How to examine the duodenum?

Written by Wang Li Wei

Gastroenterology

Updated on September 17, 2024

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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.

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Written by Jiang Guo Ming

Gastroenterology

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Where does a duodenal ulcer hurt?

Firstly, the common sites for duodenal ulcers are the anterior and posterior walls posterior to the bulb, as well as the area behind the duodenal bulb itself. The pain symptoms typically show a pattern. For example, the pain occurs in recurrent, cyclical episodes related to eating, manifesting as sporadic abdominal pain about 2cm above the right side of the belly button, more pronounced on an empty stomach, and alleviating after meals. Sometimes, there is also pain during the night. If the ulcer is located behind the duodenal bulb, it often causes back pain. The main cause is usually an infection with Helicobacter pylori, and eradication therapy can generally cure the condition.

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Written by Si Li Li

Gastroenterology

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The manifestations of duodenal ulcer.

Duodenal ulcers can cause symptoms such as upper abdominal pain, belching, acid reflux, nausea, vomiting, heartburn, poor appetite, and indigestion. The characteristic of upper abdominal pain in duodenal ulcers typically lessens after eating and worsens when hungry. A gastroscope can reveal defects in the duodenal mucosa, confirming a diagnosis of duodenal ulcer. About 90%-100% of patients with duodenal ulcers are infected with Helicobacter pylori, therefore, a Carbon-14 breath test is recommended to determine the presence of Helicobacter pylori infection. If the infection is positive, a 14-day eradication treatment for Helicobacter pylori is required, involving a proton pump inhibitor, two types of antibiotics, and a bismuth agent. Additionally, treatment for duodenal ulcers includes acid suppression, gastric protection, enhancing gastric motility, and protecting the gastric mucosa. The treatment typically lasts about six weeks.

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Written by Wu Hai Wu

Gastroenterology

33sec

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Color of vomit from duodenal ulcer

The color of vomit from a duodenal ulcer may appear as a coffee-colored liquid or green. If the stomach contents expelled include bile, the vomit may appear green. If the vomitus contains blood, the combination of blood and stomach acid may result in a coffee-colored liquid. Therefore, a detailed analysis is necessary. Once a patient with a duodenal ulcer experiences vomiting, it is important to promptly complete an endoscopic examination. Treatment should be based on the results of the endoscopy.

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Written by Wang Hui Jie

Gastroenterology

1min 1sec

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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.

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Written by Wu Hai Wu

Gastroenterology

48sec

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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.