Symptoms and Treatment of Duodenal Ulcer

Written by Jiang Guo Ming
Gastroenterology
Updated on September 23, 2024
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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.

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Written by Wu Hai Wu
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Characteristics of vomiting in duodenal ulcer

The main characteristic of vomiting due to duodenal ulcer is postprandial vomiting. Generally, patients with duodenal ulcers are prone to pyloric obstruction. When a large meal is consumed, pyloric obstruction may occur, preventing stomach contents from passing into the duodenum, leading to vomiting. Additionally, patients might also experience vomiting of acidic stomach contents while fasting. After vomiting, patients with duodenal ulcers can use acid-suppressing medications to alleviate gastric edema and medications like mosapride to promote gastric motility. (Medication should be used under the guidance of a physician.)

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How to alleviate nausea from duodenal ulcers?

Duodenal ulcer primarily manifests with symptoms such as abdominal pain, bloating, nausea, vomiting, poor appetite, acid reflux, and belching. The characteristic pain associated with this condition typically diminishes after eating and worsens when hungry. A gastroscopy revealing defects in the duodenal mucosa can confirm a diagnosis of duodenal ulcer. Treatment focuses on acid suppression and gastric protection, enhancing gastric motility, and protecting the gastric mucosa. Additionally, a carbon-14 breath test is conducted to check for Helicobacter pylori infection, a bacterium that can cause peptic ulcers. If the test is positive, a 14-day treatment against Helicobacter pylori is required. By adhering to this treatment protocol, symptoms can be effectively resolved.

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Written by Wu Hai Wu
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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 Ren Zheng Xin
Gastroenterology
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The difference between gastric ulcers and duodenal ulcers.

Gastric ulcers and duodenal ulcers are collectively known as peptic ulcers, formed under the self-digestion action of gastric acid and pepsin. Gastric ulcers are more common in middle-aged and elderly people, generally occurring at the lesser curvature of the stomach body. The pain of a gastric ulcer typically appears within an hour after eating, also known as postprandial pain, which gradually eases after one to two hours of digestion and absorption; gastric ulcers can easily lead to bleeding and perforation. Duodenal ulcers are more common in young and middle-aged adults, frequently occurring in the duodenal bulb. Typical symptoms include postprandial pain and midnight pain, which can be alleviated by using antacids. The treatment methods for gastric and duodenal ulcers are similar. Additionally, it is important to pay attention to diet in daily life, eat less spicy, greasy, and irritating food, and consume more soft, easily digestible food.

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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.