Duodenal ulcers – Complications and treatments

Duodenal ulcers – Complications and treatments

Ulcers are formed when the digestive tract becomes damaged or inflamed. The ulcer that forms in the stomach is called gastric ulcer while the ulcer that forms in the duodenum (upper part of the small intestine) is called duodenal ulcers. Duodenal ulcers may often cause abdominal pain. The pain may start a few hours after eating. But, in most cases, the abdominal pain caused by duodenum ulcers is worse when the stomach is empty. The pain may start between meals, at night, or first thing in the morning.

Research shows that ulcers are the result of an infection caused by the Helicobacter pylori (H. pylori) bacterium. While there may be other factors that contribute to the development of ulcers, H. pylori are considered to be the key factor responsible for causing ulcers. If the ulcer is not treated on time, it can lead to certain complications. Some of these complications may prove to be fatal. Complications associated with duodenal ulcers are:

  • Bleeding: Ulcers cause internal bleeding. If the bleeding continues, it will lead to anemia. A person who has internal bleeding may see blood in their vomit or stools. A person with internal bleeding should seek immediate medical attention.
  • Perforation:  An ulcer can eat a hole through the duodenum, allowing bacteria and partially digested food to pass through to the sterile abdominal cavity, causing peritonitis (inflammation of the membrane lining the abdominal wall and abdominal organs). It can also cause a serious infection in the abdominal cavity.
  • Narrowing and obstruction (blockage): Ulcers in the duodenum cause scarring and swelling that prevent food from passing to the small intestine. This obstruction causes regular vomiting, loss of weight, and makes a person feel full even after eating a little or no food.
  • Cancer: In rare cases, chronic ulcers may become cancerous.

Treatments to cure duodenal ulcers
The treatment usually includes medications that will help in the reduction of stomach acids. If an H. pylori infection is diagnosed as the cause for ulcers, then antibiotics may be prescribed. Some medications to treat ulcers include:

  • Antibiotics: Antibiotics are used to kill the bacterium H. pylori. If an ulcer is caused by H. pylori, the usual treatment undertaken is “triple therapy.” In this treatment, a person would need to take two antibiotics and one acid-suppressing medication (like clarithromycin, amoxicillin, and omeprazole) for one to two weeks to kill the bacteria and reduce the amount of acid made by the stomach. This treatment is not recommended for people whose ulcer is caused by the use of non-steroidal anti-inflammatory drugs (NSAIDs).
  • Proton pump inhibitors or PPIs: This treatment protects the lining of the stomach by reducing the acid level and allowing the ulcer to heal.
  • Histamine receptor blockers or H2 blockers: Histamine helps in making acids. H2 blockers reduce the amount of acid produced by the stomach by blocking the hormone histamine.
  • Mucosal protective agents: These medicines protect the mucous lining of the stomach from acid damage so that it can heal.

In some cases, surgery is required if the infection caused by the bacterium H. pylori or any other factors is severe. It is necessary to continue with the treatment until the ulcer is completely cured.