Duodenal Ulcers | Digestive Health Program | Loyola Medicine

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Duodenal Ulcers

Overview and Facts about Duodenal Ulcers

Duodenal ulcers are painful sores that form inside the upper portion of the small intestine that connects to the stomach, called the duodenum. These ulcers occur when the tissue lining the intestines is damaged, often from bacterial infection or due to long-term pain medication use. An open sore inside the duodenum begins to develop when the damaged tissue is exposed to digestive acids during the normal process of digestion.   

Duodenal ulcers are considered a type of peptic ulcer, a condition that affects both the stomach and small intestine. Such ulcers are completely curable; however, severe digestive health problems may occur if peptic ulcers are left untreated.

Symptoms and Signs of Duodenal Ulcers

The most common symptom of a duodenal or peptic ulcer is burning stomach pain, which can last from a few minutes to several hours and is usually more intense when you have an empty stomach. While they do not cause ulcers, spicy foods and stress can worsen your symptoms.

Signs and symptoms of peptic ulcers include:

  • A feeling of fullness
  • Anemia
  • Belching or acid reflux
  • Bloating
  • Blood in the vomit
  • Burning stomach pain
  • Dark-colored stools​
  • Heartburn
  • Nausea or vomiting
  • Pain that improves when you drink, eat, or take antacids
  • Weight loss

Causes and Risk Factors of Duodenal Ulcers

Duodenal ulcers are caused when the intestinal lining is damaged, exposing the tissue to harmful digestive acids. Damage inside the duodenum is most often due to an infection from the bacterium pylori (H. pylori) or from the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen. In rare cases, a condition called Zollinger-Ellison syndrome is responsible for the development of ulcers, as the syndrome causes the body to increase acid production.

Tests and Diagnosis of Duodenal Ulcers

To diagnose a duodenal ulcer, your doctor will review any prescription or over-the-counter medications you are currently taking and discuss your medical history. A stool, blood, or a breath test may be undergone to determine whether the H. pylori bacterium is in your body. Other ulcers diagnostic methods include:

  • A barium swallow or other imaging test, which will help your intestines appear on x-ray scans
  • A biopsy, which involves taking a small tissue sample during an endoscopy to later examine under a microscope.
  • An endoscopy, which is a procedure that involves inserting a thin tube with a camera down your digestive tract check for bleeding or ulcers

Treatment and Care for Duodenal Ulcers

Treatment of duodenal ulcers is dependent on the underlying cause. Antibiotics are effective to kill the H. pylori bacterium, and medications that reduce or block acid production are recommended to help the tissue heal, such as proton pump inhibitors and histamine blockers. Stopping use of all NSAIDs is generally required in ulcer treatment. In extreme cases, surgery might be necessary to remove the ulcer and/or fix the damaged tissues.

Antacids can also help with symptoms, but will not heal the ulcer itself. Lifestyle changes can also alleviate various symptoms and include managing stress, getting enough sleep, avoiding alcohol, and improving digestive health habits.