Surgery may be necessary if all the medications for treating peptic ulcers are unsuccessful or if serious complications develop. In the case of a bleeding ulcer, the doctor will repair the source of the bleeding. If the ulcer has perforated the stomach or duodenal wall, an emergency operation is required to close the perforation.

In some cases the doctor may perform an operation to decrease the secretion of stomach acid. The surgery usually involves either removing part of the stomach (partial gastrectomy) or a section of the vagus nerve (vagotomy), as this autonomic nerve stimulates secretion of gastric acid.

Peptic ulcer surgery is performed only in emergencies because of the associated risk of complications. These include recurrence of the ulcer(s); the formation of fistulae (connections between the small intestine and colon); vomiting of bile; diarrhoea; haematological complications (anaemia); and dumping syndrome. Dumping syndrome occurs when the stomach empties rapidly ("dumps") into the small intestine. This may lead to reactive hypoglycaemia (low blood sugar). Symptoms include colic-like abdominal pain, diarrhoea, vomiting and/or sweating an hour after eating. Dumping syndrome may be lessened by a regimen of small meals at frequent intervals.

Read more:
Diet preparations before surgery
Diet zone

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