Why does a peptic ulcer bleed?

Written by Jiang Guo Ming
Gastroenterology
Updated on January 20, 2025
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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.

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Written by Jiang Guo Ming
Gastroenterology
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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.

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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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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
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Can people with peptic ulcers exercise?

Peptic ulcers are generally classified into duodenal bulb ulcers and gastric ulcers, along with mixed gastric-duodenal ulcers, etc. Clinically, they can generally be divided into acute active phase, healing phase, scar phase, etc. Generally speaking, patients with active peptic ulcers, in addition to standard medication, need absolute rest and must not overexert themselves. If it is in the remission or healing phase of peptic ulcer, in addition to developing good eating habits, one should also be cautious not to overexert; some light activities are still acceptable. Additionally, regular gastroscopy check-ups are necessary.

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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.