Duodenal Ulcer: Brief Version

What is a duodenal ulcer?

A duodenal ulcer is a raw place or sore in the lining of the upper small intestine. It happens in the duodenum, which is where the small intestine connects to the stomach.

How does it happen?

A duodenal ulcer happens when part of the lining of the intestine is eaten away by stomach acid. Normally the lining of the intestine is protected from stomach acid. But sometimes this protection fails. Then you may get an ulcer.

This can happen in many ways:

• Bacteria called H. pylori cause most ulcers of this type.
• Some kinds of medicine, like aspirin, ibuprofen, and naproxen, can cause these ulcers.

Cigarettes, alcohol, and caffeine can make ulcer pain worse. Doctors do not know if they can actually cause an ulcer.

What are the symptoms?

You may have:

• A pain in the upper abdomen that gnaws or burns.
• A pain that gets better when you eat or take antacids.
• A pain that gets worse when your stomach is empty (just before meals or a couple of hours after you eat).
• A pain that wakes you up during the night.

If the ulcer bleeds:

• Your vomit may have bright red blood or blood that looks like brown coffee grounds.
• Your bowel movements may be black and tarry.

How do I know I have it?

Your healthcare provider will:

• Talk to you about your symptoms.
• Ask about your medical history.
• Give you a checkup.

You may have one or more of these tests:

• Tests of your bowel movement to check for blood.
• Blood tests to look for bacteria that cause ulcers.
• A blood test for anemia. If you have an ulcer that is bleeding, you may have anemia (not enough red blood cells).
• An X-ray. For this test, you will swallow barium. This liquid lets your healthcare provider see the ulcer on an X-ray.
• An endoscopy, which is an exam that lets your healthcare provider see the ulcer with a thin flexible tube and a tiny camera. After numbing your throat, your provider puts the tube through your mouth down into your stomach.
• A special test called a biopsy. Your provider takes a piece of tissue from the first part of your intestine for lab tests.

How is it treated?

It is important to get treatment for an ulcer. Treatment will help:

• You have less pain.
• Your ulcer heal.
• Keep your ulcer from causing other problems or coming back.

Your healthcare provider may prescribe:

• Antibiotics to treat H. pylori bacteria if your test for bacteria was positive.
• Antacids.
• Medicine to lower the amount of acid your stomach makes.
• Medicine to coat and protect the area around the ulcer.

In addition your healthcare provider will recommend that you stop drinking alcohol and stop smoking cigarettes.

You may need to take medicine for quite a while. You may need to make changes in how you eat and how you take care of yourself.

How long will it take to get well?

These ulcers get better with treatment. But they can happen again. Be sure to take your medicine the way your healthcare provider tells you to take it. This will help lower the chances that the ulcer will come back.

If you do not get treated, you may have these problems:

• You may have severe bleeding.
• You may get a hole in the wall of your intestine.
• The ulcer may make scars that block food from moving from your stomach to your intestine.

If you have these problems:

• You may need to stay at the hospital.
• You may need surgery.

How can I take care of myself and help prevent ulcers?

Get the medical care you need.

• Take all the medicine prescribed by your healthcare provider.
• Keep your follow-up appointments.
• If you keep having symptoms or you get worse, tell your provider right away.

There are things you should stay away from if you can:

• Do not smoke cigarettes.
• Do not drink alcohol.
• Don't take aspirin, ibuprofen, or naproxen. Ask your healthcare provider if you can use acetaminophen (for example, Tylenol) for pain.

Take care of yourself.

• Eat small meals 4 to 5 times a day instead of 2 or 3 large meals.
• Choose healthy meals.
• Get plenty of rest.
• Exercise as recommended by your healthcare provider.
• Do not eat or drink things that may bother your stomach. Common things that can bother the stomach are coffee, colas, and acidic foods like oranges and other citrus fruits.