Duodenal ulcer

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Written by Wu Hai Wu
Gastroenterology
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Characteristics of vomiting in duodenal ulcer

The main characteristic of vomiting due to duodenal ulcer is postprandial vomiting. Generally, patients with duodenal ulcers are prone to pyloric obstruction. When a large meal is consumed, pyloric obstruction may occur, preventing stomach contents from passing into the duodenum, leading to vomiting. Additionally, patients might also experience vomiting of acidic stomach contents while fasting. After vomiting, patients with duodenal ulcers can use acid-suppressing medications to alleviate gastric edema and medications like mosapride to promote gastric motility. (Medication should be used under the guidance of a physician.)

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Written by Jiang Guo Ming
Gastroenterology
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What medicine is taken for duodenal ulcer?

Duodenal bulb ulcer, its main cause should be related to Helicobacter pylori infection. In this case, first check for Helicobacter pylori infection, generally using the carbon-13 or carbon-14 breath test. If there is Helicobacter pylori infection, then formal antibiotic treatment is required. For example, a proton pump inhibitor combined with two antibiotics, secondly, bismuth preparations, constitute the standard quadruple therapy, with a treatment duration of 10 to 14 days. If there is no Helicobacter pylori infection, symptomatic treatment is generally sufficient. For example, suppressing stomach acid, protecting the gastric mucosa, etc. At the same time, attention should be paid to regular dietary habits, quitting smoking and alcohol, and avoiding excessive fatigue, etc. (Specific medication use should be conducted under the guidance of a doctor.)

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Written by Wu Hai Wu
Gastroenterology
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Is hot compress effective for duodenal ulcer?

Patients with duodenal ulcers may achieve some effects through hot compresses, but hot compresses cannot truly effectively treat duodenal ulcers. To effectively treat duodenal ulcers, it is first necessary to detect the presence of Helicobacter pylori infection through the carbon-13 breath test or carbon-14 breath test. If the Helicobacter pylori infection is positive, it is necessary to eradicate Helicobacter pylori using a quadruple therapy containing bismuth. Subsequently, it is important to use proton pump inhibitors or H2 receptor antagonists to inhibit gastric acid secretion, and medications like aluminum magnesium carbonate to protect the gastric mucosa. (The use of medications should be under the guidance of a physician.)

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Written by Wu Hai Wu
Gastroenterology
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How large does a duodenal ulcer have to be to be considered severe?

There is no specific size to determine the severity of a duodenal ulcer. However, ulcers with a diameter greater than 1.5 cm are generally considered large. In such cases, strong acid-suppressing medications are needed for treatment, along with drugs to protect the gastric mucosa. Additionally, it is necessary to test for Helicobacter pylori infection. If the infection is positive, a bismuth-containing quadruple therapy should be used for two weeks to eradicate Helicobacter pylori. The choice of specific medications, as well as their dosages and administration, should be under the guidance of a doctor.

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Written by Ren Zheng Xin
Gastroenterology
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The difference between gastric ulcers and duodenal ulcers.

Gastric ulcers and duodenal ulcers are collectively known as peptic ulcers, formed under the self-digestion action of gastric acid and pepsin. Gastric ulcers are more common in middle-aged and elderly people, generally occurring at the lesser curvature of the stomach body. The pain of a gastric ulcer typically appears within an hour after eating, also known as postprandial pain, which gradually eases after one to two hours of digestion and absorption; gastric ulcers can easily lead to bleeding and perforation. Duodenal ulcers are more common in young and middle-aged adults, frequently occurring in the duodenal bulb. Typical symptoms include postprandial pain and midnight pain, which can be alleviated by using antacids. The treatment methods for gastric and duodenal ulcers are similar. Additionally, it is important to pay attention to diet in daily life, eat less spicy, greasy, and irritating food, and consume more soft, easily digestible food.

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Written by Wang Li Wei
Gastroenterology
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Is a duodenal frost-like ulcer serious?

The frost-like ulcers in the duodenal bulb are not severe. They refer to relatively superficial ulcers in the duodenum that will heal quickly. To shorten the healing duration of duodenal frost-like ulcers, several aspects should be considered: First, check for Helicobacter pylori infection. If this bacterium is present, it is necessary to first eradicate the bacteria with a quadruple therapy, and then treat with medications that suppress stomach acid or promote ulcer healing. Second, pay attention to the diet. It is not advisable to eat too many gas-producing foods, such as soy products or foods high in starch. Third, avoid smoking and drinking alcohol. Fourth, finally, treatment should be administered systematically and throughout the entire course.

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Written by Jiang Guo Ming
Gastroenterology
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Where does a duodenal ulcer hurt?

Firstly, the common sites for duodenal ulcers are the anterior and posterior walls posterior to the bulb, as well as the area behind the duodenal bulb itself. The pain symptoms typically show a pattern. For example, the pain occurs in recurrent, cyclical episodes related to eating, manifesting as sporadic abdominal pain about 2cm above the right side of the belly button, more pronounced on an empty stomach, and alleviating after meals. Sometimes, there is also pain during the night. If the ulcer is located behind the duodenal bulb, it often causes back pain. The main cause is usually an infection with Helicobacter pylori, and eradication therapy can generally cure the condition.

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Written by Jiang Guo Ming
Gastroenterology
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Gastric ulcer and duodenal ulcer

Gastric ulcers and duodenal bulb ulcers both belong to upper gastrointestinal ulcers. Their symptoms slightly differ; gastric ulcers typically manifest as postprandial pain in the upper abdomen, whereas duodenal bulb ulcers present as hunger pains in the upper abdomen, sometimes accompanied by nocturnal pain. Both types generally exhibit symptoms such as acid reflux and heartburn. The predominant cause for these is infection by Helicobacter pylori, detectable through tests such as the carbon-13 or carbon-14 breath test. If an infection is present, antimicrobial treatment can typically lead to a complete recovery of the ulcers. If there is no Helicobacter pylori infection, the initial approach should still focus on symptomatic treatment. Additionally, adopting good dietary and living habits can facilitate regular gastroscopic follow-ups.

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Written by Wang Hui Jie
Gastroenterology
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The difference between gastric ulcers and duodenal ulcers.

The differences between gastric ulcers and duodenal ulcers, in terms of symptoms, include that gastric ulcers often manifest as burning pain, or dull pain, distention pain, etc., usually postprandial pain, occasionally with nighttime pain. If it occurs at the pyloric canal, it lacks typical symptoms, with intense pain likely occurring after eating, and poor drug efficacy, prone to vomiting and pyloric obstruction, perforation, and bleeding. Gastric ulcers have a minor possibility of becoming cancerous. Duodenal ulcer pain is mostly located in the upper abdomen, characterized by hunger pain and midnight pain. Abdominal pain generally eases after eating or taking some antacid medications. For ulcers occurring behind the bulb, nighttime pain and a radiating pain in the back are more common. However, the effectiveness of medication is relatively poor, and it is prone to bleeding. Duodenal ulcers are more likely to lead to perforation and pyloric obstruction, but generally do not become cancerous.