Prophylaxis and management of stress ulcers.

Stress ulcers are located in the body and fundic part of the stomach. They occur in the majority of severely ill or injured patients, but only about 10% will bleed. The most effective prophylaxis are measures against the condition giving rise to risk factors as septicaemia, shock and malnutrition. The medical prophylaxis consists of antacids and/or histamine2-blockers. Most bleedings will stop after intensive care and medication with vasopressin particularly if risk factors can be eliminated. Gastric surgery should be the last step in the treatment of bleeding stress ulcers and then we recommend non-resectional surgery as gastric devascularisation or suture ligation of bleeding vessels.