What should I do if there is bleeding from a gastric ulcer?

Written by Jiang Guo Ming
Gastroenterology
Updated on December 25, 2024
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If there is only a small amount of bleeding in gastric ulcer bleeding, manifested as black stool without any other special discomfort symptoms, this condition can be treated with oral medication in an outpatient setting. The treatment plan is usually determined based on the presence or absence of Helicobacter pylori infection.

For those with Helicobacter pylori infection, a quadruple therapy is generally used for eradication treatment. For those without the infection, proton pump inhibitors are the preferred choice, combined with medications that protect the gastric mucosa, and so on. If there is a significant amount of bleeding, with symptoms like vomiting blood, this situation requires timely hospital treatment, usually involving fasting and intravenous fluid therapy. If medical treatment is ineffective, a combined medical and surgical approach may be necessary.

(The use of medications should be under the guidance of a doctor.)

Other Voices

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Written by Wu Hai Wu
Gastroenterology
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Is a gastric ulcer in the pyloric region serious?

Whether gastric ulcers and duodenal bulb ulcers are severe depends on the size of the ulcers and whether there are complications. If there are complications such as perforation and bleeding, it can be very serious. Severe cases may require surgical intervention and could potentially endanger the patient's life. Patients with gastric and duodenal bulb ulcers are likely caused by Helicobacter pylori infection, though it cannot be ruled out that some may be caused by ingestion of non-steroidal anti-inflammatory drugs or steroids. Treatment varies depending on the cause. For instance, if it is caused by Helicobacter pylori infection, standardized eradication of Helicobacter pylori is necessary, along with comprehensive treatment to suppress gastric acid secretion and protect the gastric mucosa.

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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 Li Xue Qing
Gastroenterology
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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.

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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 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.