Duodenal ulcers are a common cause of abdominal pain. Once treated, they usually get better in a matter of weeks.
What is a duodenal ulcer?
A duodenal ulcer is a sore that forms in the lining of the duodenum. Your duodenum is the first part of your small intestine, the part of your digestive system that food travels through straight after it leaves your stomach.
You can get an ulcer in your stomach as well as in your duodenum. Stomach ulcers and duodenal ulcers are both types of peptic ulcers. If you have either of these, you have what's called 'peptic ulcer disease'.
Causes of duodenal ulcers
Your stomach makes a strong acid that kills germs and helps you digest food. To protect themselves against this acid, cells of the stomach and duodenum make a barrier from mucus. If this barrier is damaged, an ulcer can form.
The main cause of this damage is infection with bacteria called Helicobacter pylori, or H. pylori. The bacteria can cause the lining of your duodenum to become inflamed and an ulcer can form.
Some medications can also cause a duodenal ulcer, particularly anti-inflammatory drugs such as ibuprofen and aspirin. Rarely, other medicines or medical conditions might cause an ulcer.
It's possible that you are more likely to get a duodenal ulcer if you smoke, drink a lot of alcohol or you are stressed, but these things are less important than infection with H. pylori.
Symptoms of a duodenal ulcer
If you have a duodenal ulcer, you might:
- have pain in the stomach or abdomen (this might come and go and is relieved by eating or taking an antacid)
- have indigestion
- feel very full and bloated after eating
- feel like you might vomit (nauseous)
- lose weight
Very occasionally, an ulcer can cause serious complications. Go to the emergency department if:
- you have a sharp pain in your stomach that doesn't go away
- your vomit or stools (poo) look bloody or a black colour
If you are concerned about symptoms, you can use healthdirect's online Symptom Checker to get advice on the next appropriate healthcare steps and when to seek medical attention.
Diagnosis of a duodenal ulcer
To diagnose a duodenal ulcer, your doctor will talk to you and examine you. They will probably also run some tests, which could include:
- a gastroscopy (also called an endoscopy), where a specialist uses a thin, flexible tube with a camera on the end to look inside your stomach and duodenum
- a blood test, stool sample, or breath test to find out if you have a H. pylori in your system
If you have a gastroscopy, the surgeon might take a sample of tissue (a biopsy) to test for H. pylori.
Treatment for a duodenal ulcer
If your ulcer is caused by H pylori, the usual treatment is 'triple therapy'. This involves taking 2 antibiotics to kill the bacteria, and a medicine to reduce the amount of acid made by your stomach.
If you don't have an H. pylori infection, and you have been using anti-inflammatory drugs, you will need to stop taking them (if possible) and to start taking a drug to reduce acid production by your stomach.
Taking antacids, drinking less alcohol, and quitting smoking if you smoke may also help.
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Last reviewed: February 2020