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 Ren Zheng Xin
Gastroenterology
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The difference between peptic ulcer and gastric ulcer.

Peptic ulcers refer to ulcers occurring in the digestive tract, including duodenal ulcers and gastric ulcers, whereas gastric ulcers specifically refer to ulcerative lesions occurring in the gastric mucosa. Clinically, there is often a distinction made between duodenal ulcers and gastric ulcers. Clinically, gastric ulcers cause postprandial pain, while duodenal ulcers are characterized by midnight pain and hunger pain. Additionally, the locations of occurrence differ; gastric ulcers commonly occur on the lesser curvature of the stomach, whereas duodenal ulcers commonly occur in the bulb. The treatment methods are fundamentally similar, primarily involving the use of medications that inhibit gastric acid secretion and protect the mucous membrane. Moreover, it involves enhancing health education, maintaining a regular diet, reasonable rest, and avoiding excessive fatigue. (Please use medication under the guidance of a physician.)

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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
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 Jiang Guo Ming
Gastroenterology
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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.

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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.