Vomiting duodenal ulcer. Statistics: how often do people get duodenal ulcers? Causes and factors influencing the development of the disease

Contents of the article:

Most common symptoms of ulcers twelve duodenum in men. This disease is rare in children; in the stronger half of humanity it is diagnosed twice as often as in women. All men over 25 years of age have a risk of getting the disease, but most of those affected have reached the advanced age of 55 to 65 years.

What is an ulcer

Duodenal ulcer is called chronic illness. A defect (ulcer) forms on the intestinal wall, affecting not only the mucous layer, but also the submucosal layer. The bottom of this ulcer may be located even deeper, in the muscle layer.

There are a number of factors that protect the duodenum, and a number of aggressive factors that contribute to the onset of the disease. If the protective ones stop working, and the aggressive ones become more active, a man may develop a duodenal ulcer.

Protective factors:

1. Good blood supply, which helps to provide all mucosal cells with nutrients, as well as quickly restore any damage that has occurred.
2. The formation of mucus, which can destroy bacteria and protect the mucous membrane from them.
3. Alkaline environment, it helps neutralize hydrochloric acid.

Aggressive factors:

• increased acidity in the stomach;
• enhanced synthesis of certain enzymes;
• the stomach works in an enhanced mode.

Causes of ulcers

There are many reasons why a patient develops a peptic ulcer. Sometimes a combination of certain factors is to blame.

Main reasons

The main cause of both gastric ulcers and duodenal ulcers is the bacterium Helicobacter pylori. About half of the world's population is infected with this bacterium, but not everyone suffers from ulcers. The disease is caused only by a special strain, and there must be other factors contributing to its appearance, so duodenal ulcer occurs in only 10-15% of infected people. Other experts believe that the main reason is increased acidity.

Secondary reasons

There are other reasons that contribute to the appearance peptic ulcer:

1. Genetic predisposition. Men whose close relatives also suffered from duodenal ulcers become ill.
2. Chronic stress, constant overwork. Men who disappear day and night are often diagnosed with ulcers, since a constant state of stress leads to impaired blood circulation and nutrition of the intestinal mucosa.
3. Poor nutrition. The strong half of humanity often does not monitor their diet. At work, men can easily forget about lunch. But then they overload digestive system, having a hearty snack. Many men love everything fried, smoked, fatty, and also do not refuse canned foods and fast food.
4. Bad habits. Some women also abuse alcohol and smoke, but these bad habits are still more common in men. Therefore, they suffer from ulcers, especially those who frequently drink alcohol and smoke on an empty stomach.
5. Night shift work. Sometimes you have to work on such a schedule, especially for men. This also affects a person’s health; the immune system is weakened, which contributes to the appearance of ulcers.
6. Taking certain medications. This may be taking NSAIDs, but not a short course, but long time or other medications, such as anticoagulants.

Symptoms

If a patient has a duodenal ulcer, then it will proceed cyclically: that is, first an exacerbation, which can last several days, or 1.5-2 months, and then remission, which can also be either long or short. For most people, exacerbations of the disease occur either in the spring or in the autumn, and this is the time when they worry unpleasant symptoms duodenal ulcers. During remission, most patients have no signs of illness.

Pain

One of the main symptoms of an ulcer is pain. It appears some time after eating, in the upper abdomen. “Hunger pains” are also identified; they occur in the patient either at night or early in the morning. The pain can be localized either in one place or spread throughout the entire abdominal cavity.

The intensity of pain may vary. Some patients complain of aching pain, for some it is similar to a burning sensation, but it can also be stabbing. The pain goes away if the person eats something.

Due to the fact that patients regularly experience pain after eating, they may refuse to eat, or, conversely, overeat, since the pain subsides after eating.

Dyspepsia

Dyspepsia is a series of symptoms that occur when there is indigestion. With a duodenal ulcer, symptoms of dyspepsia are also observed:

• feeling of heaviness, fullness in the stomach;
• heartburn. Approximately 30% of patients suffer from it. The acidic contents of the stomach enter the esophagus, causing a burning sensation;
• nausea or vomiting. This symptom does not bother everyone. When vomiting, either the food you eat or the contents of your stomach comes out. After it it becomes easier.
• flatulence, that is, bloating, accumulation of gases in the intestines;
• bowel disorder. The patient may have both diarrhea and constipation.

Dangerous symptoms

If you have any of the above symptoms of an ulcer, you should visit a doctor. But there are some symptoms whose manifestation should alert you. They indicate that the patient has a complication of an ulcer. Then you need to call an ambulance.

1. Severe “dagger” pain, pale skin, pain increases with movement. It may get better later, but this is an imaginary improvement. These are the signs perforated ulcer, that is, a hole appeared in the wall of the duodenum, the entire contents of the intestine could end up in abdominal cavity. An urgent operation is necessary, otherwise the person will die.
2. Severe pain also appeared, although not as intense as in the first case. She may be talking about penetration of the ulcer. And in this case, the patient must be hospitalized.
3. The stool became dark in color, the vomit also changed color, it had the hue of ground coffee. This indicates that internal bleeding has opened, since due to the appearance of the ulcer, not only the tissue, but also the walls were destroyed blood vessels. The bleeding must be stopped; only doctors can do this.
4. The patient became very pale, covered in cold, sticky sweat, complained of weakness and dizziness, and lost consciousness. These are signs of massive blood loss. If a patient has a duodenal ulcer, these are symptoms of severe intestinal bleeding, the patient requires urgent medical attention.

Diagnostics

If a patient has persistent dyspepsia, the doctor may suspect a duodenal ulcer. But a doctor can make a diagnosis only after a thorough examination of the patient:

1. First, the doctor will question the patient and pay attention to the symptoms of the disease. He may ask whether there were any relatives in the family with peptic ulcer disease, whether the patient had been taking any medications for a long time, or whether the man had bad habits (smoking, alcohol abuse).
2. Then he can ask the patient to take tests: blood, stool, breath test, which can show the presence of Helicobacter pylori.
3. Fibroesophagogastroduodenoscopy or FEGDS is prescribed, which will help assess the condition of the gastrointestinal mucosa. An endoscope with a camera is inserted through the patient's mouth.

Treatment

If the doctor confirms the diagnosis, and the man really has a duodenal ulcer, he will have to not only take medications, but also adhere to a strict diet.

Diet

The patient should eat frequently in small portions, about 5-6 times a day. He is allowed only warm dishes, cold and hot are prohibited.

During an exacerbation, the patient should adhere to diets 1a and 1b, eating mainly liquid and pureed foods. Then he can switch to diet No. 1. The patient can eat boiled porridge, puree soups, steamed cutlets, meat souffle. You can drink milk and eat non-acidic dairy products, dried wheat bread is allowed, not strong tea with milk and rosehip drink.

You will have to give up some dishes: all canned food, marinades, spicy food, pickles, smoked meats and mushrooms, sour fruits or berries. You cannot drink strong tea or coffee, soda, or alcohol.

Medicines

To cure a duodenal ulcer, it is necessary to take medications. The treatment regimen is developed by the doctor; it depends on the stage of the disease, the cause of the ulcer, and other factors.

The most commonly prescribed drugs are:

1. Antibacterial drugs to cope with the bacterium Helicobacter pylori.
2. Gastroprotectors. They are necessary to protect the mucous membrane from of hydrochloric acid.
3. Medicines that inhibit the secretion of gastric juice: H2 receptor blockers, inhibitors proton pump, anticholinergics.
4. Antacids. They help cope with heartburn, coat the stomach, protect it from hydrochloric acid.
5. Prokinetics. They are necessary to improve gastrointestinal motility, as well as to get rid of nausea and vomiting.
6. Drugs that help improve blood supply to the intestinal mucosa, which promotes good cell nutrition.
7. Antispasmodics. They help cope with pain.

After the patient has completed the course of treatment, he is again carefully examined. This is necessary to determine whether the therapy helped the patient.

It is possible to completely cure a duodenal ulcer only if the cause of its occurrence is the bacteria Helicobacter pylori. But the patient can achieve stable remission. To do this, he must lead a healthy lifestyle, forget about bad habits, eat right and follow your doctor's recommendations.

Signs of a sucking in the pit of the stomach in the morning, nausea, and a feeling of hunger can be a signal of an impending disaster called an “ulcer.” There is no need to wait for persistent pain and dangerous complications, but it is better to immediately visit a therapist at the slightest suspicion of pathology. Let's look at what a duodenal ulcer is, its symptoms and treatment, diet, complications and consequences.

What is the duodenum

Duodenum (duodenum) is a section of the digestive canal located immediately behind the stomach. Its length is equal to the width of 12 fingers, which is 25-30 cm. It is shaped like a loop with a bend around the head of the pancreas. The wall consists of the same layers as the entire digestive canal:

1. External (from connective tissue) – carries out protective functions.
2. Muscular – provides contractile activity, contains nerve nodes.
3. Submucosal (with many blood vessels and lymphatic vessels) – forms crescent-shaped and spiral folds. They do not smooth out even when the intestines are full of food gruel.
4. Mucous (with short and wide villi).

WPC - part small intestine, which performs a number of important functions:

• The breakdown of carbohydrates, fats and proteins into molecules that can be absorbed into the blood.
• A shift in the pH of food coming from the stomach towards an acidic reaction.
• Regulation of the process of secretion of pancreatic juice and bile depending on the contents of chyme nutrients Oh.
• Gatekeeper's job.

What causes ulcers?

Duodenal ulcer (ICD code 10 K26) occurs when the balance between aggressive factors digestive canal and its protective capabilities:

• Creation alkaline environment.
• Mucus secretion.
• Blood supply and nutrition of cells.

The disease begins with inflammation of the mucous membrane duodenum, but ends with the formation of serious defects on it with the bottom in the muscle layer. They appear, as a rule, in the initial part of the duodenum, where acidic acid is most often thrown gastric juice.

The disease occurs in 10% of the population. These are mostly young and middle-aged men. They are not drafted into the army. In women, pathology is less common due to estrogens, which provide a trophic effect on tissues, improve their blood supply and nutrition, and increase vitality. Cases are not uncommon full recovery women with ulcers during pregnancy.

Among the causes of the disease are not last place occupies a spiral - a common inhabitant gastrointestinal tract. It coexists with the host for a long time, but under certain conditions it sharply increases the size of the colony and damages the cells that produce mucus.

Early theories of ulcer development include the idea of ​​an imbalance between the protective properties of the mucosa and destructive impact enzymes and hydrochloric acid, which are observed with pyloric dysfunction. Today no one denies that there are more ulcers among people with blood group I.

IN Soviet time The prevailing opinion was that defects in the duodenum are more often formed in people exposed to chronic stress and overwork (this stimulates the release of gastrin as a mediator of inflammation). The hormone is released in greater volumes if a person spends a long time in the sun. Gastroenterologists are confident that the ulcer is psychosomatic illness. Usually it affects people with constant mood swings, excessive suspiciousness, excitability, and anxiety. An important circumstance is the weakening of the immune system.

Provocateurs of ulceration include corticosteroids and non-hormonal anti-inflammatory drugs, as well as antibiotics. The mucous membrane suffers from the negative effects of nicotine and alcohol. Ethanol causes direct harm to her.

A repetition of the “family scenario” threatens those who have ulcers in their family. The reason is hereditary factors, namely the psychological status, as well as the number of cells that produce hydrochloric acid. In combination with poor nutrition and an erratic lifestyle, the likelihood of defects occurring on the walls of the duodenum reaches 100%.

Ulcer symptoms, how it hurts

The pathology is characterized by a chronic relapsing course. Periods of exacerbations are followed by remissions. Scars form in place of the damaged mucosa. Their big number deforms and narrows the lumen of the duodenum. Signs of an ulcer become more pronounced during exacerbation, including:

• Pain above the navel radiating to the heart and scapula. Occurs in dark time days, 2-3 hours after eating. It intensifies with alcohol abuse, non-compliance with diet, and taking a number of medications.
• Mild belching and heartburn.
• Feeling of fullness in the abdomen.
• Nausea and vomiting.
• Stool disorders with prolonged constipation, stool with mucus or blood.
• Irritability, problems sleeping.
• Losing weight even with a good appetite.

The disease worsens in the off-season. The most difficult, according to doctors, is a “silent” ulcer that occurs without pain. Occurs in 15% of cases. It makes itself felt only during exacerbation in the form of perforation or bleeding.

Accurate diagnosis

To identify a peptic ulcer, the doctor needs to find out:

• How often do you worry about discomfort in the epigastric area, what is it associated with?
• Have any blood relatives suffered from gastrointestinal problems?

The patient is asked to undergo tests:

• Urine, blood, feces.
• To determine the pH level of gastric juice.

Among instrumental diagnostic methods:

• and determining the condition of the mucous layer with a biopsy for histological examination nature of defects. The doctor can visually assess the characteristics of the ulcerations. At the same time, it is possible to remove existing polyps.
• to examine the outlines of the duodenum, its deformations, areas of narrowing, and neoplasms. An outdated method, which is used if the medical institution does not have the appropriate equipment or the patient has suffered a stroke or suffers from angina pectoris or recurrent attacks bronchial asthma, severe arrhythmias.

Ultrasound of the abdominal organs is less informative methods diagnostics of the disease in question, but also clarifies the overall picture.

Treatment of duodenal ulcers

The disease is successfully cured using one of the specially developed regimens, including drips, injections, and tablets. Along with conservative therapy, the following are useful:

• Health-improving gymnastics that eliminates congestion V alimentary canal.
• Spa treatment.
• Physiotherapy.
• Compliance special regime nutrition.

Taken together, these measures help get rid of Helicobacter pylori and bulbitis, do not allow development negative consequences. In case of complications, the patient is hospitalized in order to observe and take timely measures in each case.

Medicines

At the core conservative therapy proton pump inhibitors to reduce the secretion of hydrochloric acid:

• Omez.
• Losek.
• Gastrozol.
• Paries.

Gastrocepin and other drugs that block M-cholinergic receptors help reduce the synthesis of pepsin and chloride acid and resist pain. Taking them often leads to dry mouth and increased heart rate.

H2-histamine blockers are no longer used in treatment practice, since when they are discontinued, the signs of pathology quickly return.

To protect the bottom of the ulcer, Sucralfate is used, De-nol helps to create a film on intestinal defects. For stimulation recovery processes and mucus formation, prostaglandins are used.

Symptomatic treatment Duodenal ulcers are treated using certain groups of medications:

• Antispasmodics.
• Drugs that improve nutrition of the mucous membrane.
• Antidepressants to calm the central nervous system nervous system.
• Cerucal, Metoclopramide and other prokinetics to normalize intestinal motility.

Antacids in liquid form: Almagel, Maalox, in tablet form (Becarbon, Bellalgin) help eliminate heartburn, neutralize hydrochloric acid, and have an adsorbing astringent effect. The action time is from 10 minutes to an hour, depending on the alkalizing properties of the medication. Dosage regimen: several times during the day with an additional portion at night.

If Helicobacter is present, use antibacterial drugs:

• Clarithromycin.
• Amoxicillin.
• Metronidazole.

If the microbes survive, therapy is carried out according to a different scheme. The process is controlled by a doctor. Self-medication can result in complications.

For duration therapeutic measures influences general state patient, as well as the size of the ulcerations. They usually last from 2 to 6 weeks. In case of exacerbation, bed rest and rest are indicated.

Baking soda, which has always been the No. 1 remedy for high acidity of gastric juice, really instantly neutralizes the cause of low pH. But it leads to the release of large volumes of carbon dioxide, which only enhances the secretory capabilities of the duodenum. Therefore, when used frequently, it does more harm than good.

Folk remedies

Among the most effective formulations:

• Freshly squeezed potato juice (can be combined with cabbage). It’s easy to prepare: chop healthy tubers and squeeze out the liquid part from them. From 1 to 3 days – drink 1 tbsp. l. 3 times a day half an hour before meals. From 4 to 6 - 2 tbsp. l. WITH gradual increase up to 125 ml at a time. The course of treatment is 3-4 weeks. Take while on a diet. Repeat if necessary.
• Natural honey is no less useful. Ayurveda uses it to transport a number of medicines that provide healing. It can be eaten in pure form or take in combination with olive oil (1:1) 5-6 times a day, 1 tbsp. l. mixtures. The course lasting 2 weeks is repeated if necessary after 10 days.
• Decoction of 10 g plantain seeds and 100 ml of boiling water. Let cool, drink 3 times 1 tbsp. l. an hour before meals.
• A mixture of a kilogram of melted butter and 150 g of crushed propolis. For complete dissolution, keep in a water bath and store in the cold. Take 1 tsp. 3 times an hour before meals. The course of treatment is a month. After 3 weeks you can repeat.
• Powerful wound healing antimicrobial St. John's wort has an anti-inflammatory effect. Drink 1 tsp of its decoction. on an empty stomach.
• To reduce the duration of scarring of ulcerations To relieve pain and discomfort in the abdominal area, you can also use yarrow and calendula.

All folk remedies can be taken only after permission from a doctor.

Surgery

Surgery is indicated for the following conditions:

• The presence of polyposis, which increases the secretion of gastric juice.
• Bleeding.
• Degeneration of an ulcer into a cancerous tumor.
• Ineffectiveness of drug therapy.

Local excision of the ulceration or resection of the duodenum is performed.

Diet

A gentle diet for ulcers should become part of the patient’s life. It can be zigzag, that is, during an exacerbation, it is as dietary as possible, and during periods of calm (within reasonable limits) even some harmful products. Remissions will be longer if:

• Take food at least 5 times a day in small portions.
• Avoid cold and too hot foods; the optimal temperature for ulcers is 25-30 °C.
• Minimum salt.
• In case of exacerbation, only pureed food.
• Soft ripe fruits and vegetables.
• Dilute concentrated juices with water.

Permitted and prohibited products

The list of dangerous foods includes those foods that provoke an increase in the acidity of gastric juice:

• Baking and Rye bread.
• Rich broths.
• Fried foods.
• Canned food.
• Smoked meats.
• Citrus.
• Garlic and onion.
• Alcohol, fortified and dry wines.
• Sparkling water.

The diet should include more soups with milk and vegetable broths, cereals, boiled meat and low-fat fish.

Foods rich in fiber irritate the walls of the duodenum. Therefore, it is worth excluding or limiting the consumption of corn, peas, radishes, white cabbage.

Exacerbation of ulcer

If a person violates the medical and protective regime, does not follow a diet, abuses alcohol, is exposed to constant stress, That chronic illness, which is characterized by a wave-like flow, inevitably worsens. In spring and autumn, the body's resistance decreases, so the manifestation of ulcers becomes brighter. Saves intensive therapy, carried out in the department of surgery or gastroenterology for a period of 2 to 8 weeks.

Complications and consequences

At timely treatment duodenal ulcers, it is possible to relieve pain, achieve healing of the mucous membrane, and long periods of satisfactory well-being. Without adequate medical care quite possible severe conditions:

• Narrowing (stenosis) of the duodenal lumen as a result of scarring. In this case, food stagnation occurs, as well as repeated vomiting.
• Internal bleeding, which can be identified by dark, tarry stool, loss of consciousness.
• Development cancerous tumor at the site of mucosal defects.

Particularly dangerous is intestinal perforation, which looks like a sudden rupture of its membranes with characteristic features:

• "Board belly."
• Nausea, vomiting.
• Cold sweat.
• Thirst.
• Dagger pain.

After some time, the discomfort partially disappears. The imaginary improvement lasts no more than 24 hours, then peritonitis develops with chills, fever up to 38-39 °C, and confusion. In this condition, the patient must be urgently taken to the hospital.

Good day, dear readers!

In this article we will look at such things as - duodenal ulcer, as well as its causes, symptoms, exacerbations, diagnosis, treatment, folk remedies and prevention of duodenal ulcer. So…

What is a duodenal ulcer?

Duodenal ulcer (duodenal ulcer)– a chronic disease in which an ulcer forms in the mucous membrane of the duodenum due to various pathological processes.

A duodenal ulcer is often a complication due to the fact that the organ itself, i.e. – The duodenum (lat. duodenum) is a continuation of the gastrointestinal tract, and it follows immediately after the stomach. For clarity, below is a picture of the structure of the human gastrointestinal tract.

Sometimes, ulcers of the stomach and intestines are located simultaneously in both organs, which is again due to their close location to each other. Thus, it can be argued that gastric and duodenal ulcers are a related disease with similar symptoms(clinical manifestations) and practically the same reasons(etiology). The difference lies mainly in the displacement of pain down the abdomen. However, let us consider this disease in all its aspects.

The main reasons for the development of a duodenal ulcer is infection of this organ with the bacterium Helicobacter pylori, which, under unfavorable conditions for the human body - increased acidity in the intestine, poor nutrition, begins to affect the mucous membrane of the duodenum, forming a peptic ulcer in it over time.

1) Helicobacter pylori penetrates the mucus layer of the host’s stomach or duodenum and attaches to epithelial cells; 2) bacteria catalyze the conversion of urea into ammonia, neutralizing the acidic environment of the stomach; 3) reproduce, migrate and form an infectious center; 4) as a result of destruction of the mucous membrane, inflammation and death of epithelial cells, ulcerations of the stomach or duodenum are formed.

The main symptoms of a duodenal ulcer are pain in the abdomen, just above its middle, sour belching, bloating and nausea.

Development of duodenal ulcer

Now let's take a quick look at how peptic ulcer disease develops in the duodenum?

The duodenum consists of 3 main walls - the mucous membrane (inner wall), middle layer(submucosal layer, muscle tissue, nerve plexus) and outer layer.

This organ follows immediately after the stomach and is the initial section of the small intestine, so it is actively involved in food processing. As in the stomach, the duodenum contains a certain amount of acid and gastric juice. In this regard, the intestinal mucosa, like the stomach, when normal position affairs and health, protects the walls of these organs from the pathological effects of acid and various pathological microflora, for example, the same bacterium Helicobacter pylori.

The formation of a peptic ulcer occurs due to a combination of unfavorable conditions.

With increased acidity, or if the integrity of the intestinal mucosa is damaged by rough food, with hypovitaminosis, or with the production of an insufficient amount of mucus, which forms the mucous membrane and protects it from pathological processes, the mucous membrane becomes susceptible to the influence of adverse factors.

Further, when the bacterium Helicobacter pylori enters the body, it adheres to a weakened mucous membrane or a damaged area on it and begins to multiply. At the same time, this type of infection produces substances that promote the breakdown of the mucous membrane - ammonia, mucinase, lipase, urease and protease, and also increase the concentration of hydrochloric acid in the organ. In addition, the organ’s production is disrupted required quantity mucus. The bacterium, together with its harmful derivatives, toxic substances, if on this initial stage do not start treatment, it begins to affect the inner wall of the duodenum, and then the outer one, after which the infection and acid begin to negatively affect the organs adjacent to the intestine. The consequences that all this can lead to are perforation of the duodenal wall, bleeding.

Symptoms during the development of duodenal ulcer are cyclical, sometimes intensifying, sometimes practically not felt. Usually, the peak of pain and clinical manifestations falls in spring-autumn, which is apparently due to an insufficient amount of vitamins during these periods, as well as seasonality and humans, which weaken the immune system.

Duodenal ulcer - ICD

ICD 10: K26.0 – K26.9.

Symptoms of duodenal ulcer

How does duodenal ulcer manifest? Among the main signs of this disease are abdominal pain, mainly just above the middle of the abdomen, with frequent exacerbations at night, as well as when consuming alcoholic beverages, acute and fatty foods, with a long period between meals and strong physical activity. Often, the pain disappears after eating gentle food, such as soup or porridge.

Other symptoms of duodenal ulcer

• , often attacks after eating, after 2-3 hours;
• Heaviness in the stomach after eating;
• Sour belching;
• , sometimes with attacks;
• Increased appetite;
• The coating on the tongue is yellow;
• Pain when pressing on top part belly.
• There may be pain in the heart, right hypochondrium and lumbar region.

Important! About 25% of cases of duodenal ulcer are practically asymptomatic, therefore, if pain and the above symptoms are detected, it is better to consult a doctor, because this disease can be fatal.

Complications of duodenal ulcer

A duodenal ulcer sometimes leads to life-threatening complications:

Perforation of the stomach. The contents of the duodenum, along with acid, enter the abdominal area. In this case, the patient feels severe pain in the abdomen, and he exhibits signs of intoxication; pain shock may develop.

Penetration. The process of destruction of the wall of the duodenum, after which the organs surrounding the intestine – the stomach, right kidney, pancreas, intestines, liver, abdominal aorta. At the same time, the level of alpha-amylase in the blood increases, and body temperature can rise to .

Bleeding of the duodenum. Is one of the possible deaths of this disease. Symptoms include severe vomiting of blood, shortness of breath, black stools, low blood pressure and increased sweating. The patient experiences blood loss.

Chronic vomiting of blood.

Causes of duodenal ulcer

The main and most common reason duodenal ulcer – the bacterium Helicobacter pylori. Doctors claim that this type of infection is present in the bodies of 80% of Russian residents, but as we already mentioned in the article, the bacterium itself, without a secondary factor, cannot sufficiently harm the digestive organs and cause the development of peptic ulcers, both intestines and stomach .

Let's look at how the bacterium Helicobacter pylori enters the human body:

• non-compliance;
• eating unwashed food, drinking contaminated water;
• using unwashed dishes;
• when using infected items in contact with oral cavity– , spoons, forks, etc.;
• through saliva, for example, when kissing an infected person.

Pathological factors that contribute to a decrease in the protective functions of the body (immune system) and the susceptibility of the duodenum to pathogenic microflora:

• Nervous system disorders: , ;
• Poor nutrition: consumption of coarse, spicy, fatty, too hot or cold foods, abuse of caffeine-containing drinks;
• Drinking alcoholic beverages, smoking, drugs;
• Pathological conditions: injury to the duodenum and the body, blood poisoning;
• Failure to comply with personal hygiene rules;
• Uncontrolled use of certain medications: anti-inflammatory drugs NSAID groups(“Aspirin”, “”, “Diclofenac”), antibacterial drugs, cytostatics, corticosteroid hormones.
• Lack of vitamins in the body ();
• Hereditary predisposition;
• Complication of other diseases: Crohn's disease, lung cancer, etc.

Diagnosis of duodenal ulcer

Diagnosis of duodenal ulcer includes following methods examinations:

• Taking anamnesis;
• Palpation;
• Endoscopy;
• Fibrogastroduodenoscopy FGDS;
• Tests for the presence of the bacterium Helicobacter pylori in the body (tests of blood, feces, vomit and material taken during a FGS biopsy).

Treatment of duodenal ulcer includes the following treatment methods:

1. Drug therapy:
1.1. Antibacterial therapy;
1.2. Normalization of pH levels in the stomach;
1.3. Protection of the mucous membrane;
1.4. Relieving symptoms, improving motility of the gastrointestinal tract.

3. Treatment concomitant diseases( , etc.) if they are present.

The course of treatment for duodenal ulcer usually lasts from 2 to 6 weeks.

Important! If the patient shows signs of complications of the disease, he is subject to urgent hospitalization.

Drug therapy for duodenal ulcer (drugs for duodenal ulcers)

Important! Before using medications, be sure to consult your doctor!

1. Antibacterial therapy

If, after diagnosis, it is revealed that the bacterium Helicobacter pylori is present in the human body, antibacterial drugs (antibiotics) are prescribed.

Antibiotics for duodenal ulcers: macrolides ("Clarithromycin"), tetracyclines (""), penicillins ("Amoxicillin").

2. Normalization of pH levels in the stomach (restoration of acid-base balance)

The bacterium Helicobacter pylori, through its vital activity in the body, contributes to an increase in acidity in the digestive organs, which leads to the gradual destruction of the intestinal mucosa. For recovery, i.e. for normalization acid-base balance, antisecretory drugs are used. The use of antisecretory drugs relieves symptoms of peptic ulcer such as heartburn, sour belching, nausea, and also minimizes the development of complications of this disease.

Antisecretory drugs include:

Antacids:“Almagel”, “Maalox”, “Keal”.

Antacids neutralize the increased acidity of gastric juice, thereby protecting the intestinal mucosa from the pathological effects of hydrochloric acid on it.

Proton pump blockers:"Nexium", "Omez", "Rabelok".

Proton pump blockers block the proton pump, thereby preventing the increase in hydrochloric acid in the stomach and duodenum.

M-cholinergic receptor blockers:"Gastrocepin", "Pirencepin".

M-cholinergic receptor blockers help reduce the production of hydrochloric acid in the stomach, thereby preventing it from entering the intestine. They also help relieve pain.

3. Mucosal protection

Protection of the mucous membrane of the duodenum during peptic ulcer disease is an extremely necessary measure for speedy recovery. Among the drugs are:

To destroy Helicobacter pylori and form a protective film in the intestine - “De-nol”, “Sucralfate”.

To increase the production of mucus by the stomach and duodenum, which is necessary for their normal functioning and protection from infection, as well as to normalize the acid-base balance (pH level) synthetic analogues prostaglandin E1: Misoprostol, Cytotec.

To accelerate the restoration of the mucous membrane of the duodenum - "Biogastron", "Kaved-S", "Ventroxol", and the restoration of the intestinal walls - "Entrostil".

4. Other drugs

Antispasmodics. Used to relieve pain and spasms of the digestive organs during peptic ulcers - “Drotaverin”, “No-shpa”;

Prokinetics. Helps improve motor skills digestive tract- “Itopride”, “”.

Probiotics. They are used when using antibiotics to preserve the beneficial microflora necessary for the normal functioning of the digestive organs - “Bifiform”, “Linex”.

Sedatives. Used for disorders of the nervous system - “Valerian”, “Tenoten”.

Surgery for duodenal ulcer

Surgery for duodenal ulcers is indicated only in some cases, for example:

• Drug therapy did not produce the necessary results;
• Development of bleeding;
• Perforation of the ulcer;
• The ulcer does not heal for a long time
• The peptic ulcer began to transform into a cancerous tumor.

For duodenal ulcer, the patient is prescribed a diet developed by M.I. Pevzner: the first week - diet No. 1a, the second week - diet No. 1b, the last week -.

What can you eat if you have a duodenal ulcer? Nutrition for duodenal ulcer includes: gentle soups (from different cereals), liquid porridge, low-fat varieties meat (chicken, turkey), eggs (soft-boiled or scrambled eggs), low-fat dairy products, compote, jelly, .

Food can only be eaten warm; hot and cold are prohibited. The main cooking method is steaming. Number of meals per day – 5.

What should you not eat if you have a stomach ulcer? Alcoholic drinks, spicy, fried, smoked meats, strong meat broths, flour (baked goods, baked goods), (sauces, ketchups, mayonnaise), plants that irritate the digestive organs (legumes, cabbage, radishes, tomatoes, citrus fruits, dates), drink coffee and cocoa.

Important! Before using folk remedies for duodenal ulcer, be sure to consult with your doctor!

St. John's wort. Fill a 500 ml jar of crushed St. John's wort with olive oil to the top, and place the mixture in a water bath to evaporate for 6 hours, then strain and set aside the product to cool. Take the prepared product from 2 tbsp. spoons 30 minutes before meals, before each meal. Keep refrigerated . Can also be used for treatment.

Plantain. Pour 20 g of seeds into 100 ml of boiling water, cover the container with a lid and set aside for 30-40 minutes to infuse and cool. You need to drink the prepared infusion 1 tbsp. spoon, 30 minutes before meals, 3-4 times a day.

Honey. Add 500 g, 500 ml to the jar. olive oil, juice 2x and a grain of ground walnuts, mix everything thoroughly. accept it folk remedy for duodenal ulcer you need 1 tbsp. spoon before each meal, 3 times a day, stirring before each meal. The product must be stored in the refrigerator.

Calendula and birch. Add 50 g of flowers to 3 liters of boiling birch sap, cover the container with a lid and boil the product for about 10 minutes, then remove the pan from the heat, wrap it and let it brew for about 12 hours. Then strain the product, add about 200 g of honey to it. Drink this folk remedy half a glass, 3 times a day, and store it in the refrigerator.

Collection. Mix in equal parts– roots of marshmallow, creeping wheatgrass, fennel seeds and flowers, and pour 2 teaspoons of the mixture with 250 ml of water, then put the product on the fire. Boil the product for about 30 minutes, and set aside from the heat to infuse for another 20 minutes. Strain the broth and drink 250 ml 2 times a day, morning and evening.

Prevention of duodenal ulcer includes the following recommendations:

- Completely give up alcohol and smoking;

— Use only washed dishes and cutlery;

— Avoid stressful situations, nervous tension;

— When eating food, chew it thoroughly, eat small meals, avoid eating very hot or cold food;

— Strengthen the immune system, which protects the body from;

— Try to move more, thereby improving the blood supply to all organs, and accordingly, the body works more stably;

Video about stomach ulcers

Peptic ulcer of the duodenum- a disease of the duodenum of a chronic relapsing nature, accompanied by the formation of a defect in its mucous membrane and the tissues located underneath it. Manifests severe pain in the left epigastric region, occurring 3-4 hours after eating, attacks of “hungry” and “night” pain, heartburn, acid belching, and often vomiting. The most serious complications are bleeding, perforation of the ulcer and its malignant degeneration.

General information

Duodenal ulcer is a chronic disease characterized by the occurrence ulcerative defects duodenal mucosa. It lasts a long time, alternating periods of remission with exacerbations. Unlike erosive damage to the mucosa, ulcers are deeper defects that penetrate into the submucosal layer of the intestinal wall. Duodenal ulcer occurs in 5-15 percent of citizens (statistics vary depending on the region of residence), and is more common in men. Duodenal ulcers are 4 times more common than gastric ulcers.

Reasons for development

The modern theory of the development of peptic ulcer considers the key factor in its occurrence to be infection of the stomach and duodenum by the bacteria Helicobacter Pylori. This bacterial culture is sown during bacteriological examination of gastric contents in 95% of patients with duodenal ulcers and in 87% of patients suffering from gastric ulcers.

However, infection with Helicobacter does not always lead to the development of the disease; in most cases, asymptomatic carriage occurs.

Factors contributing to the development of duodenal ulcer:

• nutritional disorders - improper, irregular nutrition;
• frequent stress;
• increased secretion of gastric juice and decreased activity of gastroprotective factors (gastric mucoproteins and bicarbonates);
• smoking, especially on an empty stomach;
• long-term use of medications that have an ulcerogenic (ulcer-generating) effect (most often these are drugs from the group of non-steroidal anti-inflammatory drugs - analgin, aspirin, diclofenac, etc.);
• gastrin-producing tumor (gastrinoma).

Duodenal ulcers resulting from ingestion medicines or accompanying gastrinoma, are symptomatic and are not included in the concept of peptic ulcer.

Classification of peptic ulcer

Peptic ulcer disease varies by location:

• Peptic ulcer of the stomach (cardia, subcardial region, body of the stomach);
• peptic post-resection ulcer of the pyloric canal (anterior, posterior wall, lesser or greater curvature);
• duodenal ulcer (bulbous and postbulbar);
• ulcer of unspecified localization.

By clinical form distinguish between acute (newly diagnosed) and chronic peptic ulcer disease. The phase is divided into periods of remission, exacerbation (relapse) and incomplete remission or fading exacerbation. Peptic ulcer disease can occur latently (without pronounced clinical symptoms), mildly (with rare relapses), moderately severe (1-2 exacerbations per year) and severely (with regular exacerbations up to 3 or more times a year).

The duodenal ulcer itself varies according to morphological picture: spicy or chronic ulcer, small (up to half a centimeter), medium (up to a centimeter), large (from one to three centimeters) and giant (more than three centimeters) sizes. Stages of ulcer development: active, scarring, “red” scar and “white” scar. With concomitant functional disorders of the gastroduodenal system, their nature is also noted: motor, evacuation or secretory function.

Symptoms of duodenal ulcer

In children and the elderly, the course of peptic ulcer disease is sometimes practically asymptomatic or with minor manifestations. This trend is fraught with the development severe complications, such as perforation of the duodenal wall followed by peritonitis, hidden bleeding and anemia. Typical clinical picture duodenal ulcer is a characteristic pain syndrome.

The pain is most often moderate and dull. The severity of pain depends on the severity of the disease. Localization is usually in the epigastrium, under the sternum. Sometimes the pain can be diffuse in the upper abdomen. It often occurs at night (at 1-2 hours) and after long periods without eating, when the stomach is empty. After eating, milk, and antacids, relief occurs. But most often the pain returns after the stomach contents are evacuated.

The pain can occur several times a day for several days (weeks), after which it goes away on its own. However, over time, without proper therapy, relapses become more frequent and the intensity of the pain increases. Seasonality of relapses is characteristic: exacerbations occur more often in spring and autumn.

Complications of duodenal ulcer

The main complications of a duodenal ulcer are penetration, perforation, bleeding and narrowing of the intestinal lumen. Ulcerative bleeding occurs when pathological process affects the vessels of the gastric wall. Bleeding can be hidden and manifested only by increasing anemia, or it can be pronounced, blood can be found in vomit and appear during bowel movements (black or bloody stool). In some cases, bleeding can be stopped during an endoscopic examination, when the source of bleeding can sometimes be cauterized. If the ulcer is deep and the bleeding is profuse, surgical treatment is prescribed; in other cases, it is treated conservatively, correcting iron deficiency. At ulcer bleeding Patients were prescribed strict fasting and parenteral nutrition.

Perforation of a duodenal ulcer (usually the anterior wall) leads to penetration of its contents into the abdominal cavity and inflammation of the peritoneum - peritonitis. When the intestinal wall is perforated, a sharp cutting-stabbing pain in the epigastrium usually occurs, which quickly becomes diffuse and intensifies with a change in body position and deep breathing. Symptoms of peritoneal irritation (Shchetkin-Blumberg) are determined - when pressing on abdominal wall, and then suddenly letting go, the pain intensifies. Peritonitis is accompanied by hyperthermia.

This is an emergency condition that, without proper medical care, leads to shock and death. Perforation of an ulcer is an indication for urgent surgical intervention.

Prevention and prognosis of duodenal ulcer

Measures to prevent the development of duodenal ulcer:

• timely detection and treatment of Helicobacter pylori infection;
• normalization of diet and nutrition;
• quitting smoking and alcohol abuse;
• control over medications taken;
• harmonious psychological environment, avoidance of stressful situations.

Uncomplicated peptic ulcer disease, with proper treatment and compliance with dietary and lifestyle recommendations, has favorable prognosis, with high-quality eradication - healing of ulcers and cure. The development of complications during peptic ulcer disease worsens the course and can lead to life-threatening conditions.

– a chronic disease that constantly progresses. The patient develops serious lesions on the intestinal mucosa. In most cases, the disease manifests itself periodically in autumn and spring. According to statistical data, peptic ulcer disease is very common, it mainly affects men. This disease occurs more often among urban residents.

Pathogenesis of peptic ulcer

Duodenal ulcer is not so easy to treat

The cause of a peptic ulcer in most cases is a bacterial infection that enters the body through the mouth, settles in the intestines and multiplies. In this case, tissue damage to the intestinal mucosa occurs. In addition to this factor, the development of the disease can be affected by:

• Hereditary factor
• Poor nutrition
• Features of the body
• Stressful situations
• Some medications
• and smoking

The increase in cells that synthesize hydrochloric acid, as well as the stimulation of the production of protective mucus, is influenced by a hereditary factor or genetic predisposition. Due to the fact that the body does not produce enough mucus, the intestinal walls are predisposed to inflammation.

Often, the disease can progress against the background of neuropsychic overload in easily excitable people. Excessive mental stress weakens the immune system and, as a result, the development of the disease. The functioning of the entire body depends on nutrition; a lack of vitamins and essential nutrients weakens it protective function.

Eating fried, sour and salty foods has a depressing effect on the entire digestive system. Some medications have contraindications in their annotations, which many patients ignore, but in vain. Many medications, when taken for a long time, can irritate the mucous membrane of the stomach and intestines during absorption.

Alcohol and smoking weaken the body's protective function.

Symptoms

Ulcer of the 12 duodenum: schematically

For a long time, the disease can be asymptomatic, occasionally the patient is bothered by aching after eating and there is a slowdown in digestive process. If you do not pay attention to these first signals from the body, the disease may progress to another stage, which may manifest itself:

• Stitching, cutting, aching pain in the abdominal area, which mainly occurs on an empty stomach or from hunger and goes away after eating
• and vomiting, especially in the morning
• Feeling full stomach and heaviness
• heartburn,
• Constant weakness
• Weight loss

The pain does not have a pronounced localization and is different character. During the disease, the amount of hydrochloric acid produced by the stomach, which is contained in gastric juice, increases. In this regard, a burning sensation often occurs. Heartburn can occur simultaneously with pain.

Many patients complain of belching. This symptom does not occur in everyone; it occurs in those people who have a weak cardiac sphincter. This fact is reflected in the movement of food through the esophagus: it changes direction to the opposite. This phenomenon is accompanied profuse salivation And .

Vomiting usually occurs due to pain. Many sick people try to induce vomiting artificially due to the fact that relief comes after it. This is explained by the fact that the vomit contains acidic gastric juice; due to the emptying of the stomach, its acidity decreases. Peptic ulcer of the duodenum is accompanied by a decrease in digestive function and absorption of nutrients, so the patient loses significant weight.

Decreased intestinal motility leads to constipation. They last up to a week and bother the patient much more than pain.

Stages of the disease and forms

A duodenal ulcer can occur in several stages:

1. Exacerbation: sharp pain and periodic vomiting
2. The appearance of a scar after healing of an ulcerative lesion
3. Remission: temporary absence of symptoms

The ulcer is classified depending on its exacerbation:

• Frequent exacerbations occur more than twice a year
• Rare exacerbations occur once or twice a year

Depending on the number of ulcers on the intestinal mucosa, a single ulcer and multiple lesions. Also during diagnosis, the location of the lesion is important: in the expanded part of the 12 duodenum (bulb) or in the post-bulb space. When diagnosing, attention is also paid to the depth of damage to the mucous membrane: minor superficial damage or deep.

Also, when making a diagnosis, the cause of the disease is taken into account:

• Stress ulcer: after mental and emotional overload
• Shock ulcer: resulting from burn or injury
• Steroid ulcer: after taking hormonal drugs

Diagnostics

Ultrasound as a method for diagnosing ulcers

The initial examination by a doctor includes questioning and palpation of the abdomen. During palpation, muscle tone is felt, the patient experiences painful sensations. Then the patient is prescribed the following diagnostic methods:

1. X-ray
2. pH-metry
3. Lab tests

An X-ray of the abdominal cavity is performed with contrast. Using certain media, the localization of bacteria in the intestines and stomach is stained; each type of microorganism is painted in a specific color.

Allows you to identify the location of the ulcer in the intestine, the degree of damage to the mucous membrane, the depth and shape of erosive changes. The doctor can examine the bottom of the ulcer, its structure and edges, and the condition of the mucous membrane on the monitor. During the study, a piece of affected tissue is taken for histological analysis to determine the condition of the cells. Laboratory diagnostics includes:

• for occult blood: indicates the presence of intestinal bleeding.
• General blood test: changes are observed only in cases where the disease worsens; in the remission stage, the indicators do not change. Indicates hidden bleeding a sharp decline hemoglobin in the blood.
• The presence in the body is determined by the following tests:
• Blood test for antibodies to Helicobacter
• Breath test to detect ammonia and carbon dioxide that appear in the patient’s body due to the activity of bacteria
• PCR analysis determines the presence of Helicobacter fragments in stool or saliva
• Microscopic examination of mucus taken during FEGDS

Treatment

Sea buckthorn in the treatment of peptic ulcers

How to treat a duodenal ulcer is determined depending on the exacerbation of the disease, the reasons for its development and the location of the lesion. The following types of treatment are currently used:

1. Drug therapy
2. Physiotherapy
3. Diet therapy
4. Surgery
5. Traditional methods of treatment
6. Drug treatment

During acute stage treatment should be carried out in a hospital setting, the patient should remain in bed. The body needs strength to quickly relieve the inflammatory process and scarring of the ulcer. Usually by the end of the second week inpatient treatment the patient's general condition improves.

The scheme according to which it will be carried out drug therapy, prescribed by the doctor depending on the etiology of the disease: whether it is bacterial or not. Several drugs are used at once:

1. Antisecretory agents: the action of these drugs is aimed at reducing gastric secretion, reducing acidity and influencing the removal of the inflammatory process. Drugs in this group include:
2. Histamine receptor blockers: Ranitidine, Famotidine, Cimetidine
3. Proton pump inhibitors: Pariet, Ranitidine
4. Anticholinergics: Gastrin

To treat bacterial ulcers, bismuth-containing preparations are used: they prevent the proliferation of Helicobacter bacteria, create a protective film on the intestinal mucosa, which protects against harmful effects acid and bacterial damage. Such means include: , Vikalin, Vikair.

To restore intestinal motility and eliminate symptoms of the disease, such as nausea and vomiting, prokinetics are used: Cerucal, Trimedat,. A mandatory drug in the treatment of Helicobacter pylori of the duodenum 12 are antibacterial drugs (antibiotics): Amoxicillin, Metronidazole.

Antacids are used for heartburn: Maalox, . With the help of these drugs, the aggressive effect on the duodenal mucosa, adsorption, and neutralization of toxic substances are neutralized. Gastroprotectors are used to protect the intestinal mucosa: Venter. Such drugs form a protective shell on the surface of the damaged mucosa, and enable it to recover, helping to relieve the inflammatory process.

To relieve pain and spasms, analgesics and antispasmodics are used: Baralgin. To restore the mucous membrane, it needs nutrition. Medicines that will help: Actovegin, vitamin B preparations.

Dietary treatment

To restore damaged intestinal mucosa, a special gentle diet is needed that excludes rough food. The temperature of the food should be close to normal temperature bodies. Small doses of food are needed every three hours. It is better to steam or boil dishes. Avoid fried, hot, spicy and salty foods. Allowed:

• Lean meat
• Fish, except oily
• Kiseli
• White bread

1. Fruits and fruit juices
2. Fatty dishes
3. Canned food
4. Strong or carbonated drinks
5. Physiotherapeutic procedures

IN complex treatment duodenal ulcers along with diet and drug treatment physiotherapeutic treatment is used. By exposing the body to microwaves, ultrasound, and heat, pain and inflammation are relieved and blood circulation is stimulated.

With the help of sinusoidal currents, pain is relieved, the inflammatory process stops and blood microcirculation improves. Exposure of the body to ultrasonic waves and electrophoresis with painkillers relieve pain and reduce secretion. The drugs used are: Novocaine, Papaverine.
Can be done on the abdominal area alcohol compress, which has a warming effect, which helps restore the duodenal mucosa.

ethnoscience

Traditional medicine will also tell you how to treat duodenal ulcer

Folk remedies can alleviate the general condition of the patient, relieve symptoms and inflammation, but to get rid of the cause of the ulcer - Helicobacter bacteria, it is necessary to take antibacterial drugs.

Sea ​​buckthorn

A good remedy for healing wounds and mucous membranes. For duodenal ulcers, it is recommended to take a teaspoon of sea buckthorn oil several times a day. During the first days of treatment, simultaneous intake of soda may be recommended to relieve it.

Calendula

An infusion of calendula is made as follows: the flowers are poured with boiling water and kept in a water bath for 5 minutes. It is recommended to drink this remedy a quarter glass several times a day.

Clover

Clover flowers along with the stem and fireweed should be taken in equal proportions. Drink half a glass of freshly brewed tea from these ingredients twice a day.

Licorice

Dilute licorice root, orange peels, honey in a glass of water and put on fire. Evaporate until the liquid has evaporated. The resulting thick mixture must be divided into three daily doses.

Potato broth

As everyone knows, it contains a large number of starch. This remedy will help reduce the aggressive effects of acid on the mucous membrane. Peeled unsalted potatoes are boiled, removed, and the liquid should be drunk in a glass daily.

All the myths about duodenal and gastric ulcers in the video: