(Peptic Ulcer of the Duodenum)
by Cynthia M. Johnson, MA
A duodenal ulcer is a sore in the lining of the intestine. The first part of the small intestine, just past the stomach, is called the duodenum.
Upsets in the balance of stomach acid and digestive juices can lead to an ulcer. This can be caused by:
Less common causes are:
Things that may raise the risk of this problem are:
Some people may not have symptoms. Others may have problems that come and go. Food or fluids sometimes make symptoms better. Having an empty stomach may make symptoms worse.
Problems may be:
Ulcers can cause serious problems and severe belly pain. One problem is bleeding. This may result in:
A perforated ulcer is a break through the wall of the duodenum. It causes sudden and severe pain.
The doctor will ask about your symptoms and health history. A physical exam will be done.
Tests may include:
Treatment depends on what is causing the ulcer. Options are:
NSAIDs causing this problem may need to be stopped or changed. Medicine may also be given to protect the stomach against NSAID damage.
Other medicines may be:
Changes may need to be made, such as:
People who are not helped by other methods may need surgery to:
Use NSAIDs as advised to lower the risk of this health problem.
American College of Gastroenterology
American Gastroenterological Association
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
Fashner J, Gitu AC. Diagnosis and treatment of peptic ulcer disease and H. pylori infection. Am Fam Physician. 2015;91(4):236-242.
Lanas A, Chan FKL. Peptic ulcer disease. Lancet. 2017 Aug 5;390(10094):613-624.
Peptic ulcer disease. American College of Gastroenterology website. Available at:
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Accessed October 21, 2020.
Peptic ulcer disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/peptic-ulcer-disease. Accessed October 21, 2020.
Peptic ulcers (stomach ulcers). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers. Accessed October 21, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 5/18/2021