Such a pathology as duodeno-gastric reflux (in the ICD-10 there is no code) is detected in 15% at first glance of healthy people. This is a disease of the digestive tract, which is characterized by the injection of bile acids and duodenal enzymes into the stomach. The disease is very rare on its own. In most cases, the development of duodeno-gastric reflux occurs as a result of other diseases, such as gastritis, ulcer, gastroesophageal reflux disease, but there are many other reasons.
general information
Duodeno-gastric reflux develops in violation of duodenal patency, as a result of which there is an increase in pressure in the duodenum. In this case, the closure function of the pylorus is noticeably weakened. The pyloric sphincter ceases to perform its basic functions properly, and food that has managed to partially digest and advance into the intestines returns to the stomach.
According to statistics, the disease occurs in approximately the same number of men and women. Often he is diagnosed with students.
Causes of the disease
As the causes of duodeno-gastric reflux, gastroenterologists distinguish factors such as:
- pancreatitis
- gastrin hormone deficiency;
- hepatitis;
- diaphragm hernia;
- cholecystitis;
- dysbiosis;
- diabetes;
- syndrome of incomplete turn of the small intestine and intestines;
- obesity;
- inflammatory processes in the gallbladder and pancreas;
- helminthic invasion;
- insufficiency and other diseases of the pancreas;
- pregnancy;
- Surgical interventions on the digestive system (cholecystectomy, suturing ulcers and other operations).
The following can also lead to the development of pathology:
- smoking;
- alcohol addiction;
- frequent eating too hot, spicy and fatty foods;
- irregular nutrition;
- unbalanced diet, lack of liquid food in the diet;
- long-term use of antispasmodics, antibiotics;
- frequent stresses.
Symptoms of the disease
Signs of duodeno-gastric reflux can often be confused with the symptoms of other diseases of the digestive system. But this ailment has its own distinctive feature. All symptoms begin to appear about half an hour after eating. That is how much time is usually necessary for food to start processing in the stomach and go to the next stage. In the presence of a disease, this established process gives a malfunction, as a result of which particles of food, together with enzymes and acids, enter the stomach and affect its mucous membrane.
Duodeno-gastric reflux is accompanied by the following symptoms:
- Stomach ache. Usually they are localized in the upper part, are paroxysmal in nature, have medium or high intensity.
- Flatulence.
- Heartburn, which occurs almost immediately after eating.
- Belching with air (in some cases, acidic contents).
- Spitting up with acidic contents or a small amount of food.
- Taste of bitterness in the mouth.
- The appearance of a white or yellowish coating on the tongue.
- Nausea, vomiting with impurities of bile (in cases when the disease progresses).
Since the diagnosis of duodeno-gastric reflux disrupts digestion, nutrients cease to be fully absorbed. As a result, vitamin deficiency develops, which is characterized by:
- weight loss;
- redness and seizures in the corners of the mouth;
- deterioration of the condition of nails, skin and hair.
If you find the above symptoms of the disease, you should immediately contact a gastroenterologist who will conduct an examination and prescribe the correct treatment.
Degrees of disease
Depending on how long the development of the disease began and how much bile acid is contained in the stomach, the pathology is divided into several degrees:
- Duodeno-gastric reflux of 1 degree. This is the initial stage of the disease, during which a minimal amount of the duodenum is found in the stomach. As a rule, at this stage there are no signs of the disease. In more rare cases, the patient may notice some symptoms, but does not pay attention to them and thinks that they have arisen due to malnutrition and will soon disappear on their own.
- Duodeno-gastric reflux 2 degrees. It is at this stage that most patients learn about their disease. During diagnosis, enzymes and acids of the duodenum 12 are found in the fundus of the stomach. Periodically occurring symptoms make the patient suspect the presence of an ailment and seek help from a gastroenterologist.
- Duodeno-gastric reflux 3 degrees. This form of the disease is considered to be the most complex and neglected. The contents of the duodenum 12 can be found in the lower sphincter of the esophagus and at the bottom of the stomach. The third degree is accompanied by a pronounced appearance of all the symptoms of the disease, which cause the patient great discomfort.
Diagnosis of the disease
Often, duodeno-gastric reflux can be diagnosed completely by accident. For example, this can happen during a routine examination or a comprehensive examination, the purpose of which was to identify a completely different disease of the digestive system.
In other cases, special diagnostics will be required. Visual examination of the patient will not produce almost any result. The only thing a doctor can note is a white or yellowish coating on the tongue. Auscultation (listening) and palpation (palpation) of the abdomen are also performed. During these procedures, the presence of soreness, peristaltic noises and rumbling in the abdomen is determined.
To identify duodeno-gastric reflux, instrumental research methods are also necessary. It can be:
- Antroduodenal manometry;
- measurement of acidity of gastric juice;
- electrogastrography.
If necessary, auxiliary diagnostic methods can be used:
- Ultrasound
- FGDS;
- survey radiography;
- differential diagnosis.
Before confirming the diagnosis of duodeno-gastric reflux, a gastroenterologist will have to completely exclude the presence of ailments with similar symptoms:
- gastritis;
- ulcer;
- duodenitis;
- acute cholecystitis;
- acute pancreatitis;
- acute cholangitis;
- cholelithiasis.
Drug treatment
The use of drugs for duodeno-gastric reflux is performed on an outpatient basis. The need for hospitalization arises only with severe pain, severe vomiting and the development of various complications of the disease, as well as with the aim of conducting additional examinations.
The main goal of drug treatment is to restore the functionality of the digestive system. For this purpose, the patient may be prescribed:
- Prokinetics for the speedy digestion of food, its better absorption and promotion of the small intestine. Such drugs include Domperidone and Cerucal.
- “Trimedat” will help improve intestinal motility.
- To protect the stomach from exposure to the contents of the duodenum 12, Nexium and Omez are used.
- Gaviscon, Fosfalugel, Almagel will help get rid of heartburn.
- Mosapride citrate will enhance peristalsis of the upper gastrointestinal tract.
- Ursodeoxycholic acid preparations will make the contents of the duodenum 12 water-soluble, which will reduce its aggressive effect on the stomach.
In cases where drug treatment did not bring the desired results, a decision is made on the need for surgical intervention. But here everything is not so simple. The fact is that to perform high-quality plastic pyloric stomach is very difficult technically. And the imposition of anastomosis (anastomosis) between the intestines and stomach will not be able to replace and fully perform the functions of the sphincter.
Diet as part of general therapy
Treatment of duodeno-gastric reflux includes adherence to a special strict diet. Patients are allowed to eat:
- vegetable-free soups;
- boiled, baked or steamed fish;
- lean meat;
- eggs
- vegetables;
- non-acidic fruits;
- greens;
- jam;
- compotes;
- honey;
- jelly;
- dried bread.
Food with duodeno-gastric reflux should be fractional, which implies the use of small portions up to six times a day.
As for the restrictions, for the entire period of treatment the patient is prohibited:
- fried dough;
- fresh bread and pastries;
- fat and animal fats;
- mushrooms;
- spices and seasonings;
- chocolate;
- legumes;
- cakes with cream and butter creams;
- ice cream.
Treatment with folk remedies
Treatment of duodeno-gastric reflux does not exclude the use of various folk remedies. In particular, it can be decoctions of such plants as yarrow, St. John's wort, chamomile, calamus, sage, flax, angelica. At the same time, experts remind that one should not completely abandon drug treatment and give preference to folk remedies that seem safer. The latter can only complement the main therapy.
Possible complications
Duodeno-gastric reflux can cause the development of other, more serious diseases and pathologies. For example, it can be:
- Toxic-chemical gastritis C. Usually, the disease occurs as a result of improper or incomplete treatment of duodeno-gastric reflux. The disease is an inflammation of the gastric mucosa due to the constant exposure of pancreatic juice and bile to it.
- Adenocarcinoma. This is a malignant neoplasm of the esophagus, which occurs as a result of changes in its mucous membrane, the growth and degeneration of its cells. The main reason this process occurs is the ingestion of the contents of the stomach into the esophagus.
- Gastroesophageal reflux disease. It is accompanied by a drop into the esophagus of the contents of the stomach and duodenum.
In especially severe cases, complications may occur in the form of “prolapse” of the stomach and duodenum from the normal act of digestion. In this situation, the patient will not be able to eat on his own, he will be fed by introducing special substances through the blood.
Forecast for the future
In most cases, the prognosis for the future after treatment of duodeno-gastric reflux will be favorable. The occurrence of undesirable negative consequences is possible only with the neglect of the disease, improperly selected therapy, refusal to follow all the doctor's recommendations.
Prevention
To prevent the appearance of such an unpleasant disease as duodeno-gastric reflux, it is necessary:
- adjust your nutrition;
- eliminate overeating;
- promptly seek help from specialists in case of problems with the digestive system;
- Do not self-medicate and take drugs only under the supervision of a doctor;
- engage in physiotherapy exercises and perform exercises to strengthen the abdominals and muscle corset.
Be healthy!