Duodenal Ulcer

Duodenal ulcers that occur on the inside of the upper portion of your small intestine (duodenum)

Duodenal ulcers that occur on the inside of the upper portion of your small intestine (duodenum)

Infection usually causes a duodenal ulcer with a germ (germs) called Helicobacter pylori (H. pylori). A 4- to 8-week course of acid-suppressing medication will permit the ulcer to recover. Also, a one-week course of 2 antibiotics plus an acid-suppressing medication will usually clear the H. pylori infection. This usually avoids the ulcer from coming back. Anti-inflammatory medications utilized to treat conditions such as arthritis often cause duodenal ulcers. If you require to continue with the anti-inflammatory drug, then you might need to take long-lasting acid-suppressing medication.

What Is a Duodenal Ulcer?

A duodenal ulcer is an ulcer that occurs in the lining in the part of the small intestine simply beyond the stomach (the duodenum). An ulcer in the lining of the stomach is called a gastric ulcer.

There are separate brochures called Non-ulcer Dyspepsia (Functional Dyspepsia), Stomach Ulcer (Gastric Ulcer) and Acid Reflux and Oesophagitis.

What Is Duodenal Bulb?

The duodenal bulb is the portion of the duodenum closest to the stomach. It usually has a length of about 5 centimeters. The duodenal bulb starts at the pylorus and ends at the neck of the gallbladder. It is located posterior to the liver and the gallbladder and superior to the pancreatic head. The gastroduodenal artery, portal vein, and common bile duct lie simply behind it. The distal part of the bulb is located retroperitoneally. It abuts the Pyloric sphincter.

The duodenal bulb is the place where duodenal ulcers happen. Duodenal ulcers are more typical than gastric ulcers and unlike gastric ulcers, are brought on by increased gastric acid secretion. Duodenal ulcers are commonly situated anteriorly, and rarely posteriorly. Anterior ulcers can be made complex by perforation, while the following ones bleed. Their area explains the reason for that. The peritoneal or stomach cavity lies anterior to the duodenum. Therefore, if the ulcer grows deep enough, it will bore, whereas if a posterior ulcer grows deep enough, it will perforate the gastroduodenal artery and bleed.

General Symptoms of a Duodenal Ulcer

  • Pain in the upper tummy (abdomen) simply below the breastbone (sternum) is the typical sign. It usually comes and goes. It may take place most previously meals, or when you are starving. It might be alleviated if you consume food, or take antacid tablets. The pain might wake you from sleep.
  • Other symptoms which may occur consist of bloating, retching, and sensation sick. You might feel especially complete after a meal. Often food makes the pain even worse.
  • Issues happen in some cases and can be major. These include:
    • Bleeding ulcer. This can range from a drip to a life-threatening bleed.
    • Perforation. The ulcer goes right through (bores) the wall of the first part of the small intestinal tract (duodenum). Food and acid in the duodenum then leakage into the stomach cavity. This usually triggers severe pain and is a medical emergency.

Treatments for a Duodenal Ulcer

General advice

Lifestyle steps can enhance symptoms, such as:

  • Drop weight if you are obese.
  • Avoid any trigger foods, such as coffee, chocolate, tomatoes, fatty foods or hot foods.
  • Consume smaller sized meals and eat your evening meal 3-4 hours before going to bed.
  • Stop smoking.
  • Reduce alcohol usage to advised limits.

Acid-suppressing medication
The most frequently used medicine is a proton pump inhibitor (PPI). See the different brochure called Indigestion Medication to learn more.

If H. pylori triggered your ulcer
Nearly all duodenal ulcers are triggered by infection with H. pylori. See the different leaflet called Stomach Pain (Helicobacter Pylori) to learn more.

If an anti-inflammatory medication caused your ulcer
If possible, you must stop the anti-inflammatory medication. This permits the ulcer to heal. You will likewise typically be recommended an acid-suppressing medication for many weeks (see above).

Surgery
Surgery is now typically only needed if a problem of a duodenal ulcer establishes, such as extreme bleeding or a hole (perforation).

General Causes of Duodenal Ulcers

There is typically a balance in between the quantity of acid that you make and the mucous defense barrier. An ulcer might develop if there is a modification in this balance, allowing the acid to harm the lining of the stomach or duodenum. Causes of this consist of the following:

Infection with H. pylori
Infection with H. pylori is the cause in about 19 in 20 cases of duodenal ulcer. More than a quarter of people in the UK become contaminated with H. pylori at some stage in their lives. See the separate leaflet called Stomach Pain (Helicobacter Pylori) for additional information.

Anti-inflammatory medicines – including aspirin
Anti-inflammatory medicines are sometimes called non-steroidal anti-inflammatory drugs (NSAIDs). These medicines sometimes impact the mucous barrier of the duodenum and allow acid to trigger an ulcer.

Other causes and factors
Other reasons are unusual — for example, the Zollinger-Ellison syndrome. In this rare condition, much more acid than usual is made by the stomach.

Other factors such as cigarette smoking, stress and drinking significantly might increase the risk of having a duodenal ulcer. However, these are not typically the underlying reason for duodenal ulcers.

Causes of Duodenal Irritation

Duodenitis is inflammation that occurs in the duodenum, which is the start of the little intestine. Duodenal inflammation can cause pain and other unpleasant intestinal symptoms.

While there are various types of duodenitis, duodenal irritation is constantly connected to some sort of irritation involving the mucus lining of the duodenum. Often this irritation can progress to duodenal ulcers. These ulcers remain in truth open sores in the lining of the duodenum. The duodenum has numerous mechanisms that enable it to neutralize highly acidic stomachs. Some of those systems are large quantities of mucus and alkaline secretions, as well as water from the pancreas and gallbladder.

Because the duodenum is close to the stomach and receives partly absorbed stomach contents, along with gastric juices and enzymes, it has to withstand a lot of chemical irritation. While for the a lot of part, it handles the chemical influx, it can end up being swollen under particular scenarios. When asked, what is duodenitis, lots of doctor first describe the various types.

Diagnosis

  • Gastroscopy (endoscopy) is the test that can verify a duodenal ulcer. In this test a medical professional or nurse looks inside your stomach and the first part of your small intestine (duodenum). They do this by passing a thin, flexible telescope down your craw (esophagus). They can see any inflammation or ulcers.
  • A test to discover the H. pylori germ (bacterium) is typically done if you have a duodenal ulcer. If H. pylori are discovered, then it is most likely to be the cause of the ulcer. Quickly, it can be found in a sample of stool (feces), or a breath test, or from a blood test, or a biopsy sample taken throughout an endoscopy. See the separate brochure called Stomach Pain (Helicobacter Pylori) for more details.

Last modified: December 13, 2018

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