Asymptomatic peptic ulcer

Written by Jiang Guo Ming
Gastroenterology
Updated on November 16, 2024
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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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Clinical characteristics of peptic ulcer

The main cause of peptic ulcers is believed to be infection by Helicobacter pylori. Other factors such as smoking, alcohol, poor diet, living habits, medication use, or emotional issues can also play a role. Clinically, these ulcers are often characterized by upper abdominal pain. In the case of gastric ulcers, the pain is primarily in the upper left abdomen or below the sternum, and can manifest as dull pain, blunt pain, or a feeling of distension. This pain is often more apparent after meals, commonly occurring half an hour to an hour after eating, and usually subsides two to three hours later. Duodenal bulb ulcers are characterized by upper abdominal muscular pain, occurring around two centimeters above and to the right of the navel, sometimes accompanied by nighttime pain. If the ulcer is located behind the bulb, back pain can also occur. Peptic ulcers can lead to other complications, such as perforation, bleeding, or even cancer.

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

Peptic ulcers, including gastric ulcers and duodenal bulb ulcers, can generally be completely cured in most cases. Treatment plans are usually determined based on the presence of Helicobacter pylori infection. If there is an infection with Helicobacter pylori, quadruple therapy is typically used to eradicate the bacteria. If there is no Helicobacter pylori infection, symptomatic treatment is sufficient. Some patients may experience recurrent peptic ulcers, which are usually caused by several factors. Firstly, the failure to completely eradicate Helicobacter pylori can lead to recurrent ulcers. Additionally, the recurrence of ulcers might also be facilitated by poor dietary and lifestyle habits after the ulcers have healed, such as long-term alcohol abuse, smoking, or consumption of spicy and irritating foods.

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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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Can people with peptic ulcers exercise?

The primary cause of peptic ulcers is usually Helicobacter pylori infection, though other factors can also trigger the onset of peptic ulcers, such as tobacco and alcohol irritation, poor dietary habits, and emotional issues. Additionally, excessive fatigue is also one of the causes that can trigger or cause a recurrence of peptic ulcers. Therefore, whether or not a person with peptic ulcers can exercise depends on the specific condition of the illness. If it is an acute active phase or a subacute peptic ulcer that has not fully healed, strict rest is necessary in such cases. If a gastroscopy shows that the ulcer has completely healed, moderate and light activities are permissible, but excessive fatigue should still be avoided.

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

Common types of peptic ulcers, including gastric ulcers, duodenal bulb ulcers, complex ulcers, and anastomotic ulcers after gastric resection, share common characteristics and have their own distinct symptoms. Abdominal pain is a usual symptom. The pain from duodenal bulb ulcers tends to be dull, bloating, or blunt, and it is generally more noticeable when hungry. The pain often eases after eating as food neutralizes stomach acid. Sometimes, there is pain at night. If the ulcer is beyond the bulb or is a penetrating ulcer, it often comes with back pain; gastric ulcers primarily manifest as postprandial pain, meaning pain occurring half an hour to an hour after eating, which gradually alleviates; complex ulcers often present with both types of symptoms mentioned above. As peptic ulcers are often associated with excessive stomach acid, symptoms like acid reflux, heartburn, and nausea are common.