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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How should gastric ulcers be treated?

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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Can gastric ulcers be cured?

Gastric ulcers are classified into benign and malignant types. Most duodenal bulb ulcers and gastric ulcers are benign and can be cured through medication. Treatment plans are usually determined based on the presence of Helicobacter pylori infection. Patients with Helicobacter pylori infection can be treated with antibacterial therapy. If there is no infection, symptomatic treatment alone is generally sufficient for a cure. If the ulcer is malignant or is a giant ulcer, surgical treatment is generally required. For those who cannot undergo surgery, radiotherapy or chemotherapy may be needed. Generally, the prognosis for malignant ulcers is worse than for benign ulcers.

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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.

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What should be noted for bleeding from gastric ulcers?

After a gastric ulcer bleeds, the first thing to pay attention to is emotional control. Many people will feel emotionally excited and fearful when they experience bleeding and vomiting, and at this time, family members should soothe them promptly; Secondly, dietary adjustments should be made. Eat more soft, easily digestible foods, such as noodles, soft rice, soy milk, eggs, as well as a lot of green vegetables and fresh fruits. Supplementing with vitamin C can help heal the ulcer. In addition, restrict some raw, spicy, and fried foods. You should eat less food that is too sweet, too hot, too acidic, or too salty, and actively quit smoking and drinking.

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What foods to eat for gastric ulcers?

People with stomach ulcers should eat foods that are easy to digest and high in protein and vitamins, such as soft rice, porridge, and noodles. Foods rich in protein include fish, milk, and walnuts. Foods high in vitamins include tomatoes, carrots, bean sprouts, and spinach. Patients with stomach ulcers should avoid spicy and stimulating foods such as chili peppers, garlic, leeks, and ginger, as well as seasonings like cinnamon, star anise, and Sichuan pepper. They should also avoid overly acidic foods, raw and cold foods, fried foods, and foods that are high in rough fiber.