Duodenal ulcers

Peptic ulcers can develop in the oesophagus, stomach or duodenum. Around 80% of all peptic ulcers are duodenal ulcers (Misiewicz and Punder 2000). Duodenal ulcers are most common in men aged between 20 and 50 years and in individuals who have type O blood. It is now well recognised that Helicobacter pylori, a spiral Gram-negative bacteria, is present in the stomach of over 80% of individuals who present with gastric or duodenal ulcers. The presence of Helicobacter pylori leads to impairment of the function of the protective mucosal membrane.

In peptic ulcer disease, erosion of the affected mucosa can lead to haemorrhage, perforation and peritonitis. The typical clinical presentation of duodenal ulcers includes gnawing or burning epigastric pain occurring shortly after meals, heartburn and nocturnal pain. The epigastric pain can be exacerbated by certain foods (i.e. fatty food) but relieved by others (i.e. milk).

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