How to treat peptic ulcers?

Written by Jiang Guo Ming

Gastroenterology

Updated on September 06, 2024

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The treatment of peptic ulcers should be based on specific causes, as well as the patient's gender, age, medical history, and medication history, among other factors. Generally speaking, the primary cause of peptic ulcers is usually Helicobacter pylori infection. Therefore, the first step is to test for Helicobacter pylori. If Helicobacter pylori is present, antibacterial treatment is required, with the first choice being quadruple therapy, which includes a proton pump inhibitor, two types of antibiotics, and a bismuth agent, administered over a 10 to 14-day treatment course. If there is no Helicobacter pylori infection, the first choice would be proton pump inhibitors and gastric mucosal protective drugs, combined with symptomatic treatment. Meanwhile, it is crucial for patients with peptic ulcers to develop good eating and living habits, and relaxing their mindset can also be helpful.

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Written by Jiang Guo Ming

Gastroenterology

1min 8sec

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Principles of treatment for peptic ulcers

Peptic ulcers include gastric ulcers, duodenal ulcers, complex ulcers, etc. There can be many complications, such as gastrointestinal bleeding, and if not healed over a long period, degeneration may occur, leading to the development of gastric cancer. Therefore, peptic ulcers must be treated promptly. As for the principles of treatment, they should be determined based on specific symptoms and whether there is a Helicobacter pylori infection. If there is a Helicobacter pylori infection, the general approach is to use quadruple therapy for antibacterial treatment; if there is no Helicobacter pylori infection, treatment generally focuses on symptomatic relief, such as suppressing stomach acid, protecting the mucosa, and increasing gastric motility, etc. At the same time, it is essential to pay attention to regular eating and living habits, eating on a regular schedule or having small, frequent meals. Avoid overeating, as well as stimulating substances like cold, greasy, and spicy foods. Additionally, it is important to keep warm and get plenty of rest.

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Written by Chen Rong

Gastroenterology

1min 51sec

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Treatment of bleeding from peptic ulcers

Gastrointestinal ulcer bleeding may require different management based on the volume of bleeding. With significant bleeding, the condition becomes critical and rapidly changing. Priorities include anti-shock measures, rapid replenishment of blood volume, maintaining a supine position, keeping the airway clear to avoid aspiration during vomiting, providing oxygen if necessary, fasting during active bleeding, closely monitoring the patient's vital signs, immediate blood typing and cross-matching, promptly establishing an effective intravenous infusion pathway, and replenishing blood volume. Medications such as PPIs or H2 receptor antagonists can be used; the former should be chosen for severe bleeding and administered intravenously. About 80% of patients with gastrointestinal ulcer bleeding may stop bleeding without any special treatment, while the remaining patients may experience persistent bleeding or rebleeding. Emergency gastroscopy is crucial to determine if the patient is at high risk of rebleeding or has ongoing bleeding and can include therapeutic endoscopic interventions such as drug injections, electrocoagulation, and the use of hemostatic clips. If endoscopic treatment fails, the gastric and duodenal arteries may be embolized via arterial intervention. If pharmacologic, endoscopic, and interventional treatments cannot control the bleeding, and there is ongoing significant blood loss threatening the patient's life, surgical treatment may be necessary. (Specific medications should be administered under the guidance of a physician.)

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Written by Jiang Guo Ming

Gastroenterology

1min 1sec

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How to treat peptic ulcers?

The treatment of peptic ulcers should be based on specific causes, as well as the patient's gender, age, medical history, and medication history, among other factors. Generally speaking, the primary cause of peptic ulcers is usually Helicobacter pylori infection. Therefore, the first step is to test for Helicobacter pylori. If Helicobacter pylori is present, antibacterial treatment is required, with the first choice being quadruple therapy, which includes a proton pump inhibitor, two types of antibiotics, and a bismuth agent, administered over a 10 to 14-day treatment course. If there is no Helicobacter pylori infection, the first choice would be proton pump inhibitors and gastric mucosal protective drugs, combined with symptomatic treatment. Meanwhile, it is crucial for patients with peptic ulcers to develop good eating and living habits, and relaxing their mindset can also be helpful.

home-news-image

Written by Jiang Guo Ming

Gastroenterology

53sec

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Causes of Peptic Ulcers

Peptic ulcers, which include gastric ulcers, duodenal bulb ulcers, complex ulcers, and anastomotic ulcers following gastric surgery, are among the common gastrointestinal diseases. It is currently believed that the infection of Helicobacter pylori is closely associated with gastritis, ulcer activity, gastric cancer, etc., thus, Helicobacter pylori infection is considered the main cause of gastric ulcers. Other factors, such as excessive smoking and alcohol consumption, can also lead to peptic ulcers. Poor dietary and living habits, such as binge eating, excessive consumption of cold, greasy, spicy, or alcoholic foods, can cause this condition as well; moreover, excessive emotional stress, such as long-term mental pressure, can also lead to the development of peptic ulcers.

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Written by Jiang Guo Ming

Gastroenterology

49sec

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Can gastric lavage be performed for peptic ulcer?

Peptic ulcer is one of the common upper gastrointestinal diseases, including gastric ulcer, duodenal bulb ulcer, compound ulcer, etc. In this case, since the ulcer site is often deep, sometimes reaching the base layer, even the serous layer of the gastric mucosa. If gastric lavage is performed too vigorously, gastric perforation may occur. Therefore, generally, gastric lavage is not advocated, but in a few cases, such as organophosphate pesticide poisoning or other drug poisonings, etc. If gastric lavage is not performed promptly, it often leads to serious complications, even life-threatening. Therefore, gastric lavage is still needed in a few cases, and in these situations, the procedure must be gentle and not too prolonged.