Principles of treatment for peptic ulcers

Written by Jiang Guo Ming
Gastroenterology
Updated on October 20, 2024
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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.

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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.

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Written by Jiang Guo Ming
Gastroenterology
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Principles of treatment for peptic ulcers

The principles of treatment for peptic ulcers, if malignant ulcers are present, surgical treatment is preferred. For benign peptic ulcers, it is first necessary to cultivate good dietary and living habits, quit smoking and drinking, avoid excessive fatigue, and adhere to a light diet with regular and measured meals, strictly avoiding overeating and binge eating. Meanwhile, the medication treatment should be determined based on whether there is a Helicobacter pylori infection; if there is an infection, standard antibacterial treatment is required, commonly involving quadruple therapy. If there is no Helicobacter pylori infection, symptomatic treatment usually yields satisfactory results. Proton pump inhibitors are the preferred drugs, such as rabeprazole and lansoprazole, combined with gastric mucosal protectants, prokinetic agents, etc. (Medication use should be conducted under the guidance of a professional doctor.)

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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 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.