The difference between gastric ulcers and duodenal ulcers.

Written by Ren Zheng Xin
Gastroenterology
Updated on September 06, 2024
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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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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.)

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Differentiation between Duodenal Ulcer and Gastric Ulcer

Duodenal ulcers and gastric ulcers primarily differ in their locations: duodenal ulcers occur in the mucosa of the duodenum, whereas gastric ulcers are found in the gastric mucosa. Secondly, the characteristics of upper abdominal pain differ between the two. Pain from duodenal ulcers typically worsens when hungry and lessens after eating, whereas with gastric ulcers, pain intensifies after eating and decreases when hungry. Thirdly, the prognosis differs; gastric ulcers have a certain potential for malignant transformation, and some large ulcers may already be gastric cancer, while duodenal ulcers rarely develop into malignant tumors. It is advisable to undergo active treatment after a clear diagnosis.

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Written by Zhu Dan Hua
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Symptoms of duodenal ulcer

Duodenal ulcers are relatively common in clinical practice and are a frequent condition in gastroenterology. Duodenal ulcers are generally more prevalent among middle-aged individuals, with symptoms most commonly including abdominal pain, bloating, nausea, and vomiting. The abdominal pain typically manifests as upper abdominal pain, usually hunger pain which often improves after eating. It typically presents as long-term, chronic episodes over extended periods and can also occur at night as hunger pain. Therefore, for some typical patients, especially middle-aged individuals, upper abdominal pain should raise concerns about duodenal ulcers. If a patient exhibits symptoms other than abdominal pain, such as black stools, this could suggest bleeding associated with duodenal ulcers, potentially leading to black stools or even vomiting blood. Hence, it is advised that if a patient has symptoms of gastrointestinal bleeding along with abdominal pain, consideration should be given to the possibility of a bleeding duodenal ulcer. It is recommended that such patients undergo thorough gastroscopic examinations to clarify the diagnosis further.

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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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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.