Introduction:
Peptic ulcers are sores that develop on the stomach lining and the upper part of the small intestine (duodenum). Peptic ulcers include gastric and duodenal ulcers. Gastric ulcers are ulcers that occur on the stomach, and duodenal ulcers are ulcers that appear on the duodenum (upper portion of the small intestine).
What Causes Duodenal Ulcers?
Ulcers are formed when the acid in the digestive tract eats the inner surface of the stomach or small intestine. The acid creates a painful sore that may bleed. The digestive tract is usually coated with a mucous layer that protects against stomach acid. Ulcers are formed if the amount of acid is increased or mucus is decreased.
The following can cause gastric and duodenal ulcers:
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Bacterium: Helicobacter pylori is a bacteria that usually lives in the mucus layer that lines the stomach and small intestine. Usually, the bacteria do not cause any problems, but sometimes they can cause inflammation of the stomach’s inner lining producing an ulcer.
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Pain Killers: Regular use of certain painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs) can cause inflammation of the stomach and small intestine lining. The medications include Ibuprofen, Naproxen sodium, and Ketoprofen.
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Other Medications: Certain medications such as steroids, anticoagulants, and low-dose Aspirin, when taken along with non-steroidal anti-inflammatory drugs (NSAIDs), can cause ulcers.
What Are the Risk Factors for Duodenal Ulcers?
The risk factors for ulcers include:
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Smoking: Smoking increases the risk of ulcers in people infected with Helicobacter pylori.
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Alcohol: Drinking excessive alcohol can irritate the mucous lining of the stomach.
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Stress and spicy foods can also increase the risk of ulcers.
What Are the Symptoms of Duodenal Ulcers?
Many people do not show any symptoms. However, if symptomatic, the most common symptom is burning stomach pain. Stomach acid and an empty stomach make the pain worse. The pain is worse at night and between meals.
The other symptoms include:
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Feeling of fullness.
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Bloating or belching.
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Nausea.
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Intolerance to fatty foods.
Some rare severe signs and symptoms of ulcers include:
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Vomiting or blood vomiting.
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Trouble breathing.
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Unexplained weight loss.
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Appetite changes.
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Giddiness.
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Trouble breathing.
How Can We Diagnose Ulcers?
Complete medical history is taken, and a physical examination is done. In addition, the following tests are done to confirm the diagnosis:
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Tests for Helicobacter Pylori: The doctor performs blood, stool, or breath tests to look for the helicobacter pylori bacterium. The breath test is the most accurate.
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Endoscopy: It is a procedure done to examine the upper digestive tract. During an endoscopy, the doctor inserts a thin, hollow tube with a camera into the throat, esophagus, stomach, and small intestine. The doctor looks for ulcers, and if ulcers are present, a tissue sample is taken for analysis in the laboratory. Endoscopy is recommended in older patients with signs of bleeding, recent weight loss, or difficulty eating and swallowing.
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Barium Swallow: The patient drinks a liquid containing barium that coats the digestive tract lining, and a series of X-rays are taken to make ulcers more visible.
How to Treat Duodenal Ulcers?
Treatment depends on the cause. It involves killing the Helicobacter pylori bacteria, reducing the use of NSAIDs, and healing the ulcer with medication.
Medications include:
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Antibiotics: A combination of antibiotics is given to kill Helicobacter pylori. These include Amoxicillin, Clarithromycin, Metronidazole, Tinidazole, Tetracycline, and Levofloxacin.
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Proton Pump Inhibitors: These medications block acid production. The medications include Omeprazole, Lansoprazole, Rabeprazole, Esomeprazole and Pantoprazole.
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H2 Receptor Blockers: These medications reduce the amount of stomach acid released into the digestive tract. Drugs include Famotidine, Cimetidine, and Nizatidine.
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Antacids: Antacids neutralize the stomach acid and provide rapid relief.
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Cytoprotective Agents: These medications protect the stomach and small intestine lining. Drugs include Sucralfate and Misoprostol.
Treatment is usually successful, resulting in the healing of ulcers. However, the doctor recommends a follow-up endoscopy sometimes to see whether the ulcer is completely healed.
What Are the Complications of Duodenal Ulcers?
If untreated, ulcers can result in:
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Internal Bleeding: Bleeding can result in slow blood loss, which results in anemia or severe blood loss that causes bloody vomit or black or bloody stools.
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Perforation: Ulcers can perforate the stomach or small intestine wall, resulting in severe abdominal cavity infection (pericoronitis).
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Obstruction: Ulcers can sometimes block the passage of food through the digestive tract resulting in the fullness of the stomach.
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Gastric Cancer: People infected with Helicobacter pylori have an increased risk of gastric cancer.
What Are Refractory Ulcers?
The ulcers which do not heal with treatment are called refractory ulcers. The causes of refractory ulcers include:
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Not taking the prescribed medications.
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Regular use of tobacco.
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Regular use of non-steroidal anti-inflammatory drugs (NSAIDs).
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Some Helicobacter pylori become resistant to antibiotics.
Treatment of refractory ulcers involves eliminating the factors that interfere with healing.
How Can We Prevent Ulcers?
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Protection Against Infections: Studies show that Helicobacter pylori infection can be transmitted from person to person through food and water. Frequently washing hands with soap and water and eating well-cooked foods can prevent the spread of these infections.
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Cautious Use of Painkillers: If you regularly take painkillers, take additional medications such as an antacid, proton pump inhibitor, or an acid blocker. Take medicine with meals and avoid alcohol consumption while taking non-steroidal anti-inflammatory drugs (NSAIDs) as both combine to increase the severity of ulcers.
What Are the Lifestyle and Home Remedies for Duodenal Ulcers?
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Switching Pain Killers: Ask the doctor whether Acetaminophen can be used as an alternative for non-steroidal anti-inflammatory drugs (NSAIDs).
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Control Stress: Stress can worsen the signs and symptoms of ulcers. Try some techniques to cope with stress like exercise, reading, or spending time with friends.
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Avoid Smoking: Smoking can worsen the ulcer and also increases stomach acid.
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Avoid Alcohol: Excessive alcohol use can irritate the mucosal lining of the digestive tract.
Conclusion:
Duodenal ulcers are a part of peptic ulcers that occurs due to disruption of the mucosa of the duodenum. If diagnosed and treated correctly, duodenal ulcers have a good prognosis. In addition, duodenal ulcers are not usually associated with cancer.