Duodenal peptic ulcers occur in the first part of the intestine, one
or two inches past the end of the stomach. Most duodenal ulcers occur
in patients with H. pylori infection. If duodenal ulcers are treated with
antacids or drugs such as Tagamet, Zantac, or Pepcid, they usually come
back when the drugs are stopped. Acid reducing drugs are expensive and
do not cure the duodenal ulcer problem.
It has now been proven that by killing Helicobacter pylori, many patients
with duodenal ulcer can be cured. The treatment is most successful in
patients under the age of 50, but older persons also benefit. After killing
the H. pylori germ, most patients (80%) will be able to stop taking acid
reducing drugs (i.e. Tagamet, Zantac, Pepcid).
Generally speaking, peptic ulcers are ulcers in the stomach or duodenum.
These are the parts of the gut where acid bathes the surface. Peptic means
an area where digestion of food occurs (and acid is present).
In the images below, the small circular diagrams show where the endoscope
was when the photograph was taken.
The 2 cm duodenal ulcer on the left is viewed looking through the pylorus
(the valve at the bottom of the stomach). The white base of the ulcer is
marked by a blackish area signalling a recently bleeding vessel. This
patient should probably stay in hospital for a couple of days and have a
blood transfusion ready to go in case it bleeds. The image of a 2 cm
gastric ulcer on the right shows the “lesser curve” of the stomach.
The black “hole” to the bottom of the photograph is the pylorus.
The ulcer has a clean white base and some swelling around its edges.
It is quite deep and could possible burrow through the stomach wall
(perforate) if left unchecked.
Images courtesy of the educational and realistic Gastroman Game.