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Duodenitis, Symptoms and Treatment in Adults. How to treat duodenitis

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Duodenitis - inflammation of the mucosa of the duodenum. The disease may be acute or chronic. Depending on the area of ​​pathological processes commonly isolated and limited duodenitis.

In lesions of upper parts of the symptoms resemble stomach ulcer and duodenitis lower divisions causes symptoms similar to pancreatitis or cholecystitis. The disease is accompanied by general weakness, pain in the stomach, heartburn, belching, nausea, vomiting.

Acute duodenitis in compliance with sparing diet (sometimes starvation) usually ends in a few days. Recurrent disease become chronic, complicated gastrointestinal bleeding, perforation of colon wall, the development of acute pancreatitis.

What it is?

Duodenitis - is an inflammatory process in the mucosa of the duodenum (duodenal ulcer), which causes structural changes in the mucous membranes, and resulting in impaired functions body. According to statistics, more than 10% of the population have experienced the symptoms of duodenitis - is the most common pathology of the initial part of the small intestine.

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acute duodenitis

A prerequisite for the rapid development of acute poisoning are duodenitis, or love of oriental spicy dishes. On this background, an inflammatory response at mucosal surfaces 12 duodenum provoke formation ulcerative and erosive lesions, sometimes ulcerated pus-filled cavity formed in the surface layer of the gut (Phlegmon).

Duodenitis symptoms in adults at the stage of acute course occur:

  1. Sharp pain in the stomach area;
  2. Digestive disorders;
  3. Vomiting, nausea and weakness.

The development of acute process almost always provoke a reaction of inflammation in the intestines or stomach. it is often diagnosed as gastric duodenitis that is fundamentally not true, inflammation of mucous membranes of the stomach cavity has its own name - gastritis.

Provocative role conducive to the development of pathological inflammatory reactions in mucous duodenal structure plays a violation mobility or motility, making it difficult to promote condensed contents of the small intestine to the outlet (Duodenostasis). If treatment is properly selected and the patient compliance with sparing diet, inflammation of the duodenum docked fairly quickly. But, in case of repeated inflammation of the intestine walls, develops a chronic stage of the disease.

chronic duodenitis

Chronic duodenitis can be primary and secondary. Primary chronic duodenitis occurs when malnutrition (Used acute irritating, hot food, alcohol), smoking. More common secondary chronic duodenitis - he develops on the background of already existing inflammatory diseases such as chronic gastritis; duodenal ulcer; improper treatment of acute duodenitis.

According to the degree of structural changes there are several options for chronic duodenitis:

  • atrophic (thinning of duodenal mucosa with its secretory fading function);
  • surface (the inflammatory process involves only the upper layers of the mucosa);
  • hyperplastic (the excessive growth of tissue);
  • interstitial (without damage glands); erosive-ulcerous (characterized by the appearance on the mucosa of small ulcers and erosions).

Symptoms of chronic duodenitis

  • heartburn,
  • belching,
  • feeling of fullness in the upper abdomen ( "the stomach"),
  • loss of appetite,
  • sometimes nausea or vomiting bile
  • constipation.

periods of exacerbation - constant pain in the stomach, aggravated by fasting or 1,5-2 hours after meals. There are night pain. Some patients complain of headaches, fatigue, irritability, shortness of breath and heart palpitations because of the hormonal functions of the duodenum.

How to treat?

Treatment of chronic duodenitis periods of exacerbation is conducted in a hospital. Treatment is prescribed depending on the cause, provoking the disease.

  1. When detecting H. pylori infection used antibiotics.
  2. In the presence of giardiasis and prescribe the appropriate chemotherapy of helminthiasis (flag, furazolidone, hloksin).
  3. To protect the mucosa overlying the prescribed medication (de-nol, Sulfacrate). With the aim of anti-inflammatory recommended to use decoction of chamomile and yarrow. To restore the digestive enzyme preparations prescribed.
  4. At higher acidity - drugs that reduce acid secretion (omeprazole, ranitidine), and antacids which neutralize gastric acidity (Almagelum, Maalox, Aluminum phosphate gel).

If the cause of duodenitis was dysmotility duodenum (duodenostasis), for example, an obstruction, it is necessary to establish the cause. If it is associated with the violation of any of the functions of the digestive system, treatment of duodenitis conservatively. Displaying frequent meals in small portions, drugs that bind bile and promote its secretion (cholagogue). Effectively duodenal intubation with washing duodenum.

In the presence of adhesions, mechanical barriers and other types of obstruction, intractable therapeutic treatment, operative treatment of duodenitis. When secondary duodenitis, necessary treatment of the underlying disease.

symptoms duodenita

Duodenitis in adults may start as suddenly or gradually. Often it manifests after any dietary excesses, alcohol, stress. Duodenitis usually difficult to distinguish from other diseases of the digestive system.

After all, for duodenitis is characterized by the same clinical symptoms as in most other gastrointestinal ailments:

  • symptoms of gastric dyspepsia (heaviness, burning or discomfort in the epigastric area; belching, nausea, bloating);
  • pain (mild or very intense pain associated with the type and time of the meal, there are areas in the upper abdomen: the epigastric area, hypochondria);
  • psycho-emotional disorders (unmotivated irritability, tearfulness, fast emotional exhaustion et al.);
  • problems with a chair (chronic diarrhea or constipation, systematic, their sequencing).

Depending on the combination of clinical symptoms of the following forms may be in duodenitis:

  • asymptomatic (set in the case of complete absence of clinical manifestations common among elderly patients);
  • holetsistopodobnaya (pain similar to biliary colic, a sense of bitterness in the mouth, vomiting of bile);
  • gastritopodobnaya (pain occur after a meal, they are often accompanied by the phenomenon of gastric dyspepsia);
  • nervnovegetativnaya (sweating episodes of dizziness and weakness, palpitations etc.);
  • pankreatopodobnaya (patients hurts mainly the left upper quadrant, can be observed "girdle" pain, diarrhea, vomiting);
  • mixed (in this form in patients showing signs of various other forms of duodenitis);
  • yazvennopodobnom (the most common variant, "night" and "hungry" pain at the top of the stomach is extremely similar to those that are characteristic of peptic ulcer disease, they are combined with acid regurgitation and persistent constipation).

Diagnostics

The clinical picture is diverse and nonspecific duodenitis, moreover, isolated duodenitis is very rare, as a rule, he combined with other diseases (chronic gastritis, peptic ulcer disease, enteritis, pancreatitis, biliary disease tract). Therefore, a definitive diagnosis of chronic duodenitis is possible only through the study of instrumental methods, such as:

  • fibrogastroduodenoscopy with biopsy;
  • duodenoscopy;
  • pH-meter;
  • story-manometry;
  • impedancemetry.

In parallel with the diagnosis of duodenitis is necessary to conduct research associated with the duodenum digestive organs.

complications

At untimely seeking medical care or failure to comply with the diet in chronic duodenitis possible complications such as:

  • duodenal ulcer bulbs, including complicated by bleeding,
  • adhesive thin-bowel obstruction due to the growth of connective tissue in the place of permanent inflammation in the mucosa and submucosal structures
  • malabsorption of nutrients (malabsorption), which leads to weight loss, unstable chair, disruption activity and degeneration of internal organs.

Prevention of complications treatment is begun on time and comply with the recommendations of the attending physician.

duodenitis treatment

In adults, treatment of duodenitis include several directions:

  • elimination of acute inflammation;
  • prevention of transition in the chronic stage of the disease;
  • functional recovery of 12 duodenal ulcer;
  • normalize digestion.

Indications for hospitalization with duodenitis:

  • duodenitis an exacerbation;
  • suspected tumor of the small intestine;
  • severe general condition of the patient, advanced cases of the disease;
  • inflammation of the serous cover 12 duodenal ulcer (periduodenit) and nearby organs;
  • the presence or the threat of bleeding (erosive duodenitis and peptic form).

Mostly treatment is carried out at home. For a speedy recovery restful sleep needed vacation, dieting, walking, light exercise in the absence of pain. It is necessary to avoid stress, give up smoking and alcohol. Such measures help to normalize blood circulation in the duodenum, restore its protective properties of the mucosa.

drug therapy

duodenitis treatment in adults involves the administration of the following groups of products:

  • antibiotics that are recommended in the detection of the bacteria Helicobacter Pylori;
  • proton pump inhibitors that block cancer, which are responsible for the secretion of hydrochloric acid (e.g., omeprazole);
  • antacids, enveloping and having local anesthetic effect since neutralize hydrochloric acid (Almagel, Maalox);
  • H2-histamine blockers used in the presence yazvopodobnogo duodenitis; drugs that inhibit the production of the group of hydrochloric acid (ranitidine, famotidine);
  • multienzyme preparations promoting digestion and normalizing digestion;
  • prokinetic appointed when diagnosed gastritopodobny duodenitis; they affect the intestinal peristalsis, have antiemetic effect;
  • antispasmodics, removing bowel spasms and eliminates pain.

Each patient selected individual scheme pharmacological therapy depending on the shape and the clinical features of the disease.

Diet for duodenitis

Proper nutrition plays a key role in the treatment of duodenitis. In acute inflammation or exacerbation of chronic duodenitis first 3-5 days is necessary to adhere to a strict diet 1A. Its basis - slimy decoctions of cereals (rice, oats), pureed soups, liquid milk porridge (semolina, buckwheat flour) and baby food. 1 time per day allowed chicken or lean fish (pike) in the form of puree or steam souffle. Power fractional: 6 times a day, small portions.

Further expanding diet. Depending on the shape and characteristics of the course duodenitis patients with different diets can be recommended:

  • ulcer-like duodenitis - diet №1;
  • gastritis-like duodenitis (at a reduced secretion of the stomach) - Diet №2;
  • holetsisto- and pancreatitis-like duodenit diet - №5.

When signs duodenitis should not self-medicate various folk remedies that can only be complementary therapies. Otherwise, severe complications in the form of intestinal bleeding, malabsorption syndrome, peptic ulcer or intestinal obstruction. It is important to remember that duodenitis - a disease that responds well to conventional treatment, so it is important to see a doctor in time.

Forecast

The prognosis of acute and chronic forms of the disease favorable. Full recovery after acute duodenitis occurs almost always, if the excluded factors that have an irritating effect on the mucous membrane of the duodenum.

If the patient develops complications, the prognosis for life remains favorable, and health questionable due to a violation of the internal organs function. In some cases, the presence of scarring lesions bulb ulcers, frequent exacerbations of peptic ulcer disease (3-4 times per year or more), with a decrease in body weight more than 15%, anemia and other laboratory abnormalities, dystrophy, as well as in case of need for surgical treatment, the patient may be assigned disability.

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