Symptoms of peptic ulcers

Written by Jiang Guo Ming
Gastroenterology
Updated on September 24, 2024
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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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Written by Chen Rong
Gastroenterology
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Treatment of bleeding from peptic ulcers

Gastrointestinal ulcer bleeding may require different management based on the volume of bleeding. With significant bleeding, the condition becomes critical and rapidly changing. Priorities include anti-shock measures, rapid replenishment of blood volume, maintaining a supine position, keeping the airway clear to avoid aspiration during vomiting, providing oxygen if necessary, fasting during active bleeding, closely monitoring the patient's vital signs, immediate blood typing and cross-matching, promptly establishing an effective intravenous infusion pathway, and replenishing blood volume. Medications such as PPIs or H2 receptor antagonists can be used; the former should be chosen for severe bleeding and administered intravenously. About 80% of patients with gastrointestinal ulcer bleeding may stop bleeding without any special treatment, while the remaining patients may experience persistent bleeding or rebleeding. Emergency gastroscopy is crucial to determine if the patient is at high risk of rebleeding or has ongoing bleeding and can include therapeutic endoscopic interventions such as drug injections, electrocoagulation, and the use of hemostatic clips. If endoscopic treatment fails, the gastric and duodenal arteries may be embolized via arterial intervention. If pharmacologic, endoscopic, and interventional treatments cannot control the bleeding, and there is ongoing significant blood loss threatening the patient's life, surgical treatment may be necessary. (Specific medications should be administered under the guidance of a physician.)

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Written by Jiang Guo Ming
Gastroenterology
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Can people with peptic ulcers eat meat?

Peptic ulcers generally require conventional medication treatment first. If accompanied by bleeding or severe symptoms, hospitalization may be necessary. It is important to pay attention to dietary and living habits in such cases. Initially, one should consume light and easily digestible foods, such as soft and mushy rice, porridge, and the like. Fresh vegetables and fruits are also suitable, but they should not be too cold or raw. At the same time, remember not to overeat or drink excessively; it is best to eat regular, measured meals or small frequent meals. As for meat, if it is during the acute phase of the ulcer or if there is bleeding, try to avoid meat consumption; if it is during the recovery phase of the ulcer, meat can be consumed in small amounts but should not be too spicy. (Specific medication should be administered under the guidance of a physician)

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Written by Jiang Guo Ming
Gastroenterology
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Can people with peptic ulcers exercise?

The primary cause of peptic ulcers is usually Helicobacter pylori infection, though other factors can also trigger the onset of peptic ulcers, such as tobacco and alcohol irritation, poor dietary habits, and emotional issues. Additionally, excessive fatigue is also one of the causes that can trigger or cause a recurrence of peptic ulcers. Therefore, whether or not a person with peptic ulcers can exercise depends on the specific condition of the illness. If it is an acute active phase or a subacute peptic ulcer that has not fully healed, strict rest is necessary in such cases. If a gastroscopy shows that the ulcer has completely healed, moderate and light activities are permissible, but excessive fatigue should still be avoided.

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Written by Jiang Guo Ming
Gastroenterology
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Why does a peptic ulcer bleed?

Peptic ulcers include gastric ulcers, duodenal bulb ulcers, and so on. Gastrointestinal bleeding is one of the common complications of peptic ulcers, usually caused by the ulcer being relatively large or deep, invading the blood vessels, leading to vessel rupture and resulting in bleeding. For minor bleeding, the patient may not have any discomfort symptoms, primarily indicated by black stools or a positive fecal occult blood test. If there is substantial bleeding, it can lead to symptoms such as vomiting blood. Such cases need attention and usually require hospitalization for observation and treatment. Sometimes, recurrent gastrointestinal bleeding may require surgical treatment.

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Written by Jiang Guo Ming
Gastroenterology
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How is peptic ulcer treated?

The treatment of peptic ulcers mainly depends on their cause. It is generally believed that infection with Helicobacter pylori is most closely related to peptic ulcers. In such cases, the first step is to check for Helicobacter pylori infection. If there is an infection, antibacterial treatment is generally used, with the common regimen being quadruple therapy: a proton pump inhibitor plus two antibiotics and a bismuth agent. If there is no Helicobacter pylori infection, symptomatic treatment is generally sufficient. The preferred method is to use acid-suppressing and stomach-lining-protecting medications, combined with symptomatic treatment. At the same time, it is helpful to develop good dietary and living habits, opt for a light and easy-to-digest diet, and eat regularly in fixed amounts. Avoid overeating and excessive fatigue; abstain from smoking and alcohol, and maintaining a good mood all help. (Medication should be used under the guidance of a professional doctor.)