Duodenal Ulcers: Symptoms, Treatment, and Concerns - Gastroenterology and Hepatology

Duodenal ulcer

Doctor, after experiencing duodenal bleeding on March 17, I had bleeding control and have been taking one Pantoloc daily.
However, I still feel a sensation of contraction and expansion in my abdomen, and I have difficulty with bowel movements, often straining to pass stool.
During my follow-up appointment, the doctor prescribed Moshuwei, magnesium oxide, and Gaske'er for me.
Is this just pure bloating, or do I have another ulcer?

Hsu Chia-Jui, 10~19 year old female. Ask Date: 2017/04/11

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Some individuals taking ulcer medications may experience a tendency toward constipation; therefore, adjustments to the medication and the addition of other medications can be considered.

Reply Date: 2017/04/11

More Info

Duodenal ulcers, also known as peptic ulcers, are sores that develop on the lining of the duodenum, which is the first part of the small intestine. They can cause a variety of symptoms and complications, and understanding these can help in managing the condition effectively.

Symptoms of Duodenal Ulcers
The symptoms of duodenal ulcers can vary from person to person, but common signs include:
1. Abdominal Pain: This is often described as a burning sensation in the stomach area. The pain may come and go and is typically worse when the stomach is empty. It may improve after eating or taking antacids.

2. Bloating and Gas: Many patients report a feeling of fullness or bloating, which can be uncomfortable and may be accompanied by excessive gas.

3. Nausea and Vomiting: Some individuals may experience nausea, and in severe cases, vomiting may occur.

4. Changes in Bowel Habits: As you mentioned, difficulty in bowel movements can occur, leading to constipation or straining during defecation.

5. Weight Loss: Unintentional weight loss can happen due to changes in appetite or eating habits.

6. Bleeding: In more severe cases, ulcers can lead to gastrointestinal bleeding, which may manifest as black or tarry stools or vomiting blood.

Treatment Options
The treatment for duodenal ulcers typically involves a combination of medications and lifestyle changes:
1. Proton Pump Inhibitors (PPIs): Medications like Pantoloc (pantoprazole) reduce stomach acid production, promoting healing of the ulcer.

2. Antacids: These can help neutralize stomach acid and provide symptomatic relief.

3. Antibiotics: If the ulcer is caused by Helicobacter pylori infection, antibiotics may be prescribed to eradicate the bacteria.

4. Bismuth Compounds: These can protect the stomach lining and help in healing.

5. Lifestyle Modifications: Avoiding NSAIDs, reducing alcohol consumption, quitting smoking, and managing stress can significantly aid in recovery.

Concerns and Follow-Up
Given your symptoms of abdominal discomfort and difficulty with bowel movements, it is essential to consider a few possibilities:
- Gas and Bloating: The medications you are taking, including magnesium oxide and other antacids, can sometimes lead to increased gas production, resulting in bloating and discomfort.

- Potential Recurrence of Ulcers: If your symptoms persist or worsen, it is crucial to follow up with your healthcare provider. They may recommend further diagnostic tests, such as an endoscopy, to assess the condition of your duodenum and rule out the possibility of a recurrent ulcer.

- Dietary Factors: Certain foods can exacerbate symptoms of ulcers and gastrointestinal discomfort. Keeping a food diary may help identify any triggers.

Conclusion
In summary, while your current symptoms may be related to bloating and gas, it is essential to monitor them closely. If you experience any new or worsening symptoms, such as increased abdominal pain, changes in stool color, or persistent nausea, it is crucial to seek medical attention promptly. Regular follow-ups with your healthcare provider will help ensure that your treatment plan is effective and that any potential complications are addressed in a timely manner.

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