Causes and symptoms of stomach and duodenal ulcers. Drug treatment, diet

Causes

The most common cause of peptic ulcer disease is infection with the bacterium Helicobacter pilory. It can be contracted through saliva through close contact with another person. In patients with duodenal ulcers, helicobacter is detected in 90% of cases; in patients with gastric ulcers, the figure is 50–60%.

In addition to bacteria, stress, poor diet and long-term use of non-steroidal drugs can be a provoking factor. Many people believe that a peptic ulcer is a complication of gastritis, but this is not true: these are different diseases and gastritis does not develop into a peptic ulcer.

general description

Peptic ulcer of the stomach/duodenum is a chronic polyetiological disease that occurs with exacerbations; the morphological manifestation is an ulcer of the gastroduodenal zone.
Peptic ulcer disease is widespread, affecting 5 to 15% of adults. Duodenal ulcers predominate over gastric ulcers by 4 times.

Peptic ulcer disease is a pathology of multifactorial origin, but the main cause is exposure to the infectious agent Helicobacter pylori.

Etiological factors can also be: non-steroidal anti-inflammatory drugs, genetic predisposition, gastrinoma, bad habits, use of glucocorticosteroids, impaired immunity, stress.

An ulcer occurs when there is an imbalance in the aggressive and protective mechanisms of the gastroduodenal mucosa.

Aggressive factors are increased production of hydrochloric cysts due to overproduction of gastrin or neurohumoral stimulation, overproduction of pepsin, motor-evacuation dysfunctions, entry of bile acids and pancreatic enzymes into the stomach in case of duodenogastric reflux.

A decrease in the protective properties of the mucous membranes of the stomach and duodenum occurs due to impaired mucus formation, blood supply, decreased production of bicarbonates, prostaglandins, and regeneration of the mucosal epithelium.

• Stomach ulcer.
• Duodenal ulcer.

Treatment

Treatment depends on whether helicobacter is detected in the patient’s body or not. In the first case, the doctor prescribes two types of antibiotics, because one does not kill her, as well as drugs that create unfavorable conditions for the life of bacteria. Sometimes, after destroying the bacteria, the ulcer itself does not heal, then the patient is prescribed drugs that reduce secretion and improve tissue trophism. If helicobacter is not detected, antibiotics are not prescribed.

The course of treatment usually lasts 14 days, in certain cases it takes longer. Thus, a callous ulcer (large, advanced, with a diameter of more than 5 cm) can heal in 2-3 months. Usually, the defect grows to such a size in older people who have been taking non-steroidal drugs for years and have not checked their stomach. First of all, to heal it, the doctor stops the medications that cause peptic ulcers.

Operation

Treatment of peptic ulcers rarely requires surgery. It is only necessary in case of complications. For example, a perforated (perforated) ulcer can only be cured through surgery. The operation is also performed for massive bleeding, when it cannot be stopped conservatively, and for spinosis (narrowing of the duodenum).

Nutrition

To heal the defect, in addition to drug treatment, you must follow a diet. It consists of following a diet: a person should eat small portions 4-5 times a day, excluding spicy, salty, fried, smoked foods. All food must be boiled or steamed. When the ulcer heals, you no longer need to follow a diet, but you should still not abuse spicy, fried, smoked and salty foods. It is also important to eat regularly, without skipping meals, to prevent exacerbation. Alcohol is contraindicated for any gastrointestinal disease. Products that are best avoided: baked goods, brown bread, tomatoes, coffee, strong tea, lard, lamb fat, margarine, chocolate. The diet can include: dried wheat or yesterday's bread, crackers, savory cookies, milk soups, beef, chicken, pike perch, pike, perch, water porridge with the addition of milk (semolina, buckwheat, oatmeal, pearl barley, rice).

Symptoms

Diagnostics

To diagnose peptic ulcers, patients undergo fibrogastroscopy, during which they can do a quick urease test and be examined for helicobacter. Somewhere, additionally, pH measurements are performed in order to find out the level of acidity in the stomach. During this examination, a probe is inserted into the patient's stomach through the nose and acidity is measured throughout the day.

Early diagnosis of diseases of the gastrointestinal tract allows you to timely identify and prevent the risk of developing infectious, inflammatory and tumor diseases of the gastrointestinal tract, avoid the development of complications and the transition of the disease to a severe form. We care about the health of our patients and offer to use our programs for the prevention and treatment of diseases of the digestive system. These programs can be completed in 1 visit to the clinic.

You can make an appointment with a gastroenterologist at the Naedine Clinic by phone in Kirov: (8332) 32-7777 or through the form on the website

Peptic ulcer of the stomach and duodenum

Peptic ulcer disease is a chronic disease accompanied by the formation of an ulcer (defect) in the wall of the stomach or duodenum and occurs with alternating periods of exacerbation and remission. Depending on the location of the defect, ulcers of the stomach (cardiac and antrum, body, pylorus, pyloric canal), duodenal ulcers (bulb, postbulbar) and combined are distinguished.

Main symptoms

Peptic ulcer disease can occur with varying severity of symptoms - from practically asymptomatic to pronounced pain and be accompanied by varying degrees of damage to the mucous membrane - from barely noticeable changes and overflow of blood vessels to pronounced ulcers. The danger of peptic ulcer disease is that there is no direct relationship between its symptoms and damage to the mucosa. There are cases when patients with extensive ulcerations do not have any manifestations of the disease.

The leading symptom of a peptic ulcer is pain in the epigastric region, which can radiate to the left half of the chest and left shoulder blade, thoracic or lumbar spine. Depending on the location of the ulcer, pain manifests itself in different ways and at different times:

• immediately after eating;
• an hour and a half after eating;
• late pain (2-3 hours after eating) or hunger pain that occurs on an empty stomach and goes away after eating, as well as night pain.

Burning pain in the abdomen significantly worsens a person’s quality of life; in addition, heartburn, sour belching, nausea, vomiting, a tendency to constipation or diarrhea, fatigue and weakness may be observed.

During the remission stage, all symptoms weaken, but may periodically intensify. The unpleasant symptoms that accompany the course of a peptic ulcer may increase or decrease over time, for example, in autumn and spring, after a diet disorder or stress.

Mechanism of disease development

An ulcer may appear due to a weakening of the protective properties of the inner lining of the stomach and duodenum and an increase in the aggressive effect of acid and pepsin contained in the stomach on them. This process can be caused

• Helicobacter pylori bacteria that have settled in the stomach;
• long-term use of aspirin, nyse, ibuprofen and other non-steroidal anti-inflammatory drugs;
• increased acidity;
• hereditary predisposition;
• the presence of other diseases of the gastrointestinal tract, endocrine disorders.

Stress, bad habits and eating disorders provoke exacerbations of the disease and can contribute to its occurrence, but they cannot be the main cause of the formation of ulcers.

When to see a doctor

• if you are bothered by constant discomfort and pain in the abdomen, as well as abdominal pain at night;
• often there is heartburn, sour belching and food is disgusting;
• your close relatives have a peptic ulcer or have been diagnosed with Helicobacter pylori infection;
• there is weight loss for no apparent reason;
• due to the presence of diseases, you often have to take painkillers; you have been in a stressful situation for a long time;

Complications

Without treatment, peptic ulcer disease can lead to a number of life-threatening complications, such as bleeding, perforation of the ulcer, and primary ulcerative gastric cancer.

Why does peptic ulcer develop?

Previously, it was believed that the cause of the disease in question was poor nutrition and alcohol abuse. Modern research indicates that the causes of atrophic gastritis (it is the “harbinger” of an ulcer) lie in the presence of the bacterium Helicobacter pylori, which lives in gastric juice and neutralizes it. This bacterium can enter the human body in the simplest ways - through dirty hands, dishes, doctor’s instruments, and also from a woman to her fetus during pregnancy.

In addition to the main cause of the development of the disease in question, there are a number of provoking factors:

1. Taking certain medications. Diclofenac, Ibuprofen and other non-steroidal anti-inflammatory drugs used for a long time have a negative effect on the condition of the gastric mucosa. A high risk of peptic ulcer disease exists in patients over 65 years of age who simultaneously take both coagulants and corticosteroids.
2. Abdominal injury - blows/bruises, frostbite, internal burns.
3. The presence of common diseases - tuberculosis, syphilis, inflammation of the pancreas or liver.
4. Regular violation of diet and diet, alcohol abuse and smoking.

Duodenitis

Duodenitis: symptoms, treatment, diet

Duodenitis is a disease of the duodenum, which is characterized by inflammation of the mucous membrane. Pathology can occur in acute and chronic form. Duodenitis has similar symptoms to other gastrointestinal diseases, such as ulcers and gastritis, so successful treatment requires consultation with an experienced gastroenterologist and high-quality diagnosis.

Causes of the disease

Primary duodenitis occurs against a background of poor nutrition and bad habits. Sour, spicy, fried foods, and alcohol stimulate the secretion of hyperacid gastric juice, which enters the intestine with food and damages its wall.

Primary duodenitis is rare. The secondary form of the disease is more often diagnosed when signs of inflammation of the duodenum appear for the following reasons:

• Helicobacter pylori infection.
• Chronic gastritis and other gastrointestinal diseases.
• Impaired blood supply to the duodenum, for example, after surgery.
• Digestive disorders.
• Adhesive processes in the intestines.
• Compressive intestinal obstruction.

There are also specific forms of duodenitis, when the cause of inflammation of the duodenum is Crohn's disease, tuberculosis, immunodeficiency, Whipple's disease and other pathologies.

Symptoms of duodenitis

Signs of the disease are nonspecific. When pathological foci are localized in the upper sections, the symptoms of inflammation of the duodenum are often confused with a gastric ulcer. Damage to the lower sections has signs of cholecystitis or pancreatitis.

There is a classification of symptoms of inflammation of the duodenum according to where it hurts and what manifestations it is accompanied by:

• Ulcerative duodenitis. The patient complains of nagging pain in the stomach, which intensifies at night and on an empty stomach. After eating, the symptoms subside. Bitter-tasting belching and heartburn are common.
• Gastritis-like duodenitis. The stomach begins to hurt 15-20 minutes after eating. Signs of duodenitis: flatulence, loose stools, rumbling in the stomach, nausea, loss of appetite.
• Pancreatic-like and cholecyst-like duodenitis. The pain is acute and occurs in the hypochondrium, similar to biliary colic. Stool and digestive disorders are observed.
• Neurovegetative duodenitis. The patient becomes ill due to chronic stress, which results in hormonal imbalances and various autonomic disorders of internal organs and systems.
• Duodenitis of mixed form. There are clinical signs of several types of diseases.
• Asymptomatic duodenitis. The disease is diagnosed in adults and older people during examination for other complaints.

Chronic duodenitis during periods of exacerbation is manifested by night pain. Patients also complain of weakness, nervousness, headaches, tachycardia, and shortness of breath. The symptoms are due to the fact that when the duodenum becomes inflamed, its hormonal function is disrupted.

Diagnosis of duodenitis

The main diagnostic method is gastroscopy. Based on the endoscopic picture, the doctor can confidently talk about the development of duodenitis and determine its form.

As part of evidence-based medicine, histology is required to diagnose inflammation.

To clarify the diagnosis, the following is prescribed:

• X-ray of the stomach and duodenum

with contrast.

• pH-metry of digestive juice.
• General and biochemical blood test.
• Duodenal intubation, during which samples of gastric juice are taken.
• Coprogram.
• Biopsy for suspected malignancy of mucosal defects.

Treatment of duodenitis

Treatment of inflammation of the duodenum is selected individually, taking into account the clinical form of the disease.

Duodenitis of an infectious nature requires the use of antibiotics - the drug is selected individually to relieve the inflammatory process. The doctor also prescribes medications to reduce the production of gastric juice and coating medications to protect the mucous membrane. Enzymes help restore digestion.

Treatment of duodenitis with enteritis is based on a strict diet. The patient is advised to exclude cereals, milk, and other foods that are poorly digested from the diet. To maintain the functioning of the gastrointestinal tract, the doctor prescribes probiotics. A balanced diet for duodenitis should become habitual - this is the only effective measure to prevent exacerbations. It is recommended to exclude spices, fresh baked goods, salty, spicy, fried foods, and alcohol from the diet. It is better to steam or boil meat, vegetables and fish.

Inflammation against the background of duodenostasis requires clarification of the cause of intestinal obstruction. The patient is prescribed a diet and is advised to eat small portions. Depending on the specific clinical picture, the doctor may prescribe medications that enhance intestinal motility and bind bile. A good result is obtained by probing the duodenum with lavage.

In difficult cases, surgical treatment is indicated. During the operation, the doctor removes adhesions and mechanical obstructions, and intestinal patency is restored. Gradually, the symptoms of duodenitis weaken and disappear. Treatment is carried out in a hospital setting. After the operation, the patient is prescribed a constant diet.

To prevent duodenitis, in addition to diet, patients are advised to give up bad habits, follow a daily routine, and avoid stress. Any diseases of the digestive system and parasitic infestations must be treated promptly.

Diagnosis and treatment of duodenitis in Nizhny Novgorod

You can make an appointment with a gastroenterologist on the website of the Alfa Health Center clinic. Consultations are held at a time convenient for the patient. In our clinic you can take the necessary tests, undergo a comprehensive examination, and receive qualified treatment. Call us to select an appointment time.