When you have a duodenal ulcer, you may feel pain and burning in the abdomen. The treatment for a duodenal ulcer often involves antacid medications that relieve the symptoms.
What is a duodenal ulcer?
A duodenal ulcer occurs due to inflammation of the lining of the first part of the small intestine, known as the duodenum, which leads to irritating and uncomfortable symptoms.
There are many causes of duodenal ulcers, including taking anti-inflammatory medications in high doses over a long period without consulting a doctor or due to bacterial infection that promotes ulcer formation.
The duodenal ulcer is one of the most common ulcers in the digestive system. Another type is called a gastric ulcer, which occurs when the lining of the stomach becomes inflamed. The difference between a gastric ulcer and a duodenal ulcer lies in the location of the inflammation.
Proper treatment of a duodenal ulcer prevents serious complications, such as bleeding or life-threatening perforation. Fortunately, these complications are uncommon and typically occur only in untreated severe cases.
Luckily, duodenal ulcers are generally benign and have a low likelihood of becoming cancerous, unlike gastric ulcers, which have a higher potential for malignancy. Read more about stomach cancer.
Symptoms of a duodenal ulcer
The most common symptom of a duodenal ulcer is a burning abdominal pain, which can be severe enough to wake the patient from sleep.
Some patients may not experience any noticeable symptoms, as symptoms vary depending on the severity of the inflammation and the extent of damage. Common symptoms of a duodenal ulcer include:
Abdominal pain, especially at night
Bloating, fullness, and belching
Nausea and vomiting
Unexplained weight loss
Bloody stools or vomiting blood in cases of perforation or rupture of the ulcer
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Causes of a duodenal ulcer
For a long time, it was believed that duodenal ulcers were caused by psychological conditions like stress and excessive anxiety, but these claims have not been proven.
It is now known that digestive secretions and stomach acid play a role in ulcer formation, as these secretions irritate the lining of the digestive system.
Studies have shown a link between duodenal ulcers and the following causes:
Helicobacter pylori (H. pylori)
This bacterium lives in the mucous layer covering the lining of the stomach and small intestine. These bacteria irritate and damage the mucus that protects the duodenum, contributing to ulcer development.
H. pylori is present in most people but usually coexists naturally without causing problems. It can spread from person to person through direct contact or contaminated food.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
The chronic and unregulated use of NSAIDs like aspirin or pain relievers such as ibuprofen without medical supervision irritates the mucous membrane that protects the intestines, promoting duodenal ulcer formation. Thus, excessive use of these drugs should be avoided.
How to diagnose an ulcer
The specialist doctor will listen to your medical history and ask several questions about your symptoms and what led you to seek medical advice.
If an ulcer is suspected, the following tests may be requested:
Endoscopy
This involves a scope connected to a video screen, which is inserted through the mouth to allow the doctor to view the lining of the digestive system. The doctor looks for ulcers or signs of previous inflammation in the stomach and duodenum.
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Laboratory tests for H. pylori detection
As mentioned earlier, there is a proven relationship between this bacterium and duodenal ulcers. It can be detected through blood, stool, or a breath test, which helps identify the bacterium.
X-rays
An X-ray of the digestive system with barium swallow can help detect stomach and duodenal ulcers, which appear abnormally on the image.
Duodenal ulcer treatment
To treat a duodenal ulcer and completely eliminate its symptoms, lifestyle modifications must be combined with one of the following treatment methods:
Medications for treating duodenal inflammation
Medications play a significant role in treating peptic ulcers. If H. pylori is the cause, a triple therapy regimen is used, combining two antibiotics with an antacid medication.
Common medications for treating duodenal ulcers include:
Antibiotics
Used to treat ulcers caused by bacterial infections, aiming to eliminate the bacteria responsible for the inflammation. Amoxicillin is one of the most commonly used antibiotics.
Antacids
These medications inhibit the production of stomach acid to accelerate the healing process of the duodenal ulcer since digestive acids exacerbate the ulcer by irritating the intestinal lining.
There are two main types of antacids: proton pump inhibitors (PPIs), such as omeprazole, and H2 receptor blockers, like cimetidine.
Ulcer-protective drugs
Some medications help protect and strengthen the lining of the digestive system to prevent ulcer formation. These are known as supportive agents, with sucralfate and misoprostol being the most common.
Herbal remedies for duodenal ulcers
In reality, herbs alone cannot fully cure a duodenal ulcer, but they may help manage inflammation by promoting digestive health.
Modern medicine has shown the effectiveness of herbs in treating various conditions, including gastric and duodenal ulcers. Some commonly used herbs include:
- Licorice: Medical research has shown licorice’s effectiveness in accelerating ulcer healing by inhibiting bacterial growth in the stomach.
- Honey: Studies indicate that honey helps reduce digestive acid secretion and alleviates ulcer symptoms.
- Chamomile: Chamomile flowers have anti-inflammatory effects and can be used to treat stomach and intestinal spasms.
- Ginger: Ginger is widely used for treating gastrointestinal disorders such as constipation and bloating due to its anti-inflammatory properties.
- Garlic: Garlic also helps prevent inflammation due to its antioxidant properties.
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Complications of duodenal ulcers
Untreated duodenal ulcers can lead to a variety of complications, some of which can be life-threatening, such as severe bleeding or perforation of the ulcer.
The most common complications associated with duodenal ulcers are:
Bleeding
Bleeding occurs when blood vessels in the ulcer area are damaged. The bleeding may be slow, leading to anemia, or severe, causing vomiting or bloody stools, which requires urgent treatment.
Perforation
The ulcer can erode through the intestinal wall, causing perforation. Perforated ulcers require urgent emergency intervention to prevent intestinal bacteria from passing through the perforation into the body’s internal organs and causing severe infection.
Obstruction
A large ulcer can obstruct the passage of food through the digestive tract, leading to vomiting and early fullness during meals.
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Prevention of duodenal ulcers
You can prevent digestive ulcers by making healthy lifestyle changes, including:
- Avoid overuse of anti-inflammatory medications without consulting your doctor
- Limit foods that irritate your stomach, such as spicy and fatty meals
- Wash your hands regularly and avoid contaminated foods to prevent bacterial infections
- Quit smoking and alcohol
- Eat more fruits and vegetables rich in fiber
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