Duodenal Ulcers

Duodenal ulcers are sores or a raw patches that form in the lining of the duodenum where acid and pepsin are present.

These type of ulcers are more common than stomach ulcers.

Both stomach ulcers and ulcers in the duodenum are generally referred to as peptic ulcers.

Peptic ulcers are usually 1-2 cm in diameter.

Duodenal Ulcer Causes

The primary cause of ulcers in the duodenum is an infection with bacteria called Helicobacter pylori (H. pylori). Helicobacter pylori produces substances that weaken the duodenum's protective mucus and make it susceptible to the damaging effects of acid and pepsin. The acid causes inflammation and ulcers.

Inheritance is also cited as causative factor in ulcers in the duodenum, especially where blood group O is present.

Anti-inflammatory drugs (NSAIDs) which are commonly taken for arthritis and muscular pains sometimes affect the lining of the duodenum and allow acid to cause an ulcer. NSAIDs include aspirin, ibuprofen, and diclofenac.

Another rare cause is the Zollinger-Ellison syndrome. In this condition more acid than is needed is made by the stomach. It ends up in the duodenum and causes inflammation.

Other factors such as smoking, stress, and drinking heavily may increase the risk of having peptic ulcers.

Duodenal Ulcer Symptoms

The most common symptom of peptic ulcers is pain in the upper abdomen just below the sternum (breastbone) that comes and goes. It mostly occurs before meals when the stomach is empty. The pain may awaken you from sleep.

The pain may be eased by eating food or taking antacid medicines.

Other symptoms include:

  • Bloating
  • Belching
  • Hematemesis (vomiting blood)


    Likely complications resulting from peptic ulcers include bleeding from the ulcer and Perforation.

    The bleeding can range from a trickle to a life-threatening bleed.

    Perforation is an instance where the ulcer perforates the wall of the duodenum.

    Food and acid in the duodenum may then leak into the abdominal cavity.

    This causes a lot of pain and requires immediate surgery.

    How to Detect a Duodenal Ulcer

    Endoscopy is the test that can confirms the presence ulcers in the duodenum.

    In this test a doctor looks inside the stomach and duodenum by passing a thin, flexible telescope down the oesophagus.

    The doctor will then be able to determine the location and severity of the ulcer as well as any inflammation. If no ulcer is present, endoscopy provides an alternative diagnosis.

    A test to detect the H. pylori bacteria is a common standard procedure if you have a duodenal ulcer. If H. pylori is found then it is likely to be the cause of the ulcer.

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