How to examine the duodenum?

Written by Wang Li Wei
Gastroenterology
Updated on September 17, 2024
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For some diseases of the duodenum, such as inflammation, ulcers, polyps, and tumors of the duodenum, the main examination method is gastroscopy. Gastroscopy can clearly and accurately identify the nature and location of the specific lesions. Additionally, by taking biopsies for pathology, it can specifically determine the benign or malignant nature of the disease, which is very helpful for subsequent treatment plans.

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How to alleviate nausea from duodenal ulcers?

Duodenal ulcer primarily manifests with symptoms such as abdominal pain, bloating, nausea, vomiting, poor appetite, acid reflux, and belching. The characteristic pain associated with this condition typically diminishes after eating and worsens when hungry. A gastroscopy revealing defects in the duodenal mucosa can confirm a diagnosis of duodenal ulcer. Treatment focuses on acid suppression and gastric protection, enhancing gastric motility, and protecting the gastric mucosa. Additionally, a carbon-14 breath test is conducted to check for Helicobacter pylori infection, a bacterium that can cause peptic ulcers. If the test is positive, a 14-day treatment against Helicobacter pylori is required. By adhering to this treatment protocol, symptoms can be effectively resolved.

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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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Is duodenal ulcer bleeding a sign of cancerous change?

Duodenal ulcer bleeding does not indicate cancerous changes. The duodenal area is relatively thin, so once a duodenal ulcer occurs, it is more likely to lead to complications such as ulcer bleeding and perforation. If vomiting blood occurs with a duodenal ulcer, it indicates that the patient with the duodenal ulcer has a bleeding complication. In terms of treatment, it is first necessary to complete an endoscopic examination, which can include endoscopic hemostasis; secondly, proton pump inhibitors should be used to suppress the secretion of stomach acid and increase the pH level in the stomach; additionally, treatments that protect the stomach lining, such as aluminum hydroxide and magnesium carbonate, should be used. (Medication should be taken under the guidance of a physician.)

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Symptoms of duodenal ulcer

Duodenal ulcers are relatively common in clinical practice and are a frequent condition in gastroenterology. Duodenal ulcers are generally more prevalent among middle-aged individuals, with symptoms most commonly including abdominal pain, bloating, nausea, and vomiting. The abdominal pain typically manifests as upper abdominal pain, usually hunger pain which often improves after eating. It typically presents as long-term, chronic episodes over extended periods and can also occur at night as hunger pain. Therefore, for some typical patients, especially middle-aged individuals, upper abdominal pain should raise concerns about duodenal ulcers. If a patient exhibits symptoms other than abdominal pain, such as black stools, this could suggest bleeding associated with duodenal ulcers, potentially leading to black stools or even vomiting blood. Hence, it is advised that if a patient has symptoms of gastrointestinal bleeding along with abdominal pain, consideration should be given to the possibility of a bleeding duodenal ulcer. It is recommended that such patients undergo thorough gastroscopic examinations to clarify the diagnosis further.

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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.