1 Structure and functions of the

organ The duodenum has 4 departments:

• upper horizontal;
• descending;
• bottom horizontal;
• ascending.

The upper horizontal part of the intestine is considered the initial and is the continuation of the pylorus of the stomach. The upper section has a round shape, and therefore it is also called an onion. Its length is 5-6 cm. The descending section, the length of which is 7-12 cm, is located near the lumbar spine. It is in this department that the ducts of the stomach and pancreas are excreted. The length of the lower horizontal section is about 6-8 cm. It crosses the spine in the transverse direction and passes into the ascending section. The ascending part is 4-5 cm in length. It is located on the left side of the spinal column.

The duodenum is located within 2-3 lumbar vertebrae. Depending on the age and weight of a person, the location of the gut may vary.

The duodenum performs secretory, motor and evacuation functions. The secretory function consists in mixing the chyme with the digestive juices that enter the intestine from the gallbladder and pancreas. The motor function is responsible for the movement of the food gruel. The principle of the evacuation function consists in the evacuation of chyme to the subsequent sections of the intestine.

2 Causes of pathology

Inflammation of the gut, as a rule, occurs against the background of gastrointestinal disorders. Causal factors include viral infection, inflammation of the gastric mucosa or gall bladder, diarrhea, low blood flow to the intestine.

Inflammation of the intestine is often caused by Helicobacter pylori infection. This bacterium is in the stomach and does not manifest itself in any way. Its presence in the body leads to increased production of gastric acid, which further irritates the mucosa of the duodenum. Without treatment, the bacterium can cause ulcers of the intestine.

Diseases of the duodenum can develop against a background of severe stress or surgical intervention. In some cases, the primary cause may be the use of non-steroidal anti-inflammatory drugs, tobacco smoking or excessive consumption of alcohol.

Inflammation of the duodenum can be caused by food poisoning, the use of acute or fatty foods, as well as a foreign object. It is proved that some pathologies of the intestine can be hereditary. Such pathogenic factors as diabetes mellitus and cholelithiasis can cause the development of the disease of the duodenum.

Symptoms of duodenal disease have their clinical picture and can differ from each other.

3 Peptic ulcer

A characteristic symptom of peptic ulcer is a digestive disorder. The patient has a frequent and loose stool. Often in patients there is a complete intolerance of dairy products and fruits. If the patient has a sharp weight loss with increased appetite, this may indicate that the duodenum is inflamed.

If ulcers injure an organ such as the duodenum, the symptoms of the disease can manifest itself in a characteristic yellow raid on the tongue. This is due to spasms of the bile ducts, which lead to stagnant bile. At the advanced stages of the disease, pain appears in the right side and the skin acquires a yellow tint.

With duodenal ulcer, cicatricial changes occur in the stomach, which results in the evacuation of food. Stagnant state in the stomach leads to nausea and vomiting. Often after vomiting, the general condition of the patient improves for a while.

A characteristic symptom of peptic ulcer is pain. It can be aching or abrupt, prolonged or paroxysmal. As a rule, the pain subsides after eating, so they are also called "hungry."This symptom occurs in 70-80% of patients. Pain is felt most often in the lumbar or thoracic region. In some cases, patients with a duodenal ulcer may complain of pain in the collarbone area.

4 Bowel cancer and duodenitis

If the patient has been diagnosed with bowel cancer, the symptoms of the disease can manifest as jaundice, fever and skin itching. With cancer of the first degree, pain appears. It occurs as a result of compression of the tumor by nerve fibers or blockage of the bile duct. Pain syndrome is most often felt in the right hypochondrium, but in some cases, pain can spread to other organs.

One of the symptoms of an ailment is itchy skin. It appears because of the high content of bilirubin in the blood and irritation with the bile acids of the skin receptors. Against the background of the itch, the patient develops arousal and insomnia.

No less common disease of duodenal ulcer is duodenitis. This ailment manifests itself in the form of raspiraniya stomach after eating, dull and constant pain, nausea, loss of appetite, vomiting. Patients with this diagnosis feel the epigastric region painful.

5 Proper nutrition

For any of the 12 duodenal diseases, the patient is prescribed a diet. Diet in combination with complex treatment excludes exacerbations and significantly improves the overall condition of the patient. If the duodenum is inflamed, then primarily foods that are capable of stimulating the production of gastric acid are excluded from the diet. Such products include acidic fruits, fat broths, fresh vegetable and fruit juices, mushrooms, smoked, salted, fried and pickled foods and spices. Under the ban also sweet fizzy and alcoholic drinks.

The menu should contain easily digestible fats, for example, vegetable oil, cream or margarine.

It is necessary to limit the intake of products that somehow irritate the mucosa. To avoid overloading the stomach and exacerbation of the disease is not recommended to use cold or hot dishes. The food should be at room temperature.

It is forbidden to eat foods that have mechanical irritation. Such products include raw vegetables and fruits, beans, peas, and coarse grains. With inflammation of the duodenum, doctors recommend that you exclude from the diet mustard, vinegar, salt and other seasonings.

Power should be frequent. In a day you need to eat about 4-5 times. Between meals should be no less than 3-4 hours. Preference should be given to dishes cooked in boiling water or steamed.

6 Treatment measures

Symptoms and treatment of duodenal pathology is determined by the doctor after an appropriate examination. If the diagnosis has confirmed a peptic ulcer, the patient is prescribed medication. To kill Helicobacter pylori, the patient is given a course of antibiotics. These drugs include Erythromycin, Clarithromycin, Metronidazole and Ampiox.

To reduce the production of hydrochloric acid, doctors prescribe omeprazole, de-nol and ranitidine.

These drugs also have a bactericidal effect. With severe pain, doctors prescribe antacids.

Surgical treatment of duodenal ulcer is rare. Indications for surgery include complications of the disease. In this case, during surgery, the surgeon can remove the affected area of ​​the intestine, this helps reduce the secretion and level of hydrochloric acid.

Treatment of patients diagnosed with cancer of the duodenum is performed with the help of surgical intervention. The type of operation is chosen depending on where the malignant tumor is located and at what stage of development the disease is located. A small tumor is removed by laparoscopic means, that is, through minimal punctures in the abdominal wall. If the tumor is large, it is removed by extensive surgery. In this case, the doctor removes the gastric outlet and the gland adjacent to it, part of the duodenum, gallbladder and pancreas head.

If a malignant tumor has been diagnosed at a late stage, this greatly complicates the operation. In this case, the surgeon removes not only the tumor, but also the affected lymph nodes and adjacent tissues.

In addition to surgical treatment, the patient is prescribed radiotherapy and chemotherapy. Such treatment helps to prevent relapse and contributes to the prolongation of the patient's life.

Patients diagnosed with duodenitis are prescribed medication and physiotherapy. In acute or chronic duodenitis, doctors prescribe painkillers: Drotaverine, No-shpu and Papaverin. To reduce the acidity of gastric juice antacids are prescribed, for example, Omeprazole or Almagel.

If duodenitis develops against a background of helminthic invasion, the treatment is performed with antibiotics. To normalize the work of the intestine, drugs are prescribed that enhance its peristalsis. Such preparations include Maalox and Domperidone.

Physiotherapy is provided as an auxiliary treatment. Ultrasound, heating, paraffin applications and magnetotherapy are considered to be effective. Physiotherapeutic procedures allow to normalize the blood supply and lymph flow of the abdominal organs, to remove pain.