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Duodenal ulcer
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Duodenal ulcer

Contributors: Michael W. Winter MD, Khaled Bittar MD, Nishant H. Patel MD, Desiree Rivera-Nieves MD
Other Resources UpToDate PubMed


A duodenal ulcer is a form of peptic ulcer disease. It is defined by a mucosal defect extending through the muscularis mucosa in the intestinal lining. Duodenal ulcers are at risk for eroding into blood vessels, leading to gastrointestinal bleeding.

NSAIDs are a common cause of duodenal ulcer. Mucosal injury due to chronic infection from Helicobacter pylori may be a cause. Smoking is a strong risk factor for developing ulcers. There are other much less common causes including Zollinger-Ellison syndrome.

Patients can present with a variety of symptoms from duodenal ulcers. Epigastric abdominal pain and dyspepsia are most common. If eroded into a blood vessel, hematemesis, melena, or rarely bright red blood per rectum (if there is brisk bleeding) can be presenting symptoms.

Helicobacter pylori is a common worldwide infection predisposing to duodenal ulcers. Untreated, it is also a carcinogen associated with the development of gastric cancer.

Patients with concern for a duodenal ulcer, whether bleeding or not bleeding, should undergo an esophagogastroduodenoscopy (EGD) to confirm the diagnosis.


K26.9 – Duodenal ulcer, unspecified as acute or chronic, without hemorrhage or perforation

51868009 – Duodenal ulcer disease

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Last Reviewed:05/23/2017
Last Updated:03/18/2020
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Duodenal ulcer
A medical illustration showing key findings of Duodenal ulcer : Nausea, Vomiting, Epigastric pain, Recurring episodes or relapses, Melena, Dyspepsia
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