Gastric ulcers cause gastric bleeding and need timely treatment

It is very common for gastric ulcers to cause gastric bleeding if not treated in time, which is very serious. Gastric ulcers are prone to recurrence. During treatment, patients with gastric ulcers should quit bad habits, such as smoking and drinking. They can be treated with medication, and severe cases require timely surgery.

1. General treatment

With the study of the pathogenesis of gastric ulcer, general treatment has become increasingly important. Among them, regulating diet and lifestyle is an important aspect. This includes stopping smoking, drinking, chewing betel nuts and other highly irritating foods, and eating three meals regularly and in moderation. For patients with stressful lives, work and study, it is necessary to pay attention to rest and combine work with rest, or even rest in bed.

2. Drug treatment

According to the pathogenesis of gastric ulcer and the characteristics of drug action, it can be divided into four categories: antacid preparations, various parietal cell receptor blockers, mucosal protectants and anti-Helicobacter pylori antibiotics.

(1) Antacids:

The main ones include sodium bicarbonate, aluminum hydroxide and many compound preparations such as Weidela and Weishule. These drugs have certain efficacy in relieving symptoms.

(2) Receptor blockers:

①H2 receptor blockers: including cimetidine, ranitidine, famotidine, etc. The latter two are 4 to 20 times more effective than cimetidine. This type of drug reduces gastric acid secretion by blocking H2 receptors on parietal cells, while acetylcholine receptors and gastrin receptors are also inhibited. Cimetidine: 0.2-0.3

g / time, 3 times / day, take one more dose at night before going to bed. The total amount should not exceed 1.0-1.2 g/d. The cure rate can reach 60% to 80% in 4 to 8 weeks. Ranitidine: 0.15g/time, 2 times/day, or 0.3g before going to bed at night. Famotidine: 20 mg/time, 2 times/d, or 40 mg before bedtime. The cure rate of famotidine after taking it for 8 weeks is 91% to 97%.

② Proton pump inhibitors: This type of drug includes omeprazole (losec) 20 mg, once a day, or taken before going to bed at night. It is the most powerful drug known to date for inhibiting gastric acid secretion. It can almost completely inhibit gastric acid secretion, and the cure rate in 4 weeks can reach more than 95%.

③Gastrin receptor blockers: Drugs in this category include proglumide, which competitively inhibits the action of gastrin receptors in gastric parietal cells, thereby promoting gastric acid secretion and ulcer healing. 0.4g/time, 3 times/d, the cure rate in 4 to 8 weeks is 66.9%.

(3) Mucosal protectants: This type of drug mainly protects the gastric and duodenal mucosa by increasing mucosal thickness and promoting mucus and HC03- secretion. Includes prostaglandins and topical preparations.

(4) Anti-Helicobacter pylori drugs: Recent studies have shown that gastritis and gastroduodenal ulcers are closely related to Helicobacter pylori infection.

3. Surgical treatment

With the development of medicine and the role of drugs in the treatment of peptic ulcer, there have been great changes in the treatment of peptic ulcer. Currently used anti-ulcer drugs can heal 75% of ulcers within 4 weeks and 85% to 95% of ulcers within 8 weeks. The relapse rate after drug treatment is also decreasing. Moreover, a large amount of clinical data shows that elective surgeries are decreasing, while the proportion of emergency surgeries (especially those due to perforation and massive bleeding) is increasing. However, the indications for surgical treatment of gastric ulcers should be appropriately relaxed compared with those for surgical treatment of duodenal ulcers.