Can a peptic ulcer heal itself?

Written by Zhu Dan Hua
Gastroenterology
Updated on September 23, 2024
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Peptic ulcers, commonly referred to as stomach ulcers and duodenal ulcers, are relatively common in clinical settings and generally have a good prognosis. For simple peptic ulcers, patients usually do not exhibit common symptoms such as abdominal pain, vomiting blood, bloody stools, abdominal distension, vomiting, etc., and these can often heal on their own. However, if a patient experiences typical upper abdominal symptoms like vomiting blood, bloody stools, or significant abdominal pain, especially pain in the lower back, it is advisable for the patient to seek timely treatment at a local hospital for further clarification. In treating this condition, a few points should be noted: First, pay attention to diet and rest, it’s advisable to eat smaller, more frequent meals and avoid spicy foods and abstain from smoking and alcohol. Second, if peptic ulcers are suspected, one might consider using supplementary oral medications, such as antacids or gastroprotective drugs etc., which generally lead to a good prognosis. Of course, if the patient does not exhibit any special symptoms, regular observation may suffice.

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Written by Jiang Guo Ming
Gastroenterology
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Symptoms of peptic ulcer

Peptic ulcers typically include gastric ulcers, duodenal bulb ulcers, and complex ulcers, among others, all of which feature upper abdominal pain. For gastric ulcers, the pain is generally located below the xiphoid process or in the upper left abdomen, primarily occurring after meals and often accompanied by symptoms such as abdominal bloating and acid reflux. Duodenal bulb ulcers usually present as hunger-like pain in the upper abdomen, which can be alleviated by eating and may include nighttime pain, often with significant acid reflux and heartburn. These can be definitively diagnosed via gastroscopy. Additionally, many elderly individuals may develop gastric ulcers after taking nonsteroidal anti-inflammatory drugs, often without significant pain, typically requiring a gastroscopy for accurate diagnosis.

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Written by Jiang Guo Ming
Gastroenterology
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Can peptic ulcers be cured?

Peptic ulcers include gastric ulcers, duodenal bulb ulcers, complex ulcers, and more. The primary cause is usually Helicobacter pylori infection, particularly in patients with duodenal bulb ulcers. Generally, eradicating Helicobacter pylori can cure the ulcer. However, a small number of patients, due to underlying diseases or irregular medication use, often develop resistance to Helicobacter pylori. In such cases, peptic ulcers are prone to recurrent flares. Additionally, peptic ulcers caused by other factors, such as smoking and alcohol stimulation, poor dietary habits, medication, emotional issues, etc., can generally be cured by removing the triggers. However, it's essential to develop good dietary and living habits and strictly follow medical advice regarding medications.

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Written by Jiang Guo Ming
Gastroenterology
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Clinical characteristics of peptic ulcer

Peptic ulcer is a common and frequently occurring upper gastrointestinal disease. The most likely cause may be infection by Helicobacter pylori, with other potential causes including irritation from smoking and alcohol, poor dietary and living habits, severe psychological stress, or medications, among others. The primary change is usually an excessive secretion of gastric acid, which irritates the gastric mucosa leading to self-digestion and the appearance of gastric or duodenal erosion and ulcers. Clinically, it often presents as long-term, periodic, rhythmic upper abdominal pain, which may be located in the upper left abdomen or slightly right of the navel, and is often accompanied by regurgitation, belching, acid reflux, nausea, etc. If there is ulcer bleeding, it often presents as black stools or even vomiting blood, among other symptoms.

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Written by Jiang Guo Ming
Gastroenterology
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The main causes of peptic ulcers

It is generally believed that Helicobacter pylori is closely related to gastric inflammation, ulcer formation, and malignancies. Therefore, the main cause of peptic ulcers should be the infection of Helicobacter pylori. Furthermore, certain conditions, such as connective tissue diseases and kidney diseases, may require long-term use of steroids or nonsteroidal anti-inflammatory drugs. This can damage the gastric mucosa and increase the secretion of gastric acid, thereby promoting the occurrence of peptic ulcers. Other factors like long-term poor dietary and living habits, such as smoking and consuming alcohol or spicy food, can also damage the gastrointestinal mucosa, thus leading to the development of peptic ulcers.

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Written by Jiang Guo Ming
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Peptic ulcer clinical symptoms

Helicobacter pylori infection is considered the primary cause of peptic ulcers, often leading to excess stomach acid, abnormal gastric motility, and other symptoms. Excess stomach acid can cause acid reflux, heartburn, and a burning sensation, while abnormal gastric motility may lead to nausea, belching, and even vomiting and bloating, with stomach acid irritation likely causing upper abdominal pain. Gastric ulcer pain is generally located in the upper left abdomen or below the sternum, typically presenting as postprandial pain. Duodenal bulb ulcers generally cause pain to the upper right of the navel, typically fasting pain that eases upon eating, sometimes accompanied by menstrual-like pain, with pain from ulcers behind the bulb potentially radiating to the back.