An ulcer is simply an open sore, or lesion, that can occur on the mucous membranes. When an ulcer occurs in the stomach, it is known as a gastric ulcer. When it occurs in the duodenum, it is known as a duodenal ulcer. Ulcers result from the action of hydrochloric acid in the stomach on the mucosa. The underlying cause has been shown to be almost exclusively the bacterium Helicobacter pylori, present in over 80-90% of ulcer patients. Although ulcers do not always cause symptoms, the most common symptom is a gnawing or burning pain in the abdomen between the breastbone and the navel. The pain often occurs between meals and in the early hours of the morning. It may last from a few minutes to a few hours. Milk or food usually makes the pain subside slightly.

What are the Treatments for Stomach Ulcer?

Patients experiencing ulcer symptoms should be evaluated by their physician.First-line therapy involves treatment of the H. pylori infection with antibiotics, and H2-receptor antagonists or proton pump inhibitors to control acid secretion. For situations where these measures fail, several types of surgery may be indicated to address the problem.

Am I a Candidate for Ulcer Surgery?

If you have chronic ulcer disease which is unresponsive to medication or have significant complications, such as obstruction of digestive flow, bleeding, or perforation, surgery may be a viable option.

What Does Surgery for a Stomach Ulcer Involve?

Surgical procedures to treat ulcers are now performed laparoscopically to reduce invasiveness.There are three major procedures used:

• vagotomy - a procedure that involves cutting parts of the vagus nerve (a nerve that transmits messages from the brain to the stomach) to interrupt messages sent through it, therefore, reducing acid secretion.
• antrectomy - an operation to remove the lower part of the stomach (antrum), which produces a hormone that stimulates the stomach to secrete digestive juices. Sometimes a surgeon may also remove an adjacent part of the stomach that secretes pepsin and acid. A vagotomy is usually done in conjunction with an antrectomy.
• pyloroplasty - a surgical procedure that may be performed along with a vagotomy, in which the opening into the duodenum and small intestine (pylorus) are enlarged, enabling contents to pass more freely from the stomach.

What Are The Advantages Of Surgery?

Surgery provides a direct method of reducing acid secretion; this may be a more effective measure of control in disease refractory to pharmacotherapy
Performing the procedure laparoscopically, as opposed to the old open method provides for:

• Fewer/smaller incisions
• Significantly less blood loss during procedure
• Better view of internal organs magnified via laparoscope during procedure
• Reduced incidence of infection; faster recovery.

How Long Does It Take?

Varies depending on the surgical procedure or combination of procedures utilized.

How Many Treatments Are Required?

Usually, one treatment is required.

When Will I See Results?

You should start seeing results soon after recovery from treatment, as the production of acid is being cut off at the source.

What Are My Alternatives for Stomach Ulcer Treatment?

The preferred short-term treatment for gastric ulcers is drug therapy. Drugs such as cimetidine, ranitidine, famotidine, H2 blockers, and sucralfate were efficient, with omeprazole and other PPIs (proton pump inhibitors) considered the "gold standard" for active gastric ulcer treatment. Surgical intervention, however, is recommended for people who do not respond to medical therapy.

Will I Have Pain?

Pain at or around the incision site, as well as abdominal cramping, nausea/vomiting, or diarrhea may occur.

When Can I Go Back To Work Or School?

Four to six weeks are generally required for full recovery. Hospital stays are usually 6-8 days.

Who Will Perform My Treatment?

A physician experienced in the methods of gastroenterologic surgery and laparoscopy will perform the procedure.

How Much Does It Cost?

Please call TopSurgeons at 800-506-8084 for more information.

Will My Insurance Cover Stomach Ulcer Surgery?

Insurance should cover cases where surgery is deemed necessary or desirable to control the condition.