What is duodenitis?

Duodenitis is an inflammation of the duodenum. Isolated it is rare. The anatomical and functional connection in the upper sections with the stomach creates favorable conditions for the spread of the process from the pyloric section to the bulb of the duodenum.

The term "duodenitis of the stomach" is erroneous. The correct name for the lesion of both organs is gastroduodenitis. In the lower zone, through the pharynx of the papillae, the intestines of the gallbladder and pancreas enter the intestine. Hence, duodenitis necessarily accompanies cholecystitis, cholangitis, cholelithiasis, pancreatitis.

Treatment of duodenitis in adults is often associated with the restoration of secretory activity of the stomach and pancreas, bile secretion. In 94% of the disease has a chronic course. Men suffer 2 times more often. In children, the pathology usually manifests itself in an acute form. It is well treated by diet, phytotherapy.

Why does it cause inflammation of the duodenum?

There are primary and secondary duodenitis. If the primary is an independent pathology, then the secondary one is always a complication of other diseases of the digestive organs. The mechanism of the development of primary inflammation of the duodenum consists in irritation of the mucous membrane with the acid of gastric juice.

Under normal conditions, the pyloric compartment "extinguishes" the acidity and the food enters the intestines weakly alkaline. Epithelium of the duodenum is not adapted to the effect of acid, therefore it becomes inflamed, with chronic effects in the wall degenerative processes occur, atrophy. The main cause of malfunction of the normal operation of the primary part of the intestine is the nutritional factor.

The adult person himself creates such a violation, preferring to use:

• fried foods;
• alcohol;
• sharp seasonings;
• smoked meat products;
• fast food;
• canned food.

To duodenitis result in irregular eating( overeating, craving for fashionable hungry diets, strong coffee), propensity to eat dry, smoking. It is important to change the regulation of digestive processes at the level of the nervous and endocrine system. Frequent stressful situations, overstrain, lack of regular rest, work at night lead to disruption of the mechanisms of adaptation.

The causes of secondary duodenitis can be diseases of neighboring organs involving the duodenal ulcer in the inflammatory process:

• infection with Helicobacter pylori caused by food from the stomach;
• chronic gastritis;
• of bowel disease( colitis, enteritis, Crohn's disease);
• peptic ulcer disease;
• hepatitis;
• calculous and acalculous cholecystitis, atony of the biliary tract with congestion of bile;
• pancreatitis;
• infringement of a blood supply at an atherosclerosis of vessels of a mesentery;
• change in innervation after injuries, injuries, abdominal operations.

Cases create conditions for disruption of the duodenum. It delays arriving content( food lump, bile, pancreatic juice).Due to impaired peristalsis, balance of enzymes, there is duodenosis, inflammation. In the future, the formation of ulcers, perforation in the abdominal cavity, adhesions with other loops of the intestine, obstruction.

Varieties

The classification of duodenitis, as already noted, provides for the isolation of primary and secondary diseases, acute and chronic forms. Since it is the chronic pathology that is most significant for damage to the bowel function, it is divided according to different criteria into more precise types of the disease.

Depending on the location: the focus of inflammation is in the region bordering the stomach( bulbs) - bulbite, in the lower sections - postbulbar duodenitis. The prevalence of the process can be local( small, delimited) or diffuse( cover the entire gut).

The development of endoscopic capability allowed the following lesions to be distinguished from the lesion pattern:

• erythematous;
• hemorrhagic;
• atrophic;
• erosive;
• nodular.

Depending on the results of morphological examination of tissues in areas of inflammation, duodenitis is distinguished: superficial( catarrhal), interstitial, atrophic. Specific specific forms include inflammation in tuberculosis, candidomycosis, Crohn's disease, Whipple, amyloidosis of the intestine.

The current clinical classification is more dependent on the manifestations of the symptomatology, indicating the cause of the lesion. Isolate acidideptic bulbit( usually combined with a hyperacid gastritis, peptic ulcer disease), duodenitis with enteritis and other intestinal lesions, inflammation due to duodenosis, focal duodenitis of the pharyngeal papilla( periapodal diverticulitis).

Symptoms in adults

In adults, the signs of duodenitis reflect current chronic inflammation. They give manifestations similar to those that triggered a duodenal response. Symptoms of inflammation in the acidodepitic form of duodenitis are expressed by an ulcerative syndrome with intense pain in the epigastric region of the fasting, at night, 1.5-2 hours after ingestion.

The enteric variant is manifested by signs of intestinal dyspepsia( diarrhea, constipation), impaired absorption of nutrients, protein, vitamins, water. Pain syndrome is characterized by spastic contractions around the navel, aching sensations below the epigastrium.

Duodenostasis is manifested by attacks of raspiruyuschih pain. They are located in the epigastric region, in the hypochondrium on the right. Irradiate in the back, lower back, in the collarbone and shoulder. Patients are worried about constant rumbling in the abdomen, swelling, belching bitterness, nausea, vomiting with bile. Disturbed innervation causes a reflux of the contents into the stomach and then into the esophagus.

Gastric reflux in this case is triggered by a systemic disruption of food movement from the upper intestine. Local inflammation in the papilla prevents the outflow of bile, so the symptoms of atony of the biliary tract are manifested( dilating blunt pains in the hypochondrium on the right, a feeling of bitterness in the mouth, nausea).

With calculous cholecystitis, mild jaundice of the skin and sclera appear, darkens the urine, clarifies the feces due to the release of bilirubin into the blood. Simultaneous damage to the pancreas and duodenum is expressed by severe shingles in the upper third of the abdomen, the lower back, both hypochondria.

Chronic duodenitis leads to cell degeneration, causing a decrease in the synthesis of enzymes involved in digestion( secretin, enkephalins).Insufficiency affects not only the work of the gastrointestinal tract, but also causes changes in the nervous system. Therefore, there are general symptoms( fatigue, weakness, irritability, insomnia, headaches).

Forms of the disease

Clinical manifestations of duodenitis are masked for other diseases, so doctors distinguish forms. Distinctive features are presented in the table.

Form name	Symptomatic
Yazvennopodobnaya	Pain in the epigastric region or slightly to the right, disturb at night, on an empty stomach, aching, pulling, do not give irradiation, accompanied by belching with bitterness, heartburn. The condition improves after eating, drinking milk.
Gastritelike	Pain provoked by eating, occurs after 15-30 minutes, characterized by dyspepsia in the form of nausea, vomiting, belching, diarrhea, bloating. Patients have no appetite, in the abdomen there is a constant grunting.
Cholecystlike or pancreatic-like	Intensive pain in the hypochondrium to the right, left or girdle, irradiates into the scapula, upward into the shoulder and collarbone, occurs paroxysmally, accompanied by vomiting of bitterness, diarrhea, bloating.
Neurovegetative	The main manifestations of secretory deficiency, hormonal and vegetative disorders: weakness, dizziness, headaches, insomnia, irritability, sweating, dumping syndrome.
Mixed	Combines the symptoms of various forms.
Asymptomatic current of	It is observed in old age against a background of systemic atherosclerotic vascular lesions, dystrophy of the epithelium of the duodenum. Is detected by accident.

Disease in childhood

In children, duodenitis occurs more often and is associated with gastritis. The main reasons are:

• food poisoning( toxicoinfection);
• use of "adult" dishes, fatty foods, spices, to which the digestive system of the child is not ready( alcohol for adolescents);
• congenital abnormalities of the intestines that cause duodenosis;
• frequent food preservatives, fast food;Bad chewing of rough products;
• fizzy drinks;
• allergy and the effects of certain medications( aspirin, sulfonamides, antibiotics);
• infection with helminths, giardiasis;
• household poisoning with detergents, solvents;
• stress states.

Inadequate nutrition, effects on the gastric and duodenal ulcers of poisons, toxins, infectious agents lead to inflammation. The formation of inflammation of the mucous membrane of the gastroduodenal zone is explained by pediatricians as a function of the correlation in the child's body of local defense factors and the strength of aggression.

Protection is provided by the secretion of mucus, the ability to restore the epithelium, sufficient blood supply, inhibition of production of hydrochloric acid and pepsin, saliva and pancreatic juice retained by the motility of the duodenum. Aggressive factors include: pepsin, hydrochloric acid, bile acids.

For acute inflammation characterized by:

• rise in temperature to 38-39 degrees;
• signs of intoxication( weakness, headache);
• pain in the upper abdomen;
• nausea, vomiting;
• loss of appetite;
• belching;
• increased salivation;
• diarrhea or constipation;
• bloating;
• increased heart rate.

How to detect an ailment?

The main method of diagnosis is esophagogastroduodenoscopy. Obtaining a visual accessible endoscopic picture gives the opportunity to determine the degree of spread, the form of the disease, the detection of the transition to an ulcer, the taking of material on a biopsy.

pathology. Other survey methods are additional:

• radiography with contrasting of the stomach and duodenum - allows you to examine the contours of the organs, to identify stagnant phenomena with a disturbed motility;
• study of the acidity of gastric juice - indicates the available active stimulus with increasing levels;
• duodenal sounding - makes it possible to check the composition of bile, to detect a tendency to form stones, infectious agents;
• biochemical blood tests - are necessary for the analysis of the functional state of the liver, pancreas activity;
• coprogram - indicates a latent bleeding, reflects the results of the digestion process.

Complications of

Both acute and chronic form of duodenal inflammation without timely therapy can cause more severe complications:

• bleeding from the erosive surface of the mucosa;
• formation of an ulcer penetrating into the depth of the wall;
• perforation of the intestine, exit of contents into the abdominal cavity with the development of peritonitis;
• duodenostasis and reflux filling of the contents into the stomach, then the esophagus promotes the development of esophagitis( inflammation of the esophagus), possibly - gastroesophageal reflux disease;
• gut deformity, narrowing of the lumen with signs of high obstruction;
• adhesions with the intestine and adjacent organs, impeding motor activity;
• acute and chronic pancreatitis.

How to treat duodenitis depending on the form of the disease?

Treatment of inflammation of the duodenum depends on the specific clinical form of the disease. With acidodepitic chronic duodenitis, it is necessary to provide ways of influencing the release of Helicobacter pylori infection( eradication course).

Strengthening of local mucosal protection( inhibition of hydrochloric acid synthesis by proton pump inhibitors, antacid agents, H2 blockers), prescription of medicines with enveloping effect. The use of enzymes to ensure the restoration of the digestive process.

Identification of helminths and lamblia will require the conduct of courses with specific drugs with cure control. If duodenitis proceeds according to the enteric variant, then in the treatment process great importance is given to excluding from the diet of coarse, intractable foods( milk, legumes, cabbage, raw vegetables and fruits).

Detection of duodenosis causes the need to eliminate the causes of stagnation and obstruction. Conservative methods consist in the application of: food in fractional small portions( with the prohibition of any products stimulating bile secretion), drugs that enhance transport function, the output of bile acids, duodenal sounding with the withdrawal of contents and washing of the intestine.

If the delay is caused by a mechanical obstruction( adhesion process, stone, tumor), then surgically treated with resection and removal of the affected area is effective.

How to eat sick?

Patients with chronic gastroduodenitis recommended dietary nutrition option, the same with peptic ulcer. The diet depends on the stage of exacerbation, fading, remission, acidity of the gastric juice. If the patient has an increased acidity, tables # 1a, # 1b are successively assigned, and in the convalescence phase - # 1.

Against the background of secretory deficiency, it is recommended to eat food according to the type of table number 2.It is distinguished by the presence of sokonnyh substances. Diet 1a is prescribed no longer than for 2 weeks. It is as gentle as possible, excludes any physical and chemical irritants, but it is low in calories.

Table 1b is recommended for a month. It is physiologically full, but excludes sharp, fried food, smoking, coarse fiber, salt, remains rubbed. The rules of diet number 1 patient must comply with another 6 months. It is considered moderately sparing, allows lumpy boiled meat, finely chopped vegetables, steep porridges.

Do not reduce the amount of food intake( at least 6 times a day), overload the stomach at night, drink alcohol, fizzy drinks, eat fried and fatty foods. Chronic process requires the implementation of the rules of the table number 5, because most often the patient remains in the period of remission functional changes in the system of biliary excretion.

Can I cope with duodenitis with folk remedies?

With the help of folk recommendations, it is possible to support the recovery of the mucosa during the period of remission. It is not recommended to use herbal medicine in an acute period. Any means should correspond to the individual acidity of the gastric juice. Broth of wild rose or chamomile has a general anti-inflammatory effect, you can drink them anyway.

If you are inclined to duodenosis, you should consult an experienced specialist. In this condition, medicinal plants that enhance bile synthesis are not shown, but it is possible to take cholekinetics that stimulate the motor activity of the ducts and duodenum.

Since duodenitis often accompanies and complicates other pathological conditions of the gastrointestinal tract, chronic patients should adhere to recommendations for the prevention of exacerbations, proper nutrition and regimen. The appearance of additional disorders is extremely undesirable, quickly affects the risk of complications.