I have four ulcers. Recently, I was in serious pain and was vomiting blood. My friend advised me that usually doctors would perform emergency laser surgery so that the bleeding ulcer does not cause further problems. I would like to know if this is correct information, and, if so, how does the surgery work?

Lynne

Ulcers in the stomach and upper intestine (duodenum) most often are caused by a bacterium called Helicobacter pylori or by use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen. Patients with such ulcers may have no symptoms, or they may suffer from upper abdominal pain and/or vomiting. In addition to acid-suppressive medications to promote ulcer healing, effective therapy includes antibiotics against H. pylori and stopping the use of NSAIDs.

As you have found, ulcers may lead to complications such as obstruction of the stomach, perforation and severe bleeding. Bloody vomit or black, tarry stools are the most common signs of a bleeding ulcer. If an ulcer happens to wear through the stomach's lining into a large blood vessel, a patient may require blood transfusions and emergency surgery. A doctor may use an endoscope to inject solutions into the bleeding vessel to close it off, or the vessel may be sealed using a heated electrical probe. Less frequently, a laser (also passed into the stomach through an endoscope) is used to seal off the blood vessel. However, laser surgery requires specialized equipment and rooms that are not available in all hospitals. Either way, endoscopic methods are the gold standard for treating bleeding ulcers.