Diseases Of The Intestine
Diseases Of The Intestine

Duodenal ulcer( duodenal ulcer): symptoms, treatment, diet

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1 The causes of the disease

Now scientists argue that there are two main causes of duodenal ulcer development:

  1. Infection with the bacterium Helicobacter pylori, which eventually and with certain factors provokes inflammation and erosion of the walls of the stomach and duodenum. Infection of Helicobacter pylori occurs from person to person through a kiss, common utensils, cutlery and personal hygiene items. After entering the stomach, the bacterium begins to multiply actively, producing urease and proteases. These enzymes destroy the protective layer of the walls of the stomach and the duodenum, as a result, defects appear in the mucosa and a peptic ulcer begins. There is a metabolic disorder in the damaged tissues, mucous cells do not work properly and produce less mucus.
  2. Gastric ulcer develops due to a decrease in the protective properties of the mucosa, which is no longer able to withstand the corrosive effect of gastric juice. The increased aggressiveness of pepsin and hydrochloric acid against the background of pathological structural changes in tissues leads to the appearance of mucosal defects and duodenal ulcers.
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It is worthwhile to consider predisposing factors:

  1. Heredity. At the genetic level, parents transmit to their children an excessive number of cells producing hydrochloric acid or reduced secretion of protective mucus components.
  2. The excitable nervous system. Ulcer disease often occurs in quickly excitable people, who tend to keep the consequences of stress and problems in themselves.
  3. Incorrect power. It is very harmful to eat on dry land and on the run, especially when using semi-finished and fast-food dishes. Abuse of spicy, smoked, fried, salty foods and seasonings leads to irritation of the gastrointestinal mucosa and impaired gastric juice production.
  4. Admission of analgesics and non-steroidal anti-inflammatory drugs. Ibuprofen, Acetylsalicylic acid, Orthophene have a strong irritant effect on the gastric mucosa and duodenum.
  5. Bad habits. Heavy smokers and lovers skip a glass of vodka, too, fall into the risk group of the stomach ulcer and duodenal ulcer.
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Rare reasons provoking duodenal ulcer are: amyloidosis, celiac disease, Crohn's disease, cirrhosis, chronic obstructive bronchitis, diseases of the nervous system, HIV infection and germination of pancreatic cancer.

2 Symptoms of pathology

The first symptoms of duodenal ulcer are the pains systematically appearing in the upper half of the abdomen. A characteristic feature is pain at night and so-called "hungry" pain, when the patient needs to eat at least biscuits, so that they retreat. With ulcer of the duodenum, the symptoms have their rhythmicity - pain occurs 1.5-3 hours after eating, when the patient feels hungry, and disappears after eating food and antacids( Maalox, Almagel).

Painful sensations are localized over the navel or in the epigastric region. They can give in the back, under the shoulder blade and into the heart area. The use of food that does not fit into the diet, nutritional excesses, carbonated drinks and alcohol can provoke a clear increase in pain.

It is noteworthy that heartburn occurs in patients with gastric ulcer and duodenal ulcer after 2-3 hours after eating. Not all patients have nausea, vomiting, belching with a sour taste and constipation.

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People with peptic ulcer have a normal or even increased appetite, but they still have a decrease in body weight. Against the background of night hunger and pain develops nervousness, poor sleep and unstable mood.

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In the advanced stage, duodenal ulcer without appropriate treatment can make itself felt with vomiting blood. Blood in the feces is noticed by changing the color of the stool, it becomes black. These signs are an occasion for urgent hospitalization, as the patient began internal bleeding, fraught with a fatal outcome. Note that the symptoms of ulcers of the intestine do not always manifest, without treatment, the defect of the mucosa will become deeper, and this is dangerous by perforating, bleeding and contaminating blood.

3 Diagnostic methods

  1. Endoscopy is the most informative way to investigate the internal conditions of the stomach and duodenum. With the help of endoscopic equipment during eso gastroduodenoscopy, the doctor not only sees the enlarged data on the mucosa, but can take a sample of ulcer tissue and a sample of gastric contents, for subsequent detection of Helicobacter pylori microbes and acidity of the gastric juice.
  2. Helicobacter pylori bacteria are searched for in all available biomaterials - blood, feces, vomit and sample obtained from biopsy of EGDS.
  3. X-ray study of the DPC.Currently, the technique is rarely used.
  4. Palpation. This method is used by talented diagnosticians for setting a preliminary diagnosis.

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4 Treatment procedures

It is necessary to prepare for the fact that treatment of duodenal ulcer will be long and complex. This includes the use of medicines, diet, physical therapy, exercise therapy and systematic sanatorium treatment.

How to treat duodenal ulcer in the acute stage? The answer is unambiguous - in a hospital.

To relieve pain and early cicatrization of the ulcer, the patient needs a bed rest, complete emotional rest and a strict diet.

The treatment regimen is made in accordance with the revealed pathologies and test results. If helicobacteria were found on the stomach and duodenal mucosa, emphasis will be placed on the use of antibiotics to kill microorganisms.

In general, the treatment of duodenal ulcers includes the following drug groups:

  1. Antibiotics and antiprotozoal agents directed to suppress the vital activity of Helicobacter pylori. These drugs include Metronidazole, Tetracycline, Amoxicillin, Clarithromycin.
  2. Complex preparations containing bismuth subnitrate or bismuth subcitrate - De-nol, Vikair, Vikalin. They have a bactericidal effect on Helicobacter pylori and promote the formation of a protective film on the walls of the stomach and DPC.In addition, these drugs contain magnesium salts, which reduce the acidity of gastric juice and reduce the activity of pepsin.
  3. Antisecretory drugs designed to reduce the production and reduce the aggressiveness of gastric juice. In this group were the inhibitors of the proton pump( Pariet, Omeprazole, Pantoprazole, Rabeprazole, Esomeprazole), H2-histamine receptor blockers( Roxatidine, Ranitidine, Nizatidine, Famotidine, Kwamatel), blocking M-cholinergic receptors( Gastrotsepin, Buskopan, Pirenzepin).
  4. Prokinetics - drugs that improve the motility of the stomach and intestines, treatment with Trimedatum simultaneously removes the tone of the esophagus and affects the receptors of the large intestine, which leads to its rapid emptying. Tserukal and Motilium help to get rid of nausea and vomiting, epigastric pain, heartburn, belching, feelings of early overflow in the abdomen, etc.
  5. Antacids( Maalox, Almagel, Fosfalugel, Keal) reduce the acidity of the stomach, adsorb excess acid and gases, envelop the walls of the stomachand the intestine, thereby for several hours reducing pain in the upper abdomen.
  6. Gastroprotectors( Sucralfate, Venter) accelerate the healing of peptic ulcers of the intestine and stomach, protect the stomach and duodenum from hydrochloric acid and pepsin. Venter almost 1/3 reduces the activity of pepsin, but does not affect the acidity of gastric juice. The active substance of both preparations - Sucralfate binds to proteins in place of the ulcer, resulting in a protective film. Thus, the medicine accelerates the restoration of damaged tissues, accelerating the scarring process, and prevents the development of relapses of peptic ulcer.
  7. Auxiliary drugs - antispasmodics and analgesics: Baralgin relieves spasm of stomach and intestines and reduces pain. Drotaverin eliminates spasm of smooth muscles and removes spasmodic pains, by expanding the lumen of the vessels and improving the flow of oxygen into the tissues.
  8. Means to improve nutrition of the intestinal mucosa. The most often prescribed vitamins B and Actovegin. The latter has a stimulating effect on the metabolism and the process of assimilation of nutrients, and also enhances blood supply.

5 Dietotherapy

Than to treat a duodenal ulcer, it is now clear. There are a lot of drugs, so the appointment should only be done by a doctor. Consider that an important role in the treatment of peptic ulcer is diet. It should exclude chemical, mechanical and thermal irritation of the stomach and duodenum. During the period of exacerbation, a special diet No. 1 is indicated, implying fractional meals in small portions, that is, 5-6 times a day. It includes low-fat boiled meat and fish, fresh dairy products, puree from boiled vegetables( not containing insoluble vegetable fiber), boiled, baked or wiped fruits and berries, cereal liquid cereals, yesterday's white bread, rose hips, and cocoa onmilk, not strong tea and coffee.

The ban applies to pickled, salted, smoked and fried dishes, on canned goods, sour berries and fruits, sour-milk products, bran, beans, cabbage, beets, radish, radish, fatty meat and fish, strong coffee, sour fruit juices and carbonatedbeverages. Food should be warm, sick hot and cold food is contraindicated.

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6 Surgical treatment

If the ulcer of the intestine or stomach is perforated, bleeding appeared or the stenosis of the duodenal pylor developed, urgent surgical intervention is required. Surgical treatment of ulcers is recommended for patients who have not had a benign ulcer after 4 months of conservative therapy.

7 Physiotherapy

At the acute stage, physiotherapy increases the effectiveness of medications. So ultrasound and microwave therapy, electrophoresis with papaverine and novocaine relieve pain and reduce the production of gastric juice.

Modulated sinusoidal currents are used to anaesthetize and reduce inflammation. All these procedures improve the circulation of the digestive system.

8 Therapeutic physical training

Simple exercises of physiotherapy help to normalize the secretory function of the duodenum, as well as improve the motor skills and overall blood supply of the intestine. LFK is useful to people after in-patient treatment and prolonged bed rest.

Specialized treatment for patients with peptic ulcer disease can take place in sanatoriums of resort type Morshin, Kvitka Polonina( in Transcarpathia), Truskavets, Borjomi, Essentuki, Zheleznovodsk. At the usual time, people with stomach ulcers and duodenal ulcers are recommended to drink mineral water Jermuk, Borjomi, Essentuki №4.Duodenal ulcer is treated with a whole complex of measures, trust the prescription of medicines to an experienced doctor, but remember that a diet is very important for recovery.

Contents
  • 1 Causes of the disease
  • 2 Symptoms of the pathology
  • 3 Diagnostic methods
  • 4 Treatment procedures
  • 5 Dietotherapy
  • 6 Surgical treatment
  • 7 Physiotherapy
  • 8 Physiotherapy

People with stomach ulcers and suffering from its manifestations may not even think that they are developing duodenal ulcer;symptoms and treatment of peptic ulcer of the stomach and duodenum are similar in many respects. Relapses usually fall in the spring and autumn, and the rest of the time the disease can and does not manifest itself. It is very important to diagnose the disease in time, otherwise a person can die from complications of perforation of the duodenal ulcer, which he did not even suspect.

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