• Duodenal Ulcer

    (Peptic Ulcer of the Duodenum)


    A duodenal ulcer is a sore in the lining of the intestine. It is in the first part of your small intestine, known as the duodenum. Ulcers can be treated. A small percentage of them may be cancerous. See your doctor if you think you may have a duodenal ulcer.
    Duodenal Ulcer
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    Ninety-five percent of duodenal ulcers are from a bacterial infection. They are caused by Helicobacter pylori ( H pylori ). Other causes include:

    Risk Factors

    Some factors thought to increase the risk of duodenal ulcer are:
    • Gender: male
    • Age: the incidence of duodenal ulcers peaks around age 40
    • Family history of duodenal ulcers


    Symptoms of a duodenal ulcer may include:
      Burning pain in the gut that feels like a dull ache and comes and goes:
      • It often starts 2-3 hours after a meal and goes away after you eat
      • It may also come in the middle of the night when your stomach is empty
    • Weight loss
    • Loss of appetite
    • Pain while eating
    • Nausea
    • Vomiting


    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Other tests may include:
    • Biopsy —removal of a sample of tissue for testing
    • Blood tests
    • Endoscopy—a thin, lighted tube inserted down the throat to examine parts of the body
    • Upper gastrointestinal (GI) x-ray
    • Measurement of bile acid (bile acid aids in digestion and absorption of fats and fat-soluble vitamins in the small intestine)
    • Breath tests


    Talk with your doctor about the best plan for you. Some ulcers will heal if you avoid caffeine, NSAIDs, alcohol, and tobacco. Other treatment options include:


    Treatment with medications focuses on:
    • Stopping your stomach from making acids
    • Killing the bacteria that is causing your ulcer
    Medications used to treat gastric ulcers include:
    • Proton pump inhibitors
    • Histamine receptor blockers
    • Antibiotics
    Antacids may also help reduce pain and heal ulcers.


    If ulcers do not heal with medications, surgery may be needed. Surgery can remove the ulcers and/or reduce the amount of acid your stomach makes.


    Steps you can take to prevent duodenal ulcers include:
    • Stop using NSAIDs. You can talk with your doctor about alternatives.
    • Do not smoke.
    • Do not drink alcohol.


    American College of Gastroenterology http://www.acg.gi.org/

    National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/


    Canadian Association of Gastroenterology http://www.cag-acg.org/

    Veteran's Affairs Canada http://www.vac-acc.gc.ca/


    Duodenal peptic ulcer disease. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed July 5, 2007.

    What I need to know about peptic ulcers. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/pepticulcers%5Fez/ . Accessed July 5, 2007.

    Revision Information

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