What Is Stress Ulcer?

Aphthous ulcers are a common condition with which most people are familiar. In contrast, stress ulcers are relatively rare. So, what exactly are stress ulcers?

What Are Stress Ulcers?

Stress ulcers are an acute gastric mucosal lesion—also termed acute hemorrhagic gastritis—typically triggered by severe physical stressors such as major trauma, infection, burns, critical illness, or acute erosions and ulcers of the stomach and duodenum. Clinical manifestations may include sudden hematemesis (vomiting blood), melena (black, tarry stools), or perforation of peptic ulcers. These lesions most commonly occur in the gastric antrum and can pose significant health risks to affected patients, warranting prompt clinical attention.

Stress ulcers arise primarily in response to physiological stress, especially following severe traumatic injury, shock, or serious psychiatric disorders, leading to acute gastric ulcer formation and associated bleeding. Therefore, management emphasizes early prevention, timely diagnosis, and prompt intervention. If a patient with any of the aforementioned severe underlying conditions develops hematemesis or melena, stress ulcer should be strongly suspected. Immediate fasting and intravenous proton pump inhibitor (PPI) therapy are recommended; in some cases, topical thrombin may be administered for hemostasis.

If pharmacologic treatment proves ineffective, endoscopic hemostasis may be considered. In patients with coagulopathy, platelet transfusions and prothrombin complex concentrate may be required. Should endoscopic therapy fail to control bleeding, interventional radiology (e.g., embolization) or even surgical intervention may become necessary. Accordingly, stress ulcers predominantly occur in critically ill patients or those suffering major trauma; thus, early recognition is paramount. We hope this explanation has been helpful.