Causes of gastric ulcers

Written by Ren Zheng Xin
Gastroenterology
Updated on March 27, 2025
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Gastric ulcers refer to inflammatory defects in the gastric mucosa, with several common causes as follows: First, infection with Helicobacter pylori is directly related to the development of peptic ulcers. Second, various drugs that damage the gastric mucosa, such as non-steroidal anti-inflammatory drugs, corticosteroid hormones, etc. Third, dietary factors. Long-term alcohol consumption, spicy foods, strong tea, and coffee can all cause gastric ulcers. Fourth, the digestive actions of gastric acid and pepsin damage the gastric mucosa, leading to a decline in the protective barrier function of the mucosa and causing ulcers. Fifth, abnormalities in gastric motility and decreased emptying ability, leading to food retention in the stomach, continuously irritating the gastric mucosa, causing increased gastric acid secretion and resulting in ulcers.

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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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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 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 Li Xue Qing
Gastroenterology
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What department should I go to for gastric ulcers?

Gastric ulcer is a gastrointestinal disease. Therefore, it requires consultation in the department of gastroenterology or gastroenterology clinic. Gastric ulcer is caused by infection with Helicobacter pylori, inappropriate medication use, irregular diet, or certain psychological factors, and can arise in emergency situations. It presents with periodic, rhythmic upper abdominal pain, more often occurring in the autumn and winter seasons, and can be diagnosed through gastroscopy. For treatment, methods mainly include triple therapy or quadruple therapy to eradicate Helicobacter pylori and facilitate gastric recovery.

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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.)