A duodenal ulcer is a type of peptic ulcer that forms in the duodenum, the first section of the small intestine just beyond the stomach. It occurs when the protective lining of the duodenum is eroded, leading to an open sore that can cause pain and other symptoms.

Causes of Duodenal Ulcers

The main causes include:

• Helicobacter pylori (H. pylori) Infection: This bacterium weakens the protective mucus lining and increases acid production, leading to irritation and ulceration.
• Long-term Use of NSAIDs: Medications like aspirin, ibuprofen, and naproxen can damage the duodenal lining and increase the risk of ulcers.
• Excess Stomach Acid: Some people naturally produce more stomach acid, which can contribute to ulcer formation.

Symptoms of Duodenal Ulcers

• Abdominal Pain: A burning or gnawing pain in the upper abdomen, often felt between meals or at night.
• Bloating and Belching: Due to irritation in the digestive tract.
• Nausea or Vomiting: May occur, especially in more severe cases.
• Weight Loss: Due to reduced appetite or avoiding food to prevent pain.
• Black or Tarry Stools: This may indicate bleeding in the digestive tract, a more serious complication.

Diagnosis

• Endoscopy: An imaging test where a camera examines the digestive tract to confirm the ulcer and check for bleeding.
• H. pylori Testing: This can involve a breath test, stool test, or biopsy taken during an endoscopy to detect the bacterium.

Treatment of Duodenal Ulcers

1. Antibiotics: To eliminate H. pylori infection if present.
2. Proton Pump Inhibitors (PPIs): Medications like omeprazole reduce stomach acid production, allowing the ulcer to heal.
3. Antacids and H2 Receptor Blockers: These medications can neutralize stomach acid or reduce acid production to provide symptom relief.
4. Avoiding NSAIDs: If NSAIDs contributed to the ulcer, avoiding them may be necessary to allow healing.
5. Dietary and Lifestyle Changes: Reducing alcohol, spicy foods, and caffeine, and not smoking can help manage symptoms and prevent recurrence.

Complications

If untreated, a duodenal ulcer can lead to serious complications:

• Bleeding: Can cause blood in stools or vomit, potentially leading to anemia.
• Perforation: A hole may develop, allowing stomach contents to leak into the abdominal cavity and causing a severe infection (peritonitis).
• Obstruction: Scar tissue from the ulcer may block food from passing through the digestive tract, leading to vomiting and weight loss.

Duodenal ulcers often respond well to treatment, especially if caught early and managed with lifestyle changes and medication.