Duodenal Ulcer – Signs and Therapeutic Options

The duodenal ulcer, as one of the most common types of ulcer diseases, affects numerous people worldwide. In this condition, the mucous membrane of the duodenum is damaged, causing pain and other unpleasant symptoms. The incidence of duodenal ulcers is remarkably high, as the number of affected individuals is six times that of those suffering from gastric ulcers. Fortunately, the likelihood of malignant degeneration is extremely low, and with appropriate treatment, complications can also be avoided.

The causes of duodenal ulcer formation are similar to those of gastric ulcers, but the symptoms of the two diseases differ significantly. Recognizing and treating the disease is important for maintaining a good quality of life. A duodenal ulcer is not only painful but also requires lifestyle changes from those affected.

Causes and Symptoms of Duodenal Ulcer Formation

Several factors may contribute to the development of a duodenal ulcer, including stress, poor diet, and various medications, particularly non-steroidal anti-inflammatory drugs. The pain associated with duodenal ulcers typically occurs 2-3 hours after eating and is known as hunger pain, as eating temporarily alleviates the discomfort.

This pain is felt mainly in the area between the navel and the lower edge of the sternum, primarily on the right side, and often radiates to the back or towards the stomach. Following the emptying of the duodenum, acid from the stomach irritates the ulcer, which may exacerbate the symptoms. Symptoms can also occur at night, but appetite usually remains intact, and nausea or vomiting is rare.

It is interesting to note that duodenal ulcers can also appear seasonally, and the disease is three times more common in men. Familial clustering is also observed, and it can occur at any age, although it most frequently affects younger individuals.

Diagnosis and Treatment of Duodenal Ulcer

The diagnosis of duodenal ulcer follows similar procedures to those for gastric ulcers. X-ray examinations usually provide diagnostic value only when a narrowing occurs. However, the most reliable and common examination method is gastrointestinal endoscopy, which allows for direct observation of the ulcer.

Most duodenal ulcers are located in the initial section of the intestine, the duodenum, and their size can vary, reaching several centimeters. Treatment is generally similar to that of gastric ulcers, involving medication therapy and adherence to dietary recommendations.

During treatment, it is important to prevent complications, as the most common complication is bleeding, which is managed through endoscopic procedures. Other complications of duodenal ulcers include perforation, which is more common in men and smokers. Perforation causes acute abdominal pain and requires urgent medical intervention.

Complications and Their Treatment

The complications of ulcer disease can pose serious health problems, with bleeding being the most common. Endoscopic procedures are the primary solution for diagnosis and treatment. Complications of duodenal ulcers also include perforation, which affects 7-10 cases per 100,000 people annually.

Perforation occurs particularly among men and smokers, characterized by acute abdominal pain that demands urgent medical attention. Additionally, the ulcer can penetrate into adjacent organs, a phenomenon known as penetration. Back wall ulcers often involve the pancreas, but the liver and common bile duct may also be at risk.

Gastric outlet obstruction (stenosis) can also develop during the prolonged presence of a duodenal ulcer, typically causing nausea and vomiting. During treatment, endoscopic dilation or surgical intervention, such as Billroth I or II surgery, is applied.

Overall, a duodenal ulcer is a serious condition that can be effectively managed with appropriate treatment and lifestyle changes. Medical care and patient awareness are crucial for preventing complications and improving quality of life.