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An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. [1] The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain, and upper abdominal pain that improves with eating. [1] With a gastric ulcer, the pain may worsen with eating. [7]
As particles of food become small enough, they are passed out of the stomach at regular intervals into the small intestine, which stimulates the pancreas to release fluid containing a high concentration of bicarbonate. This fluid neutralizes the gastric juices, which can damage the lining of the intestine and result in duodenal ulcer.
The ulcer is known initially as a peptic ulcer before the ulcer burns through the full thickness of the stomach or duodenal wall. A diagnosis is made by taking an erect abdominal/chest X-ray (seeking air under the diaphragm). This is in fact one of the very few occasions in modern times where surgery is undertaken to treat an ulcer. [3]
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Bland diets are often recommended following stomach or intestinal surgery, or for people with conditions such as ulcers, acid reflux (GERD), gastritis, heartburn, nausea, vomiting, diarrhea, gastroenteritis and gas. [2] A bland diet allows the digestive tract to heal before introducing foods that are more difficult to digest.
Endoscopic image of a posterior wall duodenal ulcer with a clean base, which is a common cause of upper gastrointestinal hemorrhage. Specialty: Gastroenterology: Symptoms: Hematemesis (vomiting blood), coffee ground vomiting, melena, hematochezia (maroon-coloured stool) in severe cases
Rauws and Tytgat describe cure of duodenal ulcer by eradication of H. pylori using Borody's triple therapy combination. [51] Triple-therapy, modernized to a proton pump inhibitor and two antibiotics, soon becomes first line therapy for eradication. World Congress of Gastroenterology recommends eradicating H. pylori to cure duodenal ulcers. [51]
The duodenal bulb is the site of duodenal ulcer occurrence. Duodenal ulcers are more common than gastric ulcers and - unlike gastric ulcers - are caused by increased gastric acid secretion. Duodenal ulcers are commonly located anteriorly, and rarely posteriorly. Anterior ulcers can be complicated by perforation, while the posterior ones bleed.