duodenal ulcer

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An ulcer in the duodenum, caused by the action of acid and pepsin on the duodenal lining (mucosa) of a susceptible individual. It is usually associated with an increased output of stomach acid. Infection of the antrum of the stomach with Helicobacter pylori is almost always present. Other causes include ingestion of aspirin or other NSAIDs. Symptoms include pain in the upper abdomen, especially when the stomach is empty, which often disappears completely for weeks or months; vomiting may occur. Complications include bleeding (see haematemesis), perforation, and obstruction due to scarring (see pyloric stenosis). Symptoms are relieved by antacid medicines; most ulcers heal if treated by an antisecretory drug, or if H. pylori is eradicated by a combination of a proton-pump inhibitor (or an H2-receptor antagonist) and antibiotics. Surgery (see gastrectomy, vagotomy) is now rarely required.

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