Symptoms of peptic ulcer

Written by Jiang Guo Ming
Gastroenterology
Updated on October 26, 2024
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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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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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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.

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Written by Jiang Guo Ming
Gastroenterology
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How is peptic ulcer treated?

The treatment of peptic ulcers mainly depends on their cause. It is generally believed that infection with Helicobacter pylori is most closely related to peptic ulcers. In such cases, the first step is to check for Helicobacter pylori infection. If there is an infection, antibacterial treatment is generally used, with the common regimen being quadruple therapy: a proton pump inhibitor plus two antibiotics and a bismuth agent. If there is no Helicobacter pylori infection, symptomatic treatment is generally sufficient. The preferred method is to use acid-suppressing and stomach-lining-protecting medications, combined with symptomatic treatment. At the same time, it is helpful to develop good dietary and living habits, opt for a light and easy-to-digest diet, and eat regularly in fixed amounts. Avoid overeating and excessive fatigue; abstain from smoking and alcohol, and maintaining a good mood all help. (Medication should be used under the guidance of a professional doctor.)

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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 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.)