Q1: What is peptic ulcer?
Peptic ulcer is an inflammatory reaction and necrotic lesion in the mucosa under the action of various pathogenic factors, and the lesion can reach deep into the mucosal muscle layer, among which stomach and duodenum are the most common, so it is also called gastric and duodenal ulcer.
Q2: Is the development of peptic ulcer related to stomach acid?
The view that “no acid, no ulcer” is generally accepted. However, a certain level of gastric acid is necessary for the development of most peptic ulcers, and duodenal ulcers rarely occur in people whose maximum gastric acid secretion is less than 12~15 mmol/h. Acid-suppressing or acid-neutralizing treatments such as H2 receptor antagonists, proton pump inhibitors and antacids can promote the healing of gastric and duodenal ulcers. Therefore, gastric acid is one of the important factors in the development of peptic ulcers.
Q3: Is peptic ulcer related to Helicobacter pylori infection of the stomach?
Helicobacter pylori (Hp) infection is a worldwide problem. The rate of infection increases with age. The detection rate of Hp is 60% to 70% in patients with chronic gastritis, 70% to 80% in gastric ulcers, and 80% to 100% in the gastric sinus of patients with duodenal ulcers. Only 15% of HP-infected patients develop peptic ulcers, indicating that in addition to bacterial capacity, genetic susceptibility also plays a role.
Q4：Is the onset of peptic ulcer related to the season?
The onset of some peptic ulcer patients has a certain seasonality, regardless of initial or recurrence, with the onset in late autumn or early spring when the temperature is variable, while the incidence is lower in summer, and the specific reasons for this seasonal difference are unclear.
Q5：What are the effects of tobacco, alcohol and tea on peptic ulcer patients?
Smokers are more likely to have peptic ulcers than non-smokers. Drinking alcohol has a significant damaging effect on the gastric mucosa, causing gastritis and prompting ulcer formation, and is more harmful to patients with active ulcers and a history of ulcers, often aggravating, bleeding or recurring ulcers. Coffee, strong tea and other beverages can significantly stimulate gastric acid secretion, and epidemiology has not confirmed that coffee, strong tea and other beverages are associated with the occurrence of peptic ulcers. However, long-term consumption may increase the risk of peptic ulcers.
Q6: Are peptic ulcers hereditary?
Genetic factors may be one of the causes of peptic ulcers, and there is family aggregation in the development of peptic ulcers.
Q7：Is peptic ulcer related to blood type?
The incidence of duodenal ulcers is about 35% higher in people with blood type O than in those with other blood types.
Q8：What drugs can cause peptic ulcers?
Some drugs can cause gastric and duodenal ulcers. Peptic ulcers occur in 10%-25% of patients who take a large amount of long-term non-steroidal anti-inflammatory drugs such as aspirin, anti-inflammatory pain, botrytisone and ibuprofen; long-term use of hormonal drugs such as adrenal corticosteroids can induce peptic ulcers or aggravate the condition of patients with a history of ulcers; drugs such as reserpine have histamine-like effects and can increase gastric acid The drugs have histamine-like effects and can increase gastric acid secretion, so they have potential ulcerogenic effects. The epidemiological survey shows that 15%-30% of the people who take NSAID and aspirin can suffer from peptic ulcer, and NSAID and aspirin increase the risk of ulcer bleeding, perforation and other complications by 4-6 times, while about 25% of peptic ulcer disease and complication rate and death rate among the elderly are related to NSAID and aspirin.
Q9：Who is prone to peptic ulcer?
Those who have H. pylori infection, those who take a large amount of long-term NSAIDs, adrenocorticotropic hormones, blood pressure medication, blood pressure medication, family history of peptic ulcer, long-term smokers, overeaters and irregular eaters, and those who live in high mountainous areas are prone to peptic ulcer, with a higher incidence in men than women, and more young than old. Certain chronic diseases, such as liver cirrhosis, chronic obstructive pulmonary disease, rheumatoid arthritis, uremia, primary hyperparathyroidism, and gastrinoma are prone to ulcers.
Q10：Can peptic ulcers become cancerous?
The cancer of gastric ulcer is still a matter of debate. It is generally estimated that the incidence of cancerous gastric ulcers is only 2%~3%, but duodenal bulb ulcers generally do not cause cancerous changes.
Q11：Who should be alerted to gastric ulcer carcinogenesis?
Any middle-aged or older patients with gastric ulcer who have the following conditions should be suspected of the possibility of gastric ulcer carcinoma: (1) those who have no improvement in symptoms after 4~6 weeks of strict medical treatment or those who have no complications but the rhythmical disappearance of pain, loss of appetite and significant weight loss; (2) those who have persistently positive fecal occult blood test and anemia; (3) those whose gastric ulcer malignancy cannot be excluded by barium X-ray meal or gastroscopy. Both barium X-ray and gastroscopy must be repeated regularly.
Q12：What are the differences between peptic ulcer and gastric cancer?
It is very important to distinguish benign gastric ulcer from malignant ulcer. Malignant ulcer is mostly seen in middle age or above, with progressive and continuous development, short duration of disease, mostly measured in months, and significant wasting. The differentiation of the two is sometimes difficult. Special attention should be paid to the following cases: (i) middle-aged and elderly people with recent upper middle-abdominal pain, bleeding or anemia; (ii) patients with gastric ulcer whose clinical manifestations have changed significantly or whose anti-ulcer medication is ineffective; (iii) patients with gastric ulcer biopsy pathology with intestinal chemosis or atypical hyperplasia. Clinically, patients with gastric ulcers should be followed up with regular endoscopy under active medical treatment and closely observed until the ulcer heals.