A B C D E F G H I J K L M N O P R S T U V W

DUODENAL ULCER

What is a Duodenal Ulcer ?

The stomach and duodenum are situated in the upper part of the abdomen. Food passes from your mouth, through the oesophagus (gullet), into the stomach. From the stomach, it moves through into the first part of the intestine called the duodenum. An ulcer occurs when there is a break in the lining of the duodenum. Duodenal ulcers typically cause episodes of pain in the upper abdomen. The pain may be affected by food and by milk or antacids bought from the chemist.. There are often pain-free periods. Night pain (usually between 1.00 and 3.00 a.m.) is common. Nausea and vomiting occasionally occur and may relieve the pain. You may get other symptoms such as heartburn. Less often, the ulcer may bleed, causing either bloody vomit or passing black blood in the stools.

How does a Duodenal Ulcer occur ?

Ulcers are formed when the lining of the duodenum is damaged. There are several factors which influence the health of the lining of the duodenum. Drugs, infection and the general health of the individual can all be involved.

Why does a Duodenal Ulcer occur ?

The vast majority of duodenal ulcers occur in people exposed to certain drugs or who have a chronic infection with a bacteria called helicobacter pylori. The drugs usually involved are aspirin or so called non steroidal anti-inflammatory drugs. Examples include nurofen (ibuprofen) and many other drugs used as pain killers, particularly for arthritis. Many people are infected with the infection helicibacter pylori and it remains unclear as to why a minority of them will develop uclers whilst many never have any problem at all.

Treatment Involved for a Duodenal Ulcer

It is often necessary for your doctor to confirm the diagnosis before commencing any treatment. This is done by performing an endoscopy which involves examining the stomach and duodenum with a narrow camera passed through the mouth. If an ulcer is found then infection can be looked for at the same time. If the ulcer is related to the use of certain drugs then if possible they should be discontinued. At the same time a course of acid suppressing medication will be prescribed. If the drug causing the ulcer cannot be discontinued then ulcer healing medication may have to be taken long term but otherwise the medication is given for a few weeks. If infection with helicobacter pylori is confirmed then this can usually be eradicated by a course of two antibiotics taken for a week together with acid suppressing medication which actually heals the ulcer. In a minority of patients there are complications of ulcers which can occur. The commonest of these is bleeding from the ulcer. This is usually treated through the telescope used to examine the stomach but an operation is sometimes required. Other complications of ulcers are fortunately rare but may also require operation.

During Treatment for a Duodenal Ulcer

Pain is usually controlled within a few days of starting treatment and complications will be rare at this stage. If antibiotics are required they can cause diarrhoea and occasionally other side effects or allergic reactions. A normal diet can be eaten. It is important to try to complete the course of treatment even when feeling better.

After Treatment for a Duodenal Ulcer

Once the ulcer is healed there are usually no long-term problems. Sometimes it will be appropriate to be certain that the helicobacter pylori has been successfully eradicated. This can be done by a breathing test performed a few weeks after completion of treatment or by a recently introduced stool test. If the treatment has failed to eradication then another ulcer is likely to occur in the future. If this occurs further courses of different antibiotics can be given.

If a Duodenal Ulcer is Left Untreated

Many ulcers will heal but recur unless appropriate treatment is given. Complications from persistent ulcers are more likely.

Effects on Family of a Duodenal Ulcer

Once diagnosed straightforward ulcers are unlikely to affect the family since symptoms are rapidly controlled. The complications are fortunately rare but can be life threatening.