Can gastric lavage be performed for peptic ulcer?

Written by Jiang Guo Ming
Gastroenterology
Updated on September 08, 2024
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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.

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Written by Jiang Guo Ming
Gastroenterology
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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 Jiang Guo Ming
Gastroenterology
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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.

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Written by Jiang Guo Ming
Gastroenterology
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What can people with peptic ulcers eat?

Peptic ulcers include duodenal bulb ulcers, gastric ulcers, complex ulcers, etc. In such cases, formal treatment should be administered first. Depending on whether there is a Helicobacter pylori infection, different treatment plans should be adopted. At the same time, it is important to develop good dietary and living habits, quit smoking and drinking, and ensure that the diet is light and easy to digest. While ensuring adequate nutrition, efforts should be made to minimize gastric irritation. Foods like soft and mushy rice, porridge, and soft noodles are preferable. Fresh vegetables and fruits are fine. Try to avoid overly cold, greasy, spicy, or irritating foods. Be sure to eat regularly and in moderation or have small, frequent meals, and avoid binge eating.

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Written by Zhu Dan Hua
Gastroenterology
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Can peptic ulcers become cancerous?

Peptic ulcers generally refer to gastric ulcers and duodenal ulcers. It is generally believed that most gastric ulcers are benign, but a small portion of patients may develop cancer, approximately 3%-5%, especially in middle-aged and elderly patients. If the ulcers recur and continue to enlarge, there needs to be vigilance for potential malignancy. However, duodenal ulcers generally do not become cancerous and are more common in young people, presenting symptoms such as abdominal pain, bloating, and bloody stools. Therefore, for peptic ulcers, most are benign, but a small fraction of patients may have ulcers that evolve into cancerous ones, presenting as benign peptic ulcers, which calls for caution, especially in middle-aged and elderly patients. Therefore, it is recommended that patients regularly treat gastric and duodenal ulcers. If the treatment period is prolonged and peptic ulcers recur frequently with poor outcomes, patients should be alert to the potential for cancer and are advised to undergo gastroscopic examination and biopsy for further clarification.

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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.