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Home :: Digestive Disorders

Duedenal Ulcer


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Duedenal Ulcer is a chronic and recurrent disease. The ulcer is usually deep and sharply demarcated. More than 95% of duodenal ulcers occur in the first portion of the duodenum. These ulcers are round or elliptical, less than 1 cm in diameter. Esophageal ulcers may also occur and are typically associated with the reflux of stomach acid. A perforated ulcer (the ulcer has eaten a hole in the wall of the stomach or duodenum and bacteria and partially digested food has spilled into the hole, causing inflammation) or a narrowing and obstruction of the intestinal opening preventing food from leaving the stomach and entering the small intestine. Peptic ulcer disease is common, affecting millions of Americans yearly. The medical cost of treating peptic ulcer and its complications runs in the billions of dollars annually.

Duodenal ulcer is a common condition characterized by the presence of a well-demarcated break in the mucosa that may extend into the muscularis propria of the duodenum.Peptic ulcers are open sores that develop on the inside lining of your stomach, upper small intestine or esophagus. The most common symptom of a peptic ulcer is pain.An ulcer is where the lining of the gut is damaged and the underlying tissue is exposed. If you could see inside your gut, an ulcer looks like a small, red crater on the inside lining of the gut. Peptic ulcers are open sores or erosions in the lining of either the duodenum (duodenal ulcers) or the stomach (gastric ulcers). Additional aggressive factors include smoking, ethanol, bile acids, aspirin, steroids, and stress. Important protective or defensive factors are mucus, bicarbonate, mucosal blood flow, prostaglandins, alkaline tide, hydrophobic layer, restitution, and epithelial renewal. An ulcer in the duodenum is called a duodenal ulcer. Together, ulcers of the stomach and duodenum are referred to as peptic ulcers. Ulcers located in the stomach are called gastric ulcers. Doctors now know that a bacterial infection or medications - not stress or diet - cause most ulcers of the stomach and upper part of the small intestine (duodenum).

A peptic ulcer is erosion in the lining of the stomach or duodenum (the first part of the small intestine). Contrary to popular belief, ulcers are not caused by spicy food or stress but, rather, are most commonly due to either an infection or long term use of certain medications.In the last two decades, major advances have been made in the understanding of the pathophysiology of PUD, particularly regarding the role of Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs). Too much stress, too much spicy food, and you may be headed for an ulcer -or so the thinking used to go. This type of peptic ulcer develops in the first part of the small intestine (duodenum). Most ulcers occur in the first layer of the inner lining. A hole that goes all the way through is called a perforation of the intestinal lining.

Causes of Duedenal Ulcer

The common Causes of Duedenal Ulcer :

  • The most common cause of such damage is infection of the stomach with a bacterium called Helicobacter pylori (H.pylori) .
  • Nicotine in tobacco increases the volume and concentration of stomach acid, increasing your risk of an ulcer. Smoking also may slow healing during ulcer treatment.
  • people with this uncommon condition have tumors in the pancreas and duodenum that produce gastrin, a hormone that stimulates gastric acid production.
  • Other causes of ulcers are conditions that can result in direct damage to the wall of the stomach or duodenum such as heavy use of alcohol, radiation therapy, burns, and physical injury.
  • For a variety of reasons, the protective mechanisms may become faulty, leading to a breakdown of the lining.
  • Caffeine stimulates acid secretion in the stomach, thus aggravating the pain of an existing ulcer.
  • On the other hand, many people have this organism living in their GI tract but they don't get an ulcer.
  • Anti-inflammatory medicines which many people take for arthritis, muscular pains, etc. For example: aspirin, ibuprofen, and diclofenac - but there are others.

Symptoms of Duedenal Ulcer

Some are common Symptoms of Duedenal Ulcer :

  • Chest pain
  • Belching
  • Weight loss
  • Nausea
  • Weakness
  • Loss of appetite
  • Pain may be relieved by antacids or milk
  • Vomiting blood
  • Fatigue
  • Heartburn , indigestion , belching
  • Bloody or dark tarry stools
  • Last from a few minutes to many hours

Treatment of Duedenal Ulcer

Here is the list of the methods for treating Duedenal Ulcer :

  • Treatment often involves a combination of medications to kill the Helicobacter pylori bacteria, reduce acid levels, and protect the GI tract.
  • Medications that protect the tissue lining (like sucralfate)
  • The discovery of the link between ulcers and H. pylori resulted in a probable new treatment option -- antibiotics for patients with H. pylori.
  • Smoking has been shown to delay ulcer healing and has been linked to ulcer recurrence; therefore, people with ulcers should not smoke.
  • Mucosal protective agents to shield the stomach's mucous lining from the damage of acid, but do not inhibit the release of acid.
  • Bismuth (may help protect the lining and kill the bacteria)
  • Obstruction can complicate PUD, particularly if PUD is refractory to aggressive antisecretory therapy, H pylori eradication, or avoidance of NSAIDs. Obstruction may persist or recur despite endoscopic balloon dilation.
  • A surgical procedure that may be performed along with a vagotomy, in which the opening into the duodenum and small intestine (pylorus) are enlarged, enabling contents to pass more freely from the stomach.