Peptic ulcer

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Written by Jiang Guo Ming
Gastroenterology
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The main cause of peptic ulcers

Peptic ulcer is a common gastrointestinal disease, and the primary cause should primarily be Helicobacter pylori infection. Extensive research has proven that Helicobacter pylori infection is closely related to gastric inflammation activity, the formation of peptic ulcers, and gastric cancer. Secondly, drugs are a factor; many drugs can damage the gastric mucosa, such as non-steroidal anti-inflammatory drugs and corticosteroids, which often lead to the occurrence of peptic ulcers. Additionally, mental stress is often a catalyst for stomach diseases, with numerous studies showing that a person's emotions, personality, and mental stress are related to peptic ulcers. Furthermore, poor dietary and living habits can also damage the gastric mucosa, leading to the occurrence of peptic ulcers.

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Written by Jiang Guo Ming
Gastroenterology
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Characteristics of pain in peptic ulcers

Peptic ulcers include gastric ulcers, duodenal bulb ulcers, and gastro-duodenal composite ulcers. The common characteristic of peptic ulcers is upper abdominal pain, which tends to be recurrent, periodic, and regular. For duodenal bulb ulcers, the pain is primarily located above and to the right of the navel, mainly manifesting as hunger pain in the upper abdomen, which can be alleviated after eating, accompanied by nocturnal pain. Sometimes, bulb ulcers can cause back pain. Gastric ulcers are mainly located above and to the left of the navel, primarily characterized by postprandial pain.

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Written by Jiang Guo Ming
Gastroenterology
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Principles of treatment for peptic ulcers

The principles of treatment for peptic ulcers, if malignant ulcers are present, surgical treatment is preferred. For benign peptic ulcers, it is first necessary to cultivate good dietary and living habits, quit smoking and drinking, avoid excessive fatigue, and adhere to a light diet with regular and measured meals, strictly avoiding overeating and binge eating. Meanwhile, the medication treatment should be determined based on whether there is a Helicobacter pylori infection; if there is an infection, standard antibacterial treatment is required, commonly involving quadruple therapy. If there is no Helicobacter pylori infection, symptomatic treatment usually yields satisfactory results. Proton pump inhibitors are the preferred drugs, such as rabeprazole and lansoprazole, combined with gastric mucosal protectants, prokinetic agents, etc. (Medication use should be conducted under the guidance of a professional doctor.)

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Written by Jiang Guo Ming
Gastroenterology
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What is peptic ulcer disease?

Peptic ulcer is a common upper gastrointestinal disease, typically caused by the digestive action of stomach acid and pepsin, leading to damage in the mucosal layer of the stomach. Hence, it is called a peptic ulcer, encompassing gastric ulcers as well as duodenal bulb ulcers, complex ulcers, and so forth. The majority of causal factors are due to infection with Helicobacter pylori. Other factors include stimulants such as tobacco and alcohol, poor dietary habits, and medications like non-steroidal anti-inflammatory drugs (NSAIDs) and steroids. In addition, psychological factors can also lead to the development of peptic ulcers.

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Written by Jiang Guo Ming
Gastroenterology
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Can people with peptic ulcers drink milk?

Milk is very common in our daily lives and contains a wide range of nutrients. For example, proteins, fats, minerals, vitamins, etc., have a high nutritional value, so currently there are many people who drink milk. As for whether people with peptic ulcers can drink milk, opinions vary. Some say it is possible, while others say it is not; it really depends on the specific situation. If it is the acute phase of a peptic ulcer, often accompanied by excessive stomach acid, it is generally best to avoid drinking milk. This is because drinking milk might stimulate the secretion of stomach acid. If it is the healing phase of a peptic ulcer, drinking small amounts of milk can be helpful. At the same time, try to avoid drinking milk that is too cold.

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Written by Jiang Guo Ming
Gastroenterology
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Can people with peptic ulcers exercise?

Peptic ulcers are generally classified into duodenal bulb ulcers and gastric ulcers, along with mixed gastric-duodenal ulcers, etc. Clinically, they can generally be divided into acute active phase, healing phase, scar phase, etc. Generally speaking, patients with active peptic ulcers, in addition to standard medication, need absolute rest and must not overexert themselves. If it is in the remission or healing phase of peptic ulcer, in addition to developing good eating habits, one should also be cautious not to overexert; some light activities are still acceptable. Additionally, regular gastroscopy check-ups are necessary.

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Written by Zhu Dan Hua
Gastroenterology
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Peptic Ulcer Clinical Symptoms

Peptic ulcers are a common disease and often seen in clinical practice. They are typically manifested by discomfort in the upper abdomen, which may include abdominal pain, bloating, nausea, vomiting, and belching, and patients usually visit the gastroenterology department. The abdominal pain related to peptic ulcers, particularly the most typical and common symptoms, usually presents as pain above the navel, with chronic and recurrent attacks. It often relates to dietary habits, such as postprandial worsening in the case of gastric ulcers, whereas duodenal ulcers typically improve after eating and may involve hunger pain and night pain. Therefore, if patients exhibit these typical symptoms, it is recommended to perform a gastroscopy to ascertain the presence of duodenal or gastric ulcers. Complications can occur with peptic ulcers, with the most common being gastrointestinal bleeding, manifested by vomiting blood or bloody stools, with the latter appearing as tarry, watery stools. Thus, if patients present with typical symptoms of abdominal pain, bloating, and particularly bleeding or vomiting blood and bloody stools, peptic ulcers are the most likely cause. It is advised for patients to actively seek treatment at local hospitals and receive medication therapy.

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Written by Jiang Guo Ming
Gastroenterology
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How is peptic ulcer treated?

The treatment of peptic ulcers mainly depends on their cause. It is generally believed that infection with Helicobacter pylori is most closely related to peptic ulcers. In such cases, the first step is to check for Helicobacter pylori infection. If there is an infection, antibacterial treatment is generally used, with the common regimen being quadruple therapy: a proton pump inhibitor plus two antibiotics and a bismuth agent. If there is no Helicobacter pylori infection, symptomatic treatment is generally sufficient. The preferred method is to use acid-suppressing and stomach-lining-protecting medications, combined with symptomatic treatment. At the same time, it is helpful to develop good dietary and living habits, opt for a light and easy-to-digest diet, and eat regularly in fixed amounts. Avoid overeating and excessive fatigue; abstain from smoking and alcohol, and maintaining a good mood all help. (Medication should be used under the guidance of a professional doctor.)

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Written by Jiang Guo Ming
Gastroenterology
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Can peptic ulcers be cured completely?

Peptic ulcers, including gastric ulcers and duodenal bulb ulcers, can generally be completely cured in most cases. Treatment plans are usually determined based on the presence of Helicobacter pylori infection. If there is an infection with Helicobacter pylori, quadruple therapy is typically used to eradicate the bacteria. If there is no Helicobacter pylori infection, symptomatic treatment is sufficient. Some patients may experience recurrent peptic ulcers, which are usually caused by several factors. Firstly, the failure to completely eradicate Helicobacter pylori can lead to recurrent ulcers. Additionally, the recurrence of ulcers might also be facilitated by poor dietary and lifestyle habits after the ulcers have healed, such as long-term alcohol abuse, smoking, or consumption of spicy and irritating foods.

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Written by Jiang Guo Ming
Gastroenterology
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Why does a peptic ulcer bleed?

Peptic ulcers include gastric ulcers, duodenal bulb ulcers, and so on. Gastrointestinal bleeding is one of the common complications of peptic ulcers, usually caused by the ulcer being relatively large or deep, invading the blood vessels, leading to vessel rupture and resulting in bleeding. For minor bleeding, the patient may not have any discomfort symptoms, primarily indicated by black stools or a positive fecal occult blood test. If there is substantial bleeding, it can lead to symptoms such as vomiting blood. Such cases need attention and usually require hospitalization for observation and treatment. Sometimes, recurrent gastrointestinal bleeding may require surgical treatment.