Causes
In the development of duodenal ulcers, the balance between protective and aggressive factors in the intestinal mucosa plays a role. In a healthy body, the aggressive stomach acid that flows from the stomach into the duodenum is neutralized by a protective layer of mucus on the intestinal mucosa. If this balance is destroyed, i.e. if there is more stomach acid than mucus, a duodenal ulcer develops.
The most common causes are the intake of so-called NSAIDs (non-steroidal anti-inflammatory drugs, such as Aspirin® (ASS), Diclofenac and Ibuprofen). These drugs reduce the production of the protective mucus. If these medications are taken together with glucocorticoids (cortisone, prednisolone), the risk of duodenal ulcer increases considerably.
Another common cause is infection with the bacterium Helicobacter pylori. This bacterium attaches itself to the cells of the stomach and duodenal mucosa and attacks them. The resulting inflammatory reaction prepares the way for ulcer disease.
The affected persons often produce more gastric acid and at the same time inhibit the protective factors such as the mucous layer that covers the mucous membrane. The result is an increased effect of the stomach acid on the mucous membrane of the small intestine. If this happens over a longer period of time, ulcers can develop.
Other important risk factors are increased stress, smoking cigarettes, i.e. the consumption of nicotine, excessive consumption of alcohol, and the use of certain antidepressants (SSRI – selective serotonin reuptake inhibitors, e.g. citalopram and fluvoxamine). Some rare diseases can also promote the development of duodenal ulcers, such as parathyroid hyperfunction, renal insufficiency and Zollinger-Ellison syndrome, which is a hormone-producing tumor of the gastrointestinal tract, usually the pancreas. The following topics may also be of interest to you: Side effects of Ibuprofen and symptoms of Helicobacter pylori infection
Duration
Patients with duodenal ulcers often have a certain amount of suffering behind them. Since the disease often develops slowly, no definite time period can be given until the time of diagnosis.If everything goes well, improvement is often seen after just one or two weeks of treatment with proton pump inhibitors. After four weeks of treatment, the disease is usually considered cured.
Even after years, however, there may be recurrences, a recurrence of duodenal ulcers, especially when taking certain painkillers (NSAIDs such as ibuprofen or diclofenac and others) and in smokers. If a therapy with acid inhibitors such as pantoprazole or omeprazole has been initiated, the ulcer usually heals gradually. The pain usually subsides within a few days of starting drug therapy. However, it can take months until the ulcer is completely healed.
