Duodenal ulcer

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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 worsening of duodenal ulcer is abdominal pain, which can irradiate to the lumbar spine, right hypochondrium, various abdominal parts.

Causes of

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.

There are a lot of reasons provoking the development of this disease, they are known to everyone, they all face them. 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.

Here are the main factors of that contribute to the development of duodenal ulcer:

• nutritional deficiencies - abnormal, irregular nutrition;
• 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 NVPs( ketorolac, diclofenac, indomethacin, ibuprofen, aspirin) also adversely affects the walls of the duodenum, and may give impetus to the development of ulcers.

Symptoms of duodenal ulcer

For a long time, the disease may 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 common symptoms of duodenal ulcers occur with the progression of the disease:

1. Often pain may be the only symptom of , over which peptic ulcer can be recognized. 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.
2. Nausea, a feeling of fullness of the stomach, bloating, heartburn, belching.
3. General weakness, weight loss, decreased performance.

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

Diagnosis

Diagnosis of duodenal ulcer is possible due 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.

Radiologic examination is also used, the feces and blood are analyzed, and a biopsy is performed.

Complications of

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

1. Penetration of an ulcer is characterized by penetration into adjacent organs through a defect that infects the gut.
2. Narrowing of the lumen of the duodenum is the result of the formation of a scar or edema.
3. 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.
4. Perforation of an ulcer - 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 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. An acute ulcer leads to the need to provide the patient with a strict bed rest and emotional rest for scarring, since the ulcer in the stage of white scar is not a danger to the life of the patient.

Drug treatment

Drug groups that are used to treat duodenal ulcers:

1. When detecting hilakobacteria, treatment consists of 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.
2. For the elimination of pain by reducing the secretion of hydrochloric acid: omez, gastrozole, bioprazole, control, sanpras, helico, lansap, zulbex, zolizpan, etc.
3. Preparations that eliminate pain by forming a protective film on the duodenal mucosa:A, the 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 intake should be a competent specialist who can monitor the treatment process and evaluate its results.

Surgical treatment

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 performed:

1. Vagotomy - the intersection of nerves that stimulate gastric secretion and lead to recurrences of peptic ulcer.
2. The resection of the stomach is the removal of 2/3 of the stomach and the connection of the remaining part with the intestine, often also performing vagotomy when performing a resection.

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

Diet for 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 with NAD is Table 1, which is divided into Table 1a and 1b, depending on the stage of the disease( exacerbation or fading).

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

When peptic ulcer is not recommended use:

• spicy dishes;
• fried food;
• salty foods;
• smoked meat;
• various canned food;
• fatty meat and fish varieties( pork);
• of fermentation( sauerkraut, tomatoes, cucumbers);
• rye bread and bakery products from 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.

Foods 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);
• is not fatty meat( rabbit, chicken, veal);
• various kinds of porridge( 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 should be cooked, baked in the oven, stewed or steamed

It is recommended to eat food in small portions. 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 preventive measure 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.