Causes of gastric ulcers

Written by Ren Zheng Xin

Gastroenterology

Updated on March 27, 2025

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Gastric ulcers refer to inflammatory defects in the gastric mucosa, with several common causes as follows: First, infection with Helicobacter pylori is directly related to the development of peptic ulcers. Second, various drugs that damage the gastric mucosa, such as non-steroidal anti-inflammatory drugs, corticosteroid hormones, etc. Third, dietary factors. Long-term alcohol consumption, spicy foods, strong tea, and coffee can all cause gastric ulcers. Fourth, the digestive actions of gastric acid and pepsin damage the gastric mucosa, leading to a decline in the protective barrier function of the mucosa and causing ulcers. Fifth, abnormalities in gastric motility and decreased emptying ability, leading to food retention in the stomach, continuously irritating the gastric mucosa, causing increased gastric acid secretion and resulting in ulcers.

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Causes of gastric ulcer

It is currently believed that Helicobacter pylori infection is closely related to gastritis activity, ulcer formation, and tumors. Therefore, the main cause of gastric ulcers is the infection of Helicobacter pylori. Other factors, such as drugs, long-term use of non-steroidal anti-inflammatory drugs or steroid medications, often lead to gastric mucosal damage and result in peptic ulcers. Psychological factors, such as long-term excessive tension or high stress, often lead to peptic ulcers as well. Poor dietary and living habits, such as excessive drinking, consuming raw, irritating, greasy food, or binge eating, also promote the occurrence of peptic ulcers.

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Written by Ren Zheng Xin

Gastroenterology

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What should be noted for bleeding from gastric ulcers?

After a gastric ulcer bleeds, the first thing to pay attention to is emotional control. Many people will feel emotionally excited and fearful when they experience bleeding and vomiting, and at this time, family members should soothe them promptly; Secondly, dietary adjustments should be made. Eat more soft, easily digestible foods, such as noodles, soft rice, soy milk, eggs, as well as a lot of green vegetables and fresh fruits. Supplementing with vitamin C can help heal the ulcer. In addition, restrict some raw, spicy, and fried foods. You should eat less food that is too sweet, too hot, too acidic, or too salty, and actively quit smoking and drinking.

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Written by Ren Zheng Xin

Gastroenterology

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Are stomach ulcers prone to recurrence?

After healing from a gastric ulcer, it is not easy to relapse if health education is strengthened. Usually, it is important to rest more, reduce stress, as excessive tension can lead to excitement of the vagus nerve, stimulate gastric acid secretion, and easily induce ulcers. Additionally, improving dietary habits, strictly quitting smoking and drinking, minimizing consumption of strong tea and coffee, and ceasing the use of medications that irritate the gastric mucosa when necessary, such as non-steroidal anti-inflammatory drugs and corticosteroid hormones, are essential. Meals should be on a regular schedule and in controlled portions, avoiding overeating and overdrinking. If gastrointestinal irritation symptoms occur, treatment should be proactive, and if infected with Helicobacter pylori, the bacteria should be actively eradicated. (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 Li Xue Qing

Gastroenterology

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How should gastric ulcers be treated?

The treatment of gastric ulcers is divided into general treatment and medication treatment. General treatment mainly requires patients to avoid spicy, irritating, and cold foods, maintain a calm mindset, have regular meals, and avoid the use of some drugs that can damage the stomach, such as non-steroidal anti-inflammatory drugs. Medication treatment can be administered through gastric protection, which includes drugs that neutralize stomach acid, such as magnesium aluminum carbonate chewable tablets. Drugs that suppress stomach acid include proton pump inhibitors and H2 receptor blockers. Medications that protect the gastric mucosa include sucralfate, bismuth preparations, etc. Additionally, there is targeted eradication treatment for Helicobacter pylori, which clinically includes triple and quadruple therapies. Triple therapy refers to a proton pump inhibitor or a bismuth agent combined with two antibiotics. Quadruple therapy consists of a proton pump inhibitor added to a bismuth agent and two antibiotics, which could include amoxicillin, clarithromycin, levofloxacin, furazolidone, metronidazole, tetracycline, etc. Treatment generally lasts seven to ten days, and the overall treatment for gastric ulcers is typically around one month. (Medications should be used under the guidance of a doctor based on the specific situation.)