A peptic ulcer is an open sore or raw area that can develop in any one of the following two places:
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The lining of the stomach (gastric ulcer)
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The duodenum (duodenal ulcer)
Symptoms of Stomach Ulcers
Stomach ulcers produce symptoms related to gastro-intestinal tract. The major symptoms include the following:
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Dyspepsia or indigestion
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Pain or discomfort in the abdomen
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Chest pain
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Nausea and vomiting
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Acid reflux
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Belching
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Bloating
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Feeling of fullness
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Hunger and an empty feeling in the stomach, often 1 - 3 hours after a meal
Diagnosis of Stomach ulcers
The symptoms of ulcers overlap with various other disorders. So generally the physician rules out the possibilities of other disorders before concluding to ulcer diagnosis. Some of the following tests may be performed for diagnosis:
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Rectal exam
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Complete blood count
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Fecal occult blood test (FOBT)
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Blood, breath, and stool tests to detect H. pylori
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Endoscopy
Endoscopy for Stomach Ulcers
In a case of bleeding ulcers, endoscopy is usually performed for the diagnosis, determination of treatment options, and treatment of bleeding ulcers.
Endoscopy is usually performed to treat bleeding from visible vessels that are less than 2 mm in diameter. The surgeon passes a probe through an endoscopic tube and applies electricity, heat, or small clips to coagulate the blood and stop the bleeding.
Laparoscopic Surgery for Stomach Ulcers
The vagus nerve controls acid secretion of the stomach and in some cases, cutting some of the vagal nerves reduces acid production, which allows the ulcers to heal. This procedure can be performed laparoscopically.
Laparoscopic Highly Selective Vagotomy
The procedure is performed under general anaesthesia. The surgeon makes about 3-4 small incisions in the abdomen. One of the incisions is used to insert a port (nozzle) that fills the carbon dioxide gas into the abdomen to inflate it. Now laparoscope is inserted through another incision. A laparoscope is a telescope lookalike with a light and camera on the end. It allows the surgeon to clearly view inside of the abdomen on the monitor outside. Other surgical instruments are inserted through rest of the incisions to cut some of the vagal nerves to the stomach. After completing the procedure, the carbon dioxide gas is released out, and incisions are closed with sutures or staples, or covered with glue-like bandage.
Laparoscopic Vagotomy and Pyloroplasty
The procedure is performed under general anaesthesia. The surgeon makes about 3-4 small incisions in the abdomen. One of the incisions is used to insert a port (nozzle) that fills the carbon dioxide gas into the abdomen to inflate it. Now laparoscope is inserted through another incision. A laparoscope is a telescope lookalike with a light and camera on the end. It allows the surgeon to clearly view inside of the abdomen on the monitor outside. Other surgical instruments are inserted through rest of the incisions to cut the vagal nerves (vagotomy), up near the diaphragm where the nerves enter the abdomen. This is followed by opening of the stomach outlet (the pyloroplasty) to prevent blockage later on. After completing the procedure, the carbon dioxide gas is released out, and incisions are closed with sutures or staples, or covered with glue-like bandage.
Advantages of Laparoscopic Surgery for Stomach Ulcers
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Faster recovery
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Minimal blood loss
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Only few hours or overnight hospitalization
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Sooner return to work
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Very less pain during and after the procedure
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Smaller incisions without any cut on abdominal muscles
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Negligible risks and complications
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Less chances of wound infection
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High success rate
