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Duodenal Ulcers

What are duodenal ulcers?

Peptic ulcers are open sores that develop in the lining of the stomach or in the oesophagus. Duodenal ulcers occur in the upper part of the stomach or in the duodenum.

Anatomy As the food passes down from the oesophagus into the stomach, inessential acids are secreted in the stomach to aid the digestion of food. Once done, it is passed into the first part of the small intestine, the duodenum. Enzymes are formed here to mix with the food secreted by the pancreas and the lining of the intestine. The enzymes assist in the digestion of food, which is then absorbed into the body.

When the lining of the duodenum is eroded, it results in the formation of a peptic ulcer causing abdominal pain, bleeding and other gastrointestinal symptoms. Stomach infections due to the H.pylori (Helicobacter pylori) are one of the most common causes of duodenal ulcer.

Causes

  • Helicobacter Pylori or H.Pylori – Infections develop due to the H.pylori bacterium that secretes substances that corrode the protective mucus lining in the stomach. The stomach becomes susceptible to the undesirable effects of pepsin.

  • Stress – Emotional stress can increase the pain of the ulcer, and physical stress augments the risk of developing an ulcer. Burns and surgeries are also a known cause of ulcers.

  • Caffeine – Caffeine stimulates secretion of acid in the stomach that provokes ulcerous pains.

  • Alcohol – Excessive consumption of alcohol slows down the healing process of ulcers.

  • NSAIDs – Non-steroidal anti-inflammatory drugs like ibuprofen and naproxen sodium contribute to the emission of acid and pepsin.

Signs and Symptoms

  • Burning pain between the navel and the breastbone

  • Weight loss

  • Lack of appetite

  • Nausea

  • Vomiting

  • Belching

  • Feeling of tiredness and weakness

Complications

Ulcers may have serious complications. Some of them are:

  • Bleeding – Blood vessels are damaged when the ulcer eats into the duodenal wall, causing bleeding

  • Obstruction – Ulcers in the duodenum cause scarring and swelling thus narrowing or closing the opening of the intestine

  • Perforation – A hole is formed when the ulcer eats into the wall of the duodenum. Partially digested blood spills through this opening into the peritoneum causing peritonitis.

Diagnosis

  • Barium swallow – An upper GI series is done to examine the upper digestive system inclusive of the oesophagus, stomach and duodenum. The barium liquid coats the internal organs when swallowed, and visibility of the organs is obtained on the x-ray.

  • EGD – The Oesophagogastroduodenoscopy (EGD) or upper endoscopy enables visualization of the upper intestine through a camera attached to a flexible, thin tube inserted through the mouth and throat.

  • Tissue tests – Blood and stomach tissue tests are conducted to detect the presence of H.pylori bacteria.

Treatment and Medication

Treatment for duodenal ulcers usually requires lifestyle changes. Medications such as antibiotics to kill the H.pylori, H2 blockers, acid pump inhibitors and mucosal protective agents are prescribed.

Dr. Deepak effectively treats duodenal ulcers after carefully considering the patient’s overall health, medical history, age and extent of the condition.

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