How to treat bleeding from gastric ulcers?

Written by Jiang Guo Ming
Gastroenterology
Updated on September 06, 2024
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If it is a mild gastric ulcer bleeding, it may only manifest as black stool without any obvious specific discomfort symptoms and stable vital signs. This condition can be managed by controlling the diet and appropriately taking or intravenously using proton pump inhibitors such as omeprazole, lansoprazole, etc., which often can be curative.

If the bleeding is considerable, presenting symptoms like vomiting coffee-colored or dark red liquid, fainting, profuse sweating, blood pressure drop, etc., this condition requires timely hospital treatment. Medication primarily includes proton pump inhibitors combined with hemostatic drugs, nutritional support, prevention of complications, etc. If the medical treatment is ineffective, endoscopic hemostasis might be needed, and further more, surgical intervention may be considered.

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Written by Zhu Dan Hua
Gastroenterology
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Gastric ulcer clinical symptoms

Gastric ulcers are a common clinical manifestation, with diverse symptoms. Typical symptoms include abdominal pain, bloating, nausea, vomiting, or early satiety. Typically, the abdominal pain is more noticeable after eating and presents as postprandial abdominal pain, but it can naturally subside after several hours. Of course, when accompanied by complications such as decreased appetite, nausea, and vomiting, it can manifest as vomiting blood or bloody stools, with the stools often being loose and black in color. Therefore, clinically, if you encounter situations like bleeding stools or vomiting blood accompanied by abdominal pain, ulcers should be considered, and it is recommended to seek timely treatment at a local hospital. If these conditions are relatively stable, they can be managed with medication.

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Written by Jiang Guo Ming
Gastroenterology
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Treatment of gastric ulcer with bleeding

For the treatment of gastric ulcers with bleeding, it is primarily necessary to determine the treatment plan based on the amount of bleeding. If the bleeding is minor, it can be treated with oral medication, and whether there is an infection with Helicobacter pylori must be considered. If there is an infection of Helicobacter pylori, the typical treatment is a quadruple therapy, which includes a proton pump inhibitor, two antibiotics, and a bismuth agent. If there is no Helicobacter pylori infection, symptomatic treatment is sufficient, commonly using proton pump inhibitors. If the bleeding is severe, timely hospitalization is needed. The treatment usually involves the intravenous use of proton pump inhibitors primarily, and if the medication is ineffective, endoscopic treatment might be necessary. This could include the application of hemostatic medications, electrocoagulation, or the use of titanium clips, etc. (Please use medication under the guidance of a doctor.)

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Written by Zhu Dan Hua
Gastroenterology
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How is a gastric ulcer diagnosed?

Gastric ulcers can generally be diagnosed through gastroscopy. They are commonly found in middle-aged and elderly patients, particularly those between the ages of 30-40. Some patients present with abdominal pain, bloating, and general discomfort, while a small number of patients might not experience abdominal pain but present with gastrointestinal bleeding, indicated by black stools or blood in stool. Therefore, if abdominal pain is suspected, it is generally recommended that patients undergo routine blood tests and gastroscopy, among other examinations. The abdominal pain from gastric ulcers usually manifests as upper abdominal pain, occurring in episodic attacks, with chronic and recurrent episodes and a long history of illness. Symptoms typically worsen after eating but may gradually alleviate on their own. Of course, taking some stomach-protecting medication can help manage the condition. A small portion of patients may also experience nausea and belching, which are nonspecific gastrointestinal symptoms. If gastric ulcers are suspected, further screening for Helicobacter pylori is usually conducted. (The use of medication should be under the guidance of a professional doctor.)

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Written by Jiang Guo Ming
Gastroenterology
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What medicine to take for gastric ulcer?

The stomach ulcers referred to here are generally benign gastric ulcers. The treatment plan should be determined based on whether there is a Helicobacter pylori infection. If there is no Helicobacter pylori infection, it is first important to develop good dietary and living habits, and then treat the symptoms, such as suppressing stomach acid, protecting the gastric mucosa, and increasing gastric motility. If there is a Helicobacter pylori infection, antibacterial treatment is needed. Typically, a triple or quadruple antibiotic therapy is used; a proton pump inhibitor plus two antibiotics constitute the triple therapy, and adding a bismuth agent constitutes the quadruple therapy. A course of treatment lasts for two weeks, which generally can eradicate the bacteria for a definitive cure. (Medications should be used under the guidance of a clinical doctor, according to specific conditions.)

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Written by Jiang Guo Ming
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Gastric ulcer and duodenal ulcer

Gastric ulcers and duodenal bulb ulcers both belong to upper gastrointestinal ulcers. Their symptoms slightly differ; gastric ulcers typically manifest as postprandial pain in the upper abdomen, whereas duodenal bulb ulcers present as hunger pains in the upper abdomen, sometimes accompanied by nocturnal pain. Both types generally exhibit symptoms such as acid reflux and heartburn. The predominant cause for these is infection by Helicobacter pylori, detectable through tests such as the carbon-13 or carbon-14 breath test. If an infection is present, antimicrobial treatment can typically lead to a complete recovery of the ulcers. If there is no Helicobacter pylori infection, the initial approach should still focus on symptomatic treatment. Additionally, adopting good dietary and living habits can facilitate regular gastroscopic follow-ups.