What should be noted for gastric ulcers?

Written by Ren Zheng Xin
Gastroenterology
Updated on October 19, 2024
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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.

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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.)

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Written by Jiang Guo Ming
Gastroenterology
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Can gastric ulcers be cured?

Gastric ulcers are classified into benign and malignant types. Most duodenal bulb ulcers and gastric ulcers are benign and can be cured through medication. Treatment plans are usually determined based on the presence of Helicobacter pylori infection. Patients with Helicobacter pylori infection can be treated with antibacterial therapy. If there is no infection, symptomatic treatment alone is generally sufficient for a cure. If the ulcer is malignant or is a giant ulcer, surgical treatment is generally required. For those who cannot undergo surgery, radiotherapy or chemotherapy may be needed. Generally, the prognosis for malignant ulcers is worse than for benign ulcers.

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Written by Wang Li Wei
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How long should you fast if you have a bleeding gastric ulcer?

Primarily, it depends on whether the bleeding has stopped. If the bleeding has ceased, the patient shows no signs of vomiting blood, and their gastrointestinal symptoms in the abdomen are slightly improving, generally, they can gradually start eating after about two days. If the patient still experiences vomiting of blood, or has black stools, increased frequency of bowel movements, heartburn, or if a gastroscopy confirms that the bleeding vessels from the gastric ulcer are relatively large, the duration of fasting might be comparatively longer. Therefore, the duration of fasting for a gastric ulcer bleed mainly depends on whether there is active bleeding in the patient.

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Written by Ren Zheng Xin
Gastroenterology
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Causes of gastric ulcers

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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Written by Jiang Guo Ming
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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.