What position should be taken for duodenal ulcer hematemesis?

Written by Wu Hai Wu
Gastroenterology
Updated on September 21, 2024
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Patients with duodenal ulcers, if vomiting blood occurs, are advised to slightly elevate their lower limbs, position their heads lower, and lie on their side. Because when patients with duodenal ulcers vomit blood, it indicates a relatively large amount of bleeding. Elevating the lower limbs slightly can effectively promote the return of blood from the lower limbs, ensuring the blood supply to vital organs, and lying on the side helps prevent the possibility of choking following vomiting. Once vomiting blood due to a duodenal ulcer occurs, an urgent gastroscopy is required, and hemostatic treatment should be carried out under gastroscopy.

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Written by Si Li Li
Gastroenterology
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The manifestations of duodenal ulcer.

Duodenal ulcers can cause symptoms such as upper abdominal pain, belching, acid reflux, nausea, vomiting, heartburn, poor appetite, and indigestion. The characteristic of upper abdominal pain in duodenal ulcers typically lessens after eating and worsens when hungry. A gastroscope can reveal defects in the duodenal mucosa, confirming a diagnosis of duodenal ulcer. About 90%-100% of patients with duodenal ulcers are infected with Helicobacter pylori, therefore, a Carbon-14 breath test is recommended to determine the presence of Helicobacter pylori infection. If the infection is positive, a 14-day eradication treatment for Helicobacter pylori is required, involving a proton pump inhibitor, two types of antibiotics, and a bismuth agent. Additionally, treatment for duodenal ulcers includes acid suppression, gastric protection, enhancing gastric motility, and protecting the gastric mucosa. The treatment typically lasts about six weeks.

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Written by Wu Hai Wu
Gastroenterology
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Is hot compress effective for duodenal ulcer?

Patients with duodenal ulcers may achieve some effects through hot compresses, but hot compresses cannot truly effectively treat duodenal ulcers. To effectively treat duodenal ulcers, it is first necessary to detect the presence of Helicobacter pylori infection through the carbon-13 breath test or carbon-14 breath test. If the Helicobacter pylori infection is positive, it is necessary to eradicate Helicobacter pylori using a quadruple therapy containing bismuth. Subsequently, it is important to use proton pump inhibitors or H2 receptor antagonists to inhibit gastric acid secretion, and medications like aluminum magnesium carbonate to protect the gastric mucosa. (The use of medications should be under the guidance of a physician.)

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Written by Wu Hai Wu
Gastroenterology
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What should I do if a duodenal ulcer causes diarrhea?

Patients with duodenal ulcers who experience diarrhea should undergo a routine stool examination to rule out diarrhea caused by intestinal infections. If there is no obvious organic disease in the intestines, the diarrhea associated with duodenal ulcers may be due to excessive secretion of stomach acid. It is advisable to consider using medications that suppress the secretion of stomach acid, such as proton pump inhibitors like omeprazole or lansoprazole, etc. You can also use aluminum magnesium carbonate, sucralfate, etc., to protect the stomach lining. For patients with abdominal distension, medications like mosapride can be used to promote gastric motility treatment.

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Written by Wu Hai Wu
Gastroenterology
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How large does a duodenal ulcer have to be to be considered severe?

There is no specific size to determine the severity of a duodenal ulcer. However, ulcers with a diameter greater than 1.5 cm are generally considered large. In such cases, strong acid-suppressing medications are needed for treatment, along with drugs to protect the gastric mucosa. Additionally, it is necessary to test for Helicobacter pylori infection. If the infection is positive, a bismuth-containing quadruple therapy should be used for two weeks to eradicate Helicobacter pylori. The choice of specific medications, as well as their dosages and administration, should be under the guidance of a doctor.

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Written by Wu Hai Wu
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Is duodenal bulb inflammation an ulcer?

Duodenal bulb inflammation is not an ulcer. It refers to chronic inflammation of the mucosa of the duodenum without erosion, hence it is not a duodenal ulcer. However, if patients with duodenal bulb inflammation do not receive proper treatment and fail to pay attention to their diet, among other factors, it may potentially develop into a duodenal ulcer. Once a duodenal ulcer occurs, it could lead to potential complications such as pyloric obstruction, gastrointestinal bleeding, and perforation of the duodenal bulb, etc. Therefore, it is crucial for patients with duodenal bulb inflammation to seek active treatment.