Gastroduodenitis is an inflammation affecting the mucous membrane that lies between the stomach and the duodenum. It differs from gastritis in that difficulties are added in the work of sphincters. They cover and regulate the movement of food.
Characteristics of the disease
In this disease, not only the digestive process is violated, but also the general condition of the body. This is due to the fact that the duodenum, which takes part in the production of hormones and thundering substances, starts to work incorrectly.
Disease according to ICD-10 has the code K29.9. Previously, a separate code was for gastritis( K 29.3) and duodenitis( K29).
Classification of
Depending on the main etiological factor, the following are isolated:
- primary exogenous forms of the disease,
- secondary endogenous species.
By prevalence is classified into:
- common,
- localized.
There are differences and depending on the level of acidity. In this case we are talking about gastroduodenitis with normal, low, high acidity.
In the presence of a bacterium Helicobacter:
- HP-positive;
- is HP negative.
By the form of inflammation on the walls of the stomach and duodenum, determine:
- Superficial gastroduodenitis. The initial stage of the disease with the involvement of inflammation, but without erosions and ulcers;
- Hypertrophic. As a result of the inflammatory process, the walls of the mucosa thicken;
- Erosive gastroduodenitis. Erosions are formed;
- Hemorrhagic. With this form of gastroduodenitis erosion begins to bleed;
- Atrophic gastroduodenitis. The walls of the gastric mucosa and the duodenum are thinned, the glands are atrophied, the acidity of the gastric juice is lowered;
- Mixed type. It is characterized by the presence of several forms of the disease, located in different parts of the gastrointestinal membrane;
- Duodenogastric reflux. This gastritis type C, occurs against the background of a constant casting of bile in the stomach of the duodenum.
According to the morphological features determine:
- Surface;
- Diffuse;
- Atrophic.
At the clinic of the disease:
- Acute period;
- Period of exacerbation;
- Incomplete remission, which lasted for a couple of weeks;
- Complete remission, in which the signs of the disease are completely absent for several years, but inflammatory foci are still visible in the diagnosis;
- Complete recovery, confirmed during gastroduodenoscopy.
Acute
The acute form is indicated if the disease lasts no more than 3 months. It is one of the varieties of acute gastritis. The peculiarity is that 1/3 patients do not have any manifestations. The rest can only be diagnosed with the use of instrumental diagnostic methods.
Men are treated with such a diagnosis three times more often. Identify it can at any age, but over the years the likelihood of developing a chronic form increases.
Pain in an acute form occurs unexpectedly. First it is located in the upper half of the abdomen. This sensation is associated with mucosal edema. Against this background, the work of the smooth muscles of the small intestine paralyzes. The outlook for this form is favorable.
Chronic
In a chronic form, the symptomatology depends on the particular course of the pathological process. Select the following forms:
- surface,
- hypertrophic,
- mixed,
- erosive.
Photo of the erosive form of gastroduodenitis
The clinical picture of the chronic form is polymorphic. It includes discomfort, a feeling of heaviness and raspiraniya in the stomach. Often, the pain that occurs a few hours after eating disturbs.
Anxiety in patients is caused by such manifestations as nausea, vomiting, heartburn. The chair becomes unstable. This means that constipation alternates with diarrhea. In case of illness, the tongue becomes covered with a yellowish-brown coating. There is an unpleasant smell from the mouth.
Reasons for
Internal or external factors are responsible for the development of the disease. The first is the genetic predisposition, diseases of the endocrine gland, biliary tract. Sometimes the cause is rotting teeth or tonsillitis, stress or liver disease.
To external factors, doctors include irregular nutrition, constant intake of medicines, smoking, certain types of bacteria.
For psychogenic reasons are stresses, increased nervousness. During stress, various physiological processes are triggered. Therefore, during the treatment of various forms, sedative medications are prescribed.
Another common cause is the bacterium Helicobacter pylori. The more it multiplies, the more damage to the mucosa. In extreme cases this leads to ulcers and erosions.
Symptoms of the disease in adults and children
Common symptoms of gastroduodenitis are:
- Abdominal pain. They appear on an empty stomach or after eating.
- Nausea. It is associated with an acute inflammatory disease. It appears at the peak of pain.
- Vomiting. It can be with food or just with gastric juice.
- Belching. Appears after eating.
- Lack of appetite. Especially in the period of exacerbation.
- Stool disorder. The appearance of diarrhea or constipation depends on whether the papillae of the bile duct have become inflamed.
- Flatulence. It is almost always present.
Sometimes vegetative crises occur according to the type of dumping syndrome. In this case, sudden drowsiness, weakness, sweating, tachycardia.
Symptoms of gastroduodenitis with increased acidity
In the clinical picture, gastroduodenitis is divided into two large groups:
- Yazvennopodobnye.
- Gastric like.
The first group includes symptoms that show a similarity to the development of ulcers. These include severe pain in the upper abdomen and in the navel. Heartburn occurs, which is manifested due to increased acidity. Feeling of nausea is associated with a disruption of the whole gastrointestinal tract.
Gastritis-like symptoms are slightly different. The pains are aching. Basically affect the perigapic and epigastric region. Pain appears after eating.
During the same period, a feeling of bursting may appear. Because of poor appetite, weight loss occurs. Often there is an eructation of air.
How dangerous is the disease?
Untimely treatment of gastroduodenitis can lead to permanent relapses of the disease. As you grow up, there is a decrease in working capacity, the appearance of rapid fatigue. In chronic form with low acidity there are signs of periodontal disease, bad breath.
In case of a diet violation, concomitant enterocolitis may develop. Gastric bleeding is rare, but with prolonged illness, anemia and allergic reactions occur.
In addition, the relationship between the development of cancer and gastroduodenitis has been revealed. In elderly people the probability of oncology is increased by 15%.Therefore, the form of the disease is regarded as a precancerous condition.
Differences from gastritis
Gastritis is characterized by the defeat of deep layers of mucosal epithelium on the walls of the stomach. The diagnosis of gastroduodenitis is set in the event that the inflammation touches the pyloric canal performing the transport function. The first disease is often a prerequisite for the appearance of the described pathology.
With gastritis, the main symptoms are acute pain in the stomach, heartburn, nausea and vomiting with mucus. In the process of development of gastroduodenitis additionally appears:
- increased salivation,
- migraine,
- yellow dense plaque in the tongue,
- weight loss,
- pallor of the skin,
- autonomic nervous disorders.
Diagnosis
Before performing a diagnosis, the physician first determines the clinical symptomatology. Based on this, a preliminary diagnosis is made. Confirm it using instrumental diagnostic methods.
One of the main is endoscopy. This examination of the mucosa with a special tube, which is introduced through the mouth. This technique is one of the most informative.
Other methods are used:
- Morphological study. In the process, small pieces of the mucosa are examined to identify signs of inflammation and other pathological changes. Small parts of the mucosa are taken during the endoscopic examination. The method allows to correctly determine the type of gastroduodenitis.
- X-ray. By informative method, the method is inferior to endoscopy, since it gives an opportunity to see the indirect signs of the disease.
- Intragastric pH-metry. It measures the acidity of gastric juice with the help of special electrodes, which are introduced into the stomach. The procedure allows you to assign the exact treatment.
- Bi-frequency intragastric impedance measurement. During the procedure, the activity of the glands of the stomach is measured. Allows you to more accurately establish the level of acidity.
Treatment regimen for gastroduodenitis in adults and children
Treatment in adults and children is always complex. It consists of bed rest, medication and diet.
How to treat an acute and chronic form?
In the treatment of acute form, the first step is to change the diet. It is important to follow the prescribed diet, follow all recommendations.
In the opposite case, the ailment will develop into a chronic appearance. Then treatment will be long. The method of recovery is effective only in the initial stages of the disease.
In some cases, the acute form is caused by Helicobacter pylori infection. Then you can not do without taking antibiotics. Appointed in such cases, not only drugs aimed at normalizing the acidity of the gastrointestinal tract, but also to reduce pain. Often, with the first improvements, a person gives up treatment, but such a step can become a prerequisite for bleeding.
Treatment of chronic form is more prolonged and serious. During an exacerbation, a bed rest for up to a week, special meals is prescribed.
Treatment of chronic form is carried out by courses. This allows you to reduce the likelihood of complications and quickly bring the ailment into the stage of remission.
Drugs
The administration of medications always corresponds to the goals of treatment. Often their reception is necessary for:
- Normalization of corticovisceral disorders.
- Recovering the synthesis of hydrochloric acid.
- Getting rid of problems with the motor-evacuation functions.
- Restore the balance between the factors of protection and aggression.
- Getting rid of Helicobacter pylori infection. The most commonly prescribed drugs are
Name Description Omez Assigned with increased acidity. The drug is aimed at suppressing the production of gastric juice and hydrochloric acid. De-Nol Refers to gastroprotective agents that protect the gastrointestinal mucosa. Produced in the form of tablets. The drug stops the life of bacteria, suppressing the activity of enzymes inside the microorganism. Phosphalugel This antacid, which binds hydrochloric acid, reduces the acidity of the juice. It envelops the mucous membrane, protecting it from aggressive actions. Almagel Another antacid. Eliminates the symptoms of the disease, has an analgesic effect. It is prescribed for severe pain syndrome. There are several varieties of the drug. Dospatalin Myotropic antispasmodic. Suppresses spasms, relaxes the muscles of the intestine. Dietary food
The dietary method of treatment includes the implementation of strict rules. You can not eat hot or cold food. Chew food should be very carefully. In this case, it is worth eating a lot, often.
Use permitted:
- Grounded soups. Boiled meat, steamed meatballs.
- Black caviar, boiled lean fish, chopped herring. Omelette and raw eggs.
- Sour cream with low fat content. Well-boiled porridge.
- Biscuit, slightly dried bread.
- Juices, decoctions, tea, cocoa. Grated fruits and vegetables.
- Jelly.
Completely excluded from the diet canned food, smoked and salted dishes, chocolate products. Of vegetables, it is not recommended to abuse cabbage, spinach, onions, turnips, cucumbers.
If you follow the rules, the patient does not feel hungry. Normalization of the digestive system and improvement of metabolic processes occur.
Folk remedies
There are many folk methods that can not only alleviate the condition of the patient, but also relieve inflammation.
Flax seeds are safe and useful. You need to take one spoon and brew in 0.5 liters of water. Let the mixture leave for 15 minutes. When removed from the plate, leave for an hour. Drink recommended for 100 ml before eating and before bedtime. After a month, take a break and repeat the monthly treatment.
Positively on the gastrointestinal tract acts:
- juice of plantain,
- infusion of green lettuce,
- nettle with milk,
- yarrow infusion,
- oat porridge.
Treatment during pregnancy
In many women, exacerbation of the disease occurs during pregnancy. At this time, only gentle methods of treatment are prescribed.
For example, antibiotics are not used, especially those that can adversely affect fetal development. The main direction in the treatment is the normalization of gastric juice. But antisecretory drugs are not prescribed.
Other methods depend on the nature of the course of the disease. With increased acidity, it is advisable to use:
- antispasmodics,
- antacids,
- prokinetics.
If acidity is lowered, preparations of gastric enzymes and combined agents are prescribed. Probiotics are often prescribed. Their reception does not depend on the level of acidity. The emphasis in the treatment is on proper nutrition and normalization of the gastrointestinal microflora.
How long does the disease last?
Treatment is often performed at home. With an acute form you can cope for 2-3 weeks. Chronic forms are treated up to two years.
Difficulties in treatment are that the inflammation descends into the duodenum. It regulates the work of many organs of the digestive system.
If gastroduodenitis appears against a background of a disease, then treatment should be directed not only to the removal of the symptoms of this disease, but also to the treatment of the very first disease.
Prognosis and prophylaxis
Only complex effects, compliance with diet and pastel regimen during the period of exacerbations can relieve the ailment.
Patients are assigned regular examination with a gastroenterologist, observance of all recommendations regarding proper nutrition and lifestyle.
Prevention is largely related to the main areas of treatment. To prevent the onset of the disease, it is recommended to lead a healthy lifestyle, to abandon bad habits, strong coffee. In the diet should be a lot of fresh vegetables, fruits. Limit the consumption of spicy and spicy dishes, carbonated drinks.