How should gastric ulcers be treated?

Written by Li Xue Qing
Gastroenterology
Updated on September 10, 2024
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The treatment of gastric ulcers is divided into general treatment and medication treatment. General treatment mainly requires patients to avoid spicy, irritating, and cold foods, maintain a calm mindset, have regular meals, and avoid the use of some drugs that can damage the stomach, such as non-steroidal anti-inflammatory drugs. Medication treatment can be administered through gastric protection, which includes drugs that neutralize stomach acid, such as magnesium aluminum carbonate chewable tablets. Drugs that suppress stomach acid include proton pump inhibitors and H2 receptor blockers. Medications that protect the gastric mucosa include sucralfate, bismuth preparations, etc. Additionally, there is targeted eradication treatment for Helicobacter pylori, which clinically includes triple and quadruple therapies. Triple therapy refers to a proton pump inhibitor or a bismuth agent combined with two antibiotics. Quadruple therapy consists of a proton pump inhibitor added to a bismuth agent and two antibiotics, which could include amoxicillin, clarithromycin, levofloxacin, furazolidone, metronidazole, tetracycline, etc. Treatment generally lasts seven to ten days, and the overall treatment for gastric ulcers is typically around one month. (Medications should be used under the guidance of a doctor based on the specific situation.)

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Written by Li Xue Qing
Gastroenterology
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What department should I go to for gastric ulcers?

Gastric ulcer is a gastrointestinal disease. Therefore, it requires consultation in the department of gastroenterology or gastroenterology clinic. Gastric ulcer is caused by infection with Helicobacter pylori, inappropriate medication use, irregular diet, or certain psychological factors, and can arise in emergency situations. It presents with periodic, rhythmic upper abdominal pain, more often occurring in the autumn and winter seasons, and can be diagnosed through gastroscopy. For treatment, methods mainly include triple therapy or quadruple therapy to eradicate Helicobacter pylori and facilitate gastric recovery.

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Written by Jiang Guo Ming
Gastroenterology
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What medicine to take for gastric ulcer?

The stomach ulcers referred to here are generally benign gastric ulcers. The treatment plan should be determined based on whether there is a Helicobacter pylori infection. If there is no Helicobacter pylori infection, it is first important to develop good dietary and living habits, and then treat the symptoms, such as suppressing stomach acid, protecting the gastric mucosa, and increasing gastric motility. If there is a Helicobacter pylori infection, antibacterial treatment is needed. Typically, a triple or quadruple antibiotic therapy is used; a proton pump inhibitor plus two antibiotics constitute the triple therapy, and adding a bismuth agent constitutes the quadruple therapy. A course of treatment lasts for two weeks, which generally can eradicate the bacteria for a definitive cure. (Medications should be used under the guidance of a clinical doctor, according to specific conditions.)

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Written by Zhu Dan Hua
Gastroenterology
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Can stomach ulcers cause bleeding?

Gastric ulcers with bleeding are relatively common in clinical practice, and bleeding is a common complication of gastric ulcers, so it is considered that gastric ulcers can lead to bleeding. The typical clinical manifestation of a gastric ulcer is abdominal pain. Of course, gastrointestinal bleeding is a common complication, generally presenting as vomiting blood or passing bloody stools, with a considerable amount of bleeding leading to vomiting blood in patients. The diagnosis of gastric ulcers relies on gastroscopy. Therefore, in clinical practice, if patients seek medical advice due to abdominal pain or gastrointestinal bleeding, and gastric ulcers are suspected, we recommend that patients promptly complete a gastroscopy to assess the condition. When patients with gastric ulcers experience bleeding, it is advisable for them to fast and intensify treatment with oral stomach-protecting drugs. Of course, if the blood pressure is low and vital signs are unstable, some medications to replenish blood volume might be added, and if necessary, surgical operations to stop the bleeding may be performed.

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Written by Jiang Guo Ming
Gastroenterology
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Is bleeding from a gastric ulcer serious?

Upper gastrointestinal bleeding is one of the common complications of peptic ulcers. If gastric ulcers cause vomiting blood, it often indicates that the bleeding is not minor and the condition is generally severe. It is usually considered that when about 250-300mL of blood accumulates in the stomach, vomiting blood may occur. Clinically, if vomiting blood occurs, it is firstly necessary to promptly hospitalize for treatment, including establishing venous access, nutritional support, and hemostatic treatment. Proton pump inhibitors or somatostatin analogs are commonly used. Additionally, if the bleeding does not stop, endoscopic treatment can be performed, such as spraying hemostatic drugs, electrocoagulation, or mechanical hemostasis. It is also necessary to monitor the patient's vital signs. If repeated bleeding occurs, a comprehensive treatment plan may be needed.

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Written by Zhu Dan Hua
Gastroenterology
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How is a gastric ulcer diagnosed?

Gastric ulcers can generally be diagnosed through gastroscopy. They are commonly found in middle-aged and elderly patients, particularly those between the ages of 30-40. Some patients present with abdominal pain, bloating, and general discomfort, while a small number of patients might not experience abdominal pain but present with gastrointestinal bleeding, indicated by black stools or blood in stool. Therefore, if abdominal pain is suspected, it is generally recommended that patients undergo routine blood tests and gastroscopy, among other examinations. The abdominal pain from gastric ulcers usually manifests as upper abdominal pain, occurring in episodic attacks, with chronic and recurrent episodes and a long history of illness. Symptoms typically worsen after eating but may gradually alleviate on their own. Of course, taking some stomach-protecting medication can help manage the condition. A small portion of patients may also experience nausea and belching, which are nonspecific gastrointestinal symptoms. If gastric ulcers are suspected, further screening for Helicobacter pylori is usually conducted. (The use of medication should be under the guidance of a professional doctor.)