Duodenal ulcers are open sores in the wall of the duodenum , which is the first part of the small intestine. This condition can cause complaints of heartburn to vomiting blood.
Duodenal ulcers occur when acid in the digestive tract erodes the inner walls of the stomach or small intestine. Actually, there is a membrane that functions to protect the walls of the stomach or intestines from acid. However, if the acid levels increase or the mucus levels in the digestive tract decrease, then duodenal ulcers can occur.
Please note, duodenal ulcers are not caused by spicy foods, smoking, or stress . However, these three things can exacerbate this condition and make it difficult for wounds in the intestine to heal.
Duodenal Ulcer Causes
Duodenal ulcers are caused by infection with the bacterium Helicobater pylori ( H. pylori ). These bacteria generally live in the digestive tract without causing harm. However, in some cases, H. pylori bacteria can cause inflammation of the digestive tract.
It is not yet known how this bacteria spreads, but it is suspected that these germs are transmitted through close contact, such as kissing, or from food and drink.
Apart from bacterial infections, duodenal ulcers can also be caused by long-term consumption of non-steroidal anti-inflammatory drugs ( NSAIDs ), such as:
Apart from NSAIDs, consumption of other drugs, such as corticosteroids , risedronate, and SSRIs , carries the risk of causing duodenal ulcers.
In rare cases, duodenal ulcers can also be caused by Zoolinger-Ellison syndrome . This condition causes the stomach to produce more acid than usual.
Duodenal ulcer risk factors
There are several factors that can make the condition of a duodenal ulcer worse or difficult to heal, namely:
- Age 70 and over
- Have had a duodenal ulcer or stomach ulcer
- Are under stress
- Often eat spicy food
- Have a smoking habit
- Alcohol addiction
Duodenal Ulcer Symptoms
The main symptom of a duodenal ulcer is heartburn , especially when the stomach is empty. These complaints may worsen between meals and at night. Although it can often be relieved by eating or taking antacids, heartburn can come back.
Apart from heartburn, other symptoms that can appear are:
- Nausea and vomiting
- Burning feeling in the pit of the stomach to the chest ( heartburn )
- Loss of appetite
- Hard to breathe
When to see a doctor
Immediately do an examination to the doctor if you feel the symptoms above, especially if accompanied by the following complaints:
- Vomiting blood
- BAB is black like asphalt
- bloody chapters
- Weight loss drastically
Duodenal Ulcer Diagnosis
The doctor will ask about the patient's symptoms and medical history, then carry out a physical examination. If the doctor suspects that the patient has a duodenal ulcer, the doctor will carry out further examinations in the form of:
- Blood test, to detect antibodies that appear due to H. pylori infection
- Stool antigen test, to check for the presence of protein in the stool associated with the H. pylori bacteria
- Urea breath test ( urea breath test ), to detect carbon dioxide gas in exhaled breath associated with H. pylori infection
- CT scan with the help of barium fluid, to check the condition of the duodenum, stomach, and esophagus
- Endoscopy , to examine wounds in the digestive tract, and if necessary take tissue samples (biopsy) to be examined in the laboratory
Duodenal Ulcer Treatment
Duodenal ulcer treatment depends on the cause. In duodenal ulcers caused by H. pylori infection , the doctor will give a combination of antibiotics for at least 1 week, to kill the bacteria. Types of antibiotics used include:
Meanwhile, if a duodenal ulcer is caused by long-term use of NSAIDs, the drugs to be given include:
- Antacids , to neutralize stomach acid and relieve heartburn quickly
- Proton pump inhibitors (PPIs), such as lansoprazole or omeprazole , and H2 antagonists, such as ranitidine and cimetidine , to reduce stomach acid production
- Sucralfate or misoprostol, to help protect the walls of the stomach and duodenum
Duodenal ulcers generally heal with medication. However, in some cases, this condition can be very severe and cause bleeding in the internal organs so that it needs to be treated with surgery.
Surgical procedures performed by doctors include:
- Vagotomy, by cutting the vagus nerve which controls the removal of stomach acid
- Antrectomy, by lifting the lower part of the stomach (antrum) which functions to produce stomach acid
- Pyloroplasty, by widening the hole between the duodenum and the stomach, so that stomach contents can flow more
Duodenal Ulcer Complications
Untreated duodenal ulcers can cause complications in the form of:
Anemia due to gastrointestinal bleeding
Bleeding in the digestive tract can cause sufferers to experience anemia . If it occurs suddenly in large numbers, the patient may experience shock . These conditions must be treated in a hospital, one of which is a blood transfusion .
Blockage in the digestive tract
Duodenal ulcers can cause inflammation or swelling, as well as leave scars or scar tissue on the duodenum. These scars can block the passage of food, making it easy for sufferers to feel full, vomit, and lose weight.
Infection of the abdominal cavity (peritonitis)
Ulcers can cause the wall of the duodenum to perforate so that intestinal contents come out into the abdominal cavity. The discharge of intestinal contents can cause a serious infection of the abdominal cavity called peritonitis .
Several studies have shown that patients with duodenal ulcers caused by infection with the bacterium H. pylori are at risk of developing stomach cancer .
Duodenal Ulcer Prevention
There are several efforts that can be made to prevent duodenal ulcers and reduce the risk of this disease getting worse, namely:
- Consult with your doctor regarding long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), and ask if there are other drug options that can be used.
- Take NSAIDs as directed by your doctor.
- Take antibiotics until they run out if you are diagnosed with a duodenal ulcer due to infection with the H. pylori bacteria .
- Stop smoking to speed up the healing process and reduce the risk of cancer in the stomach or digestive tract.
- Wash hands with soap and running water regularly.
- Do not eat food that is not thoroughly cooked.
- Do physical activity and exercise regularly.