The manifestations of duodenal ulcer.

Written by Si Li Li
Gastroenterology
Updated on October 19, 2024
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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 Ren Zheng Xin
Gastroenterology
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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
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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.)

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Written by Jiang Guo Ming
Gastroenterology
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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 Si Li Li
Gastroenterology
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Differentiation between Duodenal Ulcer and Gastric Ulcer

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 Jiang Guo Ming
Gastroenterology
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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.