Duodenal Ulcers

The most important disorder of the duodenum is duodenal ulceration. Duodenal ulcers are much more common than gastric ulcers, but less likely to become malignant (cancerous). The most common site for duodenal ulcers is in the first few centimetres close to the pyloric sphincter of the stomach. It is thought that the constant squirting of acid chyme from the stomach erodes the duodenum in this region before the stomach acid can be neutralised by bile. This is supported by the fact that H2-receptor antagonists or proton pump inhibitors, which reduce gastric acid secretion, but have no effect on the duodenum itself, can heal duodenal ulcers. While gastric ulcers can be treated by surgery because life is still possible (with a restricted diet) even if the entire stomach is removed, this is not true of the duodenum, which is vital to life. Therefore surgery is less of an option for duodenal ulcers.

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