Peptic ulcer


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.


Peptic Ulcer Clinical Symptoms
Peptic ulcers are a common disease and often seen in clinical practice. They are typically manifested by discomfort in the upper abdomen, which may include abdominal pain, bloating, nausea, vomiting, and belching, and patients usually visit the gastroenterology department. The abdominal pain related to peptic ulcers, particularly the most typical and common symptoms, usually presents as pain above the navel, with chronic and recurrent attacks. It often relates to dietary habits, such as postprandial worsening in the case of gastric ulcers, whereas duodenal ulcers typically improve after eating and may involve hunger pain and night pain. Therefore, if patients exhibit these typical symptoms, it is recommended to perform a gastroscopy to ascertain the presence of duodenal or gastric ulcers. Complications can occur with peptic ulcers, with the most common being gastrointestinal bleeding, manifested by vomiting blood or bloody stools, with the latter appearing as tarry, watery stools. Thus, if patients present with typical symptoms of abdominal pain, bloating, and particularly bleeding or vomiting blood and bloody stools, peptic ulcers are the most likely cause. It is advised for patients to actively seek treatment at local hospitals and receive medication therapy.


How is peptic ulcer treated?
The treatment of peptic ulcers mainly depends on their cause. It is generally believed that infection with Helicobacter pylori is most closely related to peptic ulcers. In such cases, the first step is to check for Helicobacter pylori infection. If there is an infection, antibacterial treatment is generally used, with the common regimen being quadruple therapy: a proton pump inhibitor plus two antibiotics and a bismuth agent. If there is no Helicobacter pylori infection, symptomatic treatment is generally sufficient. The preferred method is to use acid-suppressing and stomach-lining-protecting medications, combined with symptomatic treatment. At the same time, it is helpful to develop good dietary and living habits, opt for a light and easy-to-digest diet, and eat regularly in fixed amounts. Avoid overeating and excessive fatigue; abstain from smoking and alcohol, and maintaining a good mood all help. (Medication should be used under the guidance of a professional doctor.)


Can peptic ulcers be cured completely?
Peptic ulcers, including gastric ulcers and duodenal bulb ulcers, can generally be completely cured in most cases. Treatment plans are usually determined based on the presence of Helicobacter pylori infection. If there is an infection with Helicobacter pylori, quadruple therapy is typically used to eradicate the bacteria. If there is no Helicobacter pylori infection, symptomatic treatment is sufficient. Some patients may experience recurrent peptic ulcers, which are usually caused by several factors. Firstly, the failure to completely eradicate Helicobacter pylori can lead to recurrent ulcers. Additionally, the recurrence of ulcers might also be facilitated by poor dietary and lifestyle habits after the ulcers have healed, such as long-term alcohol abuse, smoking, or consumption of spicy and irritating foods.


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.


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.