complicated ulcer



OVERVIEW

OVERVIEW

Compound ulcers are the coexistence of the stomach and duodenum with simultaneous peptic ulcers or acute gastric ulcers with deformity of the duodenal bulb. In most cases, the duodenal ulcer occurs first, followed by the gastric ulcer.

Whether medical insurance

Yes

Department

Gastroenterology

Clinical Symptoms

The main clinical manifestation is more pronounced rhythmic periodic epigastric pain.

Hazards

This disease can lead to hemorrhage in the upper gastrointestinal tract.

Complications

Upper gastrointestinal bleeding, acute gastroduodenal perforation, pyloric obstruction, etc.

Examination

Helicobacter pylori test, gastric fluid analysis, fecal occult blood test, X-ray barium meal imaging, electronic gastric endoscopy, etc.

Diagnosis

Diagnosis can be made on the basis of the chronic course of the disease, epigastric pain and other manifestations, combined with endoscopy and other auxiliary examinations.

Treatment principle

Treatment is based on reducing the acidity in the stomach, eradicating H. pylori and protecting the gastric mucosa.

Curability

After treatment, symptoms can be improved and ulcers can be healed.

Dietary advice

Diet should be light, easy to digest, avoid smoking and alcohol.

Important Reminder

Early and regular treatment to avoid complications.

Causes

Epidemiology

The disease is most common in men.

Etiology

The disease is mostly associated with Helicobacter pylori infection, hypersecretion of gastric acid, stress, pharmacogenetic injury or genetic factors.

Symptoms and Diagnosis

Typical symptoms

The clinical manifestations are nonspecific and often resemble duodenal ulcer. The main manifestation is more obvious rhythmic periodic epigastric pain. Abdominal pain often occurs at night between 11 p.m. and 2 a.m., i.e., when gastric acid secretion is increased and the stomach is empty, and is relieved after eating, so it is preferable to eat several times. Abdominal pain can occur throughout the year, and is more common in early spring and late fall, with a natural onset and remission cycle.

Diagnostic basis

1. Chronic course, periodic episodes of rhythmic epigastric pain as the main manifestation. 2. Combined with X-ray barium meal imaging, endoscopy and other auxiliary examinations can be diagnosed.

Treatment

Treatment policy

Drug therapy is the mainstay of treatment to reduce intragastric acidity, eradicate Helicobacter pylori and protect the gastric mucosa. Surgery can be used if necessary.

Pharmacological treatment

(1) Reduce intragastric acidity: Proton pump inhibitors, H2 receptor blockers, anticholinergics can be used. (2) Eradication of Helicobacter pylori: recommend the quadruple therapy of PPI, colloidal bismuth with two kinds of antibacterial drugs. (3) Gastric mucosa protection: It can be treated with misoprostol, glutamine, magnesium aluminum carbonate, gefalcon, teprenone, rebarbapentin, aluminum thioglycollate, bismuth and other drugs.

Surgery

Surgical treatment of compound ulcers favors resection of most of the stomach.

Prognosis

Timely and regular treatment and timely management of complications will have a good prognosis.

Nursing care

Daily care

1. Pay attention to rest, develop good habits of living, and combine work and rest. 2. Keep happy and actively cooperate with the treatment. 3. Reasonable sports and exercise to improve one’s immunity. 4.

Dietary management

1. Diet should be light, easy to digest, rich in nutrition. 2. Do not eat spicy stimulation, greasy food. 3. Avoid smoking and alcohol.

Other Attention

Early and regular treatment to avoid complications.