Peptic ulcers develop in either the stomach, called gastric ulcers, or in the duodenum, called duodenal ulcers. The duodenum is the part of the small intestine connected to the bottom of the stomach. A layer of mucus covers both the stomach and the duodenum, protecting the tissues underneath from the gastric acids used to digest food. An ulcer occurs when the mucous lining is damaged, and a reddish indentation or crater forms. The crater reaches the underlying tissue. The cause is almost always a bacterium called H. pylori though, in rare instances, medications can lead to the condition.
Pain, often described as a burning or gnawing pain or feelings similar to hunger, is the most common symptom of a duodenal ulcer. It occurs between the breastbone and navel, and sometimes in the back. Often, the pain arises around mealtime and when the individual is hungry, and it may wake a person up at night. It can last from a few minutes to hours. Drinking orange juice or coffee can bring on the pain. Usually, a person will wake up unencumbered, but begin feeling this pain mid-morning and two to three hours after each meal. Discomfort is reduced by food or by taking an antacid. Many patients feel no pain, especially the elderly.
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