Causes and symptoms of duodenal ulcers, treatment, diet, folk remedies. Duodenal ulcer How to open a duodenal ulcer

To confirm the diagnosis of peptic ulcer, esophagogastroduodenoscopy (EGD) is necessary. This study is often called simply gastroscopy.

Gastroscopy is performed on an outpatient basis on an empty stomach. In this case, an endoscope is inserted through the mouth into the stomach - a narrow flexible tube with an optical device at the end. With its help, the doctor examines the esophagus, stomach and duodenum from the inside and, if necessary, performs a biopsy (“pinches off” a small piece of the gastric mucosa for cytological and histological examination in the laboratory).

This procedure is very informative, since the entire mucous membrane and its damage are visible “at a glance.” Gastroscopy cannot be called a pleasant procedure, but it is completely painless and takes only about 5 minutes.

To clarify the diagnosis, ultrasound and radiography of the stomach may also be prescribed.

Treatment

The discovery of the role of Helicobacter pylori in the occurrence of ulcers has significantly facilitated the approach to treating this disease. Now peptic ulcer disease is not perceived as a life sentence.

Special three- and four-component treatment regimens have been developed with the help of which you can permanently get rid of the cause of peptic ulcer disease - the bacteria Helicobacter pylori, and therefore completely recover from the ulcer, avoiding subsequent exacerbations.

Mandatory components of all treatment regimens are antibiotics (two at a time), which are usually taken for 7-10 days. In addition, patients are prescribed drugs that neutralize the main component of gastric juice - hydrochloric acid (for example, omeprazole, pantoprazole, ranitidine, etc.), as well as drugs that form a protective film on the surface of the gastric mucosa (for example, de-nol).

All ulcer sufferers must follow the correct daily routine, adhere to a special diet, and, if possible, not be nervous. It is advisable to quit smoking and alcoholic beverages during treatment.

The active course of treatment takes on average 2 weeks, after which it is necessary to continue maintenance treatment and follow a diet. To monitor the healing of the ulcer, a repeat esophagogastroduodenoscopy is prescribed.

Surgical intervention is required extremely rarely - only for long-term non-healing stomach ulcers, as well as for complications of peptic ulcer disease. During surgery for peptic ulcers, the affected area of the stomach or intestine is most often removed, and some nerve branches are also cut, which helps reduce the acidity of gastric juice.

Prevention

The occurrence of pain in the upper abdomen is most often attributed to signs of gastritis. However, this is not always the case. A person has too many organs in the stomach that can hurt and cause discomfort. And one of them is the duodenum, in which there may be a perforation of the ulcer. Let's figure out what kind of disease this is.

Functions of the organ

Duodenal ulcer is a chronic pathology characterized by the appearance of a defect in the mucous membrane (ulcer). The structure of this section of the intestine is such that it is separated from the stomach area by a special sphincter - the pylorus. From the stomach, food enters the duodenum.

The length of the duodenum in an adult is about 30 centimeters (about 12 fingers across). From it pass ducts connecting the organ with the gallbladder and pancreas.

Functionally, this organ helps reduce the acidity of the gruel coming from the stomach; digestion of food begins in this section of the intestine.

The initial section of the duodenum is called the bulb. It is in this place that ulcerative lesions most often appear, which is associated with a violation of the integrity of the mucous membrane.

Often the disease develops in parallel with a stomach ulcer. The disease is accompanied by a violation of the secretory and motor functions of the organ. The disease often affects young people, especially men. In women, in most cases, the disease worsens during the menstrual cycle.

General symptoms of the disease

In what cases might the question of the presence of an ulcer arise? Let's look in detail at the symptoms of a duodenal ulcer.

After a certain period of time after eating, patients notice pain in the stomach area. The pain subsides after the next meal, but after 2 hours it returns again. Painful sensations may be accompanied by nausea, vomiting, and heartburn. In some cases, symptoms of bloating and poor or no appetite may occur.

Due to the fact that acidity is disturbed, the production of necessary enzymes is reduced. And this leads to constipation and inflammatory processes throughout the intestinal area. This is how a duodenal ulcer manifests itself, and the symptoms depend on the location of the lesion on the mucosa:

Nausea and vomiting occur when the upper parts of the organ are affected.
The feeling of fullness is caused by an ulcer in the upper part (bulb) of the duodenum. In this case, there is a feeling of hunger at night, and the pain is stabbing or cutting in nature.
An ulcer localized in the ascending and descending sections causes pain in the left side.

All cases are characterized by pain at night. Externally, the disease manifests itself as an unpleasant odor from the mouth and a white coating on the tongue. The manifestation of the disease is seasonal: exacerbation of duodenal ulcers occurs more often in the autumn and spring periods.

Painful symptoms of ulcers can occur with varying degrees of frequency. Patients may complain of either occasional pain occurring 2–3 times a week or frequent pain throughout the day.

In young children and elderly people, symptoms of the disease may not appear at all; the disease is latent (hidden) in nature.

On the part of the nervous system, irritability, fatigue, decreased attention, poor sleep or insomnia are noted. The patient may experience general exhaustion and pallor of the skin, associated with a decrease in the level of hemoglobin in the blood.

If such symptoms occur, you should definitely consult a doctor. It is impossible to cure the disease on your own, but it is quite easy to harm yourself. The first signs of the disease are the reason for immediate contact with a gastroenterologist.

Mechanism of disease development

The duodenal mucosa has protective factors: it is able to recover with normal blood circulation and proper nutrition. Mucus allows you to resist the irritating effects of acidic contents. The organ juice has an alkaline reaction, which helps neutralize hydrochloric acid.

But there are also factors of aggression. These include increased gastric motility and increased acid content. If there is no gastric content in the duodenum, then the production of intestinal enzymes destroys epithelial cells, that is, the integrity of the mucous membrane is disrupted.

Causes of the disease

There can be several causes of the disease:

Infection (presence of Helicobacter pylori bacteria)
Stress loads. The disease may have a shock origin. In this case, it occurs as a consequence of severe injuries.
The cause of the pathology can be medications that affect the integrity of the mucous membrane (for example, hormonal drugs).
Improper nutrition.
Hereditary factors.

Those at risk are those working in hazardous industries, people experiencing stress (for example, students while studying), alcohol abusers, smokers, fans of excessive amounts of spicy food and people taking drugs that are aggressive to the digestive tract. It is important to note that bad habits increase the risk of developing the disease several times.

How to recognize a duodenal ulcer

May be similar to the signs of a duodenal ulcer. The main symptoms that the disease occurs in parallel with a stomach ulcer are cutting pain 15–20 minutes after eating, indigestion, accompanied by heartburn and belching. The pain may be localized in the heart area.

With a stomach ulcer, vomiting occurs quite rarely. A person who has a stomach ulcer often complains of pain immediately after eating, and sometimes it is not associated with eating at all.

As you can see, the symptoms of stomach and duodenal ulcers are very similar, and a correct diagnosis can only be established with the help of special medical examinations.

If there is already a history of a stomach ulcer, it is necessary to conduct an examination of the duodenum. Endoscopic examination allows for examination of the mucous membranes. With its help, the size and location of the ulcer is determined. This method allows you to get results during the procedure. It is used in almost every clinic.

In a blood test, attention is paid to the number of leukocytes. An increased rate indicates an inflammatory process. Hemoglobin levels are also taken into account. Its decrease may indicate internal bleeding. It is also possible to diagnose the disease using x-rays.

How dangerous is the disease?

The disease is progressive in nature, this must be taken into account. You cannot hope that the disease will miraculously go away on its own. A large load on the nervous system aggravates the course of the disease. Bad habits, unhealthy lifestyle and unhealthy diet do not create positive aspects in the treatment process and can cause a variety of consequences.

Do not start the disease; it is important to diagnose it in time to avoid possible complications. Tell your doctor about all your symptoms, and he will select treatment taking into account your individual characteristics.

Perforation of the ulcer. This is the name given to a violation of the integrity of the organ wall; an ulcer opens an opening from which the contents of the duodenum enter the abdominal cavity. This is characterized by sudden sharp pain. The patient is forced to take a position on his side with his knees pulled up to his chest. On palpation, the abdomen becomes very hard due to excessive muscle tension. This condition is dangerous not only for health, but also for life.
Ulcer penetration. This is a condition where the ulcer penetrates into neighboring organs. The first manifestations are similar to perforation, but the abdomen remains soft to the touch. The pain is not as severe as with perforation (perforation).
Bleeding. When the ulcer reaches a certain size, the integrity of the vessels in the intestinal walls is disrupted. The patient complains of weakness. In this case, the characteristic pain for an ulcer most often subside. The patient's skin becomes pale and sweating appears. The vomit may look like coffee grounds, and the stool may turn black.

All these complications are very dangerous and require emergency care. In some cases, immediate surgery is required.

With natural scarring of an ulcerative lesion, a narrowing of the intestinal lumen may occur. This pathology must be treated with conservative methods. In this condition, patients complain of constant nausea, vomiting and bloating.

It is important to remember that a duodenal ulcer, if left untreated, can lead to cancer.

Treatment

The disease is classified according to the number of ulcers, their depth, location, frequency of exacerbations and causes of occurrence. But only a doctor can compare and determine all this based on the collected medical history, examination, test results and endoscopic examination.

Treatment of ulcers is a long process, which will be based on a gentle diet. The patient must adhere to it constantly. For duodenal ulcers, meals should be frequent and in small portions. The patient must exclude spicy and fried foods, tea and coffee, and alcohol from his diet. You need to give up smoking completely. A dietician will help you create a diet.

Therapy is usually carried out in a hospital under the supervision of a doctor. As soon as the relapse goes into remission, the patient is discharged. But the recommended diet should be continued at home.

How to prevent the occurrence of disease

In the prevention of duodenal ulcers, a special place is occupied by a healthy lifestyle, a balanced diet, and giving up bad habits. The work and rest schedule is important. To prevent the disease, it is important to avoid stressful situations and nervous tension. Snacking on the run will not bring anything useful, but it will definitely cause problems.

Duodenal ulcer, symptoms and treatment vary depending on the location and extent of the lesion. It is necessary to take diagnosis and subsequent treatment as seriously as possible. Do not do this on your own, be sure to consult a doctor and adhere to the recommended lifestyle.

During the inflammatory process of the mucous membrane of the digestive organs, ulcers can form. The disease alternates between periods of exacerbations and remissions, occurs over a long period and is chronic. Signs of duodenal ulcer are observed in 15% of people and are more common in men over 30-40 years of age. This article will tell you about the causes of the disease, signs and diagnostic methods.

Causes of ulcers

In the duodenum there are simultaneously factors that cause aggression and protect the mucous tissue.

Organ protection occurs through the following processes:

nutrition of cells, which allows them to recover from damage;
alkaline reaction, neutralizing hydrochloric acid;
secretion of mucus, which protects cells from bacteria.

Aggressive factors that provoke peptic ulcer disease include:

excessive release of enzymes that have a destructive effect on the mucous membrane;
increased acidity of gastric juice and impaired motility.

Ulcer formation

When aggressive factors dominate over protective factors, this leads to the development of duodenal ulcers, the causes of which may be the following:

in 70% of patients, the bacterium Helicobacter pylori is detected, which is considered the main culprit in the inflammatory process of the intestinal and gastric mucosa;
prolonged fasting or, conversely, frequent overeating, which overloads the gastrointestinal tract;
genetic predisposition;
emotional overload and stress, resulting in vasospasm;
irregular nutrition, leading to impaired motor function of the stomach;
drinking alcohol and indulging in fatty, spicy and smoked foods;
smoking (especially harmful on a healthy stomach);
complications arising from gastrointestinal diseases, including tumors.

Note! The problem also occurs after prolonged treatment with non-steroidal anti-inflammatory drugs (diclofenac, aspirin, analgin, etc.).

Appearance of lesions in the duodenal mucosa

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Signs of peptic ulcer

The presence of a duodenal ulcer is determined by the following symptoms:

Pain is felt in the upper abdomen under the sternum. In this case, the person independently indicates where it is localized.
Discomfort occurs on an empty stomach, when the break between meals is prolonged. The pain syndrome varies from patient to patient and is determined by the degree of development of this pathology.
The patient experiences relief after eating or taking antacid medications. Sometimes the pain goes away on its own.
The frequency of unpleasant sensations can range from once every 2-3 weeks to several times throughout the day. If relapses are repeated over several months, the intensity of the pain increases and the interval between attacks becomes shorter.

In addition to pain, this disease is accompanied by:

periodic nausea and diarrhea;
vomiting, after which there is noticeable relief;
accumulation of gases and a feeling of “bloating” in the abdomen.

On a note! The disease worsens in the off-season - spring and autumn. Signs of duodenal ulcer in childhood and old age are often absent or mild. If the disease is not treated, complications will arise.

A characteristic symptom of the disease is pain

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Classification of the disease

This disease is classified according to the following factors:

The clinical form of the disease varies, whether it is newly diagnosed or chronic.
According to the number of relapses and the characteristics of pain, an ulcer can be:
- latent (without symptoms);
- mild (with relapses less than once a year);
- moderate (relapses occur 1-2 times a year);
- severe (exacerbates 3 or more times during the year).
According to dysfunctions of the digestive system that accompany this pathology: secretory, evacuation, motor.
Depending on the size of the wound, ulcers are: small (up to 0.5 cm); medium (from 0.5 to 1 cm); large (from 1 to 3 cm); gigantic (more than 3 cm).

Diagnosis of the disease includes various methods

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Diagnosis of the disease

The disease is diagnosed using several methods:

First, the patient is interviewed, the purpose of which is to find out the nature of the pain, the time of its occurrence (“before” or “after” eating), the season of relapse, etc.
Gastroscopy is considered the main method of identifying the problem. During the procedure, a special device called an “endoscope” examines the mucous membrane of the digestive organs. With its help, the location of the wounds is determined, whether there is internal bleeding, and the affected tissue is taken for further examination.
If it is assumed that the cause of the duodenal ulcer is Chylacobacteria, PCR diagnostics is prescribed. It detects bacteria that are present in blood, saliva, stool or biopsy samples.
The use of a contrast agent in x-rays of the duodenum penetrates the wound and helps evaluate the “wall defect”.
During duodenal intubation, a duodenal probe is used to examine the gastrointestinal tract. The pancreatic, intestinal juices and bile taken are further examined for their chemical composition, specific gravity and bacteriological picture.
If internal bleeding is suspected, blood tests are done to look for signs of anemia.

Signs of duodenal ulcers in women and men help to identify the disease, and to determine its causes, prescribe treatment and diet. If you follow the recommendations of gastroenterologists, you can overcome the disease and enjoy a full life. Good luck!

Peptic ulcer of the stomach and duodenum (DU) is characterized by a deep defect in the mucous membrane. The cause of its occurrence is an imbalance of protective factors (mucin that envelops the mucous membrane) and aggression factors (hydrochloric acid and pepsin). A huge amount of digestive enzymes from the pancreas and the acidic contents of the stomach are released into the lumen of the duodenum, which is why ulcers occur in this part of the intestine.

Diagnosis of an ulcer is the task of a gastroenterologist, who, based on complaints, anamnesis, laboratory and instrumental studies, forms a diagnosis

Indications are symptoms:

heartburn;
sour belching;
nausea;
vomiting, which brings relief (for this reason, patients often cause it themselves);
constipation

Pain with this disease occurs in the left hypochondrium if the ulcerative defect is localized in the stomach, in the right hypochondrium if the ulcer is localized in the duodenum. The occurrence of pain within 30-60 minutes after eating gives reason to suspect a process in the stomach. If pain appears 2-3 hours after eating, then attention should be paid to the duodenum. Patients with ulcers complain of so-called hunger pains, which stop after a snack.

It is worth remembering that in some patients pain does not appear at all. Such ulcers are called “silent”. They are often detected when complications occur - bleeding or perforation.

The disease has a relapsing course with periods of exacerbations and remissions. Exacerbations are characterized by seasonality - they occur in spring and autumn.

Diagnostic methods

When diagnosing ulcers, laboratory and instrumental methods are used. There are no differences in research methods between males and females.

Laboratory research

The gold standard for diagnosing any disease involves laboratory tests, and ulcers are no exception:

Blood analysis of patients with peptic ulcer does not provide valuable information. In most cases, changes are not detected. The presence of anemia indicates hidden bleeding.
Stool blood test. The study is necessary to detect bleeding.
pH-metry. In case of duodenal ulcer, the levels of stimulated and basal secretion exceed the norm. If the defect is located in the subcardial zone or in the body of the stomach, then these values will be normal or reduced.

Instrumental studies

Gastroduodeno- and fluoroscopy are the main diagnostic methods for gastrointestinal diseases:

X-ray, which reveals a niche in the relief of the mucous membrane.
Endoscopy is necessary to confirm the diagnosis, clarify the location, shape, size and condition of the ulcer.
carried out to detect Helicobacter pylori. The role of this bacterium in the occurrence of ulcers has been known for a long time: 90-95% of duodenal ulcers and 70% of gastric ulcers are Helicobacter. The test is based on identifying the enzyme urease, which is secreted by Helicobacter pylori to break down urea into ammonia and carbon dioxide. This diagnostic procedure is performed during endoscopy. A section of the mucous membrane (biopsy) is taken from the stomach and placed in a medium containing urea and phenol red. If there are bacteria in the stomach, urease will break down urea into ammonia, which will increase the pH of the environment and change the color of the indicator from yellow to red. The more Helicobacter pylori in the biopsy sample, the faster the solution will change color.

Complications of ulcers and their diagnosis

The greatest threat to the patient’s life is precisely the complications that arise when there is an ulcer in the wall of the stomach or duodenum.

Bleeding

The main symptoms are:

vomiting “coffee grounds” (under the influence of acid and digestive enzymes, hematin hydrochloride is formed from blood hemoglobin, which in appearance resembles coffee grounds);
tarry stools (feces also become black under the influence of hydrochloric acid and gastrointestinal enzymes);
tachycardia;
weakness;
dizziness;
loss of consciousness;
decrease in blood pressure;
pale skin.

Research that is necessary if there is suspicion of:

clinical blood test - a decrease in the number of red blood cells, an increase in the number of leukocytes and platelets is detected;
ESR - increases;
coagulogram - after bleeding, the activity of the coagulation system always increases;
stool examination for occult blood;
endoscopy.

Perforation

This complication is the most dangerous. It is manifested by the presence of a through defect in the wall of the organ. Perforation occurs much more often in men.

Perforation of gastric ulcer

Symptoms:

sharp pains, which are called “dagger”;
severe pain on palpation of the epigastric region;
abdominal wall muscle tension;
the presence of a positive Shchetkin-Blumberg sign (symptom of peritoneal irritation).

Penetration

This is the name for the penetration of an ulcer into neighboring organs and tissues (most often into the pancreas and lesser omentum).

Signs of penetration:

the appearance of persistent pain (if the ulcer penetrates into the pancreas, then the pain is localized in the lumbar region);
pain loses connection with nutrition;
temperature increase;
increase in ESR.

X-ray and endoscopic examinations are used to confirm penetration.

Differential diagnosis

Many gastrointestinal diseases have common symptoms with ulcers, so it is extremely important to differentiate them:

. Inflammation of the gastric mucosa differs from an ulcer by a more pronounced dyspeptic syndrome (digestive disorders in the form of belching, heartburn, nausea, vomiting) and less severe pain. An endoscopic or x-ray examination will allow an accurate diagnosis.
. In the early stages, stomach cancer clinically resembles an ulcer. Differential diagnosis is especially difficult in the case of ulcerative-infiltrative cancer. Cytological examination of a biopsy specimen is the most accurate and informative method in this case.
Cholecystitis and cholelithiasis (GSD). These diseases, like ulcers, are manifested by epigastric pain and digestive disorders. The main differences are that with cholecystitis and cholelithiasis, pain is associated with the nature of the food that a person eats. As a rule, pain appears after eating fatty, spicy, spice-rich foods. Also, pain in diseases of the gallbladder is cramping in nature.
. Pain in chronic pancreatitis, as well as in ulcers, is localized in the upper abdomen. They appear 30-60 minutes after eating fatty foods. Biochemical analysis will help to exclude pancreatitis during diagnosis. With inflammation of the pancreas, increased levels of trypsin, amylase and lipase are found in the blood.

About the symptoms of pre-ulcerative erosive gastritis.

Rationale for diagnosis

The diagnosis is made based on:

patient complaints;
general examination;
life history data;
results of instrumental and laboratory tests.

Peptic ulcer disease is a pathology that a gastroenterologist encounters more often than any other in his practice. There are many factors that contribute to the development of ulcers, starting with poor diet and activity. The ability to recognize the process and prescribe the necessary diagnostic procedures will help to identify the disease in a timely manner and avoid life-threatening complications.

Duodenal ulcer most often affects active young men and is characterized by a cyclical course.

Signs of a duodenal ulcer are pain in the upper abdomen that occurs after eating or prolonged fasting; accompanying nausea and vomiting. The picture of the disease depends on the location of the ulcer, the efficiency of the stomach, the age and gender of the patient. Sometimes the disease can occur without causing symptoms.

Structure and functions of the organ

The duodenum is part of the human digestive system and connects the stomach and jejunum. The name reflects its length - 30 cm (or the width of twelve fingers), the widest part of the organ (bulb) reaches 45-47 mm in diameter.

The organ has the shape of an arc that covers the pancreas, and depending on its direction, several sections are distinguished:

upper;
descending;
straight;
ascending.

The initial section (upper part) is the widest and connects the pylorus of the stomach with the main part of the organ. The duodenum then moves backward and to the right, forms the descending part of the organ, then forms the straight horizontal part. After this there is an ascending curve of the intestine, which rises up to the second lumbar vertebra.

The intestinal wall consists of three layers:

external - serous membrane, similar to the outer covering of the stomach;
muscular, in which 2 parts are distinguished - a longitudinal (outer) and circular (inner) layer, which ensures a reduction in length and a narrowing of the diameter of the organ;
internal - mucous membrane, forming longitudinal folds in the upper part and circular transverse folds in the horizontal and descending parts.

The intestinal mucosa has specific villi, each of which contains blood and lymphatic vessels - they ensure the absorption of nutrients. The longitudinal fold of the lower part contains a tubercle (Napilla of Vater), through which bile and pancreatic juice enter the intestine. The sphincter of Oddi serves as the regulator of intake.

The ducts of the intestinal glands exit into the base of the villi, producing duodenal juice, which contains digestive hormones and enzymes.

The main functions of the duodenum are:

secretory function, which determines the important role of the organ in the digestive process (production of hormonal compounds secretin, gastrin, cholecystokinin);
motor, which is determined by the contraction of the muscle layer, which results in the mixing of intestinal contents with digestive enzymes, pancreatic juice and bile;
transport function, which ensures the movement of the food bolus into the next sections of the intestine.

The formation and development of destruction of the mucosa and ulcers on the lining of the duodenum in adults occurs in two main directions. The mucous membrane is affected by:

Understanding the functions and structure of an organ allows us to determine the causes of disturbances in its functioning and the possibility of eliminating them.

Types of organ defects

Often, the diagnosis of duodenal ulcer occurs already at the stage of development of severe complications. The defect on the wall gradually affects all layers of the intestinal wall; depending on the level of destruction there are:

inflammation of the outer serous membrane after deep penetration of the wound into the wall of the duodenum (periduodenitis);
a perforated ulcer, in which a through defect is formed in the wall, and the internal cavity of the intestine begins to communicate with the abdominal cavity. The consequence of perforation is the development of inflammatory processes in the abdominal cavity (peritonitis), irritation of nerve endings, which provokes severe pain;
penetrating, in which the destroyed intestinal wall is closely adjacent to an organ in the abdominal cavity (pancreas) and causes acute inflammation;
a bleeding ulcer that forms as a result of a violation of the integrity of the intestinal wall.

Healing of a wound on the mucosa can cause the formation of a massive scar, deforming the muscle fibers in the walls and preventing the natural contraction of the intestine (duodenal stenosis). In rare cases, cells of an ulcerative defect can degenerate, and a new growth will form at the site of the lesion.

Causes of duodenal ulcer

The exact mechanisms of the pathology are not fully understood, but the causes of duodenal ulcers are fairly well defined. Now the overwhelming majority of practicing doctors are inclined to believe that the main provoking factor in the onset of the disease is infection by the Helicobacter pylori bacterium against the background of reduced immunity.

According to statistics, bacterial infection is detected in 30-40% of residents of developed countries, and 80-90% of residents of developing countries and post-Soviet countries.

Despite the high rates of Helicobacter infection, duodenal ulcers occur in only 5-7% of young men. The second reason that provokes the development and symptoms of duodenal ulcers is a decrease in general immunity. A depressed immune system is unable to suppress the uncontrolled proliferation of Helicobacter on the mucous membranes of the stomach and duodenum.

The main routes of infection by the bacterium will be:

violation of personal hygiene rules;
drinking contaminated water and food;
sharing toothbrushes and dishes with an infected person;
close contact with an infected person (kissing).

The main reasons that influence the decrease in immunity will be:

prolonged nervous overload and stress;
constant consumption of alcoholic beverages, toxic substances, smoking;
eating disorders - eating fatty, fried, spicy, pickled, too hard, hot or cold foods;
use of energy drinks;
prolonged hypothermia, injuries;
infectious diseases and systemic diseases;
long-term or uncontrolled treatment with non-steroidal anti-inflammatory drugs (Ibuprofen, Diclofenac), antibiotics, hormones, antitumor drugs;
consequences of hypovitaminosis;
genetic predisposition;
living in a heavily polluted environment.

Statistics show that duodenal ulcers occur most often in young men (5-7 times more often than in women), whose bodies are weakened due to nervous overload, heavy physical work, and excessive consumption of alcohol and cigarettes.

Followers of the Kyiv and Moscow Soviet clinical school are of the opinion that the cause of duodenal ulcer photo is aggression of the gastric and intestinal contents. The increase in gastric acid acidity will be influenced by:

smoking and alcohol abuse;
addiction to strong coffee and tea;
violation of diet (1-2 meals per day with long intervals between them);
the predominance of spicy, fried and smoked foods in the diet;
hereditary tendency to high aggression of gastric juice;

Practitioners especially note the destructive effect on the gastrointestinal tract of prolonged stress, physical and mental overstrain.

Manifestations of ulcers

Symptoms of a duodenal ulcer are associated with food intake and manifest as severe, dagger-like pain in the upper abdomen. In some cases, the pain may be dull. A characteristic symptom of duodenal ulcer photo is hunger pain before eating. Signs of the disease are cyclical and appear in spring and autumn, during the natural decline of immunity.

In some cases, pain appears after eating and is accompanied by nausea and vomiting. Patients often complain of:

nausea;
heartburn;
burping;
flatulence;
night abdominal pain from 2 to 4 am;
feces mixed with blood;
bowel disorders;
flatulence;
vomiting blood.

Provocateurs of pain are:

eating disorder;

alcohol;

strong nervous tension.

Blood in the discharge and vomiting are evidence of neglect of the condition and the opening of internal bleeding. In elderly and senile patients, damage to the walls of the 12-fingered intestine passes without pronounced symptoms.

Night pain with a duodenal ulcer is one of the most striking symptoms of the pathology. You can relieve them by eating a light snack or drinking baking soda. The reason is the release of hydrochloric acid after eating at night.

Long-lasting pain is caused by a duodenal ulcer upon penetration, when the intestinal wall is destroyed to the serous layer. At the peak of the pain, the patient vomits, after which the discomfort disappears.
If a duodenal ulcer is found in the heart area, the symptoms of pain resemble acute heart attacks and radiate to the left arm.

An inflamed duodenum and a formed ulcer periodically provoke heartburn, although patients usually do not suffer from an appetite disorder. It usually occurs after eating spicy, sour or salty foods.

A symptom of a painful condition of the duodenum and the presence of an ulcer is often a severe loss of weight in the patient. The process arises as a consequence of the patient’s fear of eating in anticipation of pain. Sometimes because of this, a person develops symptoms of vascular dystonia and accompanying disorders.

Diagnosis of pathology

After the patient’s treatment, the doctor diagnoses duodenal ulcers using the following methods:

collecting anamnesis and examining the patient, during which the nature and location of pain, their strength and frequency are determined;
palpation of the patient’s abdomen, during which the pathology of the intestine in the area of its localization is determined;
studies of the presence of Helicobacter pylori bacteria in the body through the determination of antibodies to it and microscopic examination of scrapings from the walls of the organ;
studies of the acidity of gastric juice as the main factor in damage to the duodenum 12;
FGDS;
Ultrasound of the abdominal organs;
X-ray examinations of the abdominal organs.

Diagnosing intestinal ulcers is now not difficult - almost all medical institutions are equipped with a device for performing gastroduodenoscopy. During the examination, the doctor can visually determine the parameters of the mucosal lesion, the size of the wound, its location and possible complications.

When X-raying a patient for the presence of an ulcer, a contrast agent is used, which can be used to determine:

defects in the surface of the mucous membranes (the contrast agent is retained in the area of the defect;
deformation of the mucosa in the defect area;
cicatricial changes on the intestinal mucosa after an ulcer;
the ability of the intestine to contract;
presence of complications - bleeding, perforation, penetration

In addition to special studies, the patient is prescribed:

general and biochemical blood test;
Analysis of urine;
stool occult blood test;
Helicobacter sensitivity test to antibiotics.

During the diagnostic process, the doctor determines the type and cause of the wound, differentiates it from other types of similar lesions, and decides how to treat the duodenal ulcer.

Types of pathology

Duodenal ulcers, the symptoms and treatment of which must be determined by a gastroenterologist, are divided into several groups. Based on the number of lesions encountered, there are:

single;
multiple;
combined (the patient develops stomach ulcers against the background of defects in the intestines).

According to the type of manifestations, they are distinguished:

ulcers with rare exacerbations (no more than once every 2 years);
with frequent relapses (every 6 months).

According to the location of the lesion:

in the ampulla of the intestine;
in the subsequent section of the intestine.

According to the severity of the wound surface:

deep;
superficial.

By size:

small;
medium and large;
gigantic.

According to the stage of scarring:

exacerbation;
remission;
healing.

By type of occurrence:

stressful, arising as a result of stress, severe nervous shock;
hormonal provoked by long-term treatment;
shock occurring after injuries.

Features of an ulcer of the intestinal bulb will be the following symptoms:

localization along the anterior wall of the organ;
young age of the sick, most often men under 40 years of age;
night and hunger pains;
absence of vomiting (rare);
frequent perforation of the wound.

When the defect is localized along the posterior wall, the lesion often enters the pancreas and the occurrence of pancreatitis.
Ulcers that form further than the bulb along the duodenum have the following features:

affects men after 40 years of age;
provokes severe paroxysmal pain in the right upper abdomen, reminiscent of an attack of cholelithiasis;
pain after eating appears 4-5 hours after eating, hunger pain is relieved 20-30 minutes after eating;
A common complication is bleeding and penetration of the defect.

Multiple ulcers are characterized by a tendency to slow scarring and frequent relapse of the pathology.

After receiving the examination results, the doctor prescribes appropriate treatment for the duodenal ulcer, selects the necessary diet, and changes the way of life.

Treatment of ulcers

The most effective treatment for duodenal ulcers will be at an early stage, after the first symptoms appear. After diagnosis, the doctor selects a multicomponent treatment regimen specifically for each patient. Various forms of medicines are used - tablets, injections, suspensions. For duodenal ulcers, standard treatment lasts up to 21 days.

Drug therapy includes:

antibiotics to relieve inflammation and relieve Helicobacter pylori. Drugs from the groups Macrolides (Clarithromycin), Penicillins (Ampicillin, Ampiox), Nitroimidazoles (Metronidazole) are used;
probiotics, which protect the gastric microflora from the effects of antibiotics;
painkillers that neutralize the irritating effect of hydrochloric acid on the intestinal wall (De Nol, which includes bismuth preparations that form a protective film on the mucous membrane, Almagel);
antispasmodics Drotaverine, No spa;
proton pump inhibitors that reduce the production of hydrochloric acid - Omez, Omeprazole;
inhibitors of the production of protective mucus - Cytotec;
regenerating intestinal mucosa Biogastron, Enterosgel;
improving peristalsis Motilium;
restoratives;
sedatives (motherwort, valerian).

If complications develop (bleeding from a duodenal ulcer, penetration, perforation), surgical treatment is performed, which consists of excision of the affected area of the intestine. Direct indications for surgical intervention are:

lack of effect from drug treatment;
deep defect of the intestinal walls;
bleeding;
frequent relapses of ulcers;
malignant tumor degeneration.

When a doctor determines how to treat a duodenal ulcer in each individual patient, he must focus his attention on giving up alcohol and cigarettes, as factors in reducing immunity and increasing acidity.

There are a large number of folk recipes for the treatment of such intestinal lesions; they are based on the use of medicinal herbs, honey and bee products.

For duodenal ulcer, regardless of symptoms and treatment, a diet is prescribed. It will be most severe in the first week of the disease, then gradually softens until the third week of the disease. According to the classification of diets adopted in the countries of the post-Soviet space, which was developed by M. Pevzner, this is diet No. 1 (with options A and B).

The main principles of nutrition for ulcers are:

frequent meals, at least 5 times a day;
small serving size;
stable food temperature - all food and drinks should be warm;
delicate mucous structure of dishes;
exclusion of fried, fatty, salty and spicy foods;
removing strong coffee, tea, cocoa from the menu;
exclusion from the use of certain vegetables with a large amount of plant fiber (cabbage, radish);
introduction of vegetable soups, cereal porridges, lean meat, dairy products, jelly into the diet;
fruits should be soft, sweet, preferably eaten without peel;
limiting sugar in the menu, introducing honey and natural sweets (jam, marshmallows, marshmallows);
caloric restriction to 2400 Kcal per day;
maintaining drinking balance.

During the most acute periods of the disease, almost all vegetables are excluded from the menu. Instead of tea and coffee, you can drink herbal teas from St. John's wort, chamomile, mint or rose hips.

Prevention of pathology

To prevent the occurrence and exacerbation of duodenal ulcers, you must adhere to some simple rules:

carefully observe personal hygiene;
use thoroughly washed dishes;
eliminate stressful situations and nervous tension;
maintain a balanced diet;
maintain a gentle daily routine;
promptly treat all viral and infectious diseases;
strengthen immunity;

It is necessary to maintain physical activity, which stimulates blood circulation, improves nutrition of organs, enhances their vitality and resistance.