How does duodenal ulcer present?

The article was professionally consulted by Gastroenterologist, Department of Examination & Internal Medicine - Vinmec Hai Phong International General Hospital

Duodenal ulcer is a disease caused by an imbalance between offensive (gastric) and protective (mucus) factors in the mucosa of the duodenal bulb. When there is an imbalance of these factors, it causes damage to the mucosal layer, causing an inflammatory reaction on the surface of the duodenal mucosa, in more severe cases causing open sores in the duodenal mucosa that can destroy the muscular layer and cause ulceration.

The most common cause is caused by H. pylori bacteria: They cause increased gastric acid secretion and at the same time reduce the production of mucus protective mucosal barrier. From there, stomach acid comes into contact with the duodenal mucosa causing duodenal ulcer. Due to diet: Eat a lot of foods that stimulate the gastrointestinal mucosa such as sour, spicy, too hot foods, alcohol, coffee, strong tea..., eating a lot of fat, smoking. , eating fast, not chewing well, eating at the wrong time, eating too full or too hungry... Due to drugs: Prolonged use of anti-inflammatory pain relievers such as corticosteroids, NSAIDs....long-term use leads to to reduce mucus secretion and reduce duodenal mucosal protective factor. Frequent stress, anxiety, anger... Family history of the disease is a risk factor for the disease.

Pain, burning in the epigastrium slightly to the right, pain in waves, increasing with weather changes, especially in the cold season, more painful. Pain related to meals: Pain caused by duodenal ulcer is often painful when fasting, eating is less painful. Nausea, vomiting, belching, heartburn. Slow digestion Patients may have signs of iron deficiency anemia due to frequent bleeding ulcers. When the ulcer causes gastrointestinal bleeding, there are symptoms: Vomiting blood, passing black stools, losing a lot of blood can cause a drop in blood pressure, shock.

Peptic ulcer disease can progress and cause life-threatening complications such as:
Gastrointestinal bleeding: Hemorrhage or ulcer bleeding often occurs profusely, may appear appear suddenly or after the patient uses substances that irritate the gastrointestinal mucosa such as drinking alcohol, using anti-inflammatory drugs ... with the expression of vomiting fresh blood, passing black, sticky stools, the patient is tired. low blood pressure... When these signs are present, they should be taken to a medical facility for emergency treatment. Perforated ulcer: The patient has severe abdominal pain like a stabbing knife, the abdomen is as hard as wood, which may be accompanied by vomiting. When these signs are present, it is necessary to take the patient to a medical facility, which is a surgical emergency if not operated, endangering the patient's life. Pyloric stenosis: If the ulcer site is wide and close to the gastric pylorus, there is a risk of pyloric stenosis. With symptoms such as fullness, slow digestion, abdominal pain, vomiting old food away from meals accompanied by dark blue gastric juice.

In order to diagnose peptic ulcer disease on the basis of clinical symptoms, it is necessary to rely on gastroduodenal endoscopy.

Gastroduodenal endoscopy helps:
Locate the peptic ulcer. Assess the condition of the ulcer: Size, shape, depth of the ulcer. Take tissue for biopsies when necessary or to look for H.

Follow a healthy diet: Eat in moderation, do not skip meals, don't eat too full, limit foods and drinks that stimulate the stomach such as sour, spicy foods, alcohol, beer, cigarettes. , coffee, condensed tea, carbonated water.... Do not exercise, exercise a lot after eating. Rest for at least 30 minutes after eating. Exercise regularly to avoid stress and help you relax. For those who have a history of peptic ulcer disease: Eat small meals, quit alcohol, tobacco, keep your mind at ease, use anti-inflammatory drugs as prescribed by the doctor, do not arbitrarily Long-term use, adhere to the treatment of peptic ulcer disease according to the instructions of the doctor. In some people, duodenal ulcer disease may have unclear or no symptoms. However, the most common sign is pain, burning in the epigastrium related to meals. When there are any signs of suspicion of duodenal ulcer disease, the patient should go to the medical facilities for examination, diagnosis and proper treatment. Untreated or improperly treated disease can cause life-threatening complications such as duodenal perforation, gastrointestinal bleeding.