What is gastroduodenitis?

The term "gastroduodenitis" in medicine is called joint inflammation, localized on the mucous membrane of the stomach and duodenum. Anatomical and physiological features of this zone of digestion are so connected that the defeat of one organ leads to the illness of the other in the absence of treatment.

Signs of gastroduodenitis necessarily precede peptic ulcer. According to statistics, 50% of adults have a pathology of the digestive system in the form of gastritis and duodenitis. Over the past two decades, the problem has worsened among young children and schoolchildren. Before we find out what gastroduodenitis is, let's figure out why these diseases occur together.

What features of anatomy and functioning are related by two organs?

The stomach comes into contact with the initial section of the small intestine in the pyloric valve through the sphincter. The adjacent part of the duodenum is called an onion, it is about it that is referred to as duodenitis.

Entered into the stomach food is 6-10 hours. This time is required to completely treat the contents with gastric juice and move toward the intestine. In the antrum area, the necessary glandular cells that produce hormone-like substances( gastrin, pepsin, histamine, acetylcholine) are located.

They stimulate the production of gastric juice under the influence of endocrine and nervous regulation. The inhibitory effect is reflexively enterogastrin and hydrochloric acid entering the bulb( acid duodenal reflex).As a result, protein substances from food are split in the stomach to albumins and peptones.

Some of the substances are absorbed into the blood already at this stage. The importance of supporting the process of digestion in the pyloroduodenal zone is indicated by a massive blood supply, adjusted according to one principle - the arteries on both sides. Such vascularization provides for the possibility of compensation and replacement in the case of thrombosis.

And, in the area below the bulb of the duodenum, blood comes only from one side( through the vessels of the mesentery).To neutralize the acid content of the stomach in the border region of the intestine, it is necessary to reduce the concentration of hydrogen ions by 100,000 times. In the upper part, the wall of the duodenum is strengthened by three layers of membranes( thereafter only 2).

Mucosal cells produce entero-gastronome, cholecystokinin, secretin, pancreosimin, enterocrinin, vallikinin to counter hydrochloric acid from gastric juice. In addition, enzymes from the bile and pancreatic secretions enter the lower parts.

One of the reasons for the failure of digestion and gastroduodenitis in patients after a resected gastrointestinal surgery( tumor, peptic ulcer disease) is the lack of the necessary duodenal hormones

Every 20-26 seconds due to the contraction of the muscular wall through the stomach passes a circular wave( in an empty stomach in an hour), which moves the food lump to the gatekeeper. The opening and closing of the channel is controlled by a reflex reflex. The signal comes from the bulb of the duodenum: if there is an acid reaction, the gatekeeper closes, when alkaline, it is open.

The normal pyloric capacity is about 3% of the contents of the stomach per minute. Any failure of a clear interconnection is reflected in the general process of digestion, gastroduodenitis affects other organs.

What causes gastritis and duodenitis?

The causes and mechanism of gastroduodenitis differ depending on the form. Acute inflammation is caused by ingestion:

• of poisonous and toxic substances in case of poisoning( accidental or with a suicidal goal);
• consumes a significant dose of alcohol;
• reaction to acute seasonings, rough meat food;
• a kind of allergic manifestation on foods, the content of pesticides in vegetables and fruits;
• is a person's experience of stress.

Under the influence of these factors gastroduodenitis sharply increases the secretion of gastric juice, the concentration of hydrochloric acid increases, it is thrown into the bulb. At the same time, local protection falls. In men, acute gastroduodenitis is detected 3 times more often. Up to 70% of cases of gastroduodenitis are chronic forms. The risk increases with age.

Their main causes:

• development of infection, most often Helicobacter, although it is possible to damage Salmonella, Staphylococcus, Enterobacteria;
• transition from the acute form in the absence of timely and full treatment of gastroduodenitis;
• violation of diet, the full value of products, the fascination of women with fashionable diets, vegetarianism instead of the expected result leads to a long period of hunger( acid corrodes its own mucous membrane), lack of protein intake, vitamins( cause anemia and immunodeficiency);
• frequent use of fast food, chips, soda water, canned food;
• work, study with constant overload, nervous breakdowns;
• the need for long-term treatment with nonspecific anti-inflammatory and hormonal agents, uncontrolled use of drugs for headache containing Aspirin, Paracetamol;
• long-term smoking, alcoholism;
• hereditary predisposition to gastroduodenitis.

The problem is aggravated by the patient's existing chronic liver, gallbladder, intestinal, pancreatic diseases, cardiac decompensation, blood diseases, endocrine and nervous systems. More often not one, but several reasons.

65-85% of cases of chronic gastroduodenitis are caused by Helicobacter pylori

As it turned out, Helicobacter pylori can be found in a person from childhood and "wait" for a convenient moment to attack. When there are other factors that break the formation of secretion, regulate the processes of digestion and food movement in the stomach and duodenum, the ability to restore the mucosa, helikobaktery "strikes".

What are the forms of gastroduodenitis?

Clinical forms of gastroduodenitis differ little in symptomatology. The main classification is determined after a visual examination of the mucosa by the method of esophagogastroduodenoscopy and determination of the acidity of the gastric juice in the patient.

Superficial gastroduodenitis - often occurs with acute inflammation, is expressed by thickening and swelling of the folds, hyperemia. Hypertrophic gastroduodenitis - against the background of reddening of the mucosa visible patches with white coating, pinpoint hemorrhages, folds edematic and thickened.

Mixed gastroduodenitis - in addition to the pattern of hypertrophy, foci of gray atrophy are identified due to impaired blood circulation, epithelial cell death, and mucosal folds in such cases are smoothened.

Erosive gastroduodenitis - typical multiple erosions( surface cracks, shallow sores), covered with mucus and fibrin film. The form is considered closest to a peptic ulcer.

The type of lesion is established by the endoscopic pattern of

. Some authors, by analogy with gastritis, add atrophic, hemorrhagic, gastroduodenitis with duodenogastric reflux. In terms of acidity, gastroduodenitis is distinguished:

• with hypersecretion( high acidity) - most cases;
• with normal secretion;
• gipisecretory - reduced secretion is characteristic of atrophic gastritis, a malignant tumor of the stomach.

Up to 40% of cases of gastroduodenitis occur in atypical and asymptomatic forms. During the diagnosis, the attending physician is convinced that the degree of organ damage does not correspond to the severity of the symptoms.

Manifestations of

Symptoms of gastroduodenitis in adults depend on the prevalence of the inflammation process. By the kind of pains the patient is concerned about, one can assume a primary lesion of the stomach or duodenum.

"Gastric" pains appear almost immediately after eating, are localized in the left side and in the center of the epigastrium. With increased acidity, they remove food intake( acid binding takes place).In character, they are noisy and bursting.

Duodenitis is expressed by hungry and nocturnal pains

Pain occurs 1.5 hours after ingestion. Localize in the right side of the epigastrium, in the navel. Disturbance of digestion with gastroduodenitis is manifested dyspeptic syndrome with acidic eructation, nausea, heartburn, bitter vomiting, stool change.

In clinical course, the following are distinguished:

• acute form - if the disease lasts up to three months;
• acute phase in a chronic process;
• incomplete remission of no more than two weeks;
• complete remission - in cases of absence of signs of pathology for several years, but if gastroduodenoscopy revealed inflammation;
• recovery, which is confirmed by the survey.

Chronic inflammation with gastroduodenitis proceeds wavy, the symptoms are less intense. Patients are troubled:

• a constant feeling of heaviness and overflow of the stomach;
• aching pain is difficult to associate with lunch or breakfast, can occur after 2.5 hours, removed after induced vomiting;
• sometimes the only manifestation is heartburn and belching, they decrease after eating, then bother again;
• appetite is not changed or elevated;
• an unpleasant aftertaste in the mouth;
• disorders of stool( diarrhea followed by prolonged constipation);
• smells from the mouth.

In the stage of exacerbation, all signs become more intense. Patients with chronic gastroduodenitis over the years are distinguished by a change in character. They are characterized by increased irritability, tearfulness, short temper, bad sleep. Often, they cause conflicts in the work collective and in the family.

Plaque thick, despite abundant saliva secretion

When examining a patient with gastroduodenitis, the doctor sees the lagging of the tongue with a white, thick coating, pale skin. Palpation is determined by soreness in the zone of maximum pain. There is no tension in the muscles of the peritoneum. About the clinical course of gastroduodenitis in childhood can be found in this article.

Diagnosis

In diagnosis, it is important to properly assess the patient's complaints. The main additional methods are as follows. Signs of anemia in the general analysis of blood( a decrease in the level of hemoglobin, the number of red blood cells), possible nonspecific confirmation of inflammation in the form of moderate leukocytosis and ESR.

Analysis of feces for scatology reveals a digestive disorder( the presence of undigested fibers, mucus).Esophagogastroduodenoscopy allows you to visually assess the extent of damage to the stomach and duodenum mucosa, clarify the form of gastroduodenitis, take material from the affected areas of the mucosa for biopsy.

Detection of the pathogen of inflammation( Helicobacter pylori) is most convenient for a urease respiratory test with urea. In acute forms of inflammation, bacteriological examination is carried out and the infection is sown. The pH-metry method is necessary to determine the type of gastric juice secretion in order to treat the disease with optimal medications.

Treatment of

Treatment of gastroduodenitis in adults is impossible without the patient's refusal to drink alcohol, smoking, compliance with dietary requirements.

Mode and power

It is recommended to normalize the mental and physical load, take a closer look at the organization of regular recreation. Eat 5-6 times a day, in small portions and strictly observing the schedule.

It is necessary to stop snacking "on the go" and dry, food should come warmed up, but not hot

Ice cream is excluded from the menu, cold temperature is stomach irritant. Among the prepared dishes, the diet does not allow anything that contributes to the increased secretion of gastric juice. You can not eat what causes increased fermentation, mechanical and chemical effects on the mucous membrane. Raw vegetables are allowed only in the garbled form.

To irritating products are: fried fish and meat, smoked products, pickled and canned vegetables, industrial juices( especially tomato), spices, spicy seasonings, sauces, baked pastries, fatty dishes, rich broths.

It's better to refuse strong coffee and tea, chocolate, carbonated drinks, you should choose low-fat dairy products. During exacerbations of gastroduodenitis, all meals are prepared only in a grated form or minced meat. The salt content is normal, if there are no contraindications for other diseases.

Meat and fish are steamed, in the form of cutlets, meatballs. From vegetables it is recommended to make stews, from fruits and berries - compotes, kissels. If the disease occurs without intense pain, heartburn, there is no need for strict mechanical treatment in the diet, but fried foods remain contraindicated.

The expansion of the diet is carried out as the digestive indices improve. In acute gastroduodenitis, table 1( first 1 "a", then 1 "b") is subsequently expanded. In chronic course of the disease, the patient will have to adapt to the strict requirements of nutrition for good.

Can gastroduodenitis be treated only with drugs without a diet? This issue worries people who are not used to the restrictions in eating and catering at work. Our answer - no matter how wonderful and expensive drugs are prescribed in the absence of shining of the stomach, a focus of continuous inflammation is created.

The process goes to deeper layers, causes ulcers, stimulates cancerous degeneration of

cells. Application of medical methods

As most gastroduodenitis is accompanied by an increase in acidity, we will elaborate on the treatment of this type of disease. To reduce acidity, different drugs are used:

• Binding acids( antacids) - support the process of alkalinization, the group includes Almagel A, Fosfalugel, Maalox, De-Nol.
• Blocking synthesis of glandular cells of the antral section - cimetidine, omeprazole, ranitidine.
• Increasing activity of antioxidant hormones - Gastal.

Spasmolytics - No-shpa, Platyphylline help to reduce pain. Patients need to use a maximum of drugs in injections, unless it is a question of the need for direct exposure to the mucosa.

For the purpose of normalizing nervous regulation, light sedatives, infusions from plants, medicinal herbs( motherwort, valerian, ready-made Novopassit preparation) are prescribed. To improve mucosal protection, recovery and healing processes, a course of biostimulators is prescribed( Aloe in injections, Actovegin, Solcoseryl).

If gastroduodenitis is diagnosed with reduced acidity, agents that stimulate the formation or replace gastric juice( ready-made drug from gastric juice, Acidin-Pepsin, Betazid,

) are used in patients with a known Helicobacter pylori infection.antibiotics( Amoxicillinum, Sumamed) in combination with metronidazole and preparations based on bismuth compounds

When infection is detected by the method of bacterial analysis with acute gastroduodenitisAt the time of remission, physiotherapy, mud baths from healing springs, and the intake of mineral waters are prescribed.

The gastroduodenitis complicating the postoperative gastrectomy period needs to be monitored by the surgeon for the terms of healing, the reasonNot all drugs are suitable for treatment with this option.

How to cure gastroduodenitis in folk ways?

Folk recommendations are supported by doctors only for therapy of the stage of fading exacerbation or remission. You can not try to treat herbs during exacerbations. The main purpose of the broths and infusions is to soothe the mucous membrane, activate local immunity, circulation in the area of ​​inflammation.

For this fit:

• daisy( flowers);
• yarrow;
• oatmeal;
• flaxseed oil and decoction;
• juice of plantain;Honeysuckle hiphop.

It is necessary to know exactly the effect of plants on acidity in a particular case, so as not to provoke an exacerbation of

Simultaneous damage to the primary parts of the digestive tract is reflected in the work of other organs. The consequences of an untreated disease can be chronic pancreatitis, cholecystitis. Do not run the disease and disobey the doctor's recommendations.