What position should be taken for duodenal ulcer hematemesis?

Written by Wu Hai Wu
Gastroenterology
Updated on September 21, 2024
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Patients with duodenal ulcers, if vomiting blood occurs, are advised to slightly elevate their lower limbs, position their heads lower, and lie on their side. Because when patients with duodenal ulcers vomit blood, it indicates a relatively large amount of bleeding. Elevating the lower limbs slightly can effectively promote the return of blood from the lower limbs, ensuring the blood supply to vital organs, and lying on the side helps prevent the possibility of choking following vomiting. Once vomiting blood due to a duodenal ulcer occurs, an urgent gastroscopy is required, and hemostatic treatment should be carried out under gastroscopy.

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Written by Ren Zheng Xin
Gastroenterology
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The difference between gastric ulcers and duodenal ulcers.

Gastric ulcers and duodenal ulcers are collectively known as peptic ulcers, formed under the self-digestion action of gastric acid and pepsin. Gastric ulcers are more common in middle-aged and elderly people, generally occurring at the lesser curvature of the stomach body. The pain of a gastric ulcer typically appears within an hour after eating, also known as postprandial pain, which gradually eases after one to two hours of digestion and absorption; gastric ulcers can easily lead to bleeding and perforation. Duodenal ulcers are more common in young and middle-aged adults, frequently occurring in the duodenal bulb. Typical symptoms include postprandial pain and midnight pain, which can be alleviated by using antacids. The treatment methods for gastric and duodenal ulcers are similar. Additionally, it is important to pay attention to diet in daily life, eat less spicy, greasy, and irritating food, and consume more soft, easily digestible food.

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Written by Wu Hai Wu
Gastroenterology
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What should I do if a duodenal ulcer causes diarrhea?

Patients with duodenal ulcers who experience diarrhea should undergo a routine stool examination to rule out diarrhea caused by intestinal infections. If there is no obvious organic disease in the intestines, the diarrhea associated with duodenal ulcers may be due to excessive secretion of stomach acid. It is advisable to consider using medications that suppress the secretion of stomach acid, such as proton pump inhibitors like omeprazole or lansoprazole, etc. You can also use aluminum magnesium carbonate, sucralfate, etc., to protect the stomach lining. For patients with abdominal distension, medications like mosapride can be used to promote gastric motility treatment.

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Written by Wu Hai Wu
Gastroenterology
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How large does a duodenal ulcer have to be to be considered severe?

There is no specific size to determine the severity of a duodenal ulcer. However, ulcers with a diameter greater than 1.5 cm are generally considered large. In such cases, strong acid-suppressing medications are needed for treatment, along with drugs to protect the gastric mucosa. Additionally, it is necessary to test for Helicobacter pylori infection. If the infection is positive, a bismuth-containing quadruple therapy should be used for two weeks to eradicate Helicobacter pylori. The choice of specific medications, as well as their dosages and administration, should be under the guidance of a doctor.

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Written by Wang Hui Jie
Gastroenterology
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The difference between gastric ulcers and duodenal ulcers.

The differences between gastric ulcers and duodenal ulcers, in terms of symptoms, include that gastric ulcers often manifest as burning pain, or dull pain, distention pain, etc., usually postprandial pain, occasionally with nighttime pain. If it occurs at the pyloric canal, it lacks typical symptoms, with intense pain likely occurring after eating, and poor drug efficacy, prone to vomiting and pyloric obstruction, perforation, and bleeding. Gastric ulcers have a minor possibility of becoming cancerous. Duodenal ulcer pain is mostly located in the upper abdomen, characterized by hunger pain and midnight pain. Abdominal pain generally eases after eating or taking some antacid medications. For ulcers occurring behind the bulb, nighttime pain and a radiating pain in the back are more common. However, the effectiveness of medication is relatively poor, and it is prone to bleeding. Duodenal ulcers are more likely to lead to perforation and pyloric obstruction, but generally do not become cancerous.

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Written by Wu Hai Wu
Gastroenterology
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Characteristics of vomiting in duodenal ulcer

The main characteristic of vomiting due to duodenal ulcer is postprandial vomiting. Generally, patients with duodenal ulcers are prone to pyloric obstruction. When a large meal is consumed, pyloric obstruction may occur, preventing stomach contents from passing into the duodenum, leading to vomiting. Additionally, patients might also experience vomiting of acidic stomach contents while fasting. After vomiting, patients with duodenal ulcers can use acid-suppressing medications to alleviate gastric edema and medications like mosapride to promote gastric motility. (Medication should be used under the guidance of a physician.)