The main cause of peptic ulcers

Written by Jiang Guo Ming

Gastroenterology

Updated on May 15, 2025

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Peptic ulcer is a common gastrointestinal disease, and the primary cause should primarily be Helicobacter pylori infection. Extensive research has proven that Helicobacter pylori infection is closely related to gastric inflammation activity, the formation of peptic ulcers, and gastric cancer. Secondly, drugs are a factor; many drugs can damage the gastric mucosa, such as non-steroidal anti-inflammatory drugs and corticosteroids, which often lead to the occurrence of peptic ulcers. Additionally, mental stress is often a catalyst for stomach diseases, with numerous studies showing that a person's emotions, personality, and mental stress are related to peptic ulcers. Furthermore, poor dietary and living habits can also damage the gastric mucosa, leading to the occurrence of peptic ulcers.

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Written by Jiang Guo Ming

Gastroenterology

1min 8sec

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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.

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Written by Chen Rong

Gastroenterology

1min 51sec

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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

1min 1sec

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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 Jiang Guo Ming

Gastroenterology

58sec

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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

53sec

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Causes of Peptic Ulcers

Peptic ulcers, which include gastric ulcers, duodenal bulb ulcers, complex ulcers, and anastomotic ulcers following gastric surgery, are among the common gastrointestinal diseases. It is currently believed that the infection of Helicobacter pylori is closely associated with gastritis, ulcer activity, gastric cancer, etc., thus, Helicobacter pylori infection is considered the main cause of gastric ulcers. Other factors, such as excessive smoking and alcohol consumption, can also lead to peptic ulcers. Poor dietary and living habits, such as binge eating, excessive consumption of cold, greasy, spicy, or alcoholic foods, can cause this condition as well; moreover, excessive emotional stress, such as long-term mental pressure, can also lead to the development of peptic ulcers.