Duodenal Ulcer
(Peptic Ulcer of the Duodenum)
Definition
A duodenal ulcer is a sore in the lining of the intestine. It is in the first part of your small intestine, known as the duodenum. Ulcers can be treated. A small percentage of them may be cancerous. See your doctor if you think you may have a duodenal ulcer.
Duodenal Ulcer
Causes
Ninety-five percent of duodenal ulcers are from a bacterial infection. They are caused by Helicobacter pylori ( H pylori ). Other causes include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Steroids
- Zollinger-Ellison syndrome —a disorder causing tumors in the pancreas and duodenum and ulcers in the stomach and duodenum
- Crohn's disease —a severe, chronic inflammatory bowel disease
- Viral infection
- Pancreatic cancer
Risk Factors
Some factors thought to increase the risk of duodenal ulcer are:
- Gender: male
- Age: the incidence of duodenal ulcers peaks around age 40
- Family history of duodenal ulcers
Symptoms
Symptoms of a duodenal ulcer may include:
-
Burning pain in the gut that feels like a dull ache and comes and goes:
- It often starts 2-3 hours after a meal and goes away after you eat
- It may also come in the middle of the night when your stomach is empty
- Weight loss
- Loss of appetite
- Pain while eating
- Nausea
- Vomiting
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Other tests may include:
- Biopsy —removal of a sample of tissue for testing
- Blood tests
- Endoscopy—a thin, lighted tube inserted down the throat to examine parts of the body
- Upper gastrointestinal (GI) x-ray
- Measurement of bile acid (bile acid aids in digestion and absorption of fats and fat-soluble vitamins in the small intestine)
- Breath tests
Treatment
Talk with your doctor about the best plan for you. Some ulcers will heal if you avoid caffeine, NSAIDs, alcohol, and tobacco. Other treatment options include:
Medications
Treatment with medications focuses on:
- Stopping your stomach from making acids
- Killing the bacteria that is causing your ulcer
Medications used to treat gastric ulcers include:
- Proton pump inhibitors
- Histamine receptor blockers
- Antibiotics
Surgery
If ulcers do not heal with medications, surgery may be needed. Surgery can remove the ulcers and/or reduce the amount of acid your stomach makes.
RESOURCES:
American College of Gastroenterology
http://www.acg.gi.org/
National Digestive Diseases Information Clearinghouse
http://digestive.niddk.nih.gov/
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
http://www.cag-acg.org/
Veteran's Affairs Canada
http://www.vac-acc.gc.ca/
References:
Duodenal peptic ulcer disease. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed July 5, 2007.
What I need to know about peptic ulcers. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/pepticulcers_ez/ . Accessed July 5, 2007.
Last reviewed January 2009 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.