What is a stomach ulcer?

Written by Li Xue Qing
Gastroenterology
Updated on September 28, 2024
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Peptic ulcer is caused by long-term Helicobacter pylori infection and the consumption of stomach-irritating medications such as corticosteroids, aspirin, and long-term use of non-steroidal anti-inflammatory drugs, as well as irregular intake of spicy, stimulating, and cold foods, coupled with long-term emergency mental factors, leading to postprandial pain. The main symptoms are periodic rhythmic upper abdominal pain, which may be accompanied by nausea, vomiting, and acid reflux. Diagnosis can be made by performing a gastroscopy. Treatment mainly involves the eradication of Helicobacter pylori and protective stomach treatments among other symptomatic treatments. Complications may include upper gastrointestinal bleeding, perforation, pyloric obstruction, and malignant transformation. Dietary recommendations include avoiding smoking, alcohol, strong tea, coffee, indigestible foods, and some stimulating condiments.

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Written by Li Xue Qing
Gastroenterology
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How to treat gastric ulcers?

The treatment of gastric ulcers mainly consists of general management and pharmacotherapy. General management involves patients avoiding spicy, stimulating, and cold foods, eating regular meals, and avoiding medications that may harm the stomach, such as non-steroidal anti-inflammatory drugs. Pharmacotherapy mainly includes gastroprotective therapy and treatment against Helicobacter pylori. Gastroprotective therapy includes neutralizing stomach acid with agents such as magnesium carbonate chewing tablets, acid-suppressing medications like proton pump inhibitors and H2 receptor antagonists, pantoprazole, cimetidine, etc. Medications to protect the gastric mucosa, such as sucralfate, bismuth preparations, etc., are also used. Treatment against Helicobacter pylori mainly includes triple and quadruple therapy. Triple therapy involves a proton pump inhibitor or a bismuth agent combined with two types of antibiotics, and quadruple therapy consists of a proton pump inhibitor, a bismuth agent, and two types of antibiotics. Antibiotics commonly used include amoxicillin, clarithromycin, furazolidone, levofloxacin, metronidazole, tetracycline, etc. Treatment generally lasts seven to ten days, with overall therapy for gastric ulcers spanning about a month. (Please undertake any medication under the guidance of a doctor.)

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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.)

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Written by Wang Hui Jie
Gastroenterology
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Symptoms of gastric ulcer

The clinical manifestations of stomach ulcers can vary from person to person. Some patients are asymptomatic and present to the clinic due to stomach bleeding or perforation. Generally, there are three main characteristics of peptic ulcers: First, they tend to be a chronic, recurrent condition. Second, they exhibit periodicity. Third, they have rhythmic manifestations. The primary symptom is periodic, rhythmic upper abdominal pain, often described as burning, dull, or bloating pain. This usually occurs in the upper abdomen, possibly on the left or right side, and typically manifests as post-meal pain. Nighttime pain is uncommon, and there may be localized tenderness. If the ulcer occurs in the pyloric canal, it may lack some of these typical symptoms. Post-meal intense pain is possible, and the effectiveness of medication is generally poor. This condition can easily lead to vomiting or pyloric obstruction and is also prone to perforation and bleeding. A minority of stomach ulcers may potentially become cancerous.

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Written by Li Xue Qing
Gastroenterology
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Foods to avoid for gastric ulcers

Foods to avoid for gastric ulcers include spicy and stimulating foods such as chili peppers, garlic, onions, leeks, ginger, and alcoholic beverages. Seasonings like cinnamon, star anise, black pepper, and fennel should also be avoided. Acidic foods such as lemons, limes, and green apples are not recommended, as well as foods that can cause bloating like soybeans and peanuts. Additionally, cold foods such as ice water and frozen fruits, as well as fried and grilled foods like street food and barbecues, should be avoided. It is also advisable to limit intake of foods high in roughage, such as corn, buckwheat, and celery.

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Written by Wang Hui Jie
Gastroenterology
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Medications for treating gastric ulcers

Here I will introduce several major types of medications for treating gastric ulcers, but specific medication use should be consulted with a doctor or pharmacist according to individual conditions. The first major type is anti-gastric acid medications. Since gastric acid plays a significant role in ulcerative lesions, it is considered appropriate to treat gastric ulcers by adjusting the stomach environment to a pH of 3.5. Anti-acid medications include antacids, H2 receptor antagonists, proton pump inhibitors, and others. The second major type is gastric mucosal protectants, which include some class B drugs, prostaglandin derivatives, and some containing sucralfate. The third major type is medications that treat Helicobacter pylori, with quadruple therapy currently being a common practice. Note: Medications should be used under the guidance of a doctor.