Duodenitis - Causes, Symptoms and Treatment .MF .
Recently, digestive system diseases are more common than previously.This is due not only to the deterioration of food quality, but with a constant human being in a stressful condition that disrupts the function of internal organs.One of these diseases is the loss of the duodenum (duodenum).
Gut is located between the outlet of the stomach department and primary department jejunum, ensuring the promotion of the food bolus in the lower divisions of the intestine, and taking part in the digestion and absorption of nutrients.In the lumen of the gut by respective ducts derived digestive juice produced by the pancreas, and bile from the gallbladder, necessary for splitting the molecules of proteins, fats and carbohydrates.Inflammatory diseases of the duodenum are called duodenitis - the most frequent diseases of the body.
Duodenitis can be an independent disease or pathology combined with other digestive tract, for example, may develop on the background of gastritis, pancreatitis, cholecystitis, enteritis
Causes of duodenitis
Duodenitis can be primary and secondary.The most common type occurs last.Primary type usually develops as a result of permanent errors in the diet and nutrition disorders, such as systematic eating irritating substances in products - sour, salty, pungent, hot, oily, deep-fried food, and alcohol.
secondary duodenitis develops against the background of such an existing pathology of the digestive system as:
- Gastritis, especially caused by Helicobacter Pylori - microorganisms, colonizing the gastric mucosa and initiates the formation of erosions and ulcers.
- Stomach ulcer, accompanied by too acidic food content, it causes an aggressive effect on the mucous membrane of the KDP.
- Pancreatitis and cholecystitis cause lack of enzymatic activity in the process of digestion of food and disruption of passage of chyme PDK, ie developing duodenostasis - stagnation of the contents in the intestinal lumen.The wall of the intestine is stretched, its blood supply is disrupted and there is a violation of the integrity of the mucous membrane.
- hepatitis and cirrhosis contribute to disruption of the formation of bile acids involved in the digestion of fatty foods, so that the undigested particles irritate the mucosa.
addition, isolated acute and chronic form of the disease.The acute form develops as a result of conditions such as:
- Acute food poisoning and foodborne viral (rotavirus, enterovirus) or bacterial (staphylococci, enterococci, etc.) nature.This isolated lesion duodenum is rare, mainly observed lesion of the gastrointestinal tract by the type of gastroenteritis or enterocolitis.
- Gross violation of the diet, such as over-eating greasy or spicy food, as is the case with the celebrations and feasts.
- Acute or chronic diseases of other organs of the digestive system.
- Burn mucosa by ingestion of toxic chemicals, such as acids, alkalis, solvents.This toxic substance before it enters the duodenum affects the mucous membrane of the esophagus and the stomach, so duodenitis combined with symptoms of esophagitis and acute gastritis.
- Foreign bodies - bones from plums, apricots, phytobezoars (agglomerated lumps of undigested residues in the use of large quantities of grapes, for example), not only mechanically injure the mucous membrane, but also in the long-term presence in the lumen of the intestine disrupt its blood supply.
chronic form, usually develops as a result of undertreated acute duodenitis or asymptomatic its course, as well as due to chronic diseases of other organs of the digestive system.Contribute chronic process frequent stress, bad habits, errors in diet and frequent meals "dry rations".
duodenitis duodenitis Clinical manifestations can be different depending on what causes it is called.The main symptom of all forms of the disease is a pain in the epigastric region (between the ribs in the upper abdomen) and in the umbilical region.
Acute duodenitis intense pain, severe, occurs most often in two - three hours after eating or at night (hungry pain).If duodenitis is combined with gastritis with high acidity of the stomach, pain may occur in 15 - 20 minutes after a meal.These clinical forms are called yazvenno- and gastritopodobnymi.
When poisoning and poisoning are observed nausea, vomiting, fever, loose stools.If a chemical burn of the mucous of the gastrointestinal tract in the first place there are signs of a lesion of the esophagus - a sharp pain in the mouth, neck and the chest, nausea, vomiting, respiratory disorders.There may be loss of consciousness and painful shock.
When errors in feeding the patient notes aching pain in the abdomen, a feeling of fullness, bloating, belching a rotten smell, frequent stools or constipation.
If inflammation of the mucous membrane of the KDP uses zone exit of the pancreatic and bile duct (Vater nipple) may experience symptoms of pancreatitis and cholecystitis - intense pain in the abdomen on the left or right, as well as herpes character frequent vomiting bile regurgitation with a bitter taste, yellow tintskin and eyeballs due to jaundice.Such variants are called flow pankreato- and holetsistopodobnymi.
All symptoms of acute duodenitis with proper treatment stoped in 7-10 days.In case of failure or absence of treatment, as well as gross violation of the diet during the recovery period often develop a chronic form of the disease, which is characterized by a dull, almost constant pain in the epigastric pain, nausea, alternating diarrhea and constipation, bloating, loss of appetite, weight loss.In the long inflammation in the mucosa and impaired absorption process providing nutritious substances other organs in the body, in particular of the nervous system.This is manifested asthenic-vegetative symptoms - fatigue, weakness, sleep disturbances, irritability, weight loss, lack of appetite, unpleasant feeling of fullness after eating, constant nausea.
diagnosis can be assumed already during the interview and examination of the patient.When probing the anterior abdominal wall are defined by pain, rumbling in the projection of duodenal ulcers, bloating.
to clarify the nature and causes of duodenitis doctor prescribes additional methods of inspection:
- General blood and urine tests, blood chemistry, the study of feces (to determine the content of undigested fat particles and starch, indicative of pancreatic insufficiency, and occult bloodwhen intestinal bleeding).
- Fibroezofagogastroduodenoskopiya (FEGDS) - visual inspection of the mucosa of the esophagus, stomach and duodenum, using a thin probe introduced through the mouth.It is the most informative method of diagnosis as it allows to evaluate the inside of the intestine.According to the picture obtained in the investigation, isolated erythematous, erosive, hemorrhagic, atrophic duodenitis.
FEGDS with erosive gastroduodenitis
- Radiography, including contrast, may be appointed if you can not perform FEGDS, but is less informative.When defects and ulcers of the mucous membrane is characterized by a symptom of "niche" - barium suspension flowing into the damaged mucosal site.
- Analysis of the reaction gastric juice obtained during gastroscopy, to evaluate the level of acidity in the stomach and the necessity of taking the drugs, lowering it.
- ultrasound of internal organs shall be appointed for exclude pancreatitis, cholecystitis, hepatitis, cirrhosis, structural abnormalities of the gallbladder and biliary tract, and so on.
Treatment duodenitis duodenitis
Treatment varies depending on the cause.The main focus in the treatment of all forms of the disease is strict adherence to a balanced diet.
So, with food poisoning and poisoning appointed detoxification therapy with intravenous fluids or fluid intake, as well as antibiotics, after which needs acceptance of probiotic preparations for the normalization of intestinal microflora (Linex, normobakt etc.).
When poisoning chemicals shown fasting for one - two days later - drugs to suppress the production of hydrochloric acid in the stomach and means enveloping effect.
for the treatment of acute and chronic duodenitis due to infection of the stomach bacterium Helicobacter appointed antimicrobials - clarithromycin, metronidazole, amoxicillin.In addition, to suppress the increased production of acid in the stomach and neutralize it, showing these groups of drugs:
- proton pump inhibitors - ransoprazol, omeprazole and other
- antihistamine blockers - cimetidine, ranitidine, and others
- antacids - almagel, Aluminium phosphate gel and..et al.
in cases where inflammation of the duodenum combined with dysfunction of other organs, appointed enzyme preparations improving digestion (Creon, ermital, mikrazim, pancreatin, etc.), as well as prokinetics, improving the passage of food bolus from the stomach into the intestine (motilium) and antispasmodics, eliminating pain syndrome (papaverine, no-spa, etc.).
If the contents of stagnation in the intestine (duodenostasis) caused by organic causes (adhesions, tumor, etc.), surgical treatment.
For successful treatment of acute duodenitis and prevention of relapse of the chronic form shows good nutrition, proper rest, with the exception of stress and bad habits.
On the concept of a balanced diet are the observance of the multiplicity of eating four to six times a day in small portions and calorie intake, but at the same time, low-fat foods to a preferred use of dishes cooked in boiled or stewed.
encouraged use of products such as:
- products provider enveloping effect on the mucous membrane of the stomach and duodenum - flaxseed, oat, potato and corn starch,
- cereal and pureed soups,
- lean meats and fishbetter in the form of cutlets, meatballs and the meatballs,
- scrambled eggs, dairy dishes,
- fruit when baked, steamed vegetables,
- stale bread, crackers,
- butter and oil in a small amount.
- canned, smoked products,
- spicy seasonings, spices,
- alcohol, coffee, lemonade,
- fast food,
- fruits and vegetables in their raw form,
- fatty meat and fish.
In the acute period of the diet should be more strict with the gradual expansion of the menu as recovery.
Compliance simple nutritional advice during and after acute duodenitis significantly reduces the likelihood of chronic process, which essentially can ruin the quality of life.Therefore, even if a person once in their lives suffered duodenitis, then he should always take care about proper nutrition.
the event of failure of the medical or non-diet in chronic duodenitis may be complications such as:
- adhesive thin-bowel obstruction due to the growth of connective tissue in the place of permanent inflammation in the mucosa and submucosal structures,
-duodenal ulcer bulbs, including complicated by bleeding,
- malabsorption of nutrients (malabsorption), which leads to weight loss, unstable chair, disruption activity and degeneration of internal organs.
preventing morbidity treatment is begun on time and comply with the recommendations of the attending physician.
prognosis of acute and chronic forms of the disease favorable.Full recovery after acute duodenitis occurs almost always, if the excluded factors that have an irritating effect on the mucous membrane of the duodenum.
If the patient develops complications, the prognosis remains favorable for life and health questionable due to a violation of the internal organs function.In some cases, the presence of rumen lesions bulb ulcers, frequent exacerbations of peptic ulcer disease (3-4 times per year or more), with a decrease in body weight of more than 15%, anemia and other laboratory abnormalities, degeneration, and, if necessary,surgical treatment, the patient may be given a disability.
therapists Sazykina OJ