Duodenal ulcer

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

The main symptom of an ulcer is the formation of a defect (ulcer) in its wall. Often, the ulcers affect not only the duodenum, but also the stomach (stomach ulcer), and other organs of the digestive system with the development of dangerous complications.

The main symptom of exacerbation of duodenal ulcers are abdominal pain, which may radiate to the lumbar spine, right hypochondrium, and various departments of the abdomen.

Causes

Peptic ulcer and duodenal ulcer due to increased acidity. Under the influence of acid in the mucous membrane destruction processes occur, which subsequently lead to an ulcer.

There are a lot of reasons for provoking the development of this disease, they are known to everyone, everyone faces them. These are stresses, nervous tension, unhealthy and poor nutrition. Also, modern medicine has established that the bacterium Helicobacter Pylori is a common cause of gastric and duodenal ulcers.

Here are the main factors contributing to the development of duodenal ulcer:

  • nutritional disorders - improper, irregular diet;
  • 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).

Prolonged treatment of various inflammatory pathologies with anesthetic NSAIDs (ketorolac, diclofenac, indomethacin, ibuprofen, aspirin) also adversely affects the walls of the duodenum, and can give impetus to the development of an ulcer.

Symptoms of duodenal ulcer

For a long time, the disease may not give any symptoms. However, in the initial stages of the disease, discomfort occurs at the top of the abdomen and minor digestive disorders.

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

  1. Often, pain may be the only symptom by which you can recognize a peptic ulcer. The kind of pain can be different: stabbing, cutting, periodical, constant, compressive, etc. It is usually localized at the top of the abdomen in the middle or on the right, but if a person feels it in the left hypochondrium, one may suspect that he has a mirror YDC. The pain most often appears before eating (fasting pain) or after it. Sometimes, a couple of hours after eating, patients feel hunger. Night pains are also characteristic, they occur in the middle of the night, and a person wakes up due to unpleasant sensations in the stomach.
  2. Nausea, feeling of fullness in the stomach, bloating, heartburn, belching.
  3. General weakness, weight loss, reduced performance.

If you find similar symptoms in yourself, you should consult a specialist. Treatment of duodenal ulcer should be complex and include not only drug therapy, but also other methods of treatment, such as diet therapy, physiotherapy, physiotherapy and sanatorium treatment.

Diagnostics

It is possible to diagnose a duodenal ulcer through endoscopy: this method gives the doctor complete information about the patient's condition. When an ulcer is detected, it estimates its location, size, type, presence of scars. During the procedure, a sample of the mucous is taken along the edge of the defect for examination for the presence of helicobacteria.

Also use X-ray examination, analyze feces, blood, do a biopsy.

Complications

When late treatment of duodenal ulcer, the disease can cause: bleeding, perforation and penetration of the intestine, narrowing of its lumen.

  1. Penetration of an ulcer is characterized by penetration into adjacent organs through a defect affecting the intestine.
  2. The narrowing of the duodenal lumen is the result of scar formation or swelling.
  3. Bleeding ulcers is a consequence of involvement in the pathological process of the vessels of the mucous membrane. Hidden bleeding can be characterized by anemia.
  4. Ulcer perforation - the formation of a gap through which the entire contents of the intestine penetrates the abdominal cavity and causes the development of an inflammatory process - peritonitis.

Treatment of duodenal ulcers

If the diagnosis of duodenal ulcer is confirmed, treatment should begin immediately. This disease requires an integrated 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 the patient with strict bed rest and emotional rest for scarring to occur, because an ulcer in the white scar stage does not represent a danger to the patient's life.

Drug treatment

Groups of drugs used to treat duodenal ulcers:

  1. When detecting chylacobacterium, treatment consists of antibacterial therapy. To do this, use the following drugs: amoxicillin; clarithromycin; metronidazole. If, after one course of antibiotics, the bacteria did not die, then this drug should not be repeated. A different treatment regimen is selected.
  2. To eliminate pain by reducing the secretion of hydrochloric acid are used: omez, gastrozole, bioprazole, kontrolik, sanpraz, gelicol, lanzap, zulbex, zolispan, etc.
  3. Drugs that eliminate pain by forming a protective film on the duodenal mucosa: Almagel, Algel A, Almagel Neo, Maalox.

The course of ulcer treatment 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 treatment of duodenal ulcer should be prescribed, and a competent specialist, who can control the treatment process and evaluate its results, should select the drugs and their regimens.

Surgery

In some emergency cases, such as perforation of an ulcer, severe gastrointestinal bleeding, obstruction of the pyloric canal, surgical treatment is resorted to. In this case, conduct two types of operations:

  1. Vagotomy - the intersection of nerves that stimulate gastric secretion and lead to recurrence of peptic ulcer.
  2. Gastrectomy is the removal of 2/3 of the stomach and the connection of the remaining part of it with the intestine, often during the resection also perform vagotomy.

With YADK, surgical intervention is indicated only in special cases, since complications often occur (inflammatory processes, hemorrhages, severe metabolic disturbances).

Diet with ulcer

There are several types of diets for duodenal ulcer. For example, an unloading diet, which is called Pevzner's Table No. 1, and corresponds to the ulcerative group of gastrointestinal diseases. There is also Table 0, which is characterized as a complete lack of food intake in the first few tens of hours after surgery on the gastrointestinal tract.

Table 1 is considered the main recipe for a diet in the YDK, which is divided into Tables 1a and 1b, depending on the stage of the disease (exacerbation or remission).

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

In case of peptic ulcer it is not recommended to use:

  • spicy dishes;
  • fried food;
  • salty food;
  • smoked meat;
  • various canned foods;
  • fatty meats and fish (pork);
  • fermentation (sauerkraut, tomatoes, cucumbers);
  • rye bread and bakery products from pastry;
  • fruits that increase acidity in the stomach (citrus, tomatoes, and others);
  • All hot, cold, spicy seasonings are excluded from the diet to reduce the activity of the production of gastric juice.

Products and dishes that can be consumed:

  • light vegetable soups;
  • dairy products (milk, not fat cottage cheese, not fat sour cream, kefir);
  • low-fat fish or dishes from it (pike perch, perch and others);
  • non-fatty meats (rabbit, chicken, veal);
  • various types of cereal (buckwheat, oatmeal, rice and others);
  • crackers and dried bread;
  • vegetables and fruits, fresh or boiled (red beets, potatoes, carrots, zucchini);
  • dishes prepared with vegetable oils (olive, sea buckthorn and others);
  • all food must be boiled, baked, stewed or steamed

It is recommended to take food fractional, in small portions. Due to this, the walls of the stomach are stretched less, 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 the ulcer. Strengthening your health, a person minimizes the possibility of getting sick. Even when infected with an infection, it will cope much easier and recover faster. Scientists have determined that health is half dependent on lifestyle.

Watch the video: Stomach and Duodenal Ulcers (December 2019).

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