hemodynamic instability or severe blood loss that cannot be controlled through medication or endoscopic treatment, emergency surgery may be required to stop the bleeding and stabilize the patient.

Development of Pyloric Obstruction

Repeated ulcers near the pylorus—the valve that controls the movement of food from the stomach to the intestines—can lead to scarring and narrowing of the passageway. This condition, known as pyloric obstruction, prevents proper digestion and can cause persistent vomiting, dehydration, and malnutrition. If medical treatments fail to relieve the blockage, surgical correction becomes necessary.

Risk of Perforation and Peritonitis

Long-standing ulcers can penetrate through the stomach wall, reaching the peritoneal cavity. This can result in a perforated ulcer, which allows stomach contents to leak into the abdominal cavity, causing peritonitis—an infection that can rapidly progress to septic shock. Immediate surgical repair is crucial to prevent fatal complications.

Potential for Malignant Transformation

While most stomach ulcers are benign, some have the potential to become cancerous over time. Gastric ulcers that show signs of malignancy or those that do not heal with standard therapy may require surgical removal. Following surgery, additional treatments such as chemotherapy or radiation therapy may be recommended depending on the stage and nature of the cancer.

In summary, while many ulcers can be managed without surgery, certain complications make operative treatment unavoidable. Early recognition of these conditions is key to improving outcomes and reducing the risk of severe illness.