What should I do if there is bleeding from a gastric ulcer?

Written by Jiang Guo Ming
Gastroenterology
Updated on December 25, 2024
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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 Ren Zheng Xin
Gastroenterology
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Early symptoms of gastric ulcer

Gastric ulcers refer to ulcerative lesions on the gastric mucosa and are very common in gastroenterology. Typical symptoms include pain in the upper abdomen, often presenting as dull pain or a burning sensation in the early stages. Particularly after eating, pain in the upper abdomen occurs within an hour and gradually eases after two hours. As the condition progresses, complications such as gastric bleeding and gastric perforation may occur. Diagnosis can be confirmed clinically through a barium meal examination and gastroscopy. Currently, with the development of internal medicine drugs, most gastric ulcers can be treated 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 Ren Zheng Xin
Gastroenterology
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How to care for gastric ulcer bleeding

Gastric ulcer bleeding is a relatively common complication. First, it is important to soothe the patient's emotions, encourage rest, reduce mental stress, and pay attention to significant bleeding, which can cause vomiting of blood. It is necessary to promptly clean the blood stains in the mouth to prevent aspiration, provide timely symptomatic treatment, and choose to use proton pump inhibitors combined with endoscopic hemostasis. Vascular intervention or surgery may be required when necessary. Dietary management should be strengthened, with regular meals, consumption of soft, easily digestible food, and avoidance of hard, cold foods. It is crucial to strictly abstain from smoking and alcohol, and to consume less strong tea, coffee, etc., while actively treating any complications. (Please use medications under the guidance of a doctor.)

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Written by Jiang Guo Ming
Gastroenterology
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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.

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Written by Jiang Guo Ming
Gastroenterology
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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.