Ulcer of duodenal bulb (ICD 10:K26) - a fairly frequent disease, diagnosed already in advanced stages. This is because people are accustomed to attribute any discomfortable sensations in the stomach to stale food or breaking the diet. A person suffers pain, drowns her with medicines, and meanwhile the disease progresses. Such a patient will go to the doctor when it becomes unbearable to ignore your body.
Epidemiology
Duodenal ulcer likeis usually secondary to lesions of the gastric mucosa. Therefore, the diagnosis is usually written "gastric ulcer and duodenal ulcer," without specifying the location.
Около 5 % всех людей на Земле имеют данную pathology. In men, it occurs 4 times more often than in the fair sex. And the ratio of townspeople and rural residents is about 2 to 1. Most likely, this is due to the quality of products, food habits and work activities of residents of urbanized areas.
Causes
Duodenal ulcer occursdue to the corrosive action of hydrochloric acid (part of the digestive juice) on the mucous membrane of the small intestine. There are several reasons for the increase in acidity:
excessive secretion of gastrin (hormone that regulates digestion);
passion for spicy, bitter, salty, sour, fried and fatty foods;
lack of food in the afternoon and overeating in the evenings;
long-term use of hormonal or anti-inflammatory drugs;
regular stress exposure;
smoking and drinking alcohol, especially on an empty stomach.
In rare cases, the appearance of erosions and ulcers inthe duodenum may be associated with increased levels of calcium in the body, decreased liver and kidney function, and chronic obstructive pulmonary diseases.
Pathogenesis
The ulcer of the duodenal bulb is manifested by a wave-like course with alternations of remission and exacerbation. Conventionally, there are three stages:
acute course (symptoms are pronounced, there are ulcers and erosion on the mucous membranes);
process attenuation (no complaints, ulcers are scarring);
remission (no symptoms, scars epithelialized).
Violation plays a major role in the appearance of an ulceracid-base balance on the intestinal mucosa. If more hydrochloric acid is formed than alkali, then it is not completely neutralized and damages the surrounding tissues. Cells break down, release enzymes and increase damage. In this area, the mucosa forms inflammation, which increases with each new portion of chyme. In addition, increased peristalsis and an increase in the number of secretory cells in the stomach allows you to secrete acid, even outside the meal.
Symptoms
How does the bulb ulcer manifest itselfduodenal ulcer? Symptoms and treatment are closely related, so it is important to find out which particular syndrome prevails. Clinical phenomena are very intense and cause a lot of inconvenience to the patient.
The very first and foremost sign is pain inumbilical region. It can be both acute and aching, it all depends on the quantity and quality of meals. In addition, at first it is easy to get rid of it by drinking antacids. Sometimes pain can return at night and radiate to the lower back.
Every ulcer knows:To get rid of nausea, belching or pain, you just need to eat. Desirable something of a jelly. But this remedy is not universal, because vomiting can return after eating, “bringing” heartburn and a feeling of heaviness as a “bonus”. Periodically, these people suffer from stool disorders in the form of constipation and flatulence.
Complications
Acute duodenal ulcer is a disease dangerous to life and health. In severe cases, severe bleeding, perforation of the intestinal wall and the formation of sepsis are possible.
An ulcer can not only eat away the wall of a holloworgan, but also seep into the next. For example, from the duodenal bulb, the pathological process shifts to the pancreas, forming fistulas and abscesses.
Chronic complications include stenosis.(narrowing) of the intestinal section. This hinders the passage of food, provokes its stagnation and rotting in the stomach. In humans, this is manifested by a feeling of heaviness, weakness, pallor, exhaustion, and lack of appetite. In some cases, there may be vomiting with slices of undigested food eaten a few days ago.
Diagnostics
Ulcer of duodenal bulbdiagnosed quite easily, given that patients seek help from a doctor already at the height of the disease, when discomfort prevents them from living a normal life.
First, the doctor collects anamnesis and conducts examination.Of course, probing the abdomen does not give a high information content, but it is possible to suspect, with a high degree of probability, the ulcerative process. Then the patient is sent to take a blood test, biochemical markers, fecal occult blood analysis, and also determine the level of gastrin and the activity of Helicobacter pylori.
Самой распространенной диагностической процедурой remains esophagogastroduodenoscopy, or, more simply, endoscopy. It allows you to inspect the mucous membrane of the digestive tube, burn all identified ulcers, take tissues and fluids for examination. Radiography is also informative. The pictures with contrast will clearly show the places of ulcers and the condition of the gastric mucosa and duodenum.
Treatment of duodenal ulcer ulcers
First of all, you need to prepare yourself toIt is a long and painstaking process, consisting of diet, physiotherapy and medication. Do not be afraid, all this must be done not at the same time, but according to a clearly developed plan and after consulting with a doctor.
For starters, a gastroenterologist determines the causewhich caused an ulcer and directs all forces to get rid of it. For this there is drug therapy. These are antacids, and prokinetics, and proton pump inhibitors, and many other pharmacological miracles. In addition, lungs sedatives and hypnotics can help in the fight against stress ulcer, but they need to be used with caution. Penicillin antibiotics and macrolides work well against Helicobacter pylori.
Balneological procedures, Novocain electrophoresis and warming are shown to the patient at the stage of recovery to maintain the strength of the body.
Folk remedies
Treatment of duodenal ulcer ulcersfolk remedies are fraught with unpleasant consequences for health. Therefore, before starting this kind of experiments, warn the attending physician. He will thank you for it.
On the Internet, as well as our grandmothersThere are many recipes for treating ulcers. In order to reduce acidity and increase mucosal resistance, people drink fresh potato juice, a mixture of honey and butter, or simply dissolve the honey in warm water and use before eating. There are also more exotic recipes, for example, the use of sea buckthorn seed oil and a teaspoon before each meal.
All these methods will be able to remove discomfort, some even contribute to the healing of ulcers, but still preference should be given to traditional methods of treatment.
Diet for ulcer duodenal ulcer
During periods of acute illness, patients shouldadhere to a sufficiently strict diet that will help reduce the intensity of pain, as well as speed up recovery. Some tips for a similar diet:
Fractional meals every 3 hours in small portions.
It is necessary to eat slowly, chewing food thoroughly.
Food should be warm so as not to irritate the already sensitive intestines.
Selected products should not stimulate additional production of hydrochloric acid, so nothing fried, spicy, salty, pickled and spiced.
Some delicacies and pickles may have to be abandoned for life. But milk, fruit, mashed potatoes and jelly, steamed vegetables and eggs can be eaten in unlimited quantities.
