Clinical characteristics of peptic ulcer

Written by Jiang Guo Ming
Gastroenterology
Updated on September 06, 2024
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Peptic ulcer is a common and frequently occurring upper gastrointestinal disease. The most likely cause may be infection by Helicobacter pylori, with other potential causes including irritation from smoking and alcohol, poor dietary and living habits, severe psychological stress, or medications, among others. The primary change is usually an excessive secretion of gastric acid, which irritates the gastric mucosa leading to self-digestion and the appearance of gastric or duodenal erosion and ulcers. Clinically, it often presents as long-term, periodic, rhythmic upper abdominal pain, which may be located in the upper left abdomen or slightly right of the navel, and is often accompanied by regurgitation, belching, acid reflux, nausea, etc. If there is ulcer bleeding, it often presents as black stools or even vomiting blood, among other symptoms.

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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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Written by Jiang Guo Ming
Gastroenterology
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Can peptic ulcers be cured completely?

Peptic ulcers, including gastric ulcers and duodenal bulb ulcers, can generally be completely cured in most cases. Treatment plans are usually determined based on the presence of Helicobacter pylori infection. If there is an infection with Helicobacter pylori, quadruple therapy is typically used to eradicate the bacteria. If there is no Helicobacter pylori infection, symptomatic treatment is sufficient. Some patients may experience recurrent peptic ulcers, which are usually caused by several factors. Firstly, the failure to completely eradicate Helicobacter pylori can lead to recurrent ulcers. Additionally, the recurrence of ulcers might also be facilitated by poor dietary and lifestyle habits after the ulcers have healed, such as long-term alcohol abuse, smoking, or consumption of spicy and irritating foods.

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Written by Li Xue Qing
Gastroenterology
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Peptic ulcer is what?

Peptic ulcers are a recurrent, periodic, and rhythmic disease characterized by upper abdominal pain. They mainly occur in the stomach and duodenum. The causes include excessive secretion of gastric acid, reduced protective function of the gastric mucosa, and infections caused by Helicobacter pylori. In terms of symptoms, there is mainly a tenderness in the upper abdomen. For diagnosis, gastroscope can be used to examine the mucosa for the presence of 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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Principles of treatment for peptic ulcers

Peptic ulcers include gastric ulcers, duodenal ulcers, complex ulcers, etc. There can be many complications, such as gastrointestinal bleeding, and if not healed over a long period, degeneration may occur, leading to the development of gastric cancer. Therefore, peptic ulcers must be treated promptly. As for the principles of treatment, they should be determined based on specific symptoms and whether there is a Helicobacter pylori infection. If there is a Helicobacter pylori infection, the general approach is to use quadruple therapy for antibacterial treatment; if there is no Helicobacter pylori infection, treatment generally focuses on symptomatic relief, such as suppressing stomach acid, protecting the mucosa, and increasing gastric motility, etc. At the same time, it is essential to pay attention to regular eating and living habits, eating on a regular schedule or having small, frequent meals. Avoid overeating, as well as stimulating substances like cold, greasy, and spicy foods. Additionally, it is important to keep warm and get plenty of rest.