A duodenal ulcer is a small sore that forms in the duodenum, the first part of the small intestine that connects directly to the stomach. It can cause indigestion, nausea, vomiting, and upper abdominal pain that may feel better after eating.
In many cases, a duodenal ulcer is linked to Helicobacter pylori (H. pylori). This bacterium can weaken the stomach’s protective lining and trigger inflammation that affects the duodenum.
Treatment is guided by a gastroenterologist and is aimed at healing the ulcer, reducing stomach acid, and treating H. pylori when present. Surgery may be needed if serious complications occur, such as bleeding or a perforation.
Main symptoms
The main symptoms of a duodenal ulcer are:
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Indigestion;
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Pain in the upper middle part of the abdomen, just below the chest;
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Pain that improves after meals;
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Bloating;
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Nausea and vomiting;
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Weight gain, since eating helps relieve the pain.
Bleeding can also occur, which may cause vomiting blood or very dark, foul-smelling stools, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Duodenal ulcer vs peptic ulcer
A duodenal ulcer may also be called a peptic ulcer. This term is used to describe ulcers that occur in the stomach or the duodenum.
People who have ulcers in both the stomach and the duodenum are generally diagnosed with peptic ulcer disease.
Also recommended: Stomach Ulcer: Symptoms, Causes, Treatment & Complications tuasaude.com/en/stomach-ulcerConfirming a diagnosis
A gastroenterologist diagnoses a duodenal ulcer by reviewing symptoms and health history and performing a physical exam, along with imaging tests when needed.
According to the NIDDK, the doctor may order an upper endoscopy to confirm the ulcer, check for other ulcers in the stomach, and take a biopsy of the lesion.
The doctor may also recommend blood tests, stool tests, or a breath test to check for H. pylori.
Possible causes
The main causes of duodenal ulcer are:
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Infection with Helicobacter pylori (H. pylori);
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Frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs);
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Zollinger-Ellison syndrome;
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Vascular insufficiency;
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Duodenal cancer;
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Chemotherapy for cancer.
A duodenal ulcer can also develop in people who smoke, drink alcohol excessively and frequently, or experience ongoing stress.
Treatment options
Treatment for duodenal ulcer should be guided by a gastroenterologist and focuses on healing the ulcer, relieving symptoms, and/or eliminating H. pylori.
The main treatments for a duodenal ulcer are:
1. Medications
Medications for duodenal ulcer that may be recommended by a gastroenterologist include:
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Antacids, such as aluminum hydroxide or magnesium hydroxide;
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Proton pump inhibitors, such as omeprazole, pantoprazole, or esomeprazole;
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Pain relievers, such as acetaminophen, in some cases.
If H. pylori is confirmed, the doctor may prescribe antibiotics such as amoxicillin, clarithromycin, or metronidazole.
If a medication is causing the duodenal ulcer, the doctor will usually advise stopping it when possible to help reduce inflammation and promote healing of the stomach lining.
2. Diet
A peptic ulcer diet aims to reduce inflammation in the duodenum and ease symptoms.
General guidance includes avoiding ultra-processed foods, reducing high-fat foods, and avoiding soda.
Also recommended: Gastritis Diet: What to Eat & Avoid If You Have Gastritis or Ulcers tuasaude.com/en/diet-menu-for-gastritis-and-ulcer3. Lifestyle changes
Lifestyle changes include avoiding smoking and drinking alcohol to help reduce duodenal ulcer symptoms and support healing of the duodenal wall.
4. Surgery
Surgery for duodenal ulcer may be recommended if complications occur, such as bleeding or a perforation of the duodenum. It is usually performed laparoscopically.
Possible complications
The main complications of a duodenal ulcer are bleeding or perforation of the duodenum, especially when treatment is not done properly.
In such cases, immediate surgery is required, as these complications are medical emergencies that can become life-threatening if not treated promptly.