What is the timeline of a peptic ulcer?

December 8, 2010 7:45 AM

How quickly can a peptic ulcer (1) form, and (2) perforate? My girlfriend just had an emergency surgery in Mexico when an ulcer she didn't know about opened 2 mm and began leaking air out of her stomach. How long might she have had it? (YANMD, naturally.)

She was eating a lot of ibuprofen in the last month because of other pain issues, and we're wondering if that might have caused it or just exacerbated it. Basically, what we want to know is how much of her stomach pains and other issues, which are plentiful and longstanding, might be explained by this ulcer. While she recovers we're all wondering why the doctors in Canada never figured this out, since she's been to clinics for abdominal pain so many times. Any info or pointers to websites (other than Wikipedia, where I've already been) would be much appreciated.

posted by Beardman to health & fitness (5 answers total)

From your girlfriends history of taking alot of ibuprofen, it would be the main cause of her peptic ulcer. especially if she took it on an empty stomach. Not recommended.

Canada has an excellant health Care system. Peptic Ulcers are a funny thing. Sometimes they are not discovered until the last minute.

The fact that your girlfriend had stomach pain for a longtime. Im surprised if she did not have an ultrasound or a gastroscope.

If she did, the ulcer may of not been present when these procedures have been done.

Why not ask your docotrs, they will be more than happy to explain her situation in great lenght. In medicine there is no such thing as a stupid question. You are stupid if you dont ask.

Hope this helps.
posted by mosby34 at 7:57 AM on December 8, 2010

I can't help with the timeline question, but it took many, many visits to doctors (also in Canada) to diagnose a peptic ulcer. "Abdominal pain" is pretty non-specific and it can be very hard to pinpoint a cause.
Best of luck to your girlfriend, I hope she feels better soon.
posted by OLechat at 8:31 AM on December 8, 2010

I had an ulcer for years as a young woman that was dismissed as "stress". Doctors don't tend to rake younger people very seriously IMHO.
posted by fshgrl at 12:55 PM on December 8, 2010 [1 favorite]

In especially at-risk populations-- say, a very old person, vented in the ICU-- an ulcer can form and perforate very quickly-- say, a matter of days. Trauma or surgical patients that stay two or more nights generally receive famotidine or ranitidine as a preventative measure, so the shortness of that stay can give you an idea of how fast this can happen. (Yeah, they're at risk outpatient too, but the bulk of the risk is during the stay.)

Frequent and/or heavy ibuprofen use is a huge risk factor for peptic ulcers. That's the likely culprit here.

It's possible, of course, that an earlier ulcer was missed. I would expect that in any patient with frequent visits for abdominal pain that endoscopy was performed, which is the (or maybe a?) way to diagnose an ulceration, but sometimes ulcers are missed on endoscopy.

I would also hope that your girlfriend would have been checked for H. pylori infection, which is the other huge risk factor for peptic ulcers.

This wikipedia page lists symptoms of peptic ulcers. Unfortunately, you're not going to be able to tell if the ulceration was a cause of previous symptoms, because the symptoms are extraordinarily non-specific.

Your girlfriend needs to follow up with physicians at home. I trust that she's being well managed by physicians in Mexico? If you have any concerns about her pain and care, I'm sure that we're all happy to offer any expertise we have. Best of luck to your girlfriend.
posted by nathan v at 4:41 PM on December 8, 2010

Thanks everyone. She is being well managed in Mexico. My understanding is that they are checking for H. pylori infection, and running biopsies to make sure she's not among the small percent whose ulcer is a cancer symptom. Her last endoscopy was a while back, probably too long ago to have turned up this ulcer. I suspect it was the ibuprofen. It appears that she is going to have to take other measures (not sure what) to fight the extraordinary painful cramps she gets--the "other issues" I mentioned. Birth control pills have so far been more trouble to her than they're worth, but she may have to give them another try.
posted by Beardman at 6:26 AM on December 9, 2010