Principles of treatment for peptic ulcers

Written by Jiang Guo Ming
Gastroenterology
Updated on October 20, 2024
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Jiang Guo Ming
Gastroenterology
1min 2sec home-news-image

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.

doctor image
home-news-image
Written by Jiang Guo Ming
Gastroenterology
46sec home-news-image

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.

doctor image
home-news-image
Written by Jiang Guo Ming
Gastroenterology
51sec home-news-image

What can people with peptic ulcers eat?

Peptic ulcers include duodenal bulb ulcers, gastric ulcers, complex ulcers, etc. In such cases, formal treatment should be administered first. Depending on whether there is a Helicobacter pylori infection, different treatment plans should be adopted. At the same time, it is important to develop good dietary and living habits, quit smoking and drinking, and ensure that the diet is light and easy to digest. While ensuring adequate nutrition, efforts should be made to minimize gastric irritation. Foods like soft and mushy rice, porridge, and soft noodles are preferable. Fresh vegetables and fruits are fine. Try to avoid overly cold, greasy, spicy, or irritating foods. Be sure to eat regularly and in moderation or have small, frequent meals, and avoid binge eating.

doctor image
home-news-image
Written by Zhu Dan Hua
Gastroenterology
1min 21sec home-news-image

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.

doctor image
home-news-image
Written by Chen Rong
Gastroenterology
1min 51sec home-news-image

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.)