A duodenal ulcer is a sore in the lining of the intestine. It is in the first part of your small intestine, known as the duodenum. Ulcers can be treated. A small percentage of them may be cancerous. See your doctor if you think you may have a duodenal ulcer.

Duodenal Ulcer

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Ninety-five percent of duodenal ulcers are from a bacterial infection. They are caused by Helicobacter pylori ( H pylori ). Other causes include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Steroids
  • Zollinger-Ellison syndrome]]> —a disorder causing tumors in the pancreas and duodenum and ulcers in the stomach and duodenum
  • ]]>Crohn's disease]]> —a severe, chronic inflammatory bowel disease
  • Viral infection
  • ]]>Pancreatic cancer]]>


Risk Factors

Some factors thought to increase the risk of duodenal ulcer are:

  • Gender: male
  • Age: the incidence of duodenal ulcers peaks around age 40
  • Family history of duodenal ulcers


Symptoms of a duodenal ulcer may include:

  • Burning pain in the gut that feels like a dull ache and comes and goes:
    • It often starts 2-3 hours after a meal and goes away after you eat
    • It may also come in the middle of the night when your stomach is empty
  • Weight loss
  • Loss of appetite
  • Pain while eating
  • Nausea
  • Vomiting


Your doctor will ask about your symptoms and medical history. A physical exam will be done. Other tests may include:

  • Biopsy]]> —removal of a sample of tissue for testing
  • Blood tests
  • Endoscopy—a thin, lighted tube inserted down the throat to examine parts of the body
  • ]]>Upper gastrointestinal (GI) x-ray]]>
  • Measurement of bile acid (bile acid aids in digestion and absorption of fats and fat-soluble vitamins in the small intestine)
  • Breath tests


Talk with your doctor about the best plan for you. Some ulcers will heal if you avoid caffeine, NSAIDs, alcohol, and tobacco. Other treatment options include:


Treatment with medications focuses on:

  • Stopping your stomach from making acids
  • Killing the bacteria that is causing your ulcer

Medications used to treat gastric ulcers include:

  • Proton pump inhibitors
  • Histamine receptor blockers
  • Antibiotics
Antacids may also help reduce pain and heal ulcers.


If ulcers do not heal with medications, surgery may be needed. Surgery can remove the ulcers and/or reduce the amount of acid your stomach makes.


Steps you can take to prevent duodenal ulcers include:

  • Stop using NSAIDs. You can talk with your doctor about alternatives.
  • Do not smoke.
  • Do not drink alcohol.