Stomach Ulcer Therapeutic Endoscopy

Stomach Ulcer Therapeutic Endoscopy is one of the treatments recommended for peptic ulcer patients who have signs of bleeding or who develop weight loss, eating and swallowing difficulties.

Most people think stomach ulcer is caused by the food we eat or starving but this is not true as they are caused by either an infection with the bacterium Helicobacter pylori (H. pylori) or the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen for a long period of time. 

Stomach ulcers are painful wounds on the lining of the stomach. It is a type of peptic ulcers and sometimes called gastric ulcers. Ulcers that are found in the upper part of the small intestine is called duodenal ulcer. When the layer that protects your stomach from digestive juices is reduced, the juices eat the tissues that lines the stomach, this results to ulcer. Although stomach ulcers are easily cured, they can become so severe if they are properly treated. 


One of the symptoms common to every ulcer patient is that pain and burning sensation in the middle of your abdomen usually between your chest and belly button. If you have an empty stomach, it increases the intensity of the pain which can last for few minutes to hours.

Other symptoms may occur although they vary from one person to another depending on the severity of the ulcer. 

  • Burning sensation in the chest (Heartburn)
  • Weight loss
  • Not wanting to eat because of the pain
  • Vomiting or Feeling of nauseous
  • Bloating
  • Acid reflux – A condition where some of the acidic contents in the stomach go back up into the esophagus.
  • Pains that increase when you take in food, drinks or antacids
  • Dark stools
  • Vomit with blood or dark colours
  • Anemia

Most people experience bleeding of the ulcer, ulcers can become dangerous when they bleed heavily. Sometimes, most people do not know they have bleeding ulcer because it bleeds slowly. Here are some symptoms of a bleeding ulcer

  • Tiredness
  • Pale skin
  • Lack of energy
  • Light-headedness
  • Shortness of breath when doing physical activities
  • Dark stools
  • Sticky stools
  • Bloody vomits that may look like coffee grounds

It is important to seek medical help with you notice any of the symptoms or diagnosed with ulcer especially when it is bleeding as it can lead to complications like:

Internal bleeding: This is a serious medical emergency and can lead to death if not properly managed.

Gastric outlet obstruction: This happens when foods cannot get into the digestive system because of the swollen stomach ulcers.

Perforation: This can lead to peritonitis, a condition where stomach bacteria infect the lining of the abdomen. This occurs when the lining of the stomach splits open and makes way for the abdomen to be infected.


The diagnosis is done by a doctor after taking note of your medical history. Some of the tests are:

Upper gastrointestinal series

An x-ray is used for this test. The doctor conducts x-rays of your digestive system ( the upper side ) to create images of your esophagus, stomach and small intestine. Still in the process, a white liquid containing barium is given to the patient to swallow, this liquid coats your digestive tracts and makes it easier to see the ulcer. 

Laboratory tests for H. pylori

This test is done to confirm if you have the bacterium that causes ulcer (H. pylori) in your body. The test can be done using your stool, blood or breath as they can show if you have the bacterium. Each method used will determine if you can use antacids for some period of time before the test, this is because the antacids can cause false negative results.

If the breath method is being used for the test, you are given a food or drink that contains radioactive carbon which is broken down by H. pylori in your stomach. Later, you are asked to breath into a bag which is then sealed and taken to the laboratory. If your breath sample contains the radioactive carbon in the form of carbon dioxide, you have H. pylori.


An endoscopy is a medical procedure where specialized instruments are used to view and operate on the internal organs of the body. It allows medical practitioners to find out the problems you have inside of your body without having to make large incisions.

The doctor uses an endoscope ( a tube with camera attached to it) by inserting it into your body through any small opening like the anus, nose, mouth, vagina or any small incisions. The instrument also has forceps which can be used to operate or remove tissue samples (biopsy) for further examination.

Endoscopy is done to

  • Collect samples of tissues which are needed for further examination
  • Help the doctor know of the cause of abnormal symptoms, and
  • To see the inside of the body during surgery.

For ulcer diagnosis, the endoscope is inserted through the mouth down your throat and into your esophagus, stomach and small intestine. This is done to look for ulcers. When an ulcer is found, the forceps on the instrument is used to collect small tissue sample which is sent for further examination in the laboratory. A biopsy can also identify whether H. pylori is in your stomach lining.


After the endoscopy has shown the ulcer, subsequent ones are done following treatment. Subsequent endoscopy are therapeutic, endoscopic therapy is done to further improve the healing of patients. Most times, patients with ulcers especially bleeding ulcers experience recurring and rebleeding due to factors like the size of the ulcers, ulcer location at the posterior duodenal bulb and high lesser curvature. One of the ways to diagnose band treat this bleeding is endoscopic hemostasis which is a form of therapy.

Endoscopic hemostasis therapy is a safe and effective method to control high-risk indications of hemorrhage: active bleeding, non-bleeding visible vessel. When there is bleeding, the circulatory dynamic state is made stable and urgent endoscopy is performed to stop the bleeding.

However, after the treatment, the condition can happen again when the effects have faded, a second treatment or therapy involving hemostasis is applied targeting the arteriole, this has a longer effect. A scheduled second endoscopy is performed to identify patients with persistent stigmata of recent hemorrhage, and retreatment is performed at 16–24h after the initial endoscopic hemostasis.


Therapeutic endoscopy is usually recommended if you have bleeding ulcers, weight loss or difficulties in eating. The endoscopy is not only used to show if you have ulcers in your stomach, it is also done as a follow-up therapy even after you have healed or your symptoms stop.

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