Is peptic ulcer serious?

Written by Jiang Guo Ming
Gastroenterology
Updated on September 23, 2024
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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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Written by Jiang Guo Ming
Gastroenterology
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The main causes of peptic ulcers

It is generally believed that Helicobacter pylori is closely related to gastric inflammation, ulcer formation, and malignancies. Therefore, the main cause of peptic ulcers should be the infection of Helicobacter pylori. Furthermore, certain conditions, such as connective tissue diseases and kidney diseases, may require long-term use of steroids or nonsteroidal anti-inflammatory drugs. This can damage the gastric mucosa and increase the secretion of gastric acid, thereby promoting the occurrence of peptic ulcers. Other factors like long-term poor dietary and living habits, such as smoking and consuming alcohol or spicy food, can also damage the gastrointestinal mucosa, thus leading to the development of peptic ulcers.

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Written by Zhu Dan Hua
Gastroenterology
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Can peptic ulcers become cancerous?

Peptic ulcers generally refer to gastric ulcers and duodenal ulcers. It is generally believed that most gastric ulcers are benign, but a small portion of patients may develop cancer, approximately 3%-5%, especially in middle-aged and elderly patients. If the ulcers recur and continue to enlarge, there needs to be vigilance for potential malignancy. However, duodenal ulcers generally do not become cancerous and are more common in young people, presenting symptoms such as abdominal pain, bloating, and bloody stools. Therefore, for peptic ulcers, most are benign, but a small fraction of patients may have ulcers that evolve into cancerous ones, presenting as benign peptic ulcers, which calls for caution, especially in middle-aged and elderly patients. Therefore, it is recommended that patients regularly treat gastric and duodenal ulcers. If the treatment period is prolonged and peptic ulcers recur frequently with poor outcomes, patients should be alert to the potential for cancer and are advised to undergo gastroscopic examination and biopsy for further clarification.

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Written by Jiang Guo Ming
Gastroenterology
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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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Written by Jiang Guo Ming
Gastroenterology
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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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Written by Jiang Guo Ming
Gastroenterology
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Can gastric lavage be performed for peptic ulcer?

Peptic ulcer is one of the common upper gastrointestinal diseases, including gastric ulcer, duodenal bulb ulcer, compound ulcer, etc. In this case, since the ulcer site is often deep, sometimes reaching the base layer, even the serous layer of the gastric mucosa. If gastric lavage is performed too vigorously, gastric perforation may occur. Therefore, generally, gastric lavage is not advocated, but in a few cases, such as organophosphate pesticide poisoning or other drug poisonings, etc. If gastric lavage is not performed promptly, it often leads to serious complications, even life-threatening. Therefore, gastric lavage is still needed in a few cases, and in these situations, the procedure must be gentle and not too prolonged.