An important role in diagnosis is played by stools with gastric ulcer. The color and consistency, as well as the nature of the defecation, are important. One of the most serious complications is bleeding. The leading symptom of blood loss is a chair of black color( melena).If there is such a sign, the doctor should make sure that the source of blood loss is in the stomach, since bleeding can sometimes be simulated with ingestion of blood with pulmonary nasal blood loss.
Black feces with stomach ulcer may accompany vomiting with a bloody impurity, but can be without it. Usually melena is a symptom of the duodenal ulcer, but it also happens when bleeding from a stomach ulcer occurs relatively slowly. Often melena is observed 12 hours after the beginning of blood loss. With massive blood loss with ulcer, black feces have tarry appearance, as there is a rapid progression of a large number of blood cleavage products along the intestine. If blood loss is small, the black stool with an ulcer has a more formal appearance. Sometimes with constipation, melena appears only on the third day.
If there is blood in the feces, the ulcer passes with an exacerbation. The black color of the feces with gastric ulcer is due to iron oxide, as well as products that are formed from hemoglobin under the influence of fermentation in the intestine. When assessing stain color, it is considered that black color can appear when taking iron-containing preparations, bismuth or carboline. Dark coloring can appear after consuming blueberries, red wine or beets. Diarrhea in case of gastric ulcer can be a significant symptom. Constipation may occur with a decrease or a complete lack of appetite. In this case, the stool volume can not provide the necessary strength for irritation of the intestine. As a result, hypotension of the stomach promotes a delay in the intestines of the contents.
Often, constipation in the stomach ulcer occurs with a strict dietary diet with a low content of foods rich in fiber. Such constipation is considered alimentary. Low motor skills are aggravated if patients have an exacerbation, and they are forced to stay in bed for a long time. In addition, constipation is due to reflex action on the large intestine, as well as an increase in the tone of the vagus nerve. Compounding the state is the constitutional weakness of the press, as well as taking medications( Almagel, Calcium Carbonate).With an exacerbation, constipation sometimes is worse than pain and comes to the fore.
Diarrhea in gastric ulcer combined with increased secretion of hydrochloric acid may indicate inflammation of the small intestine. In this condition, the pH in the jejunum is significantly reduced. In the intestine there is a violation of water absorption as a result of hypersecretion of gastrin and inactivation of pancreatic enzymes. Heavy diarrhea with the inclusion of undigested food can indicate the formation of fistula. In this case, the contents of the stomach enter the intestine.
Diarrhea in most cases may have a medical nature associated with the use of magnesia. In the remaining patients, diarrhea is not a typical symptom for ulceration of the mucosa. At half of patients at an exacerbation observe constipations and other dyspeptic phenomena. In case of blood loss, a change in stain color may be accompanied by fainting and weakness. If blood loss is more than a liter, patients may experience shock. In this case, the severity of the condition is estimated not only by the amount of blood lost, but also by the rate of bleeding. The latent loss of blood leads to multiple organ dysfunctions, development of azotemia, and further intoxication.