Medical history (history of illness) is an important component in the diagnosis of duodenal ulcer (ulcer of the duodenum). Family history Is there a history of frequent gastrointestinal disease in your family? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological … Duodenal Ulcer: Medical History
Liver, gallbladder, and bile ducts-pancreas (pancreas) (K70-K77; K80-K87). Cholelithiasis (gallstones). Pancreatitis (inflammation of the pancreas) Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93). Functional dyspepsia (irritable stomach syndrome). Gastritis (gastritis) Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; … Duodenal Ulcer: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by duodenal ulcer: Circulatory system (I00-I99) Myocardial infarction (heart attack) associated with Helicobacter pylori infection. Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Duodenal hemorrhage (bleeding from the duodenum). Duodenal perforation (perforation of the duodenum, as a complication of ulcer). Penetration … Duodenal Ulcer: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? … Duodenal Ulcer: Examination
Laboratory parameters of the 2nd order – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification Helicobacter pylori detection* . Invasive methods: Culture [sensitivity 70-90%, specificity 100%] Histology (gold standard) after endoscopic biopsy (tissue sample) [sensitivity 80-98 %, specificity 90-98 %] Urease rapid test (synonym: Helicobacter urease test; … Duodenal Ulcer: Test and Diagnosis
Therapeutic targets Improvement of the symptomatology Gastric protection, i.e., avoidance of complications. If necessary, elimination of Helicobacter pylori Therapy recommendations Proton pump inhibitors (PPI; acid blockers) [first-line therapy]. Notice: Because of increasing antibiotic resistance, eradication (germ elimination) of Helicobacter pylori should preferably be accomplished with bismuth quadruple therapy Before starting treatment, risk factors for clarithromycin … Duodenal Ulcer: Drug Therapy
Mandatory medical device diagnostics. Gastroduodenoscopy (endoscopy of the stomach and duodenum) with biopsies (tissue sampling) for detection of Helicobacter pylori – as basic diagnostics in cases of suspected duodenal ulcer and after therapy. Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – … Duodenal Ulcer: Diagnostic Tests
For classification of bleeding activity in duodenal ulcer bleeding, see Gastrointestinal bleeding (gastrointestinal bleeding)/Classification: Forrest classification. In gastrointestinal hemorrhage, targeted hemostasis is performed according to the so-called EURO concept: Endoscopy (viewing of the affected organ by means of fiber optics). Injection (with NaCl 0, 9% and/or epinephrine), fibrin glue, clipping (clipping), laser coagulation. Assess risk … Duodenal Ulcer: Surgical Therapy
To prevent duodenal ulcer (ulcer of the duodenum), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet High consumption of mono- and disaccharides such as white flour products and confectionery products Rare intake of omega-3 and -6 fatty acids. Excessive intake of table salt Micronutrient deficiency (vital substances) – see Prevention … Duodenal Ulcer: Prevention
The following symptoms and complaints may indicate duodenal ulcer (duodenal ulcer): Epigastric pain (upper abdominal pain): May occur late after food intake, at night, or else in the fasting state (fasting episodes/fasting pain) or independently of food intake Often improvement of symptoms after food intake Nausea (nausea)/vomiting Weight loss Note: Duodenal ulcers (duodenal ulcers) are … Duodenal Ulcer: Symptoms, Complaints, Signs
Pathogenesis (development of disease) In duodenal ulcer, damage to the mucosa of the duodenum occurs, usually due to infection with the bacterium Helicobacter pylori (>90% of cases). Duodenal ulcers (duodenal ulcers) are located in the anterior wall of the bulbus duodeni (first, ampullary part of the duodenum) in 90 % of cases. The majority of … Duodenal Ulcer: Causes
General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Limited caffeine consumption – Depending on individual tolerance, to avoid additional discomfort and promote ulcer healing (healing of the ulcer), the consumption of coffee and black tea should be limited … Duodenal Ulcer: Therapy