Differentiation between Duodenal Ulcer and Gastric Ulcer

Written by Si Li Li

Gastroenterology

Updated on February 01, 2025

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Duodenal ulcers and gastric ulcers primarily differ in their locations: duodenal ulcers occur in the mucosa of the duodenum, whereas gastric ulcers are found in the gastric mucosa. Secondly, the characteristics of upper abdominal pain differ between the two. Pain from duodenal ulcers typically worsens when hungry and lessens after eating, whereas with gastric ulcers, pain intensifies after eating and decreases when hungry. Thirdly, the prognosis differs; gastric ulcers have a certain potential for malignant transformation, and some large ulcers may already be gastric cancer, while duodenal ulcers rarely develop into malignant tumors. It is advisable to undergo active treatment after a clear diagnosis.

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Written by Huang Gang

Gastroenterology

53sec

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Symptoms of duodenal ulcer

What are the symptoms of duodenal ulcers? Generally, the most obvious symptom of a duodenal ulcer is pain on an empty stomach, which often occurs at midnight or early morning, causing one to wake up from sleep in pain. This is a relatively clear symptom. When this symptom occurs, it is best to go to the hospital for a gastroscope examination as soon as possible. After a clear diagnosis, medication should be taken regularly and according to the treatment course for a cure. Generally, taking medications that inhibit gastric acid secretion and protect the intestinal mucosa, and medications for gastric mucosa, can be quite effective. It is also necessary to test for Helicobacter pylori, and if there is a concurrent infection, antibacterial treatment should be carried out.

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Written by Si Li Li

Gastroenterology

1min 11sec

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The manifestations of duodenal ulcer.

Duodenal ulcers can cause symptoms such as upper abdominal pain, belching, acid reflux, nausea, vomiting, heartburn, poor appetite, and indigestion. The characteristic of upper abdominal pain in duodenal ulcers typically lessens after eating and worsens when hungry. A gastroscope can reveal defects in the duodenal mucosa, confirming a diagnosis of duodenal ulcer. About 90%-100% of patients with duodenal ulcers are infected with Helicobacter pylori, therefore, a Carbon-14 breath test is recommended to determine the presence of Helicobacter pylori infection. If the infection is positive, a 14-day eradication treatment for Helicobacter pylori is required, involving a proton pump inhibitor, two types of antibiotics, and a bismuth agent. Additionally, treatment for duodenal ulcers includes acid suppression, gastric protection, enhancing gastric motility, and protecting the gastric mucosa. The treatment typically lasts about six weeks.

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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 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

47sec

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What should I do if a duodenal ulcer causes diarrhea?

Patients with duodenal ulcers who experience diarrhea should undergo a routine stool examination to rule out diarrhea caused by intestinal infections. If there is no obvious organic disease in the intestines, the diarrhea associated with duodenal ulcers may be due to excessive secretion of stomach acid. It is advisable to consider using medications that suppress the secretion of stomach acid, such as proton pump inhibitors like omeprazole or lansoprazole, etc. You can also use aluminum magnesium carbonate, sucralfate, etc., to protect the stomach lining. For patients with abdominal distension, medications like mosapride can be used to promote gastric motility treatment.