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 Jiang Guo Ming

Gastroenterology

54sec

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Symptoms and Treatment of Duodenal Ulcer

Duodenal bulb ulcers often manifest as hunger-like pain in the upper abdomen, which relieves after eating, accompanied by nocturnal pain. Symptoms also include acid reflux, heartburn, nausea, etc. If there is bleeding, symptoms may include black stools and vomiting blood. Treatment depends on whether there is a Helicobacter pylori infection. If there is a Helicobacter pylori infection, antibacterial treatment is required, commonly using a triple or quadruple antibiotic therapy for two weeks. If there is no Helicobacter pylori infection, symptomatic treatment is sufficient, generally using proton pump inhibitors and gastroprotective medications such as bismuth agents. Additionally, it is important to develop good dietary and lifestyle habits to prevent recurrence.

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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 Ren Zheng Xin

Gastroenterology

1min 1sec

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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 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

39sec

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What position should be taken for duodenal ulcer hematemesis?

Patients with duodenal ulcers, if vomiting blood occurs, are advised to slightly elevate their lower limbs, position their heads lower, and lie on their side. Because when patients with duodenal ulcers vomit blood, it indicates a relatively large amount of bleeding. Elevating the lower limbs slightly can effectively promote the return of blood from the lower limbs, ensuring the blood supply to vital organs, and lying on the side helps prevent the possibility of choking following vomiting. Once vomiting blood due to a duodenal ulcer occurs, an urgent gastroscopy is required, and hemostatic treatment should be carried out under gastroscopy.