Gastritis hurts every afternoon

Gastric disease is very common in our lives, and many gastric diseases have a common feature that they cause stomach pain. Gastritis is the most common stomach disease. Some patients with gastritis feel pain every afternoon. This may not be caused by gastritis, but by duodenal ulcer. The regular attacks every day are related to hunger. When hunger comes, there is also a feeling of pain. We need to have some understanding of the symptoms of duodenal ulcer.

Clinical manifestations

The main clinical manifestation is upper abdominal pain, which may be dull pain, burning pain, bloating or severe pain, or it may be dull pain and discomfort only when hungry. Typical symptoms include mild or moderate persistent pain under the xiphoid process, which can be relieved by antacids or eating. Clinically, about 2/3 of the pain is rhythmic: upper abdominal pain begins 1 to 3 hours after breakfast, and if no medication or food is taken, it will continue until after lunch. The pain returns 2 to 4 hours after eating and is relieved after eating. About half of the patients experience midnight pain, which often wakes them up. Rhythmic pain usually lasts for a few weeks, then eases for a few months and can recur.

treat

1. Medication

The goals are to control symptoms, promote ulcer healing, prevent recurrence, and avoid complications. The most commonly used drugs are divided into the following categories:

(1) Drugs that inhibit gastric acid secretion are currently mainly H2 receptor antagonists (H2-RA) and proton pump inhibitors (PPIs). PPI promotes ulcer healing faster and with a higher healing rate, and is the first choice for the treatment of duodenal ulcers. Commonly used PPIs include omeprazole, pantoprazole, lansoprazole, rabeprazole, esomeprazole, and ilaprazole.

(2) The combined use of mucosal protective agents and gastric acid inhibitors can improve the quality of ulcer healing and reduce ulcer recurrence.

(3) Gastrointestinal prokinetic drugs are mainly used for patients with symptoms such as nausea, vomiting, and abdominal distension to promote gastrointestinal emptying and relieve symptoms.

(4) Eradication of Helicobacter pylori

2. Surgery

Mainly used to treat complications (perforation, bleeding, obstruction).