The manifestations of duodenal ulcer.

Written by Si Li Li
Gastroenterology
Updated on October 19, 2024
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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
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Does duodenal ulcer cause bloating?

Duodenal ulcers can lead to bloating because the duodenum is located just below the pylorus. Once an ulcer occurs in the duodenum, it can cause swelling of the pylorus. Consequently, when the pylorus is swollen, it becomes difficult for gases to be expelled from the stomach, leading to a likelihood of bloating in patients. Once a patient develops a duodenal ulcer, it is imperative first to use proton pump inhibitors to suppress gastric acid secretion to alleviate congestion and swelling of the duodenal mucosa. Secondly, medications that protect the stomach lining, such as magnesium aluminum carbonate and sucralfate, should be used for treatment. (Please follow medical advice regarding medication.)

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Written by Jiang Guo Ming
Gastroenterology
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Can duodenal ulcers be cured?

Duodenal bulb ulcers are definitely treatable. Treatment is mainly through medication, with the specific approach depending on the presence of Helicobacter pylori infection. If there is no Helicobacter pylori infection, treatment primarily focuses on symptomatic relief using traditional medicines such as proton pump inhibitors, like omeprazole and lansoprazole. If Helicobacter pylori infection is present, antibacterial treatment is generally needed, using either triple or quadruple antibiotic therapy; triple therapy consists of a proton pump inhibitor plus two antibiotics, and adding bismuth forms quadruple therapy. One treatment cycle lasts two weeks, and after completing medication, Helicobacter pylori can be rechecked in one month. Additionally, it's important to maintain good dietary and living habits. If recurrent duodenal bulb ulcers cause bleeding at night, surgical treatment can typically be considered.

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Written by Wu Hai Wu
Gastroenterology
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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.

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Written by Wang Hui Jie
Gastroenterology
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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 Si Li Li
Gastroenterology
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What are the symptoms of duodenal ulcers?

The main symptoms of duodenal ulcers include upper abdominal bloating, burping, acid reflux, nausea, vomiting, poor appetite, and indigestion. The characteristic of the upper abdominal pain associated with duodenal ulcers is that the pain intensifies when hungry and decreases after eating. In terms of treatment, the main approach includes acid suppression to protect the stomach, promoting gastric motility, and protecting the gastric mucosa, with the treatment course lasting about six weeks. Additionally, a Carbon-14 breath test is necessary to determine the presence of Helicobacter pylori infection, as Helicobacter pylori has been confirmed as the most important cause of peptic ulcers. If the Helicobacter pylori infection is positive, a 14-day treatment targeting Helicobacter pylori is required, using a regimen of a proton pump inhibitor, two antibiotics, and a bismuth agent.