Duodenal ulcer


Is duodenal ulcer bleeding a sign of cancerous change?
Duodenal ulcer bleeding does not indicate cancerous changes. The duodenal area is relatively thin, so once a duodenal ulcer occurs, it is more likely to lead to complications such as ulcer bleeding and perforation. If vomiting blood occurs with a duodenal ulcer, it indicates that the patient with the duodenal ulcer has a bleeding complication. In terms of treatment, it is first necessary to complete an endoscopic examination, which can include endoscopic hemostasis; secondly, proton pump inhibitors should be used to suppress the secretion of stomach acid and increase the pH level in the stomach; additionally, treatments that protect the stomach lining, such as aluminum hydroxide and magnesium carbonate, should be used. (Medication should be taken under the guidance of a physician.)


Is a duodenal ulcer stage II severe?
Stage 2 duodenal ulcer is not considered severe as it indicates that the patient is in the healing phase; thus, it is generally not very serious. Typically, patients in stage 2 can be cured with appropriate medical treatment. The main causes of duodenal ulcers include infection by Helicobacter pylori and the use of certain drugs that irritate the gastric mucosa, such as corticosteroids, anti-rheumatic drugs, and nonsteroidal anti-inflammatory drugs. If a patient with a duodenal ulcer is found to have a Helicobacter pylori infection, treatment involves a two-week quadruple therapy containing bismuth to eradicate Helicobacter pylori, while promptly discontinuing any drugs that are irritating to the gastric mucosa.


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.


What position should be taken for duodenal ulcer hematemesis?
Patients with duodenal ulcers, if vomiting blood occurs, are advised to slightly elevate their lower limbs, position their heads lower, and lie on their side. Because when patients with duodenal ulcers vomit blood, it indicates a relatively large amount of bleeding. Elevating the lower limbs slightly can effectively promote the return of blood from the lower limbs, ensuring the blood supply to vital organs, and lying on the side helps prevent the possibility of choking following vomiting. Once vomiting blood due to a duodenal ulcer occurs, an urgent gastroscopy is required, and hemostatic treatment should be carried out under gastroscopy.


Does duodenal ulcer cause bloating?
Duodenal ulcers can lead to bloating because the duodenum is located just below the pylorus. Once an ulcer occurs in the duodenum, it can cause swelling of the pylorus. Consequently, when the pylorus is swollen, it becomes difficult for gases to be expelled from the stomach, leading to a likelihood of bloating in patients. Once a patient develops a duodenal ulcer, it is imperative first to use proton pump inhibitors to suppress gastric acid secretion to alleviate congestion and swelling of the duodenal mucosa. Secondly, medications that protect the stomach lining, such as magnesium aluminum carbonate and sucralfate, should be used for treatment. (Please follow medical advice regarding medication.)


The difference between duodenitis and duodenal ulcer
The difference between duodenitis and duodenal ulcer is as follows: A diagnosis of duodenitis under endoscopy indicates inflammation in the duodenal bulb or descending part, featuring patchy congestion or spotted, erosive conditions identified during the endoscopic procedure, which lead to the diagnosis of duodenitis. If isolated or multiple ulcerative lesions are found in a certain area, it is diagnosed as a duodenal ulcer. Benign ulcers typically have clear boundaries, with surfaces covered with white moss or blood scabs, and the surrounding area may exhibit redness, concentrated mucosa, among other characteristics. Depending on these different presentations, there are different stages of the disease. Both duodenitis and duodenal ulcers are considered benign lesions.


How to examine the duodenum?
For some diseases of the duodenum, such as inflammation, ulcers, polyps, and tumors of the duodenum, the main examination method is gastroscopy. Gastroscopy can clearly and accurately identify the nature and location of the specific lesions. Additionally, by taking biopsies for pathology, it can specifically determine the benign or malignant nature of the disease, which is very helpful for subsequent treatment plans.


Is duodenal bulb inflammation an ulcer?
Duodenal bulb inflammation is not an ulcer. It refers to chronic inflammation of the mucosa of the duodenum without erosion, hence it is not a duodenal ulcer. However, if patients with duodenal bulb inflammation do not receive proper treatment and fail to pay attention to their diet, among other factors, it may potentially develop into a duodenal ulcer. Once a duodenal ulcer occurs, it could lead to potential complications such as pyloric obstruction, gastrointestinal bleeding, and perforation of the duodenal bulb, etc. Therefore, it is crucial for patients with duodenal bulb inflammation to seek active treatment.


What should I do if a duodenal ulcer causes diarrhea?
Patients with duodenal ulcers who experience diarrhea should undergo a routine stool examination to rule out diarrhea caused by intestinal infections. If there is no obvious organic disease in the intestines, the diarrhea associated with duodenal ulcers may be due to excessive secretion of stomach acid. It is advisable to consider using medications that suppress the secretion of stomach acid, such as proton pump inhibitors like omeprazole or lansoprazole, etc. You can also use aluminum magnesium carbonate, sucralfate, etc., to protect the stomach lining. For patients with abdominal distension, medications like mosapride can be used to promote gastric motility treatment.


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.