Duodenum: diseases and treatment. Peptic ulcer of the duodenum. Anatomy of the duodenum and treatment of possible diseases

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Inflammation 12 ti duodenal ulcer- This is a disease that affects the initial section of the intestine and is called. He must be treated: block inflammatory processes and repair damaged mucous membranes. Otherwise, the human digestive system will not be able to work normally, the patient will suffer from unpleasant symptoms, the quality of his life will be significantly reduced. This is a common disease, but most often duodenitis occurs in the male part of the population, but can also be diagnosed in women and children.

The reasons

Inflammation of the duodenum is primary and secondary. If this is primary duodenitis, it develops due to the fact that the patient for a long time ate wrong: ate a lot of salty food, loved everything fried and fatty, preferred sour and spicy, which irritated the digestive organs. The reason may be the nutrition of a person dry food. This disease can also appear in lovers of alcoholic beverages and heavy smokers.

There are other factors that contribute to the appearance of inflammation in patients:

constant stress;
a person works too much;
he does not get enough sleep and does not rest;
if the patient long time and used some drugs in large quantities.

In addition to primary duodenitis, there is also a secondary one, which develops against the background of other diseases:

Gastritis caused by bacteria.
Gastric ulcer with high acidity.
, due to which duodenostasis develops over time, which leads to a deterioration in the blood supply to the intestinal wall.
Liver diseases (hepatitis, cirrhosis), due to which the synthesis of bile acids changes in patients.
If in digestive tract chemicals got in, which caused a burn of the patient's mucosa. Or the patient had food poisoning, toxic infection.
There is a foreign body in the patient's intestines.

There are other reasons that cause inflammation of the duodenum in patients, for example, Crohn's disease or the appearance of neoplasms in the gastrointestinal tract.

Signs of the disease

Symptoms of inflammation of the duodenum in patients can be different, sometimes they are completely absent. Duodenitis is characterized by these symptoms:

the main symptom of the disease is pain in the epigastric region or near the navel. At acute form disease, the pain is strong and incised. It appears in the patient a few hours after eating or at night;
a patient with duodenitis has poor appetite;
after eating, he has discomfort in the abdomen, a feeling of heaviness;
the patient suffers from belching, flatulence, diarrhea, constipation;
the patient develops nausea and vomiting;
weakness makes itself felt, dizziness, the patient may experience irritability;
if the bile and pancreatic ducts are affected during duodenitis, then the patient may experience girdle pain, bile in the vomit, and the patient's skin and sclera will turn yellow.

Duodenitis can be acute, when all the symptoms are especially pronounced, and chronic. The disease becomes chronic if acute duodenitis reappears in the patient, or this disease could not be cured in time.

In a chronic inflammatory disease, the pain becomes constant, but it is not severe, but rather aching or "sucking". Also, the patient has severe heartburn, nausea, and sometimes vomiting.

What is the danger of inflammation of the duodenum 12

If the patient does not want to treat duodenitis, the inflammation lasts long enough, this can lead to atrophy, which cannot but affect the patient's digestion: the breakdown of food, the production of enzymes, and the absorption of substances will worsen. Because of this, the patient may eventually develop anemia, a lack of vitamins or trace elements, which will affect the state of health.

And that is not all. Some patients may experience the following complications of duodenitis:

Intestinal bleeding.
An ulcer in which both the duodenum and the stomach of the patient suffer.
Stenosis of the pylorus of the stomach. With this pathology, the passage between the duodenum of the patient and the stomach narrows greatly, which can even develop intestinal obstruction.
Malignant tumor of the intestine of the patient.
Purulent inflammation of the tissues that surround the duodenum (phlegmonosis) of the patient.

Therefore, when the first unpleasant symptoms appear, it is advisable for patients to immediately consult a doctor, undergo an examination and begin treatment, while duodenitis proceeds without complications.

Diagnostics

With duodenitis, you need to contact a gastroenterologist. He will definitely ask you, find out what exactly is bothering you, and also palpate the abdomen. If at the same time pain appears in the epigastric zone, this may indicate duodenitis.

An accurate diagnosis will be made by the attending physician after the examination. The most informative of them is esophagogastroduodenoscopy or EFGDS. A probe is inserted into the patient through the mouth, on which the camera is fixed. Thanks to this device, a physician can examine the entire gastrointestinal tract and determine what kind of disease the patient has, see the intestinal mucosa and diagnose duodenitis.

The patient may be prescribed other examinations:

X-ray.
Determination of the level of acidity.
A test that shows the presence of Helicobacter pylori bacteria.
Blood and stool tests.

Treatment

If the examination confirmed that the patient has inflammation of the 12th duodenum, the symptoms and treatment will be the same as with most diseases of the gastrointestinal tract. If this is an acute form of the disease, then doctors wash the intestines, remove food debris from it. Then drugs are prescribed. At first, it is better for the patient to refrain from eating, then he needs to adhere to special diet. With exacerbations of the chronic form of duodenitis, the patient is prescribed a sparing regimen and a treatment table.

Diet

A diet for inflammation is mandatory, proper, most sparing nutrition will help to quickly restore the patient's gastrointestinal tract. The patient should eat at least 5-6 times a day, in small portions. It is desirable to boil all dishes with duodenitis, or steam them, liquid or semi-liquid food is useful. The patient can only eat warm food.

It is better for patients with duodenitis to give up alcohol, as well as everything fried, sour, salty, spicy and smoked, canned food is not allowed.

If this is an acute form of the disease, a diet is necessary, but not for long, on average 10-12 days. How much to diet for acute duodenitis, the attending doctor should decide, he also selects the most suitable diet for the patient. If duodenitis has become chronic, then you will have to follow a diet all your life. With exacerbations of duodenitis, especially if it is an ulcerative variant of the disease, table No. 1a and 1b is recommended, then No. 1. If duodenitis occurs against the background of gastritis with low acidity, then diet No. 2. Sometimes patients simultaneously have pathologies of the gallbladder or liver, pancreatitis. Then he is assigned diet number 5.

What can you eat with inflammation of the duodenum 12

Although proper diet only a doctor can choose, and it depends on the state of the gastrointestinal tract, there are lists of products recommended for inflammation of the duodenum.

You can eat:

Soups, especially pureed soups, in which all the ingredients are ground. With duodenitis, you can cook milk soups, vegetable broths, or low-fat meat broth.
Bread - white and dried, you can buy croutons.
Meat - in the form of chopped dishes, minced meat. Meatballs, steam cutlets are prepared from it.
Also useful porridge. With duodenitis, it is better to choose the following cereals: oatmeal, semolina, rice, buckwheat. A little oil is added to the porridge.
The patient is allowed small pasta, as well as casseroles, puddings, scrambled eggs (steamed).
Patients can eat some vegetables, but in case of inflammation of the intestines they are served only boiled, in the form of mashed potatoes. These are potatoes, carrots, cauliflower and zucchini and broccoli.
Fruits are also better to boil or bake, for example, to cook compotes from them. But the patient can eat sweet berries or fruits if they are soft.
The patient is allowed to eat fresh cottage cheese and sour cream, mild cheeses.
You can drink milk with duodenitis and fermented milk drinks, compotes, jelly, rosehip drink. Vegetable juices are also allowed, but they are diluted with water. You can also tea, but only weak.

What not to eat with duodenitis

If the patient has inflammation of the duodenum, many products are contraindicated for him. This list can be expanded or, conversely, reduced, depending on the patient's well-being.

You can not eat:

under the ban with duodenitis, fatty meat or fish, everything fried, smoked;
you will have to forget about canned food, marinades, pickles, hot spices and sauces;
with inflammation of the intestines, cereals from coarse cereals, such as millet or pearl barley, all legumes are harmful;
with duodenitis, you can not eat hard-boiled eggs and fried eggs, fatty or spicy cheeses;
pasta, if they are large, is also not recommended;
for patients, many sweets and ice cream are prohibited;
you can not drink fat milk, coffee, strong tea, carbonated drinks and alcohol.

Medications

Diet is very important for the treatment of duodenitis, but without medicines not enough. Which pills to prescribe in each case, the doctor decides for the patient. The patient may take the following medications:

Pain medications, that is, antispasmodic drugs (No-shpa, Papaverine).
Antacids that help neutralize hydrochloric acid, protect the mucous membrane (Almagel, Gastal, Phosphalugel, Maalox), contribute to quick recovery walls of the duodenum 12.
Inhibitors proton pump and H2-blockers (Ranitidine, Omeprazole), which reduce the production of hydrochloric acid.
Enveloping preparations (De-Nol).
If Helicobacter pylori has been detected, antibiotics are prescribed.
To cope with duodenostasis, stimulate intestinal motility, are prescribed special preparations(Domperidone).
If this chronic illness, then anti-inflammatory drugs are prescribed that promote the healing of the intestinal mucosa (Methyluracil, aloe extract).
Drugs that help to cope with nausea and vomiting (Reglan, Cerucal).
Sedatives that help calm down during severe stress (Valerian, Motherwort).

Inflammation of the initial section of the intestine or duodenitis often occurs due to malnutrition, but can also develop against the background of other diseases. If you immediately start treatment, you can completely get rid of duodenitis, the chronic form is more difficult to cure, then periods of remission will be replaced by periods of exacerbation. But even in this case, it is important to undergo a course of treatment, even if the pain and other symptoms are not very disturbing, since due to undertreated duodenitis, a violation of the digestive process and complications may occur.

duodenum) represents the initial division small intestine, which follows immediately after the stomach. The next section of the small intestine continues the duodenum - the jejunum. The length of the intestine is equal to 12 folded fingers across ( approx. 25 - 30 cm), which is why it has such a name.

Duodenum has four parts:
Horizontal ( upper) part is at the level of the first lumbar vertebra. Directly above it is right lobe liver;
The descending part, curving downward, reaches the third lumbar vertebra and comes into contact with the right kidney;
Horizontal ( lower) part begins with a new bend to the left. Behind it is the lower vena cava and aorta;
The ascending part is located at the level of the second lumbar vertebra, bends sharply upward and passes into the jejunum.

In addition, in the first section of the intestine, a small extension is distinguished, which is called the bulb. In humans, the duodenum is shaped like a loop or horseshoe, the bend of which encircles the head of the pancreas. The walls of the duodenum have the same structure as the rest of the small intestine. But there is something that fundamentally distinguishes the duodenum - it is a large Vater papilla. It is a small anatomical structure about the size of a match head, protruding from the mucosa of the descending intestine. Behind it hide the two largest glands in the body: the liver and pancreas. They are connected to the papilla of Vater through the main pancreatic and common bile ducts. Sometimes, a small papilla may be located next to the papilla of Vater, which opens an additional duct coming from the pancreas.

The intestinal wall is represented by the following layers:
Outdoor ( serous) shell;
Muscular membrane with circular and longitudinal layers and nerve nodes;
The submucosa contains many lymphatic and blood vessels. It collects the intestinal mucosa in semilunar, spiral folds. The height of the highest folds is 1 cm. Unlike the folds of the stomach, these folds do not stretch and do not disappear when the intestine is stretched with food gruel;
The mucous membrane forms many villi. In the duodenum, unlike the rest of the small intestine, they are wider and shorter.

The laying and formation of the intestine during the period of embryonic development, together with the gastrointestinal tract, is carried out from 4 to 12 weeks.

duodenum functions

#1. The implementation of the initial process of digestion in the intestine, which is facilitated by bringing the pH of the food slurry of the acid reaction coming from the stomach to an alkaline reaction;
#2. Regulation of bile secretion and pancreatic enzymes depending on chemical composition chyme entering it from the stomach;
#3. Maintaining communication with the stomach, which consists in opening and closing the pylorus of the stomach, depending on the chemical composition of the chyme;
#4. Implementation of motor and evacuation functions.

Diseases of the duodenum

peptic ulcer intestines, as well as the stomach is a disease inflammatory nature mucous membrane, followed by the formation of inflammation in it, and then a defect ( ulcers). At present, involvement in the cause of the disease has been proven ( including gastritis.) pathogen - spiral microbe Helicobacter pylori. According to statistics, Helicobacter pylori is found in 8 out of 10 people, but only one in 10 suffers from peptic ulcer.

In order for an ulcer to occur, the following conditions are necessary:
Frequent stressful situations, which are accompanied by dysfunction of the autonomic nervous system followed by spasm of the blood vessels of the stomach and duodenum 12. In turn, this leads to a violation of tissue trophism, which makes the mucous membrane more vulnerable to negative factors;
Often drinking alcohol, spicy, fried foods, which provoke the synthesis of hydrochloric acid in excess;
Uncontrolled intake of drugs that irritate the mucous membrane, such as: aspirin, reserpine, diclofenac, etc.

The main signs of an ulcer:
Pain on an empty stomach of a aching nature in the epigastric region, usually at night. She can give back. Stopped by eating after about 30 minutes. Sometimes pain can be localized in the area of the gallbladder, which is due to dyskinesia of the bile ducts, which occurs under the influence of reflex and humoral factors from the altered intestinal mucosa.
After 2 hours, heartburn and belching with a sour taste occur;
Bloating and frequent constipation.

An ulcer is dangerous for its complications, which include: ( malignancy) degeneration into cancer, bleeding, ( perforation) perforation. Often the healing of the ulcer is accompanied by the formation of stenosis ( constriction) pylorus or bulb, followed by deformation of the intestinal walls. perforated ulcer- a formidable condition that is dangerously fatal.

Among the anomalies of the duodenum 12, which can occur even during fetal development, there may be atresia. It occurs during the laying of the organ, that is, at 2 months of pregnancy. Atresia is characterized by the absence of a bowel lumen. The pathology in the newborn is manifested by frequent regurgitation, lack of intestinal motility, and general exhaustion.

Bulbit- inflammation of the adjacent part of the duodenum 12 ( bulbs) to the stomach. The disease rarely occurs on its own. Usually it is accompanied by gastritis, gastric ulcer and duodenal ulcer. Lack of treatment contributes to the formation at the site of inflammation, first erosion, and then ulcers. Symptoms of the disease are very similar to peptic ulcer disease.

To benign formations 12 duodenal ulcers include polyps. Very often they are discovered only after death during an autopsy, since their intravital diagnosis is difficult. In addition, the symptoms characteristic of polyps strongly resemble a tumor of the bile ducts or the pylorus.

Diagnostics

Endoscopic method (EGDS or gastroscopy) is of great value in the formulation and clarification of diagnoses. A modern, more advanced method of research videogastroduodenoscopy allows the doctor directly on the monitor screen:
Visually assess the disease: the presence of an ulcer, its location, size, stage, type, etc., as well as consider polyps and scars from old ulcers;
It is better to conduct an examination of the intestinal mucosa, stomach;
Take a small section of the intestinal mucosa for diagnosis for a malignant tumor. And with small sizes of the same polyps, immediately remove them.

Radiography is performed to clarify the diagnosis using a radiopaque substance. In the picture or on the screen with fluoroscopy, the doctor can only see the outline of the intestine. In pathology, the following are clearly distinguishable: niche, narrowing, deformity, tumors.

Ultrasound is rarely performed. It can be used to determine the size and location of organs abdominal cavity, including duodenum.

Treatment and prevention

Therapist, gastroenterologist, surgeon are engaged in the treatment of diseases of the duodenum 12.
Currently, peptic ulcer disease is not a sentence. It can be successfully treated with conservative methods. There are specially designed treatment regimens. With their help, you can get rid of Helicobacter pylori forever, which is the cause of ulcers, bulbitis. Antibiotics are mandatory for all regimens. medicines, neutralizing hydrochloric acid, as well as drugs that form a protective film on the mucous membrane.

In addition to traditional medicines, remedies will be useful traditional medicine, for example, a collection of chamomile, lemon balm, shepherd's purse, centaury. Herbs will have an anti-inflammatory, healing effect.

All ulcers must adhere to a diet, especially during an exacerbation. The menu of such a diet excludes spicy, fried foods, as well as alcoholic beverages.

The course of treatment is designed for 2 weeks in autumn and spring, after which it is necessary to follow the maintenance treatment prescribed by the doctor.

How to treat long-term non-healing ulcers? Complicated peptic ulcer disease, as well as long-term non-healing ulcers, are treated only with the help of surgery. During it, the affected intestine ulcer is removed.

Prevention of diseases of the duodenum is reduced to compliance with the diet provided for by the diet. It is important to avoid the use

They occupy one of the leading places among all diseases of the gastrointestinal tract. Moreover, if earlier they appeared already in people over 30 or 40 years old, now the diseases have become much “younger”. And therefore, in order to prevent their further development in time, it is necessary to know the symptoms of manifestation for a timely visit to a specialist.

The process starts in the duodenum intestinal digestion.

Before moving on to what diseases can appear in a person and what symptoms they will manifest themselves, it is necessary to pay attention to the organ itself, to learn about its functions and purpose.

It must be said right away that the name of the duodenum was given for a reason. Its length is equal to 25-30 centimeters, or as they also consider 12 human finger sizes (transverse). The intestine is divided into four sections:

Upper. This part of the intestine is directed obliquely, and then forms a slight bend and passes into the next part. Its length is approximately equal to 5 or 6 centimeters
descending. This department is located immediately after the top. And if we talk conditionally about its location (to make it more clear), then this is approximately at the level lumbar to the right of the spine. In this part of the intestine there is a very important fold with a papilla, from which the ducts go. The length of this part of the intestine is approximately 7 to 12 centimeters
Lower. This area is located transversely to the spine. Its length is approximately 6-8 centimeters
Ascending. This is the shortest part of the intestine, the length of which is from 4 to 5 centimeters (depending on individual characteristics). This part is located right at the level of the lumbar. But in some people it is not clearly expressed

In addition, the duodenum has one anatomical feature depending on age and weight. So, in people who are fuller and younger, it is much higher than in thin or elderly people. If we talk about the functions of the body, then they are as follows:

The process of intestinal digestion begins in it, that is, the food lump is processed with acid and alkali to such a state that its further passage is possible.
Regulates the secretion of pancreatic enzymes depending on what is ingested and how much effort it takes to digest it
Supports feedback between the stomach, that is, it has the most direct effect on the normal functioning of all digestive processes

And therefore, if some pathological changes occur in the duodenum, and it stops working as required by the body, this will negatively affect all organs, and then, in general, everything human body.

Duodenitis is inflammation of the duodenum.

One of the most common diseases of this organ is duodenitis, or inflammation of the duodenum in another way. There are many reasons for the development of the disease, however, doctors note that as independent disease it is quite rare. Basically, it develops due to the influence of the following negative factors:

Food poisoning. At least once in a lifetime, a person has eaten foods that caused him food poisoning. For some, it could proceed in a weaker form, but for some it was necessary to call ambulance. And it is precisely such poisoning that can provoke the development
Improper nutrition, namely the abuse of spicy food. Since the mucosa becomes inflamed only because it is damaged in some areas, something must damage it. And just like that spicy food negatively affects the condition of the mucosa, contributing to its destruction
Abuse of alcoholic beverages, which negatively affect not only the duodenum, destroying it, but also the entire body as a whole
Damage to the mucosa by a foreign object. Such damage can occur if the remains of shellfish, bones, etc. are ingested.
The presence of foci of infection in the body
The presence in the body of such a harmful one as Helicobacter, which has a devastating effect on the stomach and duodenum, respectively
Stress, during which the main forces of the body are aimed at maintaining emotional state, and this is done at the expense of the well-being of other organs
Taking certain medications that adversely affect the mucous membrane, destroying it

Depending on what caused the development of the disease, the chosen treatment tactics will also depend, because initially doctors struggle not only with symptoms, but also with irritants (provocateurs). If we talk about the symptoms of duodenitis, then there are a lot of them:

Digestive problems, which can manifest as heaviness in the stomach, a feeling of overeating, even if the food was not eaten much
Poor appetite due to digestive problems
Attacks of nausea, and sometimes those that occur at the time of exacerbation
Pain in the abdomen, and the pain does not have a specific manifestation
Nighttime hunger pains that force the person to get up at night and either eat or take a pill
Impurities of blood in the feces or in the vomit, which appear there due to damage to the mucosa. And this means that the damage is much more serious than the person himself assumes.
Anemia, which indicates that there is a focus in the body
Constant weakness caused by anemia, poor appetite

Depending on which part of the duodenum the mucous membrane is damaged and inflamed, the symptoms may vary slightly, especially when it comes to pain after eating. If damaged upper section, then it will appear much earlier than if the lower one.

Peptic ulcer disease can be caused by Helicobacter pylori.

Almost every person knows that there is such an unpleasant and dangerous bacterium as that which provokes the appearance of ulcers in the gastrointestinal tract, and the duodenum is no exception. Of course, this is not the only reason.

This also includes the increased acidity of gastric juice, which enters the upper intestine, weak immunity, genetic predisposition, stress, malnutrition, etc. But the cause does not play a special role in the manifestation of symptoms. They will be the same anyway. The main symptoms of duodenal ulcer include:

Painful sensations, which are one of the most basic symptoms that a person has developed an ulcer. Moreover, for duodenal ulcers, special manifestations of pain are characteristic. So, she appears mainly on a hungry day, or after about 2 hours have passed after eating. But that's not all. Patients note that most often they suffer from pain at night, which occurs due to a strong accumulation of hydrochloric acid in the stomach at night. Sometimes pain occurs in case of malnutrition, namely the use of spicy, fatty, salty, alcohol, etc.
Heartburn, and some patients note that it starts abruptly and does not go away on its own. You have to drink special drugs, because at some points heartburn becomes unbearable
Belching. This is one of those symptoms that gives a person more discomfort, as it appears very abruptly and at inopportune moments.
Nausea that can occur at any time of the day or night
Vomiting, and it brings relief to the patient. And often, in order to somehow improve well-being, a person specifically calls it
Constipation. For people with duodenal ulcers, stool retention is characteristic for several days, and in the most severe cases for several weeks.
An admixture of blood in the stool, which appears due to damage to the mucous membrane. But for the most part, blood is present in the stool after long constipation when you yourself stool can damage walls.
Weight loss while still eating normally and consuming the same number of calories as always

Doctors note that symptoms may appear once a year, or several. Yes, there is some seasonality. So, most patients with duodenal ulcer note that it is in spring and autumn that there are much more attacks than in summer and winter.

The video material will tell in detail about peptic ulcer of the stomach and duodenum:

Duodenal dyskinesia

Another serious one, the symptoms of which are similar to those listed above, will be duodenal dyskinesia. Dyskinesia is a disorder motor function, due to which chyme lingers in the intestine. Symptoms of the manifestation of the disease will be as follows:

Pain after eating, which will increase immediately after eating, and subside a little after a while
Constipation, which causes many other unpleasant sensations. Moreover, the most dangerous thing that can happen as a result of a long one is intoxication of the body, during which a person’s well-being will deteriorate sharply. And with the wrong approach and treatment, it can lead to death.
Poor appetite, and after that the patient's weight will decrease
Heaviness after eating, which is difficult to relieve with drugs
Nausea and sometimes even vomiting

The symptoms are quite common, and therefore only a specialist can make an accurate diagnosis, who, based on the studies carried out, will be able to prescribe the correct treatment.

duodenal cancer

Duodenal cancer develops quickly and is therefore difficult to detect at an early stage.

Every year the number of oncological patients increases, and if earlier tumors mainly appeared in the mammary glands, stomach, lungs, now the disease is moving gradually to other places.

And those forms that were common before have now faded into the background. Duodenal cancer is no exception. Such a diagnosis is often made today. Symptoms of a tumor (malignant) include:

Pain that appears due to an increase in the tumor. At that moment, when the tumor begins to grow, it puts pressure on the nerve endings, which transmit such impulses to the brain. The larger the tumor, the more it presses on the endings, the stronger the pain
The appearance of biliary hypertension, which is manifested by discoloration of feces, jaundice (both weak and strong), dark urine. Moreover, hypertension can also cause neurological disorders, including unreasonable irritability.
Constant fatigue. Sometimes a person can walk long distances and not feel tired, and sometimes it’s even hard for him to get out of bed in the morning, the body is so exhausted
Rapid weight loss, with some patients noting that their diet has not changed much
Skin itching. Moreover, the use of creams and antihistamines and hormonal does not help.
Fever, when a person throws it into the heat, then into the cold. And this state is very difficult to control.

Duodenal cancer develops quickly, so doctors do not always have the opportunity to detect it at an early stage.

The human body is susceptible various diseases. Ailments can affect any internal organ. The duodenum is no exception. The most famous ailment of this department digestive system is a peptic ulcer. For many people, it is associated with the stomach, but in fact it is not only associated with it. The duodenum is often involved in the pathological process. What is this ailment? What other diseases can affect the duodenum? Before looking for answers to these questions, it is worth considering the structure of the named section of the digestive system.

The structure of the duodenum

The human digestive system is complex. One of its components is the duodenum. It is considered the initial section in the small intestine. Duodenum originates from and ends with the duodenal-jejunal flexure, which passes into the next section small intestine(into the jejunum).

In the duodenum, several components are distinguished:

the upper part, the length of which is from 5 to 6 cm;
the descending part, which is 7-12 cm in length;
the horizontal part, which is 6-8 cm long;
ascending part, equal in length to 4-5 cm.

Functions of the duodenum

Several important functions the duodenum performs:

The process begins here. Food coming from the stomach is brought here to an alkaline pH that does not irritate other parts of the intestine.
The duodenum regulates the production of bile and pancreatic enzymes depending on the chemical composition and acidity of the food coming from the stomach.
The initial one also performs an evacuation function. From it, the food gruel that came from the stomach is sent to other parts of the intestine.

Some diseases that may be associated with the duodenum 12

One of the diseases that occur in the duodenum is duodenitis. This term refers to inflammatory-dystrophic changes in the mucous membrane. They occur due to the effect on the body harmful factors: food poisoning, toxic substances that cause poisoning when they enter the digestive system, spicy foods food, alcoholic beverages, foreign bodies. With duodenitis, pain is felt in the epigastric region, nausea, vomiting, weakness, body temperature rises.

Diseases of the duodenum also include chronic duodenal obstruction. This is a process that leads to a violation of the passage through the duodenum, i.e., the motor and evacuation activity in this part of the digestive system is disturbed. The disease occurs in multiple various reasons(for example, the presence of tumors, congenital anomalies and etc.). The signs depend on the causes that caused chronic duodenal obstruction, on the stage of the disease and on how long the duodenum has been affected. Symptoms sick people note in themselves such as discomfort and heaviness in the epigastric region, heartburn, loss of appetite, constipation, murmur and transfusion in the intestines.

Treatment of duodenitis and chronic duodenal obstruction

Treatment of diseases should be prescribed by a doctor. In order for the duodenum to restore its functions during duodenitis, the following measures may be required:

hunger for 1 or 2 days;
gastric lavage;
appointment of a special diet (No. 1, 1a, 1b);
the appointment of astringents, enveloping, antacid, antispasmodic, anticholinergic, ganglioblocking agents, vitamins;
in some cases required surgical intervention and antibiotic therapy.

In chronic duodenal obstruction, the treatment of duodenal ulcer requires an individual approach. If the disease provoked a mechanical obstruction, then surgical intervention is performed. In other cases, prokinetics may be prescribed. These drugs have a stimulating effect on the muscles of the gastrointestinal tract, increase contractile activity, the tone of the stomach and duodenum, make the evacuation of gastric contents faster.

What is meant by peptic ulcer?

Considering the ailments of the duodenum, Special attention should be given to peptic ulcer disease. This term denotes serious illness which flows in chronic form with alternating periods of remission and exacerbation. The etiology of this disease is not well understood. It used to be thought that peptic ulcers were caused by substances such as pepsin and hydrochloric acid, which are produced in the digestive system. However, studies have shown that Helicobacter pylori microorganisms play an important role.

Statistics show that the prevalence is from 6 to 15%. It cannot be said that a representative of a particular sex is sick less often or more often. Men and women are equally susceptible to this disease.

Features of duodenal ulcers

Ulcers are lesions in the duodenum. They can be compared to erosion. However, these two types of damage have significant differences. Erosion affects only the mucous membrane that lines the duodenum. The ulcer penetrates into the submucosal and muscular layers.

Studies show that ulcers in most cases are in the upper part. They are localized near the pylorus of the stomach. The size of the damage varies. Most often there are ulcers in which this parameter does not exceed 1 cm. In some cases, large ulcers are found. Doctors in their practice met with damage to the duodenum, which in diameter reached 3-6 cm.

Clinical manifestations of peptic ulcer

In some people, the disease goes unnoticed, while in others, duodenal ulcer manifests itself with suspicious signs. The most commonly observed symptoms are:

recurrent pain localized in the upper abdomen;
digestive disorders;
deterioration in a sick person's appetite and weight loss;
tarry stool;
bleeding due to corrosive gastric juice the walls of the blood vessel;
pain in the back (they occur due to the germination of an ulcer in the pancreas);
intense pain in the abdomen (they are observed when the ulcer is perforated, the development of peritonitis).

Of these symptoms, pain is the most common. By its nature, it is different - sharp, burning, aching, indefinite, dull. Pain, as a rule, occurs on an empty stomach (in the morning after waking up). They can also appear after eating in about 1.5-3 hours. Unpleasant sensations stopped by antacids, food and even a glass of milk or warm water. The fact is that foods and drinks, when ingested, partially neutralize the effects of hydrochloric acid. However, after a short period of time, the pain resumes again.

Diagnostic procedures for peptic ulcer

The diagnosis of "duodenal ulcer" cannot be made on the basis of only one symptom and an external examination of a sick person, because the above signs are characteristic of a wide list of diseases. Behind the listed symptoms, not only a duodenal ulcer can be hidden, but also cholelithiasis, pancreatitis, benign tumors etc.

A suitable and reliable method for diagnosing peptic ulcer is fibrogastroduodenoscopy. During this study, a special instrument with a light source and a camera is inserted through the mouth into the stomach to examine the lining of the digestive system. The image is formed on the monitor. The doctor evaluates the stomach and duodenum. Diseases are diagnosed by pathological changes. If necessary, the specialist takes a sample of the mucous membrane for examination for the presence of microorganisms that provoke the occurrence of peptic ulcer.

Drug treatment of duodenal ulcer

Peptic ulcer can be treated with medication or surgically. In the first method, sick people are prescribed drugs that neutralize hydrochloric acid. They are called antacids. Medicines that help suppress the production of hydrochloric acid in the human body also help with illness. For example, omeprazole may be prescribed.

If during the diagnosis Helicobacter pylori microorganisms are detected, then it is possible to prescribe a three-component therapy. "Omeprazole" or "Ranitidine" are prescribed in combination with antibiotics ("Amoxicillin" and "Clarithromycin").

Surgery for peptic ulcer

When a duodenal ulcer is diagnosed too late, surgical treatment is prescribed. It is carried out under certain indications:

with perforation of an ulcer or heavy bleeding;
frequent exacerbations of the disease that occur despite ongoing drug treatment;
narrowing of the outlet section of the stomach, which arose due to cicatricial deformity of the duodenum;
chronic inflammation that is not amenable to ongoing drug therapy.

Essence surgical treatment is to remove During the operation, that part is excised internal organ, which is responsible for the secretion of gastrin in the body. This substance stimulates the production of hydrochloric acid.

In conclusion, it is worth noting that if you experience suspicious symptoms characteristic of diseases of the duodenum, you should seek help from specialists in the clinic. Self-medication for ailments is inappropriate, because the wrong drug therapy, its absence or unnecessary folk remedies can be applied serious harm your body, worsen your well-being.

(duodenum) are inflammatory and non-inflammatory in nature.

The inflammatory process occurs as a result of irritation of the mucous membrane of the organ by gastric juice with an increased concentration of acid, the penetration of bacterial infections.
The development of non-inflammatory diseases is facilitated by: environmental factors, malnutrition, stress.

Duodenitis (duodenitis) - the most common inflammatory disease, in which the walls and mucous membrane are affected. With a long course of the disease, atrophic changes occur in the structure of the membrane. Inflammation can occur in acute or chronic form.

Acute duodenitis occurs as a result of the negative impact chemical substances or damage to the mucous membrane by foreign bodies.

The main symptoms of the disease, which occurs in an acute form: aching or intense pain in the epigastric (pit of the stomach), nausea, vomiting, loss of appetite, weakness, fever.

Chronic duodenitis during exacerbations is manifested by a violation of the stool, rumbling in the abdomen, nausea, bitter belching, pain. Depending on the clinical manifestations, several types of the disease are distinguished.

Pain in the epigastric region some time after eating indicates an ulcer-like variant of duodenitis. Often the disease is complicated by bleeding.

In the cholecystic form of the disease, there are severe pain in the right hypochondrium, extending to the stomach or subscapular region.

A feeling of heaviness and pain in the upper part of the epigastric region are characteristic of gastritis-like duodenitis.

In some cases, there is a mixed form in which all of the above symptoms are present.

As you can see clinical picture duodenitis is similar to peptic ulcer, chronic cholecystitis, other functional disorders of the digestive tract. An accurate diagnosis is based on the results of an endoscopic examination.

Inflammation of the duodenum is classified according to the degree of change in the mucous membrane. In the catarrhal form, only the upper layers of the organ are affected. Thickening of the mucous membrane and the formation of folds is characteristic of the hypertrophic type of the disease. Small erosions and ulcers indicate an erosive form of inflammation.

With atrophic duodenitis, the mucous tissues become thinner, and the secretory function is disturbed.

According to the localization of inflammation, types of duodenitis are distinguished.

Focal. A small area of the intestine is affected.
Distal. Inflammation develops in the region where the duodenum passes into the small intestine.
diffuse. The entire mucous membrane is affected.
proximal. The pathological process occurs in the area of the intestine near the stomach.

Chronic duodenitis occurs with alternating phases of inflammation and remission. In most patients, the exacerbation lasts for several weeks.

Treatment depends on the causes of the disease. Proper therapy and diet can reduce the frequency of relapses.

Peptic ulcer of the duodenum

Duodenal ulcer is a chronic inflammatory disease.
On the mucous membrane, wounds are formed that have the shape of a small crater. The size of the ulcer is from 5 to 10 mm in diameter. In severe cases, defects of more than three centimeters are observed.

Peptic ulcer disease occurs as a result of various factors. The initial section is most often affected. The acidic contents of the stomach are thrown into it.

The main causes provoking duodenal ulcer.

Helicobacter pylori infection. Helicobacter pylori produces toxic substances that destroy intestinal epithelial cells. This leads to erosion. In addition, as a result of the vital activity of bacteria, ammonia is released, which contributes to cell death.
Aggressive effect of hydrochloric acid. Acid violates the integrity of the mucous membrane and promotes inflammation of certain areas.
Prolonged stress. They provoke spasms of the vessels of the intestinal mucosa, which disrupt the nutrition of cells. As a result, some of the cells die, ulcerations form in their place. Also, the development of duodenal ulcer is promoted by: malnutrition, hereditary predisposition, impaired immunity, and the use of non-steroidal anti-inflammatory drugs.

Some risk factors can be avoided. You need to learn how to calmly respond to stressful situations, refuse junk food, and not abuse medicines.

The clinical picture of duodenal ulcer is more pronounced during the period of exacerbation. The main symptom is hunger and night pains, subsiding after eating, antacids or vomit. Pain sensations are of varying intensity and appear periodically. The exacerbation lasts from several days to several weeks. During the period of remission, patients feel well.

Typical symptoms are: heartburn, belching, loss of appetite. Many patients experience constipation during an exacerbation. Nausea and vomiting are less common.

In some cases, the disease proceeds with mild symptoms, and the ulcer heals on its own.

If the duodenal ulcer is not treated, the submucosal and muscle layer. Complications develop in the form of bleeding, perforation, scarring and malignancy.

When the ulcer perforates, the contents of the intestine enter the abdominal cavity and cause purulent peritonitis. The first symptom of perforation is sharp pain in the epigastric region, which spreads rapidly, covers the entire abdomen and radiates to the right shoulder or shoulder blade.

Tumors of the duodenum

Benign tumors (myoma, lipoma, hemangioma, adenomatous polyp) are rare. In most cases, they are localized in the region of the Vater papilla. There are no symptoms in the early stages. Neoplasms of large size disrupt the passage of food slurry and are accompanied by bleeding, cramping pains in the epigastric region.

Duodenal cancer is also comparatively rare disease. Neoplasms are formed from intestinal glands and epithelial cells of intestinal crypts. Under the microscope, the tumors present as a dense ulcerated surface with high margins.

Predispose to the development of the disease:

hereditary factors;
Crohn's disease;
benign adenomas;
bad habits and unbalanced diet.

Cancer cells metastasize to the regional lymph glands. In neighboring organs (liver, pancreas, root of the mesentery of the small intestine) rarely spread.

In the early stages, the disease is difficult to diagnose. Cancer tumor does not show up for a long time. Symptoms appear when the neoplasm narrows the intestinal lumen or tumor intoxication develops. There are pains of varying intensity; weakness and fatigue; decreased appetite and immunity; the temperature rises.

On the late stages if the neoplasm affects the bile duct, patients develop yellowness of the skin, feces become discolored due to an increase in bilirubin.

As the pathological tumor grows, symptoms such as heartburn, nausea, vomiting, and blood in the stool are observed.

Appeal for medical care with the appearance of mild symptoms, it allows you to save health and life.

Diverticula of the duodenum 12

Saccular protrusions form on the walls of the organ.

The formation of a diverticulum is facilitated by:

congenital weakness of the duodenal wall;
inflammatory diseases of neighboring organs;
irrational nutrition;
age-related changes in connective tissue.

Usually the disease is asymptomatic. In some cases, after eating, there are pain and heaviness in the right side of the abdomen, nausea. Obstructive jaundice is observed if the bile duct is in a diverticulum.

Severe pain occurs when an inflammatory process occurs in the diverticulum.

Fistulas of the duodenum

The formation of internal duodenal fistulas is promoted pathological processes in the intestinal wall. They pass to neighboring organs (gall bladder, cavity of the large and small intestine). Also, from nearby organs, the disease can spread to the duodenum.

Symptoms depend on which part of the gastrointestinal tract communicates with the intestine through the fistulous tract. For example, when a channel is formed with gallbladder observed: gas and stool retention, nausea, vomiting, bitterness in the mouth.

External duodenal fistulas (connection of the skin surface with the intestinal lumen)
formed after penetrating wounds, injuries of the abdominal organs and discrepancies surgical sutures. As a result of the loss of digestive juice, the balance of electrolytes and proteins is disturbed.

Symptoms of diseases of the duodenum are similar to clinical manifestations diseases of neighboring organs. In some cases, the diagnosis can be made after complete examination gastrointestinal tract.