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

Written by Wu Hai Wu
Gastroenterology
Updated on September 06, 2024
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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 Huang Gang
Gastroenterology
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Symptoms of duodenal ulcer

What are the symptoms of duodenal ulcers? Generally, the most obvious symptom of a duodenal ulcer is pain on an empty stomach, which often occurs at midnight or early morning, causing one to wake up from sleep in pain. This is a relatively clear symptom. When this symptom occurs, it is best to go to the hospital for a gastroscope examination as soon as possible. After a clear diagnosis, medication should be taken regularly and according to the treatment course for a cure. Generally, taking medications that inhibit gastric acid secretion and protect the intestinal mucosa, and medications for gastric mucosa, can be quite effective. It is also necessary to test for Helicobacter pylori, and if there is a concurrent infection, antibacterial treatment should be carried out.

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Written by Jiang Guo Ming
Gastroenterology
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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.

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Written by Wu Hai Wu
Gastroenterology
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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.

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Written by Wu Hai Wu
Gastroenterology
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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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Written by Si Li Li
Gastroenterology
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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.