The main cause of duodenal ulcers is Helicobacter pylori infection. Treatment includes eradicating Helicobacter pylori, suppressing gastric acid secretion, and protecting the gastric mucosa. Helicobacter pylori infection is the primary cause of duodenal ulcers; this bacterium damages the gastric mucosal barrier, allowing gastric acid and digestive enzymes to erode the duodenal wall, leading to ulcer formation. Other factors such as long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), smoking, excessive alcohol consumption, and stress can also worsen the condition.
1. Helicobacter pylori infection is a major cause of duodenal ulcers. Helicobacter pylori damages the gastric mucosa's defense mechanisms by producing urease and toxins, leading to the erosion of the duodenal wall by gastric acid and digestive enzymes. Eradication therapy for Helicobacter pylori typically involves triple or quadruple therapy, such as the combination of amoxicillin, clarithromycin, and a proton pump inhibitor like omeprazole, with a treatment course generally lasting 7-14 days.
2. Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) is also a common cause of duodenal ulcers. NSAIDs weaken the protective function of the gastric mucosa by inhibiting prostaglandin synthesis, increasing the risk of ulcers. For patients who need to use NSAIDs, it is recommended to use gastric mucosal protectants, such as misoprostol, or H2 receptor antagonists, such as ranitidine, to reduce the risk of ulceration.
3. Smoking and excessive alcohol consumption can worsen the symptoms of duodenal ulcers. Smoking reduces blood flow to the gastric mucosa, decreasing its repair capacity; excessive alcohol consumption directly irritates the gastric mucosa and increases gastric acid secretion. Quitting smoking and limiting alcohol intake are important measures for the prevention and treatment of duodenal ulcers. Patients are advised to use behavioral therapy and medications such as nicotine patches or alcohol cessation medications to help them quit smoking and drinking.
4. Psychological stress is closely related to the occurrence and aggravation of duodenal ulcers. Stress activates the sympathetic nervous system, increases gastric acid secretion, and reduces blood flow to the gastric mucosa, leading to ulcer formation or worsening. Psychological counseling and stress management are important aspects of treatment. Patients are advised to relieve stress through psychological counseling, relaxation techniques such as deep breathing, meditation, and regular exercise.
Treatment of duodenal ulcers requires a comprehensive consideration of both the cause and symptoms. Eradicating Helicobacter pylori, inhibiting gastric acid secretion, protecting the gastric mucosa, and improving lifestyle are key. With appropriate medication and lifestyle modifications, most patients can significantly improve their symptoms and prevent recurrence. It is recommended that patients develop an individualized treatment plan under the guidance of a doctor and have regular check-ups to ensure treatment effectiveness.