What Is Duodenal Ulcer?


Duodenal ulcer is an open wound that occurs in the inner lining of the stomach and upper part of the small intestine. To understand how duodenal ulcers can occur, it will be easier if we first understand the process of action of stomach acid and human digestive system.

Normally, the stomach will produce acids that serve to digest food and kill bacteria in food. The inner wall of the stomach will form a natural protective layer of mucus. This mucus works by protecting the stomach lining of corrosive acid. Under certain conditions, mainly due to Helicobacter pylori bacterial infection and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), the inner lining of the stomach wall is damaged. As a result, the corrosive acid stomach will damage the protective mucus layer and injure the stomach wall, resulting in inflammation and open sores in the stomach.

The main symptom of duodenal ulcer is abdominal pain. The pain is felt at intervals between meals or at night. However, this disease rarely causes severe symptoms. Most duodenal ulcers may recover over time with appropriate treatment. This treatment depends on the causes and symptoms caused.


Symptoms of Duodenal ulcer

Symptoms that arise from duodenal ulcer are:
  • The pit of the liver feels pain and burns.
  • Nausea.
  • The stomach feels bloated, belching.
  • Burning sensation in the chest
Whereas severe symptoms are rare among others:
  • Decreased appetite.
  • Hard to breathe.
  • The stool is dark or black.
  • Weight loss is not fair.
  • Vomiting blood.
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The cause of Duodenal ulcer
Most cases of duodenal ulcers are caused by bacterial infection of helicobater pylori (H. pylori). Normally, this bacterium lives in a mucous protective layer and serves to fight harmful bacteria. But in some people, these bacteria actually damage the mucus protective layer and cause inflammation. The spread of bacterial infection is not yet certain, but it is suspected that this bacteria can be infected from direct contact or through food and water.

In addition to the H pylori bacterial infection, the consumption of nonsteroidal anti-inflammatory drugs / NSAIDs (such as aspirin, ibuprofen , and naproxen sodium) regularly can also cause irritation to the protective lining of the small intestine wall. These drugs are usually consumed by adult patients to cope with blood clots, arthritis, and muscle pain. Another rare cause of duodenal ulcers is the Zoolinger-Ellison syndrome. This syndrome causes more gastric acid levels resulting in a duodenal ulcer.

In addition to the cause, several factors can also make the condition of duodenal ulcer worse or difficult to heal, namely:

  • Experiencing unresolved stress.
  • Eating spicy foods.
  • Smoke.
  • Consume alcohol.
  • Being over 70 years old.
  • Have a history of having duodenal ulcer.

Diagnosis of Duodenal ulcer
To detect a duodenal ulcer, the doctor will initially ask for a medical history and perform a thorough physical examination. Furthermore, several tests are needed to confirm the possibility of H. pylori infection. The tests include:

  • Blood tests aimed at examining cells that fight infection. The presence of these cells indicates the presence of H. pylori infection.
  • A stool sample test to check the growth of H. pylori bacteria in the stool for several days.
  • Urea breath test (urea breath test). In this test, patients are asked to swallow pills containing carbon. After that, the patient exhale into a bag. If the test results indicate high levels of carbon dioxide, then the presence of H. pylori infection can be ascertained.

After laboratory examination, the doctor will also make a diagnosis based on gastrointestinal examination, which consists of:

  • Upper GI tract examination. This X-ray examination will show a picture of the esophagus, stomach, and small intestine. During this examination, the patient is asked to swallow a white liquid containing barium so that the ulcer is more easily visible.
  • Gastrocopy (endoscopy). In this procedure, a small tube with the camera will be inserted through the esophagus to see firsthand conditions in the stomach and small intestine.

Treatment of Duodenal Ulcer
Treatment of duodenal ulcer can be done after knowing the cause and severity. Treatment for duodenal ulcers caused by H. pylori bacterial infection is by antibiotics, such as amoxicillin , clarithromycin , metronidazole , tinidazole , tetracycline and levofloxacin . In addition to antibiotics, doctors will also give drugs that can suppress the production of stomach acid, such as ranitidine , famotidine , cimetidine and nizatidine. These drugs are given so that antibiotics can work effectively. Combination therapy is done for at least one week.

To make sure the infection is clean, the patient is asked to do the H. pylori bacteria examination within four weeks after the therapy is completed. If the bacterial infection is still present, repeat combination therapy with different antibiotics, Do this until the infection is completely lost.

While in the treatment of duodenal ulcer caused by the consumption of anti-inflammatory drugs on a regular basis, patients are encouraged to reduce or stop the use of the drug. Furthermore, doctors will administer inhibitory drug production of proton pump (inhibitor) such as lansoprazole or omeprazole for several weeks. This is done to reduce the amount of acid in the stomach and reduce the possibility of ulcers re-form.

In addition, doctors may combine treatment with an antacid group drug that serves to neutralize stomach acid. Drugs that serve to protect the surface of the stomach and small intestine can also be prescribed by a doctor. Examples of drugs of this class are sucralfat and misoprostol.

Another option of duodenal ulcer treatment is through surgery. This procedure is common in ancient times before gastric acid inhibitors were found. Currently, surgery is only performed for severe duodenal ulcers in which bleeding or lining the perforated bowel due to ulcers.


Duodenal ulcer complications

If the duodenal ulcer is not treated, then there may be complications, such as

  • Digestion is blocked . Gastrointestinal ulcers can cause gastrointestinal and gastrointestinal conditions to swell, experiencing inflammation or scarring that blocks the course of food in the gastrointestinal tract. These obstacles can make the sufferer susceptible to satiety, vomiting and weight loss.
  • Internal bleeding (inside). This bleeding can cause blood loss slowly leading to anemia. Under these conditions, blood transfusion or hospitalization is required.
  • Infection . Ulcers can make a hole in the wall of the stomach or small intestine so that we will be susceptible to serious infections in the abdominal cavity (peronitis).

If you experience symptoms of complications from a duodenal ulcer, see your doctor immediately for the right treatment.

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