Duodenal Ulcer
What
is it?
A
duodenal ulcer is a raw area in the lining in the
upper part of the small intestine (duodenum),
where it connects to the stomach.
Who
gets it?
People
who have a family history of duodenal ulcer are
more likely to get them, and the problem is four
times greater in men than in women over fifty
years of age. Other risk factors include having a
Helicobacter pylori infection, using nonsteroidal
anti-inflammatory drugs such as aspirin and
ibuprofen, and the use of cigarettes and alcohol.
What
causes it?
A
duodenal ulcer is caused when the lining of the
stomach is eaten away by stomach acid and
digestive juices. A type of bacteria called
Helicobacter pylori, also called H. pylori,
commonly causes this. Other common causes of
duodenal ulcers include anti-inflammatory
medications such as aspirin and ibuprofen, stress,
nicotine, caffeine, and alcohol use.
What
are the symptoms?
The
symptoms of duodenal ulcers include heartburn,
stomach pain relieved by eating or taking
antacids, weight gain, and a burning sensation at
the back of the throat. The patient is most likely
to feel discomfort two to four hours after meals,
or after having citrus juice, coffee, or aspirin.
About fifty percent of patients with duodenal
ulcers awake during the night with pain, usually
between midnight and three a.m.
If an ulcer is bleeding, the patient may have
vomit containing bright red blood or digested
blood that looks like brown coffee grounds and
black, tarry bowel movements.
How is
it diagnosed?
To
diagnose a duodenal ulcer, the doctor will review
the patient’s symptoms, medical history and
perform an exam. The doctor may order tests such
as an upper GI x-ray, in which the patient
swallows liquid barium to locate the ulcer on
x-ray. The doctor may also order blood tests to
look for H. pylori bacteria or anemia and test
stool samples to check for blood (which might come
from a bleeding ulcer). The doctor may perform an
endoscopy, which allows the doctor to view the
upper digestive tract, or a biopsy, which involves
taking a piece of tissue during an endoscopy and
sending it to the lab for tests.
What
is the treatment?
To
treat a duodenal ulcer, the doctor may prescribe
antibiotics to treat H. pylori; antacids;
sucralfate, a medicine that forms a protective
barrier over the site of the ulcer; and other
medications to reduce the amount of acid the
stomach makes.
The
doctor will probably recommend that the patient
takes antibiotics for one to two weeks, and may
recommend other medications to reduce acid for up
to twelve months to prevent new ulcers.
Rarely,
complications of duodenal ulcers can develop such
as hemorrhaging, perforation of the intestinal
wall, or an obstruction that prevents passage of
food. These complications may require surgery.
Self-care tips
Duodenal ulcers respond well to treatment, but
changes in lifestyle may be recommended to prevent
reoccurrences. Patients should consider not
smoking or using other tobacco products and reduce
their alcohol consumption and caffeine intake.
Patients may also want to avoid drugs that cause
stomach inflammation, such as aspirin, ibuprofen
and naproxen. Other lifestyle changes may include
eating balanced, nutritious meals, learning how to
manage stress, and getting plenty of rest and
exercise.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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