Duodenal ulcer

duodenal ulcer ulcer Duodenal ulcer is a chronic relapsing disease that occurs with periods of exacerbation and remission.

The main sign of an ulcer is the formation of a defect (ulcer) in its wall. Often ulcers are affected not only by DPC, but also by the stomach (gastric ulcer), and other organs of the digestive system with the development of dangerous complications.

The main symptom of exacerbation of duodenal ulcer is abdominal pain, which can irradiate to the lumbar spine, right hypochondrium, various abdominal parts.

Causes

There is a peptic ulcer of the stomach and duodenum due to increased acidity. Under the influence of acid in the mucous membrane, destructive processes occur, which subsequently lead to an ulcer.

The reasons provoking the development of this disease are quite a lot, they are known to everyone, they all face it. These are stresses, nervous overexertion, incorrect and irrational nutrition. It is also established by modern medicine that the frequent cause of gastric and duodenal ulcers is the bacterium Helicobacter pylori.

instagram viewer

Heremain factors, contributing to the development of duodenal ulcer:

alimentary disorders - irregular, irregular meals;
frequent stress;
increased secretion of gastric juice and reduced activity of gastroprotective factors (gastric mucoproteins and bicarbonates);
smoking, especially on an empty stomach;
gastrin-producing tumor (gastrinoma).

Long-term treatment of various inflammatory pathologies with anesthetic NVP (ketorolac, diclofenac, indomethacin, ibuprofen, aspirin) also adversely affects the walls of the duodenum, and can give an impetus to the development of ulcers.

Symptoms of duodenal ulcer

Duodenal ulcer For a long time the disease can not give any symptoms. However, at the initial stages of the disease there is discomfort at the top of the abdomen and minor digestive disorders.

The most characteristic symptoms of duodenal ulcers occur with the progression of the disease:

Oftenpain can be the only symptom, by which it is possible to recognize peptic ulcer. The kind of pain can be different: stitching, cutting, periodic, constant, compressive, etc. Usually it is located at the top of the abdomen in the middle or on the right, but if a person feels it in the left hypochondrium, you can suspect that it has a mirror YAD. Pain most often occurs before meals (hungry pain) or after it. Sometimes, a couple of hours after a meal, patients feel hungry. Also characterized by night pain, they arise in the middle of the night, and the person wakes up because of unpleasant sensations in the stomach.
Nausea, a feeling of fullness of the stomach, bloating, heartburn, belching.
General weakness, weight loss, decreased efficiency.

If you see similar symptoms, you should contact a specialist. Treatment of duodenal ulcer should be complex and include not only medication therapy, but also other methods of treatment, such as diet therapy, physiotherapy, therapeutic gymnastics and sanatorium treatment.

Diagnostics

Diagnosis of duodenal ulcer is possible thanks to endoscopy: this method gives the doctor complete information about the patient's condition. When an ulcer is detected, it assesses its location, size, type, presence of scars. During the procedure, a sample of the mucosa along the edge of the defect is sampled for examination for the presence of Helicobacter pylori.

Radiography is also used, feces, blood are analyzed, and biopsies are performed.

Complications

When untimely treatment of ulcers of the duodenal ulcer, the disease can cause: bleeding, perforation and penetration of the gut, narrowing its lumen.

Penetration of the ulcer is characterized by penetration into adjacent organs through a defect that infects the gut.
The narrowing of the lumen of the duodenum is the result of the formation of a scar or edema.
Bleeding ulcers is a consequence of involvement in the pathological process of the vessels of the mucous membrane. Latent bleeding can be characterized by anemia.
Perforation of the ulcer - the formation of a gap through which the entire contents of the intestine penetrates the abdominal cavity and causes the development of the inflammatory process - peritonitis.

Treatment of duodenal ulcer

If the diagnosis of "duodenal ulcer" is confirmed, treatment should be started immediately. This disease requires a comprehensive approach, otherwise you can not achieve the desired result.

An exacerbation of an ulcer, that is an attack with intense pain, is treated in a hospital. Acute ulcer leads to the need to provide patients with strict bed rest and emotional rest for that there was a scarring, after all an ulcer in a stage of a white scar does not represent danger to a life of the patient.

Medication

Groups of medications that are used to treat duodenal ulcers:

When detecting hilakobaktery treatment is in antibiotic therapy. For this, the following drugs are used: amoxicillin; clarithromycin; Metronidazole. If after a single course of antibiotics the bacterium does not die, then repeat this drug is not worth it. Another treatment regimen is chosen.
To eliminate pain by reducing the secretion of hydrochloric acid are used: omez, gastrozole, bioprazole, control, sanprase, helicol, lansap, zulbex, zolizpan, etc.
Preparations that eliminate pain, by forming a protective film on the duodenal mucosa: diamond, algebra A, diamond Neo, maalox.

The course of treatment of ulcers can take from two to six weeks, depending on the size of the defect, the general condition of the body. It should be noted that the appointment of treatment for duodenal ulcers, to select drugs and schemes for their administration should a competent specialist who can monitor the treatment process and evaluate its results.

Surgery

In a number of emergency cases, such as perforation of the ulcer, severe gastrointestinal bleeding, obstruction of the pyloric canal, resort to surgical treatment. In this case, two types of operations are carried out:

Vagotomy- the intersection of nerves that stimulate gastric secretion and lead to recurrences of peptic ulcer.
Resection of the stomach- is the removal of 2/3 of the stomach and the connection of the remaining part of it with the intestine, often with resection performed also by vagotomy.

With JADK, surgery is indicated only in special cases, as complications often occur (inflammatory processes, bleeding, severe metabolic disorders).

Diet with an ulcer

There are several types of diets with ulcer of the duodenum. For example, the unloading diet, which is called Table 1 according to Pevzner and corresponds to a peptic group of gastrointestinal diseases. There is also a Table 0, which is characterized as a complete lack of food intake in the first few dozen hours after surgery on the digestive tract.

The main recipe for a diet under the IUD is Table 1, which is divided into Table 1a and 1b, depending on the stage of the disease (exacerbation or fading).

Below we will consider the basic principles of proper nutrition, a more detailed menu can be searched by diet number.

With peptic ulcerNot recommendeduse:

spicy dishes;
fried food;
salty foods;
smoked products;
various canned food;
fatty grades of meat and fish (pork);
sugars (sauerkraut, tomatoes, cucumbers);
rye bread and bakery products made of buttery dough;
fruits that increase acidity in the stomach (citrus, tomatoes, and others);
from the diet excludes all hot, cold, spicy condiments to reduce the activity of gastric juice production.

Products and dishes that can be consumed:

light soups from vegetables;
dairy products (milk, not fatty cottage cheese, not fatty sour cream, kefir);
Fish of low-fat varieties or dishes from it (pike perch, perch and others);
not fatty sorts of meat (rabbit, chicken, veal);
different kinds of porridge (buckwheat, oatmeal, rice and others);
crackers and dried bread;
vegetables and fruits, fresh or boiled (red beet, potatoes, carrots, zucchini);
dishes cooked on vegetable oils (olive, sea-buckthorn and others);
All food should be cooked, baked in the oven, stewed or steamed

It is recommended to take food in small fractions. Due to this, the walls of the stomach stretch less, the food is absorbed almost completely and the intestine does not experience excessive load.

Prevention

The main measure of prevention is to do everything possible to avoid the cause of ulcers. Strengthening their health, a person minimizes the possibility of getting sick. Even if infected with an infectious way, he will cope much easier and recover faster. Scientists have accurately established that health is half dependent on the way of life.