Symptoms of gastric ulcer

Written by Wang Hui Jie
Gastroenterology
Updated on September 05, 2024
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The clinical manifestations of stomach ulcers can vary from person to person. Some patients are asymptomatic and present to the clinic due to stomach bleeding or perforation. Generally, there are three main characteristics of peptic ulcers: First, they tend to be a chronic, recurrent condition. Second, they exhibit periodicity. Third, they have rhythmic manifestations. The primary symptom is periodic, rhythmic upper abdominal pain, often described as burning, dull, or bloating pain. This usually occurs in the upper abdomen, possibly on the left or right side, and typically manifests as post-meal pain. Nighttime pain is uncommon, and there may be localized tenderness. If the ulcer occurs in the pyloric canal, it may lack some of these typical symptoms. Post-meal intense pain is possible, and the effectiveness of medication is generally poor. This condition can easily lead to vomiting or pyloric obstruction and is also prone to perforation and bleeding. A minority of stomach ulcers may potentially become cancerous.

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Written by Jiang Guo Ming
Gastroenterology
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What should I do if there is bleeding from a gastric ulcer?

If there is only a small amount of bleeding in gastric ulcer bleeding, manifested as black stool without any other special discomfort symptoms, this condition can be treated with oral medication in an outpatient setting. The treatment plan is usually determined based on the presence or absence of Helicobacter pylori infection. For those with Helicobacter pylori infection, a quadruple therapy is generally used for eradication treatment. For those without the infection, proton pump inhibitors are the preferred choice, combined with medications that protect the gastric mucosa, and so on. If there is a significant amount of bleeding, with symptoms like vomiting blood, this situation requires timely hospital treatment, usually involving fasting and intravenous fluid therapy. If medical treatment is ineffective, a combined medical and surgical approach may be necessary. (The use of medications should be under the guidance of a doctor.)

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Written by Li Xue Qing
Gastroenterology
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Complications of gastric ulcers

The main complications of gastric ulcers are fourfold: one is upper gastrointestinal bleeding; the second is perforation; the third is pyloric obstruction; the fourth is malignant transformation. Upper gastrointestinal bleeding is the most common complication of gastric ulcers. If a patient has experienced bleeding, there is a high likelihood of recurrence. Perforations mainly occur in elderly individuals. Pyloric obstruction is primarily caused by ulcers in the pyloric canal and pre-pyloric area. It is divided into mechanical obstruction and functional obstruction. Mechanical obstruction results from scarring after the ulcer heals, which narrows the pyloric opening. Functional obstruction is due to congestion and edema of the mucosa after the ulcer, causing relative narrowing of the pylorus. As for malignant transformation, it is still controversial, but it is generally believed to be around 1%-7%.

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Written by Ren Zheng Xin
Gastroenterology
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Is gastric ulcer contagious?

Gastric ulcers are lesions that occur in the gastric mucosa. Ulcer disease is not contagious, therefore it does not transmit from person to person. Most gastric ulcers are caused by an infection of Helicobacter pylori, which damages the protective barrier of the gastric mucosa, and ulcers arise under the stimulation of gastric acid. The principles of treatment mainly involve eradicating Helicobacter pylori, suppressing gastric acid secretion, and protecting the gastric mucosa. Additionally, dietary control is important, including eating more vegetables and fruits, consuming less spicy and irritating foods, and paying attention to regular and measured meal times.

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Written by Jiang Guo Ming
Gastroenterology
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Is bleeding from a gastric ulcer serious?

Upper gastrointestinal bleeding is one of the common complications of peptic ulcers. If gastric ulcers cause vomiting blood, it often indicates that the bleeding is not minor and the condition is generally severe. It is usually considered that when about 250-300mL of blood accumulates in the stomach, vomiting blood may occur. Clinically, if vomiting blood occurs, it is firstly necessary to promptly hospitalize for treatment, including establishing venous access, nutritional support, and hemostatic treatment. Proton pump inhibitors or somatostatin analogs are commonly used. Additionally, if the bleeding does not stop, endoscopic treatment can be performed, such as spraying hemostatic drugs, electrocoagulation, or mechanical hemostasis. It is also necessary to monitor the patient's vital signs. If repeated bleeding occurs, a comprehensive treatment plan may be needed.

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Written by Ren Zheng Xin
Gastroenterology
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What should be noted for gastric ulcers?

Gastric ulcers are closely related to lifestyle, dietary habits, and work stress. First, it is important to rest more and reduce mental stress. Secondly, improve dietary habits by eating regular meals, consuming more vegetables and fruits, and easy-to-digest foods while reducing the intake of spicy, greasy, and irritating foods. Pay strict attention to quitting smoking and alcohol, drinking less strong tea and coffee, actively use medications that inhibit gastric acid secretion and protect the gastric mucosa, and persist in taking medication as prescribed by a doctor. Avoid life's irritants, strengthen physical exercise, and engage in more outdoor activities to regulate physical and mental health.