The symptoms of duodenal ulcers include heartburn, stomach pain relieved by eating or taking antacids, weight gain, and a burning sensation at the back of the throat. The patient is most likely to feel discomfort two to four hours after meals, or after having citrus juice, coffee, or aspirin. About fifty percent of patients with duodenal ulcers awake during the night with pain, usually between midnight and three a.m. If an ulcer is bleeding, the patient may have vomit containing bright red blood or digested blood that looks like brown coffee grounds and black, tarry bowel movements.

Stomach is called a gastric ulcer; of the duodenum, a duodenal ulcer; and of the esophagus, an esophageal ulcer. An ulcer occurs when the lining of these organs is corroded by the acidic digestive juices which are secreted by the stomach cells. Peptic ulcer disease is common, affecting millions of Americans yearly. The medical cost of treating peptic ulcer and its complications runs in the billions of dollars annually. Recent medical advances have increased our understanding of ulcer formation. Improved and expanded treatment options are now available.

A peptic ulcer is erosion in the lining of the stomach or duodenum (the first part of the small intestine). The word “peptic” refers to pepsin, a stomach enzyme that breaks down proteins. If a peptic ulcer is located in the stomach it is called a gastric ulcer. Small ulcers may not cause any symptoms. Large ulcers can cause serious bleeding. Most ulcers occur in the first layer of the inner lining. A hole that goes all the way through is called a perforation of the intestinal lining. A perforation is a medical emergency.

Duodenal ulcers usually occur in younger people, while gastric ulcers occur in older age groups. It is still not clear what, if any, role stress plays in the development of ulcers. Alcohol and diet are not felt to play a very important role in the formation of ulcers. Some ulcers are caused by an organism called Helicobacter pylori, some are due to medications, and a few are caused by stomach or intestinal cancer. Therefore, treatment and long-term outcome depends on the cause of the ulcer.

The understanding of the etiology of duodenal ulcer has changed dramatically in the latter part of the 20th century. Historically, duodenal ulcer was thought to be a disease related to diet and environmental stress alone. Subsequent studies revealed the importance of pepsin and acid secretion in the pathogenesis of duodenal ulcer. The most revolutionary change in the knowledge of duodenal ulcer was the discovery in 1982 that the bacterium H pylori was present in most patients.

The most common symptom of a duodenum is a gnawing or burning pain in the abdomen between the breastbone and navel. Duodenal ulcers typically cause symptoms 2 to 5 hours after meals, when the stomach is empty, and can be relieved by eating. Gastric ulcers, on the other hand, are classically made worse by eating. You may experience pain soon after meals, and food won't improve symptoms. For each, the duration of pain can be from a few minutes to a few hours.

If a person does not receive treatment for ulcers, it could lead to a bleeding ulcer (the ulcer has eaten into blood vessels and the blood has seeped into the digestive tract), a perforated ulcer (the ulcer has eaten a hole in the wall of the stomach or duodenum and bacteria and partially digested food has spilled into the hole, causing inflammation) or a narrowing and obstruction of the intestinal opening preventing food from leaving the stomach and entering the small intestine.