How to treat gastric ulcers?

Written by Li Xue Qing
Gastroenterology
Updated on September 02, 2024
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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 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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How to treat bleeding from gastric ulcers?

If it is a mild gastric ulcer bleeding, it may only manifest as black stool without any obvious specific discomfort symptoms and stable vital signs. This condition can be managed by controlling the diet and appropriately taking or intravenously using proton pump inhibitors such as omeprazole, lansoprazole, etc., which often can be curative. If the bleeding is considerable, presenting symptoms like vomiting coffee-colored or dark red liquid, fainting, profuse sweating, blood pressure drop, etc., this condition requires timely hospital treatment. Medication primarily includes proton pump inhibitors combined with hemostatic drugs, nutritional support, prevention of complications, etc. If the medical treatment is ineffective, endoscopic hemostasis might be needed, and further more, surgical intervention may be considered.

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Written by Jiang Guo Ming
Gastroenterology
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Gastric ulcer and duodenal ulcer

Gastric ulcers and duodenal bulb ulcers both belong to upper gastrointestinal ulcers. Their symptoms slightly differ; gastric ulcers typically manifest as postprandial pain in the upper abdomen, whereas duodenal bulb ulcers present as hunger pains in the upper abdomen, sometimes accompanied by nocturnal pain. Both types generally exhibit symptoms such as acid reflux and heartburn. The predominant cause for these is infection by Helicobacter pylori, detectable through tests such as the carbon-13 or carbon-14 breath test. If an infection is present, antimicrobial treatment can typically lead to a complete recovery of the ulcers. If there is no Helicobacter pylori infection, the initial approach should still focus on symptomatic treatment. Additionally, adopting good dietary and living habits can facilitate regular gastroscopic follow-ups.

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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 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.)