How long should you fast if you have a bleeding gastric ulcer?

Written by Wang Li Wei
Gastroenterology
Updated on September 09, 2024
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Primarily, it depends on whether the bleeding has stopped. If the bleeding has ceased, the patient shows no signs of vomiting blood, and their gastrointestinal symptoms in the abdomen are slightly improving, generally, they can gradually start eating after about two days. If the patient still experiences vomiting of blood, or has black stools, increased frequency of bowel movements, heartburn, or if a gastroscopy confirms that the bleeding vessels from the gastric ulcer are relatively large, the duration of fasting might be comparatively longer. Therefore, the duration of fasting for a gastric ulcer bleed mainly depends on whether there is active bleeding in the patient.

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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 Jiang Guo Ming
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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 Si Li Li
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What should not be eaten with gastric ulcers?

Patients with gastric ulcers should be cautious about their diet, abstain from smoking and alcohol, and avoid drinking strong tea, coffee, eating fatty, greasy, spicy, fried, barbecued, raw, cold, and sweet foods, as well as drinking milk and soy milk, or eating glutinous rice and sweet potatoes. This is because some of these foods can stimulate the secretion of gastric acid, worsening the irritation of gastric mucosa and exacerbating gastric ulcers. Some are difficult to digest, thus, they are not recommended. It is advisable to eat porridge, drink soups, eat noodles, such as millet porridge, yam porridge, barley porridge, chicken soup, and pork rib soup. When eating meats, ensure they are well-stewed before consumption.

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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 Li Xue Qing
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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.)