Stress Ulcer – What in the World is it?

Stress Ulcer is not caused by the “every day stress” a person undergoes in his work or family. It rather is the manifestation of peptic ulcer because of a prolonged and serious illness. Patients who experience prolonged stay in Intensive Care Unit (ICU) typically get stress ulcers. That does not essentially mean that the facilities in the ICU have caused “Stress Ulcer”. It is because a patient undergoes prolonged stay in ICU because of the seriousness of the illness and whose health is at stake. Patients who have met with accident and have lost lot of blood also get stress ulcer when they are hospitalized. Medications also play a role in getting stress ulcer.

Generally in stress ulcer the upper region of the stomach has ulceration because the patient is in a lying down position. Not all patients in ICU may get stress ulcer. Typically stress ulcer is found to affect 3-4% of patients in ICU.

What causes Stress Ulcer?

• Prolonged stay in the ICU with many ailments and medications means the patient is already in a compromised state which can easily lead to a sudden ulcer in the stomach.
• Patients who have lost lot of blood in an accident typically do not have enough blood and oxygen. This decrease in oxygen level results in the stomach lining not being regenerated and hence the stomach line is breached and exposed thereby causing stress ulcer.

Symptoms of Stress Ulcer

The presentation is itself is the bleeding of the stomach ulcer. The patients in the ICU with the ventilation may bleed internally and the blood might come out of the naso-gastric tube which is a strong indication of the presence of stress ulcer.

How to diagnose and confirm Stress Ulcer?

As usual endoscopy of the gastric region is the option available to examine and find out the presence of Stress Ulcer.

What actually happens in the Gastric Region because of Stress Ulcer?

The lining of the gastric region is termed as gastrointestinal mucosa which is regenerated once in 5 days. This lining is breached in case of general or stress ulcer. In normal stomach or peptic ulcer, the erosions of the mucosa or the lining does not extends to reach the blood vessel but in stress ulcer, the ulcer reaches the blood vessel into the region called sub-mucosa which causes bleeding into the gastrointestinal region. Such condition can be fatal and even end up complicating the primary disease or condition for which the patient was hospitalized.