Symptoms Of A Duodenal Ulcer
If you have a duodenal ulcer, you might:
- have pain in the stomach or abdomen
- have indigestion
- feel very full and bloated after eating
- feel like you might vomit
- lose weight
Very occasionally, an ulcer can cause serious complications. Go to the emergency department if:
- you have a sharp pain in your stomach that doesn’t go away
- your vomit or stools look bloody or a black colour
If you are concerned about symptoms, you can use healthdirect’s online Symptom Checker to get advice on the next appropriate healthcare steps and when to seek medical attention.
What Causes A Duodenal Ulcer And Who Is More At Risk
Our stomach is lined with a mucus-producing inner layer known as the mucosa. This layer is delicate, and its integrity depends on a careful balance of protective factors and destructive factors .
The risk of duodenal ulcer is increased in males and in those who:
- Drink coffee
- Skip breakfast or more than one meal
- Smoke cigarettes
- With Helicobacter Pylori infection
- With a family history of peptic ulcer disease
Other factors that have been associated with an increase in peptic ulcer disease include:
- NSAID use
- Other medical conditions, such as liver disease, Crohns disease, or Zollinger-Ellison syndrome
- Physical stress, such as major surgery or burns
When Should I Go To Er
Seek emergency care if you have:
- Severe pain that doesnt go away.
- Signs of blood in your poop or bloody vomit.
- Signs of severe blood loss, such as paleness and faintness.
A note from Cleveland Clinic
Stomach ulcers are common and treatable, but they should be taken seriously. Even when they dont cause symptoms, they arent a good sign. A stomach ulcer means that your natural stomach acid is overwhelming your protective stomach lining. Thats a situation that can only get worse if it isnt managed. Lifestyle changes may help, but youll still need to treat the underlying cause. Its probably either NSAID use or a common bacterial infection. Your healthcare provider can help prescribe the right medicines for your condition.
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Diagnosis Of A Stomach Ulcer
Diagnosing a stomach ulcer is done using a range of methods, including:
- Endoscopy a thin flexible tube is threaded down the oesophagus into the stomach under light anaesthesia. The endoscope is fitted with a small camera so the physician can see if there is an ulcer.
- Barium meal a chalky liquid is drunk and an x-ray is performed, showing the stomach lining. These tests are less common nowadays, but may be useful where endoscopy is unavailable.
- Biopsy a small tissue sample is taken during an endoscopy and tested in a laboratory. This biopsy should always be done if a gastric ulcer is found.
- C14 breath test this checks for the presence of H. pylori. The bacteria convert urea into carbon dioxide. The test involves swallowing an amount of radioactive carbon and testing the air exhaled from the lungs. A non-radioactive test can be used for children and pregnant women.
Anemia With Blood Loss
People with bleeding ulcers may not even be aware of the blood loss. Instead the bleeding is slow and occurs over a long period of time. Eventually this lead to anemia. Therefore the presence of anemia should be considered as a possible sign of peptic ulcers. The symptoms of anemia can vary from fatigue to paleness and even shortness of breath in severe cases.
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What Is A Stomach Or Duodenal Ulcer
An ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body.
- An ulcer in the lining of the stomach or duodenum, where hydrochloric acid and pepsin are present, is referred to as a peptic ulcer.
- When the ulcer is in the stomach, it is called a gastric ulcer.
- When the ulcer is in the duodenum, it is called a duodenal ulcer.
What Are The Signs & Symptoms Of Peptic Ulcers
Signs of a peptic ulcer include:
- most commonly, burning pain in the belly between the breastbone and the belly button
- feeding problems
- blood in vomit or bowel movements, which may look dark red or black
If your child has any of these signs and symptoms, call your doctor. Many can be caused by other childhood illnesses, but should be reported to your doctor. Based on your child’s medical history and symptoms, the doctor may want your child to see a pediatric gastroenterologist. This is a doctor who treats problems of the stomach, intestines, and associated organs.
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Symptoms Of A Peptic Ulcer
Contrary to conventional wisdom, peptic ulcers are not caused by stress or spicy foods but both of these factors are known to exacerbate symptoms. The most common culprits of peptic ulcers, according to the Mayo Clinic , are infection by a bacterium known as Helicobacter pylori or the extended use of nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen sodium .
Can Peptic Ulcers Be Prevented
Regular use of NSAIDs can cause gastrointestinal problems and bleeding in some children. Acetaminophen does not cause stomach ulcers and is a good alternative to NSAIDs for most childhood conditions.
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How Is A Duodenal Ulcer Diagnosed
To help diagnose a duodenal ulcer, your doctor will ask you what medications you take or have been taking, and if you have had peptic ulcers or any other relevant condition in the past. Make sure you mention all the medications you are taking, especially NSAIDs such as aspirin, ibuprofen, diclofenac, or ketorolac.
Your doctor will also conduct a physical examination, to check for bloating or lumps within your abdomen, and to listen for bowel sounds. Make sure you mention any areas of pain or tenderness.
Blood may also be taken to test for infection or anemia and testing may also be conducted for Helicobacter pylori, a bacterium commonly associated with peptic ulcers. Testing usually involves either a breath test, stool sample, or biopsy. To get a clear picture of the inside of your stomach and small intestines, doctors may use an endoscope , a series of X-rays and/or a CT scan.
How Are Peptic Ulcers Treated
Treatment will depend on the type of ulcer you have. Your healthcare provider will create a care plan for you based on what is causing your ulcer.
Treatment can include making lifestyle changes, taking medicines, or in some cases having surgery.
Lifestyle changes may include:
- Not eating certain foods. Avoid any foods that make your symptoms worse.
- Quitting smoking. Smoking can keep your ulcer from healing. It is also linked to ulcers coming back after treatment.
- Limiting alcohol and caffeine. They can make your symptoms worse.
- Not using NSAIDs . These include aspirin and ibuprofen.
Medicines to treat ulcers may include:
- Antibiotics. These bacteria-fighting medicines are used to kill the H. pylori bacteria. Often a mix of antibiotics and other medicines is used to cure the ulcer and get rid of the infection.
- H2-blockers . These reduce the amount of acid your stomach makes by blocking the hormone histamine. Histamine helps to make acid.
- Proton pump inhibitors or PPIs. These lower stomach acid levels and protect the lining of your stomach and duodenum.
- Mucosal protective agents. These medicines protect the stomach’s mucus lining from acid damage so that it can heal.
- Antacids. These quickly weaken or neutralize stomach acid to ease your symptoms.
In most cases, medicines can heal ulcers quickly. Once the H. pylori bacteria is removed, most ulcers do not come back.
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What About Complicated Ulcers
While most ulcers are successfully treated with medication, some complicated ulcers may require surgery. Ulcers that are bleeding, or that have perforated your stomach or intestinal wall, will need to be surgically repaired. An ulcer that is malignant, or obstructing a passageway, will need to be surgically removed. In severe cases, an ulcer that keeps coming back may be treated by surgery to cut off some of the nerve supply to the stomach that produces stomach acid.
When To Seek Medical Advice
You should visit your GP if you think you may have a stomach ulcer.
Seek urgent medical advice if you experience any of the following symptoms:
- vomiting blood the blood can appear bright red or have a dark brown, grainy appearance, similar to coffee grounds
- passing dark, sticky, tar-like stools
- a sudden, sharp pain in your tummy that gets steadily worse
These could be a sign of a serious complication, such as internal bleeding.
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Treatment For A Duodenal Ulcer
If your ulcer is caused by H pylori, the usual treatment is ‘triple therapy’. This involves taking 2 antibiotics to kill the bacteria, and a medicine to reduce the amount of acid made by your stomach.
If you don’t have an H. pylori infection, and you have been using anti-inflammatory drugs, you will need to stop taking them and to start taking a drug to reduce acid production by your stomach.
Taking antacids, drinking less alcohol, and quitting smoking if you smoke may also help.
What Kind Of Doctor Treats Peptic Ulcers
- If you suspect you may have a peptic ulcer, you may first be diagnosed by your family practitioner or internist.
- Children or teenagers may see a pediatrician.
- For further treatment you will likely be referred to a gastroenterologist, a specialist in disorders of the digestive tract.
- If you have an emergency such as vomiting or severe abdominal pain you will be seen by an emergency medicine specialist in an emergency room.
- In the rare case where surgery is needed, you may see a general surgeon.
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What Tests Will Be Done To Diagnose A Peptic Ulcer
Endoscopy. An upper endoscopy exam is expedient because allows healthcare providers to see inside your digestive tract and also take a tissue sample to analyze in the lab. The test is done by passing a thin tube with a tiny camera attached down your throat and into your stomach and duodenum. Youll have medication to numb your throat and help you relax during the test. Your healthcare provider may use the endoscope to take a tissue sample to test for signs of mucous damage, anemia, H. pylori infection or malignancy. If they take a sample, you wont feel it.
Imaging tests. Imaging tests to look inside the stomach and small intestine include:
- Upper GI series. An upper GI X-ray exam examines the stomach and duodenum through X-rays. Its less invasive than an endoscopy. For the X-ray, youll swallow a chalky fluid called barium, which will coat your esophagus, stomach and duodenum. The barium helps your digestive organs show up better in black and white images.
- CT scan. Your healthcare provider might recommend a CT scan if they need to see your organs in more detail. A CT scan can show complications such as a perforation in the stomach or intestinal wall. For the test, youll lie on a table inside a scanner machine while X-rays are taken. You may drink or have an injection with contrast fluid to make your organs show up better in images.
Tests for H. pylori. Your healthcare provider might want to test you separately for H. pylori infection. Tests may include:
What Are The Symptoms Of Any Complications
Stomach ulcers can cause various complications but these are much less common now because of more effective treatments. However, complications can be very serious and include:
Bleeding from the ulcer
- This can range from a trickle to a life-threatening bleed.
- If there is sudden heavy bleeding then this will cause you to vomit blood and make you feel very faint.
- Less sudden bleeding may cause you to vomit and the vomit looks coffee-coloured because the stomach acid has partly broken down the blood.
- A more gradual trickle of blood will pass through your gut and cause your stools to look very dark in colour or even black .
PerforationThis is the term used to describe the ulcer having gone all the way through the wall of the stomach. Food and acid in the stomach then leak out of the stomach. This usually causes severe pain and makes you very unwell. Stomach perforation is a medical emergency and needs hospital treatment as soon as possible.
Stomach blockageThis is now rare. An ulcer at the end of the stomach can cause the outlet of the stomach to narrow and cause an obstruction. This can cause frequent severe vomiting.
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Duodenal Ulcer Symptoms In Women
Each case could be unique, thats why each persons signs and symptoms may also vary. Even sometimes duodenal ulcer doesnt have any symptoms, especially when the open sore is still mild .
But in general, a dull pain or burning sensation is the most common symptom of the disease, both in women and men. The pain is usually felt in the upper area of your abdomen, specifically between the belly button and sternum .
Typically,the pain becomes more intense before meals or at night . Sometimes the pain could be severe enough to wake you from sleep atnight.
Digestiveacid usually increases with empty stomach, making the pain get worse. You mayget temporary relief from the pain when you eat food to buffer the acid or ifyou take antacids.
On theother hand, sometimes the pain may get worse when eating certain foods,particularly some which provoke elevated digestive acid level. Fatty foods,milk, acidic foods, and very spicy foods for examples!
How long the pain lasts can vary. It may last for a few minutes or longer. Even sometimes this could be a few hours, depending on how severe the open sore is! And it may come & go until the open sore heals completely.
What Are The Symptoms Of Peptic Ulcers
Each persons symptoms may vary. In some cases ulcers dont cause any symptoms.
The most common ulcer symptom is a dull or burning pain in your belly between your breastbone and your belly button . This pain often occurs around meal times and may wake you up at night. It can last from a few minutes to a few hours.
Less common ulcer symptoms may include:
- Feeling full after eating a small amount of food
- Bloody or black stool
- Vomiting blood
Peptic ulcer symptoms may look like other health problems. Always see your healthcare provider to be sure.
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Treatment For A Stomach Ulcer
Special diets are now known to have very little impact on the prevention or treatment of stomach ulcers. Treatment options can include:
- medication including antibiotics, to destroy the H. pylori colony, and drugs to help speed the healing process. Different drugs need to be used in combination some of the side effects can include diarrhoea and rashes. Resistance to some of these antibiotics is becoming more common
- subsequent breath tests used to make sure the H. pylori infection has been treated successfully
- changes to existing medication the doses of arthritis medication, aspirin or other anti-inflammatory medication can be altered slightly to reduce their contributing effects on the stomach ulcer.
- reducing acid tablets are available to reduce the acid content in the gastric juices
- lifestyle modifications including quitting cigarettes, since smoking reduces the natural defences in the stomach and impairs the healing process.
Can You Prevent A Peptic Ulcer
While stress and spicy foods can make symptoms of a peptic ulcer worse, they donât seem to make you more likely to have one. But a few other things can raise your chances.
Be careful when you take pain relievers. Some people who have arthritis or other conditions that cause chronic pain take nonsteroidal anti-inflammatory drugs for weeks or months at a time to ease pain and swelling. These medicines can affect the mucus that protects your stomach against acid and make you more likely to have peptic ulcers.
These pain relievers include:
You’re more likely to get an ulcer while taking one of these if you:
- Are over age 65
- Are infected with H. pylori bacteria
- Take more than one NSAID at a time
- Have had a peptic ulcer in the past
- Also take a steroid drug or selective serotonin reuptake inhibitor
To lower your chances for peptic ulcers while you take NSAIDs:
- Use the lowest possible dose to control your symptoms, and stop taking them as soon as you no longer need them.
- Take your medicine with food.
- Don’t drink alcohol while youâre taking these medicines.
While you’re on NSAIDs, you can take medicine to lower the amount of acid your stomach makes. Drugs that can do that include:
You can do some things to make an infection less likely:
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Signs Of A Bleeding Stomach Ulcer
The two most common causes are:
- H. pylori infection. This common bacterial infection affects up to half of people worldwide. It primarily lives in the stomach. In many people, it doesnt seem to cause problems. Their gut immune systems keep it in check. But a portion of those infected have H. pylori overgrowth. The bacteria continue to multiply, eating into the stomach lining and causing chronic inflammation and peptic ulcer disease. H. pylori infection is associated with about 60% of duodenal ulcers and 40% of gastric ulcers.
- Overuse of NSAIDs. NSAID stands for non-steroidal anti-inflammatory drug. These include common over-the-counter pain relief medications such as ibuprofen, naproxen and aspirin. NSAIDs contribute to ulcers in several ways. They irritate the stomach lining on contact and repress some of the chemicals that defend and repair the mucous lining. Up to 30% of people who take NSAIDs regularly develop peptic ulcers. Up to 50% of all peptic ulcers are caused by the overuse of NSAIDs.
Less common causes of stomach ulcers include:
- Zollinger-Ellison Syndrome. This is a rare condition that causes your stomach to produce too much gastric acid.
- Severe physiological stress. Severe illness, burns or injuries can produce stress ulcers in the stomach. Physiological stress changes your bodys PH balance, increasing stomach acid. Stress ulcers develop very quickly in response to stress, unlike normal stomach ulcers that develop gradually.