Duodenal Ulcers Facts: Causes, Symptoms, Risk Factors

Peptic ulcers are a common cause of abdominal pain. Peptic ulcers develop on the inside lining of your stomach and sometimes on the upper portion of your small intestines. Gastric and Duodenal ulcers are the two common types of peptic ulcers. Peptic ulcers are caused due to infection with the bacterium Helicobacter Pylori (H. Pylori). Continuous use of aspirin and nonsteroidal anti-inflammatory drugs can also cause peptic ulcers.

What is a Duodenal Ulcer?

Duodenum is the first part of your small intestine that precedes the jejunum and ileum. It is a hollow jointed tube that collects the stomach to the jejunum. Duodenal ulcers develop in the lining of the duodenum. Duodenal ulcers sometimes heal on their own, but in other cases, they may require treatment.

Symptoms of Duodenal Ulcers

Symptoms of duodenal, as well as, gastric ulcers are similar. In both cases, patients complain of getting a burning pain in the stomach. Patients may also experience sharp pain in the stomach a few hours after eating. Duodenal ulcers can cause worse abdominal pain when the stomach is empty. Usually, the pain tends to respond well to foods or medications that reduce stomach acidity. But the pain returns when the effect of medications wear off.

Some of the common symptoms of duodenal ulcers are:-
 Bloating
 Gas
 Heartburn
 Feeling full
 Nausea
 Abdominal pain

The studies suggest that 75% of people who have duodenal or gastric ulcers do not exhibit any symptoms. In fact, peptic ulcers rarely cause severe symptoms. However, in a case when they show several symptoms, they can include-

 Fatigue
 Shortness of breath
 Difficulty breathing
 Blood in stool
 Vomiting blood

It is highly recommended to book an appointment with a gastroenterologist if you experience any of the symptoms mentioned above.

Causes of Duodenal Ulcers

Helicobacter Pylori Bacteria- H. Pylori is the most common cause of duodenal ulcers. The bacteria affect the mucous enabling stomach acid to damage the lining. Studies suggest that 30 to 40% of US people are infected with H. Pylori. Though the exact causes of the spread of bacteria are not known, it is believed to spread through consuming unclean water and food & according to Dr. Adam Harris “Curing (or eradicating) infection with H. pylori is more difficult than treating other infections.”

Certain Medications- Certain medications such as nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen and naproxen are likely to contribute to duodenal ulcers. All these medications can irritate and damage the lining of your stomach as well as intestines.

Other conditions- A rare condition known as Zollinger- Ellison Syndrome can cause the growth of both cancerous and non-cancerous tumors. These tumors release hormones that cause high levels of stomach acid which can lead to duodenal and gastric ulcers.

Contributing Factors- Overuse of over-the-counter painkillers, consumption of alcohol, smoking, psychological stress can promote the development of ulcers.

Diagnosis of Duodenal Ulcers

Duodenal ulcers can be diagnosed with the help of several tests which are mentioned below:-

Gastroscopy- Gastroscopy, also known as endoscopy can confirm a duodenal ulcer. In this test, your gastroenterologist will look inside your stomach using a thin, flexible tube (called an endoscope) to see any inflammation or ulcers.

H.Pylori Detection Test- H. Pylori detection test is done if you have a duodenal ulcer. It can be detected in a sample of stool, blood test, breath test or from a biopsy sample take during an endoscopy.

Upper gastrointestinal Series- Your gastroenterologist may also suggest a test called barium swallow or an upper GI series. In this test, a patient is made to drink a solution with a small amount of liquid material that shows up on an x-ray. X-rays will be taken by the doctor to see how the solution moves through your digestive system.

Who Is at Risk?

 Smokers are at high risk of getting ulcers. It is difficult to treat duodenal ulcers in people who smoke a lot and usually have a higher recurrence rate.

 Higher consumption of alcohol damages the gastric mucosa and stimulates acid secretion. Consumption of alcohol also seems to interfere with ulcer healing.

 Living in overcrowded conditions is likely to increase the chances of getting H.Pylori infection.

 Genetics also play a vital role in getting duodenal infections. Children with Hispanic and African-American backgrounds are usually at a higher risk.

 Though eating spicy food does not cause ulcers, but it can make duodenal ulcers worse and difficult to heal.

 Consuming several medications such as anticoagulants like warfarin, osteoporosis treatments, certain chemotherapy medications also increase your risk of developing gastric and duodenal ulcers.

Other factors that may increase your risk for peptic ulcers are:-

 Being over 70 years of age.
 Severe injury
 Having a history of peptic ulcers
 Drinking Alcohol
 Smoking

When To Book an Appointment with a Gastroenterologist?

You must immediately book an appointment with a private gastroenterologist if you experience localized abdominal pain, nausea withpain or black or bloody stools. Your gastroenterologist will conduct a careful examination of your stomach to get to the root cause of the problem. He may also recommend several tests such as- blood, stool or breath test for the presence of H. Pylori, upper endoscopy test or upper GI series test. Consequently, he may give you an antibiotic medicine to treat the bacterial infection. In some cases, your gastro-specialist may also suggest triple therapy which is a combination of antibiotics and antacid. On the other hand, in severe cases, surgery might be suggested. Ulcers get worse without treatment, therefore, timely diagnosis and treatment are necessary.