The duodenal ulcer is a lesion that forms in the lining of the duodenum, the initial part of the small intestine. This condition is characterized by the presence of a wound or erosion in the wall of the duodenum, which can cause pain and discomfort.
How does it occur?
The duodenal ulcer usually develops due to an imbalance between the protective factors and the harmful factors to the duodenum’s mucosa. The main causative factor is the infection by the bacterium Helicobacter pylori, which compromises the protective layer of the duodenum’s lining, allowing the stomach acid to cause damage to the mucosa.
Other risk factors include prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, as well as stress, smoking, and genetic predisposition.
These factors contribute to the imbalance between the stomach’s defense mechanisms and the aggression caused by stomach acid, leading to the formation of the ulcer.
What are the symptoms?
The symptoms of the duodenal ulcer can vary from person to person, but the most common include:
- Abdominal pain, usually located in the stomach region and that can extend to the back.
- Burning sensation or discomfort in the upper abdominal region.
- Frequent heartburn.
- Nausea and vomiting.
- Unexplained weight loss.
- Feeling of early fullness after meals.
How is the diagnosis made?
The diagnosis of duodenal ulcer is usually made through a combination of clinical history, physical examination, and complementary tests, such as:
- Upper digestive endoscopy: a procedure in which a flexible tube with a camera is inserted through the mouth to view the inner lining of the esophagus, stomach, and duodenum. During endoscopy, it is possible to identify the presence of the ulcer and perform a biopsy if necessary.
- Tests for H. pylori detection: may include blood tests, breath test, or stool sample to identify the presence of the bacterium causing the infection.
How is the treatment done?
The treatment of the duodenal ulcer involves a combined approach that aims to relieve symptoms, promote ulcer healing, and prevent recurrences. Treatment options include:
- Acid-inhibiting medications: such as proton pump inhibitors (PPIs) and H2 blockers, which reduce the production of acid in the stomach and help heal the ulcer.
- Antibiotics: when H. pylori infection is present, a combination of antibiotics is needed to eradicate the bacterium and prevent recurrences.
- Avoiding irritants: it is important to avoid the use of NSAIDs and other irritants that may aggravate the ulcer and interfere with healing.
- Diet modifications: it is recommended to avoid irritating foods, such as spicy and acidic foods, in addition to adopting a balanced and fractionated diet throughout the day.
It is important to follow the treatment prescribed by the doctor and regularly monitor to assess the effectiveness of therapeutic measures and prevent possible complications, such as perforation or bleeding of the duodenal ulcer.