Duodenalgeschwüren

Duodenalgeschwüre are open sores that develop on the inner lining of the duodenum, the first section of the small intestine. These ulcers are a common type of peptic ulcer disease. The primary cause is typically infection with the bacterium Helicobacter pylori (H. pylori). Another significant contributing factor is the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen. These medications can damage the protective mucous layer of the duodenum, making it vulnerable to stomach acid.

Symptoms of duodenal ulcers can vary but often include a burning or gnawing pain in the upper abdomen, which may worsen when the stomach is empty and improve after eating or taking antacids. Other potential symptoms include bloating, nausea, vomiting, loss of appetite, and unexplained weight loss. In some cases, ulcers may cause no noticeable symptoms until a complication arises.

Complications can include bleeding, perforation (a hole through the duodenal wall), and obstruction. Bleeding can manifest as dark, tarry stools or vomiting blood. Perforation is a medical emergency requiring immediate surgery. Obstruction can occur if swelling or scarring blocks the passage of food from the stomach into the small intestine.

Diagnosis is usually made through an upper endoscopy (esophagogastroduodenoscopy), which allows visualization of the duodenum and the collection of tissue samples for H. pylori testing. Treatment typically involves medications to reduce stomach acid production, such as proton pump inhibitors (PPIs) or H2 blockers, and antibiotics to eradicate H. pylori infection if present. Lifestyle modifications, like avoiding NSAIDs and limiting alcohol consumption, are also recommended.