Curling's Ulcer: Symptoms, Assessment & Treatment

Instructor: Dan Washmuth

Dan has taught college Nutrition, Anatomy, Physiology, and Sports Nutrition courses and has a master's degree in Dietetics & Nutrition.

A Curling's ulcer is an ulcer to the duodenum, which is part of the small intestine. Learn about the symptoms, as well as how to assess and treat this type of ulcer.

Curling's Ulcer

Matt is a 47-year-old man who recently suffered major burns to much of his body. While recovering from his burns, Matt started feeling immense pain in his stomach. This pain progressed into vomiting and then blood in his stool. Matt informed his nurse and doctor of these symptoms, and after performing some tests, Matt was told he had a Curling's ulcer.

A Curling's ulcer is an ulcer to the duodenum, which is part of the small intestine. Ulcers are lesions or wounds to various tissues in the body, such as skin or intestinal tissue. Curling's ulcers are often times a complication stemming from severe burns to the body, or other cases of massive trauma to the body, such as injuries sustained during a car accident.

When a person suffers severe burns to large portions of the body, less blood will be available to supply the intestines with oxygen and other nutrients. Because the intestines do not receive enough oxygen and nutrients from the blood, cells in the intestine begin to die off, which can result in the formation of an ulcer.

Curling ulcers affect the duodenum, which is the first segment of the small intestine.
duodenum

Curling's ulcers are often referred to as stress ulcers because they are a complication of severe stress on the body. These types of ulcers got their name from Dr. Thomas Curling, who was the first person to become aware of this special type of ulcer while evaluating some of his patients in the mid 1800's.

Symptoms of a Curling's Ulcer

Symptoms of a Curling's ulcer usually begin with intermittent stomach pains. These pains are often accompanied by lack of appetite and persistent vomiting. Sometimes patients suffering from these ulcers will also notice blood in their stool.

Sometimes these symptoms are difficult to attribute directly to Curling's ulcers. As mentioned previously, Curling's ulcers are the result of severe burns or other injuries. Therefore, a patient suffering from the symptoms of these ulcers might just believe the symptoms are caused by the burns or other injuries, rather than an ulcer. Because a patient might attribute the symptoms of Curling's ulcers to other injuries, these ulcers can sometimes go undiagnosed.

Curling ulcers are areas of damaged tissue in the duodenum that can cause stomach pains, lack of appetite, vomiting, and blood in the stool.
ulcer

Assessment and Treatment of Curling's Ulcer

One of the only ways to assess and diagnose a Curling's ulcer is by performing an endoscopy. To perform an endoscopy, a doctor inserts a long flexible tube with a small camera at the end into the GI tract of a patient, either through the mouth or anus. This camera is used to take videos or pictures of inside the GI tract. These images will allow for the diagnosis and assessment of an ulcer.

In regards to treatment, there are several different methods of treating a patient with a Curling's ulcer, including:

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