What is a Duodenal Ulcer?

A duodenal ulcer is a lesion that appears on the inner lining of the duodenum, the upper section of the small intestine. Ulcers are essentially areas of eroded tissue that have been damaged by bacteria, stomach acids, or certain medications. Duodenal ulcers are most common in older adults, though they can potentially occur at any age. Doctors can usually treat ulcers with medications or simple surgical procedures. If a duodenal ulcer goes untreated, however, it can lead to extensive internal blood loss and severe health complications.

Most duodenal ulcers are caused by a particular type of bacteria, called Helicobacter pylori (H. pylori). When the bacteria is present in large quantities, it eats away the mucous membrane that lines the duodenum. An ulcer can also emerge if a person regularly takes nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin. Increases in stomach acid from smoking and alcohol use have also been linked to duodenal ulcers.

Many people who have duodenal ulcers do not experience any physical symptoms. When symptoms are present, a person may notice abdominal pain, nausea, and occasional feelings of fatigue. Less commonly, an individual can experience vomiting, abnormally dark or tarry stools, and changes in appetite. As an ulcer grows, symptoms tend to worsen and become chronic. A person who believes he or she may have an ulcer should schedule an appointment with a doctor to receive a thorough evaluation.

A primary care physician who suspects a duodenal ulcer usually takes a blood sample to check for H. pylori and to rule out other possible causes of the patient's symptoms. After an initial inspection, the patient may be referred to a gastroenterologist for further testing. The specialist can take an abdominal x-ray or a computerized tomography scan to look for abnormalities of the duodenum. An endoscopy procedure may be conducted to confirm a diagnosis, during which a flexible tube containing a fiber optic camera is inserted down the throat. The camera is directed to the duodenum, so the gastroenterologist can clearly see an ulcer.

Treatment for a duodenal ulcer depends on its size, accompanying symptoms, and the underlying cause. Oral antibiotics and prescription antacids can resolve most ulcers in about six weeks. Surgical care may be necessary if excessive bleeding occurs or if a duodenal ulcer does not respond to medications. Following treatment, patients are usually instructed to maintain healthy diets and avoid smoking and excessive alcohol consumption to prevent future gastrointestinal problems. In addition, doctors can provide information about alternatives to NSAIDs to reduce the risk of a recurring duodenal ulcer.