Definition

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.

Duodenal Ulcer

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Causes

Upsets in the balance of stomach acid and digestive juices can lead to an ulcer. This can be caused by:

• Helicobacter pylori (H. pylori) infection
• Use of nonsteroidal anti-inflammatory drugs (NSAIDs)

Less common causes are:

• Zollinger-Ellison syndrome
• Radiation therapy
• Bacterial or viral infections
• Alcohol use disorder
• Tumors
• Certain medicines, such as steroids or those used to treat osteoporosis
• Severe stress, such as surgery, trauma, head injury, shock, or burns

Risk Factors

Things that may raise the risk of this problem are:

• H. pylori infection
• Taking NSAIDs for a long time and at higher doses
• Prior peptic ulcer disease
• Tobacco use
• Excessive alcohol intake

Symptoms

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:

• Gnawing pain that may:
  • Cause problems sleeping
  • Change when a person eats
  • Last for a few minutes or several hours
  • Feel like strong hunger pangs
  • Be relieved by taking antacids
• Nausea and vomiting
• Bloating
• Burping
• Loss of appetite
• Weight loss

Ulcers can cause serious problems and severe belly pain. One problem is bleeding. This may result in:

• Weakness
• Light-headedness
• Bloody or black, tarry stools
• Vomiting what looks like coffee grounds or blood

A perforated ulcer is a break through the wall of the duodenum. It causes sudden and severe pain.

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Tests may include:

• Blood test, stool test, or breath test to look for signs of H. pylori
• Endoscopy to view the digestive system
• Upper GI series to take pictures of the digestive system using contrast material to highlight abnormalities

Treatment

Treatment depends on what is causing the ulcer. Options are:

Prevention

Use NSAIDs as advised to lower the risk of this health problem.