Is bleeding from a gastric ulcer serious?

Written by Jiang Guo Ming
Gastroenterology
Updated on January 09, 2025
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Upper gastrointestinal bleeding is one of the common complications of peptic ulcers. If gastric ulcers cause vomiting blood, it often indicates that the bleeding is not minor and the condition is generally severe. It is usually considered that when about 250-300mL of blood accumulates in the stomach, vomiting blood may occur. Clinically, if vomiting blood occurs, it is firstly necessary to promptly hospitalize for treatment, including establishing venous access, nutritional support, and hemostatic treatment. Proton pump inhibitors or somatostatin analogs are commonly used. Additionally, if the bleeding does not stop, endoscopic treatment can be performed, such as spraying hemostatic drugs, electrocoagulation, or mechanical hemostasis. It is also necessary to monitor the patient's vital signs. If repeated bleeding occurs, a comprehensive treatment plan may be needed.

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Written by Ren Zheng Xin
Gastroenterology
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Does gastric ulcer require hospitalization?

Whether a stomach ulcer requires hospitalization depends on the condition. For minor ulcers, if the pain is mild and there are no significant symptoms of vomiting or nausea, treatment can be managed with medication, such as drugs that inhibit stomach acid secretion and protect the gastric mucosa. It is also important to regulate diet, eat soft foods, avoid cold, spicy foods, and alcohol, as symptoms can gradually ease. If the ulcer is larger and exhibits perforation or bleeding, hospital treatment is necessary, usually involving a significant portion of the stomach being surgically removed to completely cure the ulcer. (Medication should be taken 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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Precautions for Gastric Ulcer

Patients with gastric ulcers should pay more attention to rest, reduce mental stress, and, moreover, enhance health education, maintain regular eating habits, have meals at fixed times and in fixed amounts, eat less greasy, spicy, and irritating food, strictly abstain from smoking and drinking alcohol, and drink less strong tea, coffee, and other such beverages. Actively use medical treatment, commonly using medications that suppress stomach acid secretion and protect the gastric mucosa. To achieve ulcer healing, the course of acid-suppressing medication generally lasts 4 to 6 weeks. One should maintain a relaxed mood, as excessive tension and anxiety can aggravate ulcer symptoms. Through effective medical treatment, the cure rate of peptic ulcers can reach over 95%. Even after healing, strict attention must be paid to dietary habits. (Please use medication under the guidance of a doctor.)

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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 Jiang Guo Ming
Gastroenterology
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What should I do if there is bleeding from a gastric ulcer?

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.)