How is a gastric ulcer diagnosed?

Written by Ren Zheng Xin
Gastroenterology
Updated on December 05, 2024
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Gastric ulcers are inflammatory defects that occur on the gastric mucosa, related to the gastric acid and digestive actions of gastric juices. Diagnosis mainly relies on clinical manifestations and auxiliary examinations, with typical symptoms including recurring or periodic upper abdominal pain that worsens after eating, as well as occurrences of belching. X-ray barium meal examinations can reveal filling defects, and gastroscopy can provide a full view of the ulcer. Treatment primarily involves the use of medications that suppress gastric acid secretion and protect the gastric mucosa. Additionally, it is important to enhance health education, eat less spicy and greasy food, have meals regularly and in measured amounts, and consume more green vegetables. (Specific medication use should be carried out under the guidance of a doctor.)

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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.

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Written by Wang Li Wei
Gastroenterology
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How long should you fast if you have a bleeding gastric ulcer?

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 Ren Zheng Xin
Gastroenterology
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How long does it take for a stomach ulcer to heal?

Gastric ulcers are a very common disease in gastroenterology. For minor ulcers, adjustments in diet, quitting smoking and drinking, consuming more green vegetables, getting more rest, and reducing mental stress can gradually lead to recovery. More severe ulcers require active medication use. To achieve ulcer healing, the course of acid-reducing medication usually lasts four to six weeks. Commonly used medications include those that inhibit gastric acid secretion, such as HR receptor antagonists and proton pump inhibitors, as well as some bismuth agents and weakly alkaline antacids to protect the stomach lining. Meanwhile, dietary management should be strengthened. Through effective medical treatment, the healing rate of gastric ulcers can reach over 95%. (Specific medication use should be conducted under the guidance of a doctor.)

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Written by Jiang Guo Ming
Gastroenterology
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Treatment of gastric ulcer with bleeding

For the treatment of gastric ulcers with bleeding, it is primarily necessary to determine the treatment plan based on the amount of bleeding. If the bleeding is minor, it can be treated with oral medication, and whether there is an infection with Helicobacter pylori must be considered. If there is an infection of Helicobacter pylori, the typical treatment is a quadruple therapy, which includes a proton pump inhibitor, two antibiotics, and a bismuth agent. If there is no Helicobacter pylori infection, symptomatic treatment is sufficient, commonly using proton pump inhibitors. If the bleeding is severe, timely hospitalization is needed. The treatment usually involves the intravenous use of proton pump inhibitors primarily, and if the medication is ineffective, endoscopic treatment might be necessary. This could include the application of hemostatic medications, electrocoagulation, or the use of titanium clips, etc. (Please use medication under the guidance of a doctor.)

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Written by Zhu Dan Hua
Gastroenterology
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Can stomach ulcers cause bleeding?

Gastric ulcers with bleeding are relatively common in clinical practice, and bleeding is a common complication of gastric ulcers, so it is considered that gastric ulcers can lead to bleeding. The typical clinical manifestation of a gastric ulcer is abdominal pain. Of course, gastrointestinal bleeding is a common complication, generally presenting as vomiting blood or passing bloody stools, with a considerable amount of bleeding leading to vomiting blood in patients. The diagnosis of gastric ulcers relies on gastroscopy. Therefore, in clinical practice, if patients seek medical advice due to abdominal pain or gastrointestinal bleeding, and gastric ulcers are suspected, we recommend that patients promptly complete a gastroscopy to assess the condition. When patients with gastric ulcers experience bleeding, it is advisable for them to fast and intensify treatment with oral stomach-protecting drugs. Of course, if the blood pressure is low and vital signs are unstable, some medications to replenish blood volume might be added, and if necessary, surgical operations to stop the bleeding may be performed.