Can a peptic ulcer heal itself?

Written by Zhu Dan Hua
Gastroenterology
Updated on September 23, 2024
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Peptic ulcers, commonly referred to as stomach ulcers and duodenal ulcers, are relatively common in clinical settings and generally have a good prognosis. For simple peptic ulcers, patients usually do not exhibit common symptoms such as abdominal pain, vomiting blood, bloody stools, abdominal distension, vomiting, etc., and these can often heal on their own. However, if a patient experiences typical upper abdominal symptoms like vomiting blood, bloody stools, or significant abdominal pain, especially pain in the lower back, it is advisable for the patient to seek timely treatment at a local hospital for further clarification. In treating this condition, a few points should be noted: First, pay attention to diet and rest, it’s advisable to eat smaller, more frequent meals and avoid spicy foods and abstain from smoking and alcohol. Second, if peptic ulcers are suspected, one might consider using supplementary oral medications, such as antacids or gastroprotective drugs etc., which generally lead to a good prognosis. Of course, if the patient does not exhibit any special symptoms, regular observation may suffice.

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Causes of Peptic Ulcers

Peptic ulcers, which include gastric ulcers, duodenal bulb ulcers, complex ulcers, and anastomotic ulcers following gastric surgery, are among the common gastrointestinal diseases. It is currently believed that the infection of Helicobacter pylori is closely associated with gastritis, ulcer activity, gastric cancer, etc., thus, Helicobacter pylori infection is considered the main cause of gastric ulcers. Other factors, such as excessive smoking and alcohol consumption, can also lead to peptic ulcers. Poor dietary and living habits, such as binge eating, excessive consumption of cold, greasy, spicy, or alcoholic foods, can cause this condition as well; moreover, excessive emotional stress, such as long-term mental pressure, can also lead to the development of 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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Gastroenterology
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Clinical characteristics of peptic ulcer

The main cause of peptic ulcers is believed to be infection by Helicobacter pylori. Other factors such as smoking, alcohol, poor diet, living habits, medication use, or emotional issues can also play a role. Clinically, these ulcers are often characterized by upper abdominal pain. In the case of gastric ulcers, the pain is primarily in the upper left abdomen or below the sternum, and can manifest as dull pain, blunt pain, or a feeling of distension. This pain is often more apparent after meals, commonly occurring half an hour to an hour after eating, and usually subsides two to three hours later. Duodenal bulb ulcers are characterized by upper abdominal muscular pain, occurring around two centimeters above and to the right of the navel, sometimes accompanied by nighttime pain. If the ulcer is located behind the bulb, back pain can also occur. Peptic ulcers can lead to other complications, such as perforation, bleeding, or even cancer.

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Written by Jiang Guo Ming
Gastroenterology
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Symptoms of peptic ulcers

Upper abdominal pain is a symptom common to peptic ulcers, including dull, mild, or bloating pain, which is generally tolerable and varies in characteristics. For instance, the pain from a gastric ulcer is usually located in the upper abdomen, predominantly on the upper left side, and sometimes extends to the lower abdomen. It typically occurs about half an hour to an hour after meals and gradually eases after two to three hours. For duodenal bulb ulcers, the pain is generally around two fingers to the right of the belly button. It often presents as hunger-like pain in the upper abdomen, accompanied by nighttime pain. If it is a post-bulbar ulcer, it often causes back pain. Complex ulcers may exhibit characteristics of both types. Additionally, ulcers are generally associated with excessive stomach acid, leading to symptoms like acid reflux, heartburn, and abdominal bloating. If there is bleeding, it is often accompanied by black stools or even vomiting blood.

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Can people with peptic ulcers exercise?

Peptic ulcers are generally classified into duodenal bulb ulcers and gastric ulcers, along with mixed gastric-duodenal ulcers, etc. Clinically, they can generally be divided into acute active phase, healing phase, scar phase, etc. Generally speaking, patients with active peptic ulcers, in addition to standard medication, need absolute rest and must not overexert themselves. If it is in the remission or healing phase of peptic ulcer, in addition to developing good eating habits, one should also be cautious not to overexert; some light activities are still acceptable. Additionally, regular gastroscopy check-ups are necessary.