Benign duodenal bulbar ulcers can heal with 4 to 6 weeks of standardized treatment.
Duodenal ulcers are mostly caused by Helicobacter pylori, and some patients taking long-term non-steroidal anti-inflammatory drugs (NSAIDs) can also cause duodenal ulcers. Patients tend to present with rhythmic epigastric pain, such as hunger and nocturnal pain, which may gradually resolve after eating.
Severe patients are at risk of complications such as bleeding or perforation of the ulcer. Formal treatment is to advise patients to take proton pump inhibitors (e.g., esomeprazole, pantoprazole, etc.) for 4 to 6 weeks.
During treatment, it is recommended that the cause of the duodenal ulcer be clarified, and if it is clear that H. pylori is infected, a quadruple regimen (proton pump inhibitor such as omeprazole, two antibiotics such as amoxicillin and metronidazole, and bismuth such as bismuth citrate) is recommended for H. pylori eradication for 2 weeks during the course of treatment.
If the test is not available during the treatment, it is recommended to stop the medication for 2 weeks after the end of the treatment, and then perform eradication therapy if necessary. Patients who have been taking NSAIDs (e.g. aspirin, painkillers, etc.) for a long period of time are advised to stop taking them unless there are special circumstances.
If there is no discomfort after the end of treatment, gastroscopy can be postponed, because the duodenal ulcer is less likely to become malignant, but if the patient still has abdominal pain, nausea and other discomforts, it is recommended to review as soon as possible, and if the ulcer has not been healed, it is necessary to further clarify the nature of the ulcer.
When the diagnosis of duodenal ulcer is clear, it is recommended to receive standardized treatment under the guidance of a specialist.