How large does a duodenal ulcer have to be to be considered severe?

Written by Wu Hai Wu

Gastroenterology

Updated on September 06, 2024

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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 Zhu Dan Hua

Gastroenterology

1min 27sec

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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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Written by Wu Hai Wu

Gastroenterology

44sec

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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 Wu Hai Wu

Gastroenterology

50sec

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Does duodenal ulcer cause bloating?

Duodenal ulcers can lead to bloating because the duodenum is located just below the pylorus. Once an ulcer occurs in the duodenum, it can cause swelling of the pylorus. Consequently, when the pylorus is swollen, it becomes difficult for gases to be expelled from the stomach, leading to a likelihood of bloating in patients. Once a patient develops a duodenal ulcer, it is imperative first to use proton pump inhibitors to suppress gastric acid secretion to alleviate congestion and swelling of the duodenal mucosa. Secondly, medications that protect the stomach lining, such as magnesium aluminum carbonate and sucralfate, should be used for treatment. (Please follow medical advice regarding medication.)

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Written by Jiang Guo Ming

Gastroenterology

1min 1sec

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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

Gastroenterology

52sec

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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.)