Peptic ulcer

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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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What can people with peptic ulcers eat?

Peptic ulcers include duodenal bulb ulcers, gastric ulcers, complex ulcers, etc. In such cases, formal treatment should be administered first. Depending on whether there is a Helicobacter pylori infection, different treatment plans should be adopted. At the same time, it is important to develop good dietary and living habits, quit smoking and drinking, and ensure that the diet is light and easy to digest. While ensuring adequate nutrition, efforts should be made to minimize gastric irritation. Foods like soft and mushy rice, porridge, and soft noodles are preferable. Fresh vegetables and fruits are fine. Try to avoid overly cold, greasy, spicy, or irritating foods. Be sure to eat regularly and in moderation or have small, frequent meals, and avoid binge eating.

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Written by Jiang Guo Ming
Gastroenterology
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Peptic ulcer clinical symptoms

Helicobacter pylori infection is considered the primary cause of peptic ulcers, often leading to excess stomach acid, abnormal gastric motility, and other symptoms. Excess stomach acid can cause acid reflux, heartburn, and a burning sensation, while abnormal gastric motility may lead to nausea, belching, and even vomiting and bloating, with stomach acid irritation likely causing upper abdominal pain. Gastric ulcer pain is generally located in the upper left abdomen or below the sternum, typically presenting as postprandial pain. Duodenal bulb ulcers generally cause pain to the upper right of the navel, typically fasting pain that eases upon eating, sometimes accompanied by menstrual-like pain, with pain from ulcers behind the bulb potentially radiating to the back.

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Written by Chen Rong
Gastroenterology
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Treatment of bleeding from peptic ulcers

Gastrointestinal ulcer bleeding may require different management based on the volume of bleeding. With significant bleeding, the condition becomes critical and rapidly changing. Priorities include anti-shock measures, rapid replenishment of blood volume, maintaining a supine position, keeping the airway clear to avoid aspiration during vomiting, providing oxygen if necessary, fasting during active bleeding, closely monitoring the patient's vital signs, immediate blood typing and cross-matching, promptly establishing an effective intravenous infusion pathway, and replenishing blood volume. Medications such as PPIs or H2 receptor antagonists can be used; the former should be chosen for severe bleeding and administered intravenously. About 80% of patients with gastrointestinal ulcer bleeding may stop bleeding without any special treatment, while the remaining patients may experience persistent bleeding or rebleeding. Emergency gastroscopy is crucial to determine if the patient is at high risk of rebleeding or has ongoing bleeding and can include therapeutic endoscopic interventions such as drug injections, electrocoagulation, and the use of hemostatic clips. If endoscopic treatment fails, the gastric and duodenal arteries may be embolized via arterial intervention. If pharmacologic, endoscopic, and interventional treatments cannot control the bleeding, and there is ongoing significant blood loss threatening the patient's life, surgical treatment may be necessary. (Specific medications should be administered under the guidance of a physician.)

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Written by Ren Zheng Xin
Gastroenterology
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The difference between peptic ulcer and gastric ulcer.

Peptic ulcers refer to ulcers occurring in the digestive tract, including duodenal ulcers and gastric ulcers, whereas gastric ulcers specifically refer to ulcerative lesions occurring in the gastric mucosa. Clinically, there is often a distinction made between duodenal ulcers and gastric ulcers. Clinically, gastric ulcers cause postprandial pain, while duodenal ulcers are characterized by midnight pain and hunger pain. Additionally, the locations of occurrence differ; gastric ulcers commonly occur on the lesser curvature of the stomach, whereas duodenal ulcers commonly occur in the bulb. The treatment methods are fundamentally similar, primarily involving the use of medications that inhibit gastric acid secretion and protect the mucous membrane. Moreover, it involves enhancing health education, maintaining a regular diet, reasonable rest, and avoiding excessive fatigue. (Please use medication under the guidance of a physician.)

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Written by Jiang Guo Ming
Gastroenterology
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Can people with peptic ulcers exercise?

The primary cause of peptic ulcers is usually Helicobacter pylori infection, though other factors can also trigger the onset of peptic ulcers, such as tobacco and alcohol irritation, poor dietary habits, and emotional issues. Additionally, excessive fatigue is also one of the causes that can trigger or cause a recurrence of peptic ulcers. Therefore, whether or not a person with peptic ulcers can exercise depends on the specific condition of the illness. If it is an acute active phase or a subacute peptic ulcer that has not fully healed, strict rest is necessary in such cases. If a gastroscopy shows that the ulcer has completely healed, moderate and light activities are permissible, but excessive fatigue should still be avoided.

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Written by Jiang Guo Ming
Gastroenterology
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Can people with peptic ulcers eat meat?

Peptic ulcers generally require conventional medication treatment first. If accompanied by bleeding or severe symptoms, hospitalization may be necessary. It is important to pay attention to dietary and living habits in such cases. Initially, one should consume light and easily digestible foods, such as soft and mushy rice, porridge, and the like. Fresh vegetables and fruits are also suitable, but they should not be too cold or raw. At the same time, remember not to overeat or drink excessively; it is best to eat regular, measured meals or small frequent meals. As for meat, if it is during the acute phase of the ulcer or if there is bleeding, try to avoid meat consumption; if it is during the recovery phase of the ulcer, meat can be consumed in small amounts but should not be too spicy. (Specific medication should be administered under the guidance of a physician)

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Written by Jiang Guo Ming
Gastroenterology
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Causes of Peptic Ulcers

Peptic ulcers, which include gastric ulcers, duodenal bulb ulcers, complex ulcers, and anastomotic ulcers following gastric surgery, are among the common gastrointestinal diseases. It is currently believed that the infection of Helicobacter pylori is closely associated with gastritis, ulcer activity, gastric cancer, etc., thus, Helicobacter pylori infection is considered the main cause of gastric ulcers. Other factors, such as excessive smoking and alcohol consumption, can also lead to peptic ulcers. Poor dietary and living habits, such as binge eating, excessive consumption of cold, greasy, spicy, or alcoholic foods, can cause this condition as well; moreover, excessive emotional stress, such as long-term mental pressure, can also lead to the development of peptic ulcers.

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Written by Jiang Guo Ming
Gastroenterology
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Can gastric lavage be performed for peptic ulcer?

Peptic ulcer is one of the common upper gastrointestinal diseases, including gastric ulcer, duodenal bulb ulcer, compound ulcer, etc. In this case, since the ulcer site is often deep, sometimes reaching the base layer, even the serous layer of the gastric mucosa. If gastric lavage is performed too vigorously, gastric perforation may occur. Therefore, generally, gastric lavage is not advocated, but in a few cases, such as organophosphate pesticide poisoning or other drug poisonings, etc. If gastric lavage is not performed promptly, it often leads to serious complications, even life-threatening. Therefore, gastric lavage is still needed in a few cases, and in these situations, the procedure must be gentle and not too prolonged.

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Written by Jiang Guo Ming
Gastroenterology
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Clinical characteristics of peptic ulcer

Peptic ulcer is a common and frequently occurring upper gastrointestinal disease. The most likely cause may be infection by Helicobacter pylori, with other potential causes including irritation from smoking and alcohol, poor dietary and living habits, severe psychological stress, or medications, among others. The primary change is usually an excessive secretion of gastric acid, which irritates the gastric mucosa leading to self-digestion and the appearance of gastric or duodenal erosion and ulcers. Clinically, it often presents as long-term, periodic, rhythmic upper abdominal pain, which may be located in the upper left abdomen or slightly right of the navel, and is often accompanied by regurgitation, belching, acid reflux, nausea, etc. If there is ulcer bleeding, it often presents as black stools or even vomiting blood, among other symptoms.