Gastric ulcer Gastric ulcer is a type of peptic ulcer that occurs in the stomach lining. The stomach has a protective layer called the gastric mucosa, and when this mucosa is damaged for some reason, ulcers are likely to form in that area, resulting in gastric ulcers.

Gastric ulcers refer to ulcers that occur in the mucous membrane or deeper layers of the stomach. They are particularly common in the 40-46 age group. Infection with Helicobacter pylori is one of the main contributing factors. Oral medication is the primary treatment, with most cases being curable.

Gastric ulcer (GU) is a type of peptic ulcer that occurs in the stomach's inner wall. The stomach's inner wall has a protective mucous membrane, and when this membrane is damaged for various reasons, ulcers are likely to form in that area, resulting in gastric ulcers.

Gastric ulcer is a common digestive disorder that can affect individuals of any age. Globally, approximately 10% of the population will develop peptic ulcers at some point in their lives. The condition is most prevalent in middle-aged and elderly patients aged 40-60, with a higher incidence in males than females.

In the medical field, there are various classification methods for gastric ulcers, with most based on the location of the ulcer and the amount of gastric acid secretion. The most common type occurs near the lesser curvature of the stomach, with one in every two gastric ulcer patients falling into this category on average. Another noteworthy type occurs in the upper third of the stomach or around the cardia, and this type is prone to perforation or bleeding and requires special attention.

Additionally, if a patient fails to respond to 12 weeks of treatment for gastric ulcers, they may be classified as having "refractory ulcers." However, with advancements in treatment, refractory ulcers are becoming increasingly rare.

Infection with Helicobacter pylori (Hp) is a major pathogenic factor for the vast majority of gastric ulcer patients. Hp not only damages the gastric mucosa but also stimulates gastric acid secretion, further exacerbating gastric ulcers. Certain medications can also damage the gastric mucosa, with the use of non-steroidal anti-inflammatory drugs (NSAIDs) being another significant contributing factor to gastric ulcers. Research has shown that approximately 25% of gastric ulcers in Western countries are associated with NSAIDs.

Current research has not found direct causation between smoking, alcohol abuse, excessive stress, consumption of spicy foods, and intake of coffee or strong tea with gastric ulcers. However, these factors can exacerbate the symptoms of gastric ulcers and increase the difficulty of treatment.

The most common symptom of gastric ulcers is a burning pain in the stomach. The pain has several characteristics:

The abdominal pain from gastric ulcers often occurs within half an hour to an hour after eating.

If antacids are taken, the pain temporarily stops.

The pain usually lasts for several minutes or may persist for several hours.

The pain may recur over several days or weeks.

Possible Associated Symptoms of Gastric Ulcers:

In addition to the typical symptoms, patients with gastric ulcers may also experience the following symptoms:

Indigestion, decreased appetite, and unexplained weight loss.

Vomiting or vomiting blood – the vomited blood may be red or black.

Nausea and the urge to vomit.

Bloating, feeling full, or belching.

Stool may appear dark red or tarry.

Gastric ulcers and duodenal ulcers both belong to peptic ulcers and often require differential diagnosis in clinical practice. Although the location and timing of pain can provide a rough judgment, the most accurate method is still through endoscopic examination. During the examination, doctors can accurately determine the location of the lesion to distinguish between gastric ulcers and duodenal ulcers, or even identify the presence of both in the form of a compound ulcer.

In addition to treating the underlying causes, it is important for patients to maintain a good mood and healthy lifestyle habits. Patients are encouraged to quit smoking and drinking, avoid consuming spicy foods, and refrain from drinking coffee, strong tea, and the like, all of which can promote the healing of gastric ulcers. If patients are taking certain medications such as NSAIDs, they should actively communicate with their doctors to avoid exacerbating the ulcers and affecting the treatment efficacy.

Most patients with gastric ulcers can be cured through drug therapy, with only a small number requiring surgical treatment. The purpose of surgical treatment is to remove the ulcerated area to prevent recurrence or malignant transformation. Surgical treatment is necessary under the following conditions:

Intractable ulcers, where the patient has strictly adhered to 8-12 weeks of medical treatment and the ulcer has not healed, or the ulcer recurs despite continued medication after improvement from medical treatment.

Severe or recurrent bleeding that is unresponsive to drug treatment, endoscopy, or vascular intervention.

Ulcers in special locations that are not easily accessible by medication, such as prepyloric or pyloric ulcers, or ulcers in the high gastric lesser curvature.

Highly suspected malignant tumors associated with gastric ulcers.

Scarring obstruction in pyloric ulcers, unresponsive to endoscopic treatment.

Complications of gastric ulcers are relatively rare, but if not promptly diagnosed and treated, the following serious complications may occur.

Upper gastrointestinal bleeding

The most common complication of gastric ulcers is upper gastrointestinal bleeding, with an incidence of approximately 15%-25%. Patients may experience slow, prolonged bleeding, leading to symptoms of anemia such as fatigue, difficulty breathing, pale skin, and palpitations, or rapid, severe bleeding resulting in hematemesis or melena.

If patients experience these symptoms, they should seek medical attention promptly. Doctors may recommend endoscopic examination to determine the cause of bleeding and provide the patient with endoscopic hemostatic treatment.

Ulcer perforation

The incidence of perforation in patients with gastric ulcers is about 2%-5%. Sudden severe abdominal pain in a patient may indicate perforation. In such cases, the patient should be hospitalized and, if necessary, undergo surgical treatment.

Pyloric obstruction

Inflammation and scarring at the site of gastric ulcers can obstruct the passage of food into the small intestine, leading to pyloric obstruction. The incidence of pyloric obstruction in patients with gastric ulcers is about 2%-4%. Patients may experience the following symptoms:

Recurrent vomiting, with undigested food in the vomit from the previous day.

Delayed gastric emptying, abdominal distension.

Frequent feelings of fullness.

Unexplained weight loss.

After determining the cause through endoscopy, doctors will provide targeted treatment. If the obstruction is caused by inflammation, proton pump inhibitors (PPIs) or H2 receptor antagonists can be used to reduce gastric acid levels, while scarring-induced obstructions can be treated through surgery.

Alternative therapy: Doctors may place a small balloon at the site of obstruction using an endoscope, inflating it to open the obstructed area and facilitate the passage of residual food into the intestines.

Daily life management for gastric ulcer patients is crucial. Neglecting proper daily life management can easily lead to recurrent attacks, causing prolonged pain and distress for patients. Therefore, the following recommendations are advised:

Eat small, frequent meals. Do not overeat at each meal, and consider increasing the number of meals to 4-5 times per day.

Consume primarily starchy foods and avoid spicy foods such as raw garlic, chili, etc.

Avoid consuming undercooked foods to reduce the risk of infection.

Quit smoking.

Minimize alcohol consumption or abstain from it altogether.

Coffee also stimulates the gastric mucosa, so it is advisable to avoid its consumption.

Engage in moderate exercise to enhance the body's immune system.

There are four main methods to prevent gastric ulcers:

Avoid Hp infection. The main route of Hp infection is through oral transmission, and infected individuals and contaminated water sources are the main sources of infection. Oral-oral and fecal-oral transmission are the main routes, with the former being the primary mode of transmission. Therefore, it is important to avoid consuming unclean food and untreated water; in terms of lifestyle, refrain from sharing toothbrushes with others.

Avoid long-term use of NSAIDs, or if used, additional acid suppression or gastric mucosal protective agents should be taken, with close monitoring.

Quit smoking.

Maintain a healthy diet.