Characteristics of pain in peptic ulcers

Written by Jiang Guo Ming
Gastroenterology
Updated on May 14, 2025
00:00
00:00

Peptic ulcers include gastric ulcers, duodenal bulb ulcers, and gastro-duodenal composite ulcers. The common characteristic of peptic ulcers is upper abdominal pain, which tends to be recurrent, periodic, and regular. For duodenal bulb ulcers, the pain is primarily located above and to the right of the navel, mainly manifesting as hunger pain in the upper abdomen, which can be alleviated after eating, accompanied by nocturnal pain. Sometimes, bulb ulcers can cause back pain. Gastric ulcers are mainly located above and to the left of the navel, primarily characterized by postprandial pain.

Other Voices

doctor image
home-news-image
Written by Jiang Guo Ming
Gastroenterology
44sec home-news-image

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.

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

The main causes of peptic ulcers

It is generally believed that Helicobacter pylori is closely related to gastric inflammation, ulcer formation, and malignancies. Therefore, the main cause of peptic ulcers should be the infection of Helicobacter pylori. Furthermore, certain conditions, such as connective tissue diseases and kidney diseases, may require long-term use of steroids or nonsteroidal anti-inflammatory drugs. This can damage the gastric mucosa and increase the secretion of gastric acid, thereby promoting the occurrence of peptic ulcers. Other factors like long-term poor dietary and living habits, such as smoking and consuming alcohol or spicy food, can also damage the gastrointestinal mucosa, thus leading to the development of peptic ulcers.

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.)

doctor image
home-news-image
Written by Jiang Guo Ming
Gastroenterology
43sec home-news-image

What is peptic ulcer disease?

Peptic ulcer is a common upper gastrointestinal disease, typically caused by the digestive action of stomach acid and pepsin, leading to damage in the mucosal layer of the stomach. Hence, it is called a peptic ulcer, encompassing gastric ulcers as well as duodenal bulb ulcers, complex ulcers, and so forth. The majority of causal factors are due to infection with Helicobacter pylori. Other factors include stimulants such as tobacco and alcohol, poor dietary habits, and medications like non-steroidal anti-inflammatory drugs (NSAIDs) and steroids. In addition, psychological factors can also lead to the development of peptic ulcers.