Etiology of Peptic Ulcer

Written by Jiang Guo Ming
Gastroenterology
Updated on September 23, 2024
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Peptic ulcers include gastric ulcers, duodenal bulb ulcers, complex ulcers, and so on. It is currently believed that about 80% of peptic ulcers are related to infection with Helicobacter pylori. Additionally, poor dietary and living habits are closely linked to the formation of peptic ulcers, such as excessive smoking and drinking, overeating cold, greasy, spicy, and irritating foods, as well as strong tea, coffee, etc. Moreover, many medications can cause damage to the gastric mucosa, leading to gastric ulcers, such as non-steroidal anti-inflammatory drugs. Furthermore, emotional excitement and major trauma and other stress responses can also lead to acute gastric mucosal lesions, resulting in peptic ulcers.

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Symptoms of peptic ulcer

Peptic ulcers typically include gastric ulcers, duodenal bulb ulcers, and complex ulcers, among others, all of which feature upper abdominal pain. For gastric ulcers, the pain is generally located below the xiphoid process or in the upper left abdomen, primarily occurring after meals and often accompanied by symptoms such as abdominal bloating and acid reflux. Duodenal bulb ulcers usually present as hunger-like pain in the upper abdomen, which can be alleviated by eating and may include nighttime pain, often with significant acid reflux and heartburn. These can be definitively diagnosed via gastroscopy. Additionally, many elderly individuals may develop gastric ulcers after taking nonsteroidal anti-inflammatory drugs, often without significant pain, typically requiring a gastroscopy for accurate diagnosis.

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Is peptic ulcer serious?

Peptic ulcer is a common disease of the upper gastrointestinal tract, including gastric ulcer, duodenal bulb ulcer, and gastroduodenal complex ulcer, etc. The primary cause is often infection with Helicobacter pylori. Other factors, such as poor dietary habits, smoking and alcohol stimulants, drug irritants, or emotional factors, can also lead to peptic ulcers. As for the severity of peptic ulcers, it should be judged based on the patient's age, medical history, medication history, and the results of gastroscopy, among other factors. Generally, peptic ulcers are not serious and can be cured with medication. However, a minority of recurrent cases might have a tendency to become cancerous. These cases can be effectively treated with a combination of medical and surgical treatments, and are generally not severe.

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The main symptoms of peptic ulcers

Common types of peptic ulcers, including gastric ulcers, duodenal bulb ulcers, complex ulcers, and anastomotic ulcers after gastric resection, share common characteristics and have their own distinct symptoms. Abdominal pain is a usual symptom. The pain from duodenal bulb ulcers tends to be dull, bloating, or blunt, and it is generally more noticeable when hungry. The pain often eases after eating as food neutralizes stomach acid. Sometimes, there is pain at night. If the ulcer is beyond the bulb or is a penetrating ulcer, it often comes with back pain; gastric ulcers primarily manifest as postprandial pain, meaning pain occurring half an hour to an hour after eating, which gradually alleviates; complex ulcers often present with both types of symptoms mentioned above. As peptic ulcers are often associated with excessive stomach acid, symptoms like acid reflux, heartburn, and nausea are common.

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Can peptic ulcers be cured?

Peptic ulcers include gastric ulcers, duodenal bulb ulcers, complex ulcers, and more. The primary cause is usually Helicobacter pylori infection, particularly in patients with duodenal bulb ulcers. Generally, eradicating Helicobacter pylori can cure the ulcer. However, a small number of patients, due to underlying diseases or irregular medication use, often develop resistance to Helicobacter pylori. In such cases, peptic ulcers are prone to recurrent flares. Additionally, peptic ulcers caused by other factors, such as smoking and alcohol stimulation, poor dietary habits, medication, emotional issues, etc., can generally be cured by removing the triggers. However, it's essential to develop good dietary and living habits and strictly follow medical advice regarding medications.

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What can people with peptic ulcers eat?

Peptic ulcers include duodenal bulb ulcers, gastric ulcers, complex ulcers, etc. In such cases, formal treatment should be administered first. Depending on whether there is a Helicobacter pylori infection, different treatment plans should be adopted. At the same time, it is important to develop good dietary and living habits, quit smoking and drinking, and ensure that the diet is light and easy to digest. While ensuring adequate nutrition, efforts should be made to minimize gastric irritation. Foods like soft and mushy rice, porridge, and soft noodles are preferable. Fresh vegetables and fruits are fine. Try to avoid overly cold, greasy, spicy, or irritating foods. Be sure to eat regularly and in moderation or have small, frequent meals, and avoid binge eating.