Duodenal Ulcer
If you have a duodenal ulcer, you may be wondering.. how did I get this? What causes these ulcers? What diagnostic tests and treatments are usually used?
In this article, we will be going over the answers to all these questions and cover everything you need to know about duodenal ulcers.
What is a Duodenal Ulcer?
A duodenal ulcer refers to an ulcer located in the duodenum, or first portion of the small intestine. If you are not familiar, an ulcer is an erosion of epithelium (epithelium is the tissue type that forms linings and coverings in the body).
Duodenal ulcers are actually more common than ulcers in the actual stomach.
What Causes Duodenal Ulcers?
The primary cause of a duodenal ulcer is the bacterium known as H pylori. This bacteria lives in the lining of the stomach and duodenum, and weakens the lining. This infection makes the area susceptible to ulceration.
Duodenal ulcers are the most common type because what most people do not realize is that the bulk of chemical digestion occurs in the duodenum and not the stomach. The stomach is more like a storage tank for food. The stomach breaks down food into small components and liquid, but most of the actual breaking of chemical bonds between foodstuffs is done in the duodenum.
Since the duodenum handles all this heavy digestion, there is a large number digestive enzymes (such as trypsin and chymotrypsin) which are very active in the duodenum. The end result is that when the duodenal lining becomes weakened due to H pylori infection, these digestive enzymes begin to damage the duodenum and an ulcer results.
While most ulcers are caused by H pylori, a minority of ulcers may result from medication such as NSAIDs and aspirin, cancer, or other diseases.
Duodenal Ulcer Symptoms
Symptoms of duodenal ulcers are very similar to standard stomach ulcer symptoms. In fact, you cannot tell if your ulcer is gastric (in the stomach) or duodenal based on duodenal ulcer symptoms alone.
The most common duodenal ulcer symptoms are:
- Burning stomach pain
- Nausea and loss of appetite
- Feeling better after eating
- Symptoms peak on an empty stomach, particularly at late in the night or early in the morning
Duodenal Ulcer Diagnostics
In order to check for a duodenal ulcer, the most common method is via a tracing substance like barium chalk. This involves the patient drinks a barium containing solution and then gets an x-ray to get a surprisingly clear image of the gastrointestinal tract.
Alternatively, endoscopy can be used, particularly if a biopsy is needed. This is an invasive procedure and usually reserved for when symptoms become chronic or the ulcer in question is resistant to treatment. A biopsy can help distinguish between an ulcer and cancer. While cancer only causes a small portion of duodenal ulcers, it is worth investigating if the suspected duodenal ulcer did not respond to normal treatments.
Upon confirmation of an ulcer, an H pylori test is administered to check for infection.
Duodenal Ulcer Treatment
Treatment for duodenal ulcers depends on the diagnosis. In most cases, after confirming H pylori infection, antibiotics are prescribed. Additionally, certain medications to help reduce acid production can be prescribed, but that depends on the exact location and severity of the ulcer.
After the H pylori infection has been successfully quelled, most ulcers will heal on their own accord. Removing caffeine, smoking, and alcohol from the diet can help speed up recovery, but is not a “stand alone” solution for duodenal ulcers if H pylori infection is present.
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