Principles of treatment for peptic ulcers

Written by Jiang Guo Ming
Gastroenterology
Updated on October 20, 2024
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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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Asymptomatic peptic ulcer

Peptic ulcers typically include duodenal bulb ulcers and gastric ulcers. They more or less have typical related symptoms, such as long-term, recurrent, regular upper abdominal pain related to eating, along with symptoms like acid reflux. Diagnosis can be confirmed through gastroscopy. A small portion of patients, especially middle-aged and elderly patients with a history of cardiovascular and cerebrovascular diseases, often take non-steroidal anti-inflammatory drugs (NSAIDs) year-round. This situation can easily lead to the occurrence of acute gastric mucosal lesions and often results in asymptomatic gastric ulcers. Many patients present with symptoms like vomiting blood and black stools when they seek medical advice.

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Written by Jiang Guo Ming
Gastroenterology
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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 Zhu Dan Hua
Gastroenterology
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Peptic Ulcer Clinical Symptoms

Peptic ulcers are a common disease and often seen in clinical practice. They are typically manifested by discomfort in the upper abdomen, which may include abdominal pain, bloating, nausea, vomiting, and belching, and patients usually visit the gastroenterology department. The abdominal pain related to peptic ulcers, particularly the most typical and common symptoms, usually presents as pain above the navel, with chronic and recurrent attacks. It often relates to dietary habits, such as postprandial worsening in the case of gastric ulcers, whereas duodenal ulcers typically improve after eating and may involve hunger pain and night pain. Therefore, if patients exhibit these typical symptoms, it is recommended to perform a gastroscopy to ascertain the presence of duodenal or gastric ulcers. Complications can occur with peptic ulcers, with the most common being gastrointestinal bleeding, manifested by vomiting blood or bloody stools, with the latter appearing as tarry, watery stools. Thus, if patients present with typical symptoms of abdominal pain, bloating, and particularly bleeding or vomiting blood and bloody stools, peptic ulcers are the most likely cause. It is advised for patients to actively seek treatment at local hospitals and receive medication therapy.

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Written by Jiang Guo Ming
Gastroenterology
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Etiology of Peptic Ulcer

Peptic ulcers include gastric ulcers, duodenal bulb ulcers, complex ulcers, and so on. It is currently believed that about 80% of peptic ulcers are related to infection with Helicobacter pylori. Additionally, poor dietary and living habits are closely linked to the formation of peptic ulcers, such as excessive smoking and drinking, overeating cold, greasy, spicy, and irritating foods, as well as strong tea, coffee, etc. Moreover, many medications can cause damage to the gastric mucosa, leading to gastric ulcers, such as non-steroidal anti-inflammatory drugs. Furthermore, emotional excitement and major trauma and other stress responses can also lead to acute gastric mucosal lesions, resulting in peptic ulcers.

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Written by Jiang Guo Ming
Gastroenterology
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Can people with peptic ulcers eat meat?

Peptic ulcers generally require conventional medication treatment first. If accompanied by bleeding or severe symptoms, hospitalization may be necessary. It is important to pay attention to dietary and living habits in such cases. Initially, one should consume light and easily digestible foods, such as soft and mushy rice, porridge, and the like. Fresh vegetables and fruits are also suitable, but they should not be too cold or raw. At the same time, remember not to overeat or drink excessively; it is best to eat regular, measured meals or small frequent meals. As for meat, if it is during the acute phase of the ulcer or if there is bleeding, try to avoid meat consumption; if it is during the recovery phase of the ulcer, meat can be consumed in small amounts but should not be too spicy. (Specific medication should be administered under the guidance of a physician)