What are the chances of developing a stomach ulcer after gastric bypass surgery? How will it be treated?

Question

Ali Solmaz, MD · Answer

The chances of developing a stomach ulcer after gastric bypass surgery are relatively low, but it is a recognized complication. Marginal ulcers, which form where the stomach pouch connects to the small intestine, occur in about 3-15% of patients. The risk depends on factors such as smoking, the use of certain medications like NSAIDs (ibuprofen or aspirin), alcohol consumption, or the presence of an H. pylori infection. Dietary choices and stress levels can also contribute.
Symptoms of an ulcer may include persistent upper abdominal pain, nausea, vomiting, or, in more severe cases, black stools or signs of anemia due to bleeding. If an ulcer develops, it is typically treated with medications such as proton pump inhibitors (PPIs), which reduce stomach acid to promote healing. If H. pylori is involved, a combination of antibiotics may also be prescribed. Additional medications like antacids or H2 blockers may help alleviate symptoms.
Lifestyle adjustments play an essential role in both treatment and prevention. It is important to avoid smoking, alcohol, and NSAIDs, as these can irritate the stomach lining. Following post-surgery dietary guidelines and managing stress are also crucial to minimizing risk.
In rare cases, if the ulcer causes complications like bleeding or perforation, further intervention might be required, such as endoscopy or surgery. Regular follow-ups with your bariatric surgeon are essential for early detection and management of any issues. While ulcers can occur, they are manageable with prompt treatment and appropriate care.

Ricardo M. Bonnor, MD, FACS · Answer

Overall the incidence of marginal ulceration or developing an ulcer between the small pouch and intestine is rather low but can increase significantly in patients that smoke and specially those that smoke after surgery.

	These ulcers can bleed and even perforate which can be a catastrophic complication.  The simple answer is to stop smoking and this will decrease your chances of developing an ulcer. Even healthy patients can develop an ulcer in the small stomach and this can be medically treated although this may require surgery to correct this at some point.

Shawn Garber, MD, FACS, FASMBS · Answer

There is a small chance of developing what is referred to as marginal ulcers after gastric bypass surgery.  This is an ulcer just distal to the connection between the stomach pouch and small intestine.  This usually occurs in patients that have a gastric pouch which was made to large at the original surgery.  A large gastric pouch produces to much acid which irritates the small intestine and leads to an ulcer.  The dangers of ulcers are that they can either perforate or bleed.  Most ulcers can be treated with medication.  Rarely they will require revisiona surgery.

What are the chances of developing a stomach ulcer after gastric bypass surgery? How will it be treated?

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What are the chances of developing a stomach ulcer after gastric bypass surgery? How will it be treated?

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