Ulcers can be uncomfortable and disruptive to daily life, and they can affect the stomach (gastric ulcers) or the upper part of the small intestine (duodenal ulcers). While many ulcers can be controlled with medication and changes in diet, there are some situations where surgical treatment is required for a successful recovery.
When Is Ulcer Surgery Necessary?
Ulcers form as open wounds on the skin or mucous membranes. With the proper care and treatment, many ulcers can heal on their own, but some chronic ulcers need to be surgically treated. The goals of ulcer surgery are to enhance the quality of life for people who have persistent ulcers by promoting healing, reducing issues, avoiding complications, and all of the stated benefits.
Failure of Conservative Treatment
To cure ulcers, doctors typically advise a course of medication, modifications to diet, and changes in lifestyle. Nevertheless, if these conservative treatments are unsuccessful in reducing symptoms, surgery becomes a possibility.
Complicated Ulcers
Some ulcers are more susceptible to occurrences after treatment, or they could result in life-threatening consequences such as bleeding, perforation, or blockage. To avoid potentially fatal scenarios in such circumstances, surgical intervention becomes necessary.
Zollinger-Ellison Syndrome
Ulcer surgery is necessary for Zollinger-Ellison Syndrome because tumours produce excess gastrin, causing extreme acid production and severe, recurrent ulcers. Surgery removes these gastrin-secreting tumours, reducing acid levels and helping to prevent further ulcer formation.
Emergency Situations
Surgical intervention is required right away for ulcers that result in bleeding, perforation, or obstruction of the digestive tract. To reduce bleeding, treat perforations, and remove obstructions, surgery is necessary.
Non-Healing Ulcers
Some ulcers, specifically those accompanied by underlying illnesses like Crohn’s disease or cancerous tumours, may not respond to standard medical care. Surgery in these situations aims to remove the damaged tissue or tumour.
Types of Ulcers Requiring Surgery
Venous Ulcers
Venous insufficiency, which impairs circulation in the legs, frequently occurs in these ulcers. Surgical alternatives may be taken into consideration when conservative therapy is ineffective in treating the problem.
Arterial Ulcers
Peripheral arterial disease, which frequently contributes to arterial ulcers, causes insufficient blood flow to the tissues. Surgery might be required in extreme situations to reestablish blood flow while helping ulcer healing.
Diabetic Foot Ulcers
Surgery, such as debridement or reconstruction, can help diabetics with foot ulcers that don’t heal despite absorbing the proper wound care. This increases the likelihood that the ulcer will heal completely.
Pressure Ulcers
These ulcers, also referred to as bedsores, occur as an outcome of persistent pressure on the skin, frequently in those with limited movement. Wound closure can be facilitated, and additional issues can be avoided with surgical procedures like flap reconstruction or skin grafts.
Common Surgical Procedures for Ulcers
Debridement
For better healing, this surgery entails removing bacteria, debris, and necrotic tissue from the ulcer. Specific equipment, enzymatic chemicals, or autolytic or mechanical techniques can all be used for debridement.
Skin Grafts
In a skin grafting procedure, healthy skin is removed from one area of the body (the donor site) and transferred to the ulcerated area. It helps in wound closure, fosters healing, and lowers the chance of infection.
Flap Reconstruction
A more complex surgery called flap reconstruction includes transferring healthy tissue and its blood supply from a close or distant position to the ulcer site. For larger or deeper ulcers, this method is especially beneficial.
Vascular Procedures
When insufficient blood flow is the ulcer’s underlying cause, vascular operations like angioplasty or bypass surgery may be carried out to improve the area’s blood supply.
Vagotomy
A vagotomy is a method of surgery in which a section of the vagus nerve, the part that controls the natural production of stomach acid, is cut or removed. Through this procedure, the stomach’s acid production is decreased, accelerating the healing of ulcers. Vagotomy is frequently carried together with other surgical procedures.
Antrectomy
An antrectomy entails removing the antrum, the lowest part of the stomach. Gastrin, a hormone that enhances acid secretion, is produced in the antrum. By removing this part of the stomach, an ulcer may heal faster by producing less acid.
Pyloroplasty
A pyloroplasty is a surgical treatment that increases the pylorus, the passageway between the stomach and small intestine. It can be done in conjunction with antrectomy and vagotomy to enhance gastric emptying and lower the probability of problems after surgery.
Gastric Bypass Surgery
Gastric bypass surgery may be a possibility in cases where extensive ulcers occur and can’t be treated any other way. This treatment involves forming a little pouch in the upper stomach region and attaching it straight to the small intestine. The number of molecules of acid produced is substantially reduced by skipping the major part of the stomach, thereby improving the likelihood that ulcers will heal.
Conclusion
For stomach and ulcers of the duodenum, surgery is not the first course of treatment. However, when preventative measures don’t work, ulcers come back, or complications develop, it becomes required. Effective ulcer treatment can be achieved through many kinds of surgical procedures such as vagotomy, antrectomy, pyloroplasty, and gastric bypass.
The best course of action for your unique illness should always be determined in consultation with a medical professional. With the growth of medical expertise, surgical procedures are now safer and more successful than ever, giving ulcer patients hope and respite.
