Ulcer After Bariatric Surgery: Warning Signs You Can’t Ignore

Written by Kristen Carli, RD and medically reviewed by Dr. Stephen Boyce, MD

After any surgery, it’s common to have side effects as the body heals. Bariatric surgery is a life-changing procedure. It helps those seeking to lose weight and improve their health. It has many benefits.

But, it may cause some post-operative issues, including late complications of bariatric surgery, which require attention. A concern is the development of ulcers, especially marginal ones. They are unique to bariatric patients.

These ulcers can form due to various factors. They are surgery, lifestyle choices, and health issues. Furthermore, many patients might face psychological problems after bariatric surgery, which can complicate the recovery process.

It’s vital to know the risks and warning signs of post-bariatric surgery ulcers. This will help maintain your long-term health after surgery. These complications can be managed with the right approach. But, if untreated, they can cause discomfort and serious consequences. 

This article will examine post-bariatric surgery ulcers. We will cover their causes, key symptoms, and the tests doctors use to diagnose them. We’ll discuss treatments for these ulcers. They include medications and lifestyle changes. We’ll also provide prevention tips to help you avoid them. Finally, we will stress the need for early detection. It can reduce complications, improve results, and keep your quality of life after bariatric surgery.

Understanding Ulcers in Bariatric Surgery

Post-bariatric surgery ulcers are often referred to as marginal ulcers. These ulcers occur at the junction between the stomach pouch and the small intestine and occur at a rate of 1-16% based on varying reports.

Unlike peptic ulcers in the general population, these ulcers are influenced by surgical changes like reduced blood flow to the site or exposure to stomach acid and bile. What is the most common complication of bariatric surgery? While ulcers are a frequent issue, it’s critical to consider other risks like blood clots, kidney stones, and gallbladder issues.

For bariatric patients, nutritional deficiencies can also exacerbate issues, making supplements like bariatric multivitamins, bariatric calcium chews, and liquid bariatric vitamin critical for overall health.

What Causes Ulcers After Bariatric Surgery?

During bariatric surgery, some areas of the body are left with reduced blood supply. This typically happens with the creation of a small gastric pouch and its connection to the small intestine. When left without blood, these areas become susceptible to ulceration.

Alternatively, stomach acid can cause ulcers in the new pouch. This happens because the pouch lining may be thinner. It may be more vulnerable to irritation by stomach acid, bile, or other digestive enzymes.

They can also occur due to patient behaviors like smoking, using NSAIDs, or poor diet. These increase your risk of developing an ulcer after bariatric procedures.

Symptoms of Ulcers After Bariatric Surgery

If you suspect you are developing an ulcer after a bariatric procedure, look out for the following symptoms. Abdominal pain occurring as a burning or gnawing pain in the upper stomach can be a common symptom. You may also experience indigestion, heartburn, nausea, or vomiting. 

Watch for severe, life-threatening complications. They are critical. These symptoms could include bleeding, a perforated stomach, and a blockage. If you’re ever worried your symptoms may indicate complications, contact your doctor at once.

Diagnosis of Ulcers 

Ulcers are diagnosed in a few ways. Your doctor may perform an endoscopy that will allow for direct visualization of the ulcer and an assessment of its severity. Alternatively, you may need imaging tests like an upper GI x-ray series. This type of test would help identify ulcers without invasive procedures. Lastly, your healthcare provider may consider laboratory tests for helicobacter pylori infection. This is essential as its presence can greatly influence your treatment strategy.

bariatric surgery ulcers

Treatment Options for Ulcers After Bariatric Surgery

If you discover you have an ulcer, there are a few treatment routes to evaluate. You may require medications like proton pump inhibitors (PPIs). These drugs help to reduce stomach acid production, which can help ulcer healing. If your doctor discovers Helicobacter pylori infection is present, you may need a combination of antibiotics to eradicate the bacteria. 

Outside of medications, you will need to make some significant lifestyle modifications. Be sure to avoid NSAIDs and quit smoking. These changes are necessary to prevent recurrence and help to aid in healing. 

Prevention Strategies

Similar to the treatment strategies, methods of prevention often involve the same tactics. For one, be sure to avoid using NSAIDs. These type of drugs (non-steroidal antip-inflammatory medications) can irritate the stomach lining, especially in at-risk individuals. This can promote ulcer formation.

If you are a smoker, it’s crucial you attempt to quit. Smoking is a significant risk factor of developing ulcers. By stopping, you not only help to reduce your risk of ulcer development, but you also support overall gastrointestinal health. 

After bariatric surgery, proper follow up appointments are critical. Schedule regular check ups with your healthcare providers to ensure early detection and management of any potential complications. 

Importance of Early Detection of Ulcers 

As with most post-bariatric surgery complications, early detection is vital. By taking prompt action early in the course of the ulcer, severe outcomes like bleeding, perforation, and gastric obstruction can be prevented

Early detection also helps to enhance treatment efficacy. Timely intervention increases the likelihood of successful healing. It also reduces the need for more invasive treatments. 

Addressing ulcers not only improves quality of life, it also can promptly alleviate symptoms. This helps you maintain a better quality of life after surgery. 

Ulcers after bariatric surgery may seem like a daunting complication, but with proper awareness, prevention strategies, and timely intervention, they can be effectively managed. Recognizing the warning signs, such as persistent abdominal pain, nausea, or symptoms of severe complications, is crucial to avoiding more serious outcomes. By adhering to dietary guidelines, avoiding NSAIDs, quitting smoking, and attending regular follow-up appointments, you can significantly reduce your risk of developing ulcers and other complications. Remember, bariatric surgery is a powerful tool for improving your health, and staying informed and proactive about potential challenges will help ensure your long-term success. If you suspect you may have an ulcer or experience any concerning symptoms, don’t hesitate to contact your healthcare provider. Early detection and treatment not only aid in recovery but also protect the investment you’ve made in your health. By taking these steps, you can focus on enjoying the benefits of your weight-loss journey while maintaining your overall well-being.

Conclusion

Ulcers after bariatric surgery, particularly marginal ulcers, are a manageable but significant complication. They result from factors like reduced blood supply, stomach acid, or lifestyle habits such as smoking and NSAID use. Symptoms include abdominal pain, heartburn, and, in severe cases, bleeding or perforation. Diagnosis involves endoscopy, imaging, or lab tests, and treatment includes medications like PPIs, antibiotics, and lifestyle changes.

Prevention focuses on avoiding irritants, quitting smoking, and attending regular follow-ups. Early detection ensures effective treatment and prevents severe complications. Supplements from Bari Life can support recovery and overall gastrointestinal health, helping patients maximize the benefits of their weight-loss journey.

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