Symptoms of peptic ulcer

Written by Jiang Guo Ming
Gastroenterology
Updated on October 26, 2024
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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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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.

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Written by Jiang Guo Ming
Gastroenterology
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Etiology of Peptic Ulcer

Peptic ulcers include gastric ulcers, duodenal bulb ulcers, complex ulcers, and so on. It is currently believed that about 80% of peptic ulcers are related to infection with Helicobacter pylori. Additionally, poor dietary and living habits are closely linked to the formation of peptic ulcers, such as excessive smoking and drinking, overeating cold, greasy, spicy, and irritating foods, as well as strong tea, coffee, etc. Moreover, many medications can cause damage to the gastric mucosa, leading to gastric ulcers, such as non-steroidal anti-inflammatory drugs. Furthermore, emotional excitement and major trauma and other stress responses can also lead to acute gastric mucosal lesions, resulting in peptic ulcers.

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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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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 Zhu Dan Hua
Gastroenterology
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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.