The difference between gastric ulcers and duodenal ulcers.

Written by Wang Hui Jie
Gastroenterology
Updated on September 01, 2024
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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.

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How to examine the duodenum?

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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Can duodenal ulcers be cured?

Duodenal bulb ulcers are definitely treatable. Treatment is mainly through medication, with the specific approach depending on the presence of Helicobacter pylori infection. If there is no Helicobacter pylori infection, treatment primarily focuses on symptomatic relief using traditional medicines such as proton pump inhibitors, like omeprazole and lansoprazole. If Helicobacter pylori infection is present, antibacterial treatment is generally needed, using either triple or quadruple antibiotic therapy; triple therapy consists of a proton pump inhibitor plus two antibiotics, and adding bismuth forms quadruple therapy. One treatment cycle lasts two weeks, and after completing medication, Helicobacter pylori can be rechecked in one month. Additionally, it's important to maintain good dietary and living habits. If recurrent duodenal bulb ulcers cause bleeding at night, surgical treatment can typically be considered.

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Written by Wu Hai Wu
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Is duodenal bulb inflammation an ulcer?

Duodenal bulb inflammation is not an ulcer. It refers to chronic inflammation of the mucosa of the duodenum without erosion, hence it is not a duodenal ulcer. However, if patients with duodenal bulb inflammation do not receive proper treatment and fail to pay attention to their diet, among other factors, it may potentially develop into a duodenal ulcer. Once a duodenal ulcer occurs, it could lead to potential complications such as pyloric obstruction, gastrointestinal bleeding, and perforation of the duodenal bulb, etc. Therefore, it is crucial for patients with duodenal bulb inflammation to seek active treatment.

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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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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.)