The stomach is a muscular bag (a ballooned-out tube) which can vary greatly in size from one to several pints, receiving the mouthfuls of food you swallow down your gullet. It is inside your tummy or abdomen – some people refer to their tummy as "the stomach" which is inaccurate, of course. The duodenum is a tube attached to the outlet end of the stomach and receives food from it. In your condition the duodenum gets inflamed, i.e. its lining gets red, swollen & painful (rather like the lining of your throat when you have a sore throat) and may ulcerate. In addition, there may be inflammation of the lining of your stomach & infection of it by bacteria known as Heliocobacter Pylori, which can worsen & prolong this condition. It can go on for many years & the severity of the inflammation & ulceration may change from time to time, i.e. you may not always have pain & indigestion & may be quite well for months or even years.

To care for this condition & to minimise its unpleasant effects, follow the instructions below:

• Avoid any food or drink, which upsets you & brings on your pain or other symptoms. Spicy food & alcohol often irritate the stomach & duodenum, causing pain. Milk (skimmed or full cream) may have the opposite effect. Avoid large meals. You may find frequent "nibbles" help your symptoms.
  
  

• If you smoke cut it down or stop it altogether. It is now well known that smoking can worsen or even cause duodenal ulcers.
  
  

• Avoid taking any medication, which has aspirin in it, examples are: Disprin, Soplrin, Aspro, Anadin & Palaprin. Painkillers generally known as non-steroidal anti-inflammatory agents can also be harmful in this condition. Examples are: Brufen, Fenbid, Rheumox, Voltarol, Dolobid, Lederfen, Progesic, Froben, Indocid, Orudis, Ponstan, Naprosyn & Feldene. The group of medications known as Steroids can be particularly dangerous. If you need to take a painkiller, paracetomol, also known as Panadol, is permissible. If a doctor wants to prescribe a painkiller for you, make sure he knows about your condition.
  
  

• If the colour of your motions changes to black – and you have not just started taking iron tablets – inform your doctor as this may indicate that your duodenal inflammation/ulcer is bleeding or has bled slowly.
  
  

• If you get a sudden severe tummy pain contact a doctor immediately.

The purpose of any medication prescribed for you is to reduce the acidity in your stomach, which reaches its highest level in the early hours of the morning, when you are asleep. This is why you are often instructed to take these medications at night before going to bed. These medications are usually taken regularly for a number of months & thereafter only when you feel the symptoms are coming back & troubling you. If you also have the bacterial infection in the lining of your stomach a course of 2 or 3 medications (which includes antibiotics) will be prescribed for you, to take regularly for a period of 1-2 weeks only, as instructed. Please carry out the instructions for taking your medications meticulously.