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 Si Li Li
Gastroenterology
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Can you eat garlic with a duodenal ulcer?

Common symptoms of duodenal ulcer include stomach pain, bloating, burping, acid reflux, nausea, and vomiting. The pain typically becomes more noticeable when hungry and lessens after eating. This pattern of pain is a characteristic manifestation. By performing endoscopy, defects can be seen in the duodenal mucosa. Treatment involves acid suppression, stomach protection, and promotion of gastric motility, with a particular emphasis on dietary adjustments. It is important to avoid smoking and alcohol, as well as spicy, fried, barbecue, and other irritating foods. Garlic, being an irritant, should not be consumed by those with duodenal ulcers. A diet consisting of easily digestible and mild foods is recommended, such as porridge, soup, noodles, or very tenderly cooked meats, which can assist in the treatment of duodenal ulcers.

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Gastroenterology
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What is the best treatment for duodenal ulcers?

The main symptoms of duodenal ulcer include upper abdominal bloating, belching, acid reflux, nausea, vomiting, heartburn, poor appetite, and indigestion. A duodenal ulcer can be diagnosed through a gastroscopy, which reveals the presence of an ulcer in the duodenum. The primary cause of duodenal ulcers is infection by Helicobacter pylori, hence a Carbon-14 breath test is recommended to confirm the presence of H. pylori infection. Roughly 90%-100% of patients with duodenal ulcers are infected with H. pylori. Another common cause is the digestion of the stomach itself by stomach acid and pepsin. Treatment primarily involves eradicating H. pylori, suppressing acid, protecting the stomach, enhancing gastric motility, and protecting the gastric mucosa, with the treatment duration being about six weeks.

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Written by Si Li Li
Gastroenterology
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What will happen if you drink alcohol with a duodenal bulb ulcer?

Common symptoms of duodenal bulb ulcers include stomach pain, bloating, belching, acid reflux, nausea, and vomiting. A gastroscopy can reveal defects in the duodenal mucosa, which can be diagnosed as duodenal ulcers. Drinking alcohol can irritate the gastric mucosa as well as the duodenal mucosa. If there is an ulcer in the duodenal bulb and alcohol is consumed, it can exacerbate the ulcer, causing the ulcerated area to enlarge and more severe symptoms to appear. Therefore, drinking alcohol can lead to the worsening of duodenal ulcers. Thus, individuals with gastric diseases or peptic ulcers must abstain from alcohol, as it can aggravate the existing condition. If a duodenal ulcer worsens, penetrating the serosal or basal layer, it may lead to perforation. In such cases, emergency surgery is required for treatment. Hence, it is crucial for those with duodenal ulcers to avoid alcohol.

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Gastroenterology
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How large does a duodenal ulcer have to be to be considered severe?

There is no specific size to determine the severity of a duodenal ulcer. However, ulcers with a diameter greater than 1.5 cm are generally considered large. In such cases, strong acid-suppressing medications are needed for treatment, along with drugs to protect the gastric mucosa. Additionally, it is necessary to test for Helicobacter pylori infection. If the infection is positive, a bismuth-containing quadruple therapy should be used for two weeks to eradicate Helicobacter pylori. The choice of specific medications, as well as their dosages and administration, should be under the guidance of a doctor.

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Written by Wang Hui Jie
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The difference between gastric ulcers and duodenal ulcers.

The differences between gastric ulcers and duodenal ulcers, in terms of symptoms, include that gastric ulcers often manifest as burning pain, or dull pain, distention pain, etc., usually postprandial pain, occasionally with nighttime pain. If it occurs at the pyloric canal, it lacks typical symptoms, with intense pain likely occurring after eating, and poor drug efficacy, prone to vomiting and pyloric obstruction, perforation, and bleeding. Gastric ulcers have a minor possibility of becoming cancerous. Duodenal ulcer pain is mostly located in the upper abdomen, characterized by hunger pain and midnight pain. Abdominal pain generally eases after eating or taking some antacid medications. For ulcers occurring behind the bulb, nighttime pain and a radiating pain in the back are more common. However, the effectiveness of medication is relatively poor, and it is prone to bleeding. Duodenal ulcers are more likely to lead to perforation and pyloric obstruction, but generally do not become cancerous.