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 Zhu Dan Hua
Gastroenterology
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What should I do if I have a stomach ulcer?

Gastric ulcers are generally treated with internal medicine medications in clinical settings, primarily through oral medications. Patients may select from antacid and stomach-protecting drugs for a course of 6-8 weeks, after which most ulcers can be healed. It is advised that patients eat clean, easily digestible foods, and avoid intake of spicy, stimulative, and pickled foods, as well as foods like raw fish and strong coffee. If the patient has a habit of drinking alcohol, it is advised to abstain from alcohol for these two months. It is also important to focus on resting and maintaining adequate sleep. Gastric ulcers are relatively common in clinical settings and generally improve with active treatment. Patients typically seek treatment for abdominal pain or complications, with the pain usually manifesting as upper abdominal pain. The most common complication is gastrointestinal bleeding, presenting as vomiting blood or bloody stools. Therefore, it is recommended that patients experiencing such discomfort should actively seek a comprehensive gastroscopy examination.

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Written by Li Xue Qing
Gastroenterology
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Complications of gastric ulcers

The main complications of gastric ulcers are fourfold: one is upper gastrointestinal bleeding; the second is perforation; the third is pyloric obstruction; the fourth is malignant transformation. Upper gastrointestinal bleeding is the most common complication of gastric ulcers. If a patient has experienced bleeding, there is a high likelihood of recurrence. Perforations mainly occur in elderly individuals. Pyloric obstruction is primarily caused by ulcers in the pyloric canal and pre-pyloric area. It is divided into mechanical obstruction and functional obstruction. Mechanical obstruction results from scarring after the ulcer heals, which narrows the pyloric opening. Functional obstruction is due to congestion and edema of the mucosa after the ulcer, causing relative narrowing of the pylorus. As for malignant transformation, it is still controversial, but it is generally believed to be around 1%-7%.

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Written by Si Li Li
Gastroenterology
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What are the symptoms of gastric ulcers?

The symptoms of gastric ulcers mainly include upper abdominal pain, belching, acid reflux, nausea, vomiting, heartburn, early satiety, poor appetite, and indigestion. The characteristic of the upper abdominal pain is that it worsens after eating and decreases or disappears when hungry or on an empty stomach, indicating a regular pattern of pain. For patients exhibiting these symptoms, it is advised to undergo a gastroscopy to confirm the diagnosis. If the gastroscopy reveals ulcers on the gastric mucosa, the diagnosis of gastric ulcers can be confirmed. It is also recommended to conduct a Carbon-14 breath test to determine if there is an infection with Helicobacter pylori. It has been confirmed that Helicobacter pylori can cause peptic ulcers and chronic gastritis among other diseases. If the infection test is positive, eradication treatment for Helicobacter pylori is needed.

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Written by Jiang Guo Ming
Gastroenterology
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What to eat for nutrition when suffering from bleeding gastric ulcers?

This condition should be a benign gastric ulcer with bleeding, during the recovery period after treatment. In addition to adhering to medical advice and maintaining medication, daily living habits are especially important. The stomach needs care; firstly, it is essential to quit smoking and drinking, avoid getting cold, and one can engage in appropriate activity, but avoid strenuous sports. Regarding diet, it should consist of light, easily digestible foods, such as soft rice, noodles, and porridge, among others. In particular, various fresh vegetables and fruits should be chosen. Try to avoid consuming too much raw, greasy, spicy foods, and alcoholic beverages. Patients with gastric ulcers need to have regular check-ups, and it's also important to maintain a positive mindset.

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Written by Ren Zheng Xin
Gastroenterology
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Does gastric ulcer require hospitalization?

Whether a stomach ulcer requires hospitalization depends on the condition. For minor ulcers, if the pain is mild and there are no significant symptoms of vomiting or nausea, treatment can be managed with medication, such as drugs that inhibit stomach acid secretion and protect the gastric mucosa. It is also important to regulate diet, eat soft foods, avoid cold, spicy foods, and alcohol, as symptoms can gradually ease. If the ulcer is larger and exhibits perforation or bleeding, hospital treatment is necessary, usually involving a significant portion of the stomach being surgically removed to completely cure the ulcer. (Medication should be taken under the guidance of a doctor.)