What is pyloroduodenal stenosis? This is a narrowing of the duodenum. Or the pyloric stomach. This disease is a complication after the development of an ulcer of the above organs. This disease progresses in 40% of people with this pathology. Certain factors of this disease have not been studied, we are talking about prevention. That is why you should pay special attention to your well-being, also try to prevent gastrointestinal tract disorders. Accordingly, it is necessary to eat only healthy food, to lead the right lifestyle. It is quite difficult to cure this disease. You can read more about this in this article. It describes the causes, methods of treatment, as well as the classification of this disease.
Etiology
The cause of the disease is a peptic ulcer that affects either the stomach or intestines. As a rule, in the overwhelming number of cases, the source of the disease is duodenal ulcers, a little less often - neoplasms on the gastric mucosa. Most rarely, the cause of this disease may be compression of the duodenum by other organs - those that are in the stage of inflammation. The following cause is most common: obstruction of the lumen of the intestinal membrane. She goes down. This is how pyloroduodenal stenosis manifests itself. The pathogenesis of this disease is that ulcers and scars lead to deformation of the lumen and its narrowing. Because of this, inflammation can be localized not only in the nearest section, but also in other areas of the duodenum. Due to the fact that cicatricial narrowing occurs, the contents of the stomach hardly pass further through the body. At the same time, this organ is stretched, slightly lowered down, and these are already serious deviations. They can be fatal. Scarring is a pathological process that cannot be undone. Because of it, an imbalance of all types of functioning in the body occurs. Including disturbed even the water-salt and protein balance.
Classification of pyloroduodenal stenosis
This disease proceeds in several stages . Consider them.
Stage of compensation. It is characterized by the fact that the disease does not have symptoms or is expressed to a small extent. As a rule, such discomfort can occur after eating.
The next stage of pyloroduodenal stenosis is subcompensation. It differs from the previous one in that the signs of the disease are already becoming pronounced or intensifying , but they are not yet so unbearable.
The decompensation stage is characterized in that the disease is very difficult. Unpleasant sensations and the clinical picture as a whole have a pronounced shade. Moreover , already at this stage, treatment practically does not bring any positive effect, complications arise in most cases. This stage can occur both with the preservation of the function of the affected organ, and with its violations .
You can also divide this process into three types, depending on localization. We are talking about the bulb of the duodenum, duodenal , and also disorders of the gastric mucosa. Moreover, pyloroduodenal stenosis was classified by another factor.
The functional form develops due to deformation of the intestinal bulb or pylorus.
The organic form appears due to the tumor process and quickly transforms into the stage of narrowing of the pyloroduodenal region.
The transitional form of the disease is characterized by the fact that the gastric contents begin to pass quite slowly into the intestine, an inflammatory process occurs, as well as spastic contractions. It is worth noting that during this form of the disease, the passages are narrowed, and motor function is greatly impaired.
Symptoms of the compensated stage
It is worth noting that the symptoms and the overall clinical picture depend as much as possible on the stage of the disease. The compensated form is considered the easiest. That is why its symptoms may not appear. But still, in some cases, the following points are highlighted. There is a feeling of fullness of the stomach. And this despite the fact that a person could eat a very small amount of food. There is constant heartburn, and also belching with the sour smell of recently eaten food, in rare cases, there may be vomiting, and short pains also occur. This stage develops from 2 weeks to several years. After that, she goes into another form. Treatment of pyloroduodenal stenosis in this form is the easiest.
Symptoms of the subcompensated stage
The following symptoms of increased severity are characteristic of the subcompensatory form :
- Belching already with the smell of rotten eggs. This is due to the fact that food stays in the stomach for a long time.
- The pain syndrome is very strong. Many patients say that the pain is piercing .
- A rumbling in the abdomen, not inherent in ordinary hunger, may appear .
- Vomiting usually brings relief.
- Also, a person quickly loses weight.
This period can last several years.
Symptoms of a decompensated stage
The decompensated stage , unfortunately, leads to the fact that the condition deteriorates sharply. Vomiting of undigested food may occur . Very often people cause food rejection in an artificial way, hoping that this will bring them relief. But in 90% of cases it does not occur. Often a person feels a strong thirst, stool is broken, diarrhea appears. Soreness is pronounced , compared with the previous stage , the body is very weak, the person is not efficient. If the patient has admitted the disease to this stage , he needs to be prepared for the fact that it is a prerequisite for serious complications. As a rule, ulcer pyloroduodenal stenosis leads to this form .
Diagnosis of the disease
First of all, a person needs to undergo an instrumental examination. But before that - diagnostic measures.
First , the gastroenterologist should question the patient to identify symptoms. So he will understand the degree of intensity of the disease , as well as the time of its development. Moreover , it is necessary to familiarize yourself with the medical history of this patient, as well as conduct a thorough examination. Accordingly, the doctor should palpate the anterior abdominal wall.
Laboratory methods are of no use, so often doctors do not prescribe certain tests. But in some cases, the diagnosis may indicate that complications have already appeared.
Instrumental diagnostics
Instrumental diagnostic measures must be carried out without fail. It is necessary to perform an endoscopic procedure called FGDS. It involves examining and evaluating all the internal surfaces of the organs that enter the digestive system.
Moreover , radiography is done. During this procedure, doctors can see how enlarged the organs are and the pyloroduodenal zone is narrowed. In addition, thanks to this study, you can find out how much time the body needs to get rid of foreign substances. Through these studies, you can find out which therapy will be most useful.
Treatment
It is worth noting that this disease is mainly treated only with surgical intervention. Before the process to combat pyloroduodenal stenosis, preoperative preparation is mandatory. What is included here? First you need to normalize the water-electrolyte balance. This is done with the help of special medicines. In order to check the effectiveness of such treatment, blood biochemistry is performed . Moreover , enteral nutrition is prescribed , aspiration of gastric contents is performed. This is done using a probe. Antiulcer therapy is also prescribed . The course of such treatment lasts 3 weeks.
Surgical treatment is performed using several methods. A vagotomy is performed. Most often, it is performed along with additional methods . A gastrectomy is performed . As a rule, the last stage of this disease due to this passes into a lighter form - decompensation. They can also perform an antrumectomy.
Vagotomy
In the case when there is stenosis with sufficient patency of the pyloroduodenal zone, doctors can perform a vagotomy. If during the operation it is not possible to stretch a thick probe, then this process is carried out using pyloroplasty. Well, if the ability of the muscles of the stomach to contract is preserved, they perform a vagotomy with drainage.
Complications
If you ignore the symptoms and do not start treatment on time, you must be prepared for complications. We are talking about dehydration, up to the most difficult stage. Perhaps a decrease in blood chlorine, a lack of potassium, a decrease in calcium, a decrease in plasma volume, convulsive seizures. In the most severe cases, chlorohydropenic coma occurs. As a rule, it is the result of serious disturbances in the water-electrolyte balance. Its causes also include vomiting, diarrhea, compliance with a salt-free dietary table, uncontrolled intake of diuretic drugs, acute renal failure, and quite frequent gastric lavage.
Prevention
Prevention of this disease does not exist. Unfortunately, doctors have not yet identified what can help in the fight against the possible development of this disease. It is only recommended to undergo a preventive examination several times a year by a gastroenterologist. And also timely treat diseases that can lead to the formation of this disease.
To summarize
Considering this disease, it is worth saying that it is easier to prevent it than to treat it. It should be noted that many miss the beginning of the described disease, thereby complicating their lives. Do not neglect the examination by doctors, because the treatment of this disease is not only difficult, but also expensive. In his absence, a person will not live long and will suffer from rather unpleasant symptoms. The causes of this disease have already been described, so I just want to add that you should eat right , stop drinking alcohol, reduce tobacco consumption, and also monitor the condition of the stomach and duodenum, so as not to cause ulcers . You can prevent this disease with the timely treatment of ulcers , if any have already arisen. Only using the operation can fight pyloroduodenal stenosis. Surgery, however, does not provide a 100% guarantee of recovery.
At the genetic level, this disease is not transmitted, therefore, young parents have nothing to fear. Due to the fact that there is no prevention of this disease , it is more common and affects most people. Often , when patients turn to doctors in the late stages of the disease , treatment does not make sense, since after surgical intervention there may be irreversible consequences . That is why it is necessary to immediately consult a doctor when identifying the first symptoms . It is better to make mistakes several times than to miss the beginning of such a serious illness. Many patients who have experienced this disease unanimously say that living with constant symptoms is quite difficult , they had to leave work and also hire carers. If you avoid treatment, you can wait until the moment when food stops passing through the stomach into the intestine. This will lead to a painful death.