Stomach Ulcers: Risks, Follow-Up, and Cancer Concerns

Gastric ulcer carcinogenesis and follow-up?

Hello, Doctor.
I was diagnosed with a gastric ulcer in 2017, and the doctor said it was very mild at that time.
I took medication for a month (a pink orally disintegrating tablet, I forgot the name).
Over a year later, I still occasionally felt discomfort.
In March 2018, I underwent another gastroscopy, and the doctor again said I had a gastric ulcer, but it was still very mild, and there were no other issues.
My questions are: 1.
In 2019 and 2020, I still occasionally experienced stomach discomfort, but it usually resolved in 2 to 3 days.
Does this mean the ulcer has not healed? 2.
After both gastroscopies, the doctor did not recommend a follow-up gastroscopy, but I see that most people online have a follow-up after medication.
Why didn't my doctor do this? 3.
Is a gastric ulcer really the closest gastric condition to gastric cancer? I am a bit worried, and I would appreciate your answers.
Thank you.

Xiao Qing, 40~49 year old female. Ask Date: 2020/10/22

Dr. Chen Shidian reply Gastroenterology and Hepatology

→ It is best to continue monitoring, but if there are only superficial ulcers, it may not be necessary.
The overall assessment can also refer to the severity of the initial biopsy.

Reply Date: 2020/10/22

More Info

Understanding stomach ulcers, their risks, follow-up care, and potential cancer concerns is crucial for anyone who has experienced this condition. Stomach ulcers, also known as peptic ulcers, are sores that develop on the lining of the stomach or the upper part of the small intestine. They can cause significant discomfort and may lead to serious complications if left untreated.

1. Persistent Symptoms and Healing: It is not uncommon for individuals to experience intermittent discomfort even after being diagnosed with a stomach ulcer. The symptoms you describe—occasional stomach discomfort that resolves within a few days—could indicate that the ulcer has not fully healed or that there are other underlying issues, such as gastritis or acid reflux. While some ulcers can heal with medication, others may require more intensive treatment or lifestyle changes. If you continue to experience symptoms, it is essential to consult your healthcare provider for further evaluation.

2. Follow-Up Endoscopy: The decision to perform follow-up endoscopy after treatment for a stomach ulcer can vary based on individual circumstances. In many cases, doctors may recommend follow-up endoscopy if there are concerns about the ulcer's healing or if symptoms persist. However, if your doctor assessed that your ulcer was mild and you were responding well to treatment, they may have felt that additional endoscopy was unnecessary. It’s important to communicate any ongoing symptoms to your healthcare provider, as they may warrant further investigation.

3. Cancer Risk: Regarding your concern about the relationship between stomach ulcers and stomach cancer, it is important to clarify that while there is a connection, it is not as direct as one might think. Chronic ulcers can be associated with an increased risk of gastric cancer, particularly if they are related to chronic infection with Helicobacter pylori or if there are other risk factors present, such as smoking or a family history of gastric cancer. However, not all individuals with stomach ulcers will develop cancer. Regular monitoring and treatment of ulcers, along with lifestyle modifications, can significantly reduce this risk.

In summary, while your history of stomach ulcers does warrant attention, it is essential to maintain open communication with your healthcare provider. If you have ongoing symptoms or concerns about your health, do not hesitate to seek further evaluation. Lifestyle changes, such as avoiding irritants (like NSAIDs, alcohol, and smoking), eating a balanced diet, and managing stress, can also play a significant role in healing and preventing future ulcers. Regular follow-ups and adherence to treatment plans are crucial in managing your condition effectively.

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