Treatment of gastric ulcer with bleeding

Written by Jiang Guo Ming
Gastroenterology
Updated on January 31, 2025
00:00
00:00

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.)

Other Voices

doctor image
home-news-image
Written by Ren Zheng Xin
Gastroenterology
57sec home-news-image

How long does it take for a stomach ulcer to heal?

Gastric ulcers are a very common disease in gastroenterology. For minor ulcers, adjustments in diet, quitting smoking and drinking, consuming more green vegetables, getting more rest, and reducing mental stress can gradually lead to recovery. More severe ulcers require active medication use. To achieve ulcer healing, the course of acid-reducing medication usually lasts four to six weeks. Commonly used medications include those that inhibit gastric acid secretion, such as HR receptor antagonists and proton pump inhibitors, as well as some bismuth agents and weakly alkaline antacids to protect the stomach lining. Meanwhile, dietary management should be strengthened. Through effective medical treatment, the healing rate of gastric ulcers can reach over 95%. (Specific medication use should be conducted under the guidance of a doctor.)

doctor image
home-news-image
Written by Ren Zheng Xin
Gastroenterology
58sec home-news-image

How to stop bleeding from a gastric ulcer?

Gastric ulcer bleeding is a relatively common complication. Treatment methods can be selected based on the endoscopic characteristics of the bleeding lesion. Active bleeding can be treated with acid-suppressing medications such as proton pump inhibitors, combined with endoscopic treatment, and if necessary, vascular interventional treatment or surgery. For those with blood clots, proton pump inhibitors can also be chosen, with endoscopic treatment if necessary. During endoscopy, fibrin glue can be sprayed on the surface of the ulcer, adrenaline can be injected at the bleeding site, and endoscopic hemostatic clip techniques can be used. During treatment, it’s important to adjust the diet. For those with significant bleeding, temporary parenteral nutrition should be chosen, and no food should be consumed to avoid further gastrointestinal irritation. (Please use medications under the guidance of a doctor.)

doctor image
home-news-image
Written by Li Xue Qing
Gastroenterology
1min 30sec home-news-image

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.)

doctor image
home-news-image
Written by Ren Zheng Xin
Gastroenterology
43sec home-news-image

Does gastric ulcer require hospitalization?

Whether a stomach ulcer requires hospitalization depends on the condition. For minor ulcers, if the pain is mild and there are no significant symptoms of vomiting or nausea, treatment can be managed with medication, such as drugs that inhibit stomach acid secretion and protect the gastric mucosa. It is also important to regulate diet, eat soft foods, avoid cold, spicy foods, and alcohol, as symptoms can gradually ease. If the ulcer is larger and exhibits perforation or bleeding, hospital treatment is necessary, usually involving a significant portion of the stomach being surgically removed to completely cure the ulcer. (Medication should be taken under the guidance of a doctor.)

doctor image
home-news-image
Written by Zhu Dan Hua
Gastroenterology
1min 23sec home-news-image

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.)