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Peptic ulcer
Asymptomatic peptic ulcer
Peptic ulcers typically include duodenal bulb ulcers and gastric ulcers. They more or less have typical related symptoms, such as long-term, recurrent, regular upper abdominal pain related to eating, along with symptoms like acid reflux. Diagnosis can be confirmed through gastroscopy. A small portion of patients, especially middle-aged and elderly patients with a history of cardiovascular and cerebrovascular diseases, often take non-steroidal anti-inflammatory drugs (NSAIDs) year-round. This situation can easily lead to the occurrence of acute gastric mucosal lesions and often results in asymptomatic gastric ulcers. Many patients present with symptoms like vomiting blood and black stools when they seek medical advice.
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.
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.
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.
Can peptic ulcers be cured?
Peptic ulcers include gastric ulcers, duodenal bulb ulcers, complex ulcers, and more. The primary cause is usually Helicobacter pylori infection, particularly in patients with duodenal bulb ulcers. Generally, eradicating Helicobacter pylori can cure the ulcer. However, a small number of patients, due to underlying diseases or irregular medication use, often develop resistance to Helicobacter pylori. In such cases, peptic ulcers are prone to recurrent flares. Additionally, peptic ulcers caused by other factors, such as smoking and alcohol stimulation, poor dietary habits, medication, emotional issues, etc., can generally be cured by removing the triggers. However, it's essential to develop good dietary and living habits and strictly follow medical advice regarding medications.
Symptoms of peptic ulcers
Upper abdominal pain is a symptom common to peptic ulcers, including dull, mild, or bloating pain, which is generally tolerable and varies in characteristics. For instance, the pain from a gastric ulcer is usually located in the upper abdomen, predominantly on the upper left side, and sometimes extends to the lower abdomen. It typically occurs about half an hour to an hour after meals and gradually eases after two to three hours. For duodenal bulb ulcers, the pain is generally around two fingers to the right of the belly button. It often presents as hunger-like pain in the upper abdomen, accompanied by nighttime pain. If it is a post-bulbar ulcer, it often causes back pain. Complex ulcers may exhibit characteristics of both types. Additionally, ulcers are generally associated with excessive stomach acid, leading to symptoms like acid reflux, heartburn, and abdominal bloating. If there is bleeding, it is often accompanied by black stools or even vomiting blood.
Can a peptic ulcer heal itself?
Peptic ulcers, commonly referred to as stomach ulcers and duodenal ulcers, are relatively common in clinical settings and generally have a good prognosis. For simple peptic ulcers, patients usually do not exhibit common symptoms such as abdominal pain, vomiting blood, bloody stools, abdominal distension, vomiting, etc., and these can often heal on their own. However, if a patient experiences typical upper abdominal symptoms like vomiting blood, bloody stools, or significant abdominal pain, especially pain in the lower back, it is advisable for the patient to seek timely treatment at a local hospital for further clarification. In treating this condition, a few points should be noted: First, pay attention to diet and rest, it’s advisable to eat smaller, more frequent meals and avoid spicy foods and abstain from smoking and alcohol. Second, if peptic ulcers are suspected, one might consider using supplementary oral medications, such as antacids or gastroprotective drugs etc., which generally lead to a good prognosis. Of course, if the patient does not exhibit any special symptoms, regular observation may suffice.
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.
Is peptic ulcer serious?
Peptic ulcer is a common disease of the upper gastrointestinal tract, including gastric ulcer, duodenal bulb ulcer, and gastroduodenal complex ulcer, etc. The primary cause is often infection with Helicobacter pylori. Other factors, such as poor dietary habits, smoking and alcohol stimulants, drug irritants, or emotional factors, can also lead to peptic ulcers. As for the severity of peptic ulcers, it should be judged based on the patient's age, medical history, medication history, and the results of gastroscopy, among other factors. Generally, peptic ulcers are not serious and can be cured with medication. However, a minority of recurrent cases might have a tendency to become cancerous. These cases can be effectively treated with a combination of medical and surgical treatments, and are generally not severe.
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.