Treating Duodenal Bulb Ulcer with Amoxicillin and Other Medications

Summary: A patient visited our clinic due to a week-long experience of upper abdominal pain accompanied by acid reflux, heartburn, and belching, with symptoms worsening over the past three days. After undergoing necessary examinations, he was clinically diagnosed with a duodenal bulb ulcer and started on a course of medication. Following treatment, his condition improved significantly, and all discomforting symptoms were alleviated.

Basic Information: Male, 32 years old
Type of Disease: Duodenal Bulb Ulcer
Hospital Visited: Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Date of Visit: April 2022
Treatment Plan: Oral administration of Amoxicillin Capsules, Clarithromycin Tablets, Rabeprazole Sodium Enteric-Coated Capsules, and Colloidal Pectin Bismuth Capsules
Treatment Duration: 14 days of outpatient medication
Treatment Outcome: Improvement in overall condition and relief from initial symptoms

1. Initial Consultation
A 32-year-old male presented with complaints of upper abdominal pain that had developed without any clear cause one week prior, along with acid reflux, heartburn, and belching. Initially mild, these symptoms intensified over the last three days, particularly occurring while fasting. Concerned about his condition, the patient sought medical advice at our clinic.
Upon detailed inquiry, we found the patient previously healthy with no known drug allergies but had a smoking and drinking history spanning more than ten years. Physical examination revealed stable vital signs, normal heart and lung functions, and tenderness under the xiphoid process in the upper abdomen without rebound tenderness or muscle rigidity. Based on clinical presentation and physical findings, a duodenal bulb ulcer was suspected. Further tests were recommended to confirm the diagnosis, which the patient agreed to.

2. Treatment Process
The patient underwent a Carbon-14 breath test, which returned positive, indicating Helicobacter pylori infection. Subsequently, an endoscopy confirmed a duodenal bulb ulcer (Stage A1). With this diagnosis confirmed, we discussed treatment options with the patient and his family, who consented to proceed with pharmacological therapy.
Amoxicillin capsules, a penicillin-class antibiotic, were prescribed to target bacterial cell wall synthesis, effectively causing bacterial lysis. Alongside, Clarithromycin Tablets, Rabeprazole Sodium Enteric-Coated Capsules, and Colloidal Pectin Bismuth Capsules were administered to support healing and reduce gastric acidity.

3. Treatment Results
After completing the 14-day outpatient treatment, the patient revisited for follow-up. He reported significant symptom relief after approximately seven days of medication, with complete disappearance of abdominal pain, acid reflux, and heartburn within nine days. By the time of his checkup, all symptoms had vanished. A repeat Carbon-14 breath test confirmed negative results for H. pylori infection.

4. Key Recommendations
Due to the distress caused by his symptoms, the patient experienced considerable anxiety. To ensure optimal recovery, the following lifestyle and treatment guidelines were emphasized:

Maintain a nutritious, semi-liquid diet with regular meals, avoiding cold, spicy, or irritating foods.

Strictly adhere to the prescribed medication regimen without altering doses or discontinuing use prematurely.

Prioritize restful sleep and avoid fatigue or late nights to support the body's healing process.

Incorporate moderate physical activity such as walking, swimming, or jogging to boost immunity and aid recovery.

5. Clinical Insights
Duodenal bulb ulcers typically arise from excessive gastric acid secretion or weakened mucosal defenses, leading to damage in the mucosa and underlying layers. Factors like H. pylori infection, gastric acid, pepsin, and certain medications contribute to its development. Common symptoms include epigastric pain during fasting periods, acid reflux, heartburn, bloating, and reduced appetite. Prompt medical attention is crucial for early diagnosis and effective management. As demonstrated in this case, timely and appropriate treatment can lead to successful outcomes and full symptom resolution.