Duodenal Ulcer Bleeding: Causes, Symptoms, and Treatment

Duodenal ulcer bleeding is a common and potentially serious complication of peptic ulcer disease. The duodenum, which is the first part of the small intestine, contains a dense network of blood vessels beneath its mucosal lining. When an ulcer forms, it extends deeper than just the surface layer of the mucosa, reaching the submucosal and even muscular layers where blood vessels are present. This depth increases the risk of damaging blood vessels, leading to internal bleeding.

How Does Duodenal Ulcer Bleeding Occur?

Unlike superficial mucosal erosion, which only affects the top layer of the intestinal lining, ulcers penetrate deeper tissues. Once the ulcer breaches the submucosa or muscle layer, it can come into contact with larger blood vessels. If one of these vessels ruptures, it can cause significant bleeding into the gastrointestinal tract.

Signs and Symptoms of Bleeding

The symptoms of duodenal ulcer bleeding vary depending on the severity of the hemorrhage. Mild bleeding may result in melena (black, tarry stools) or hematemesis (vomiting of coffee-ground-like material), which are signs of upper gastrointestinal bleeding. When blood loss exceeds 500 mL, patients may begin to experience systemic symptoms such as dizziness, weakness, and a rapid heartbeat. If the bleeding surpasses 1000 mL, it can lead to hypovolemic shock, a life-threatening condition requiring immediate medical intervention.

Importance of Prompt Medical Attention

Bleeding is the most frequent complication associated with duodenal ulcers. It is crucial to seek emergency medical care if bleeding is suspected. Early diagnosis and treatment significantly improve outcomes. In most cases, doctors use endoscopy to both diagnose and treat the bleeding. During this procedure, a gastroenterologist can locate the source of the hemorrhage and apply interventions such as cauterization, injection therapy, or clipping to stop the bleeding.

Effective Management and Recovery

Timely medical evaluation is essential for managing duodenal ulcer bleeding effectively. Delaying treatment can lead to worsening conditions and complications. Once the bleeding is controlled, further tests may be conducted to identify underlying causes, such as Helicobacter pylori infection or the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Appropriate medication and lifestyle modifications are typically recommended to prevent recurrence and promote healing.