Stenosis of the stomach and duodenum, also known as pyloric stenosis, is a pathology of the digestive tract, which occurs as a result of narrowing of the lumen of the gastric pylorus. As a result, there is a violation of the process of passage of food from the gastric cavity into the intestine. In a neglected form, an ailment can cause severe pathologies, as well as make changes to homeostasis.
Stenosis is an acquired disease, but in rare cases there are congenital pathologies.
The causes of this disease
Gastric stenosis is inherently a complication of peptic ulcer. Healing of ulcers occurs, as a rule, through the formation of scar tissue. The scar that occurs at the site of the ulcer affects the connective tissue, thereby deforming the damaged walls of the stomach.
There are several reasons that lead to the development of stenosis of the stomach:
- The presence of hernias in the opening of the esophagus.
- Cholecystitis, proceeding according to the calculous type.
- Gastritis in a chronic course.
- Toxicosis of pregnant women.
- Getting a chemical internal burn.
- Mechanical damage to the esophagus.
- Complication after surgery.
Factors provoking this pathology
In addition, doctors identify a number of factors that can provoke the appearance of stenosis of the stomach and duodenum:
- Unbalanced and irregular diet.
- Low quality of consumed products.
- Alcohol abuse.
- Long-term use of drugs.
- Compliance with monodiet for a long time.
- The presence of malignant tumors.
Careful nutrition for stomach disease
A balanced diet involves not only eating the right and high-quality foods, but also observing the regularity of meals and the amount of food consumed. If the course of stenosis is characterized as severe, you need to carefully approach the issue of nutrition. This will eliminate the possibility of relapse.
Stages
Stenosis of the stomach according to ICD-10 (international classification of diseases) is indicated by code K-31.2. It goes through three stages of development, each of which has its own characteristics of manifestation and treatment:
- The first stage of pathology. Manifestations of the disease are insignificant, have a low degree of severity. The opening between the intestines and the stomach is only slightly closed. The patient may complain of the sour taste of burping, as well as a feeling of fullness in the stomach after taking even a small amount of food. In some cases, relief occurs only after cleansing the contents of the stomach by inducing a vomiting reflex. In general, the patient's condition is described as satisfactory.
- Second stage. It is described as compensatory and is accompanied by a feeling of fullness of the stomach constantly, even in the absence of food intake. In addition, pain and belching are observed. After eating, vomiting often opens, which brings relief, however short-lived. The patient is characterized by unreasonable weight loss.
- Third stage. It is also called decompensation and is characterized by a sharp progression of stenosis. There is a strong distension of the stomach, accompanied by exhaustion and dehydration. Quite often, in the third stage, vomiting is observed, which has an unpleasant odor, with the remains of undigested food for several days.
Treatment can give a result at any stage of the development of pathology, however, with early diagnosis, the chances of no complications are much greater.
Symptoms
Pyloric stenosis, characterized by a narrowing of the lumen between the duodenum and stomach, can manifest itself differently depending on the type of pathology and stage of its development. Specialists distinguish the following symptoms of the disease:
- Compensated stenosis is characterized by a slight narrowing of the muscles of the organ. The patient complains of a feeling of fullness of the stomach, often experiences severe heartburn, which has to be stopped with regular use of antacids. Occasionally, the patient begins vomiting, which brings relief and eliminates discomfort until the next meal. X-ray examination allows you to see acceleration in peristalsis and a slowdown in the process of intestinal emptying. Symptoms of gastric stenosis can occur within a few years, but do not gain intensity.
- The subcompensated form of stenosis is manifested by profuse and frequent vomiting, which helps the patient eliminate the unpleasant sensations of an overcrowded stomach. With the transition to this form, stenosis becomes more pronounced. The main sign of a subcompensated form of stenosis is belching of rotten foods that were eaten the day before. In addition, the patient may complain of pain in the epigastric region. X-ray examination reveals peristalsis from the left to the right. Another characteristic sign of decompensated stenosis is the expansion of the stomach and a violation of its transport function. These changes can be detected only when an x-ray is taken, when the contrast medium remains in the stomach for a long time. The duration of the stage can be several years. Symptoms of pyloric stenosis should not go unnoticed.
- The decompensated form of stenosis is determined by severe violations of the evacuation ability of the gastrointestinal tract. Quite often, the period of decompensation indicates the presence of gastric ulcer. The patient complains of regular heaviness in the stomach, frequent urge to vomit. The patient's skin becomes sagging, facial features are sharpened. In the area under the spoon, the outlines of the stretched tissues of the stomach appear, and on the x-ray there are no signs of peristalsis. On palpation, the doctor may detect a splash sound. X-rays also show the presence of a large amount of food in the stomach and a decrease in the propulsive ability of the stomach. The presence of frequent vomiting, which is difficult to stop, can cause loss of electrolytes and severe dehydration, which, in turn, can cause hypochloremic coma.
Diagnosis of a pathological condition
If you find the symptoms of stenosis of the stomach and duodenum described above, you should definitely consult a doctor. After the examination, the specialist will prescribe a number of studies, including:
- X-ray examination of the stomach. From the obtained image, it is possible to determine the change in the size of the organ in the direction of increase, as well as the degree of decrease in gastric motility and see the presence of a narrowed lumen between the duodenum. In addition, x-rays can reveal the amount of time it takes for the stomach to move food into the intestines.
- Esophagogastroduodenoscopy. It shows the stage of development of the pathological process, as well as the degree of deformation and narrowing of the lumen between the duodenum and stomach. In addition, the study will provide information on the expansion of the stomach.
- The study of the motor function of the organ. It is carried out by means of electrogastroenterography and allows you to determine the activity, tone, frequency and nature of peristalsis during meals and on an empty stomach.
- Ultrasonography.
After receiving the results of the examination and confirming the diagnosis, the doctor prescribes treatment for stenosis of the stomach.
Drug treatment of this pathology
Surgery is considered the most optimal treatment option for pathology. If the disease was detected at an early stage, and surgery is not possible, medication is prescribed, which involves the use of drugs to relieve symptoms of stenosis, including:
- Antibacterial drugs that adversely affect microorganisms that provoke the appearance of an ulcer.
- Drugs with antacid properties. They help fight belching and heartburn.
- Sorbents that promote the elimination of toxins from decayed products from the body.
- Painkillers for the relief of pain.
- Prokinetics. The action of this group of drugs is focused on restoring the motility of the stomach and intestines.
Other therapeutic measures
In addition, conservative treatment of stenosis of the output section of the stomach involves the following measures:
- Treatment of metabolic disorders.
- Bringing body weight back to normal.
- Therapy of pathologies that could provoke the development of stenosis.
To speed up the healing process of ulcerative formations in the duodenum and stomach, drugs are prescribed that have wound healing properties, including draft herbal remedies and vegetable oils.
ethnoscience
In some cases, it is allowed to use traditional medicine methods to eliminate the symptoms of stenosis of the stomach. These recipes should be used after consulting a doctor and only as an additional therapeutic agent. There are several recipes for the treatment of diseases of the gastrointestinal tract:
- Coltsfoot flowers (5 g) are poured with a glass of boiling water and infused for several hours. Then the resulting infusion is strained and taken in 100 ml in the morning and evening. The plant helps get rid of heartburn.
- Finely chop the celery root (30 g) and pour boiling water over it. The mixture is infused for half an hour, then 50 ml is taken before meals. Celery accelerates the healing process of ulcers inside the stomach.
- In equal amounts, mix motherwort, St. John's wort and valerian, pour half a liter of water. The mixture is infused in a thermos for four hours. It is taken after a meal. It is allowed to sweeten the drink with honey. This mixture has a sedative effect and normalizes the functions of the digestive system.
Using folk recipes as monotherapy for gastric stenosis is not recommended, as this will not give the expected result.
Surgery
Sometimes doctors are forced to decide on an operation for stenosis of the stomach. The most commonly used endoscopic method, which allows you to inflate a narrowed lumen between organs. The work of the pylorus stops at the same time, however, it is possible to restore the patency of the organs.
If it is not possible to get rid of gastric stenosis through medication, a cavity operation is prescribed. Quite a lot of methods are distinguished, however, most often preference is given to gastroscopy with subsequent bougienage of the pyrolytic region.
Congenital stenosis
Congenital stenosis (quite rare), is characterized by a significant narrowing of the lumen and can only be treated with surgery. Drug therapy in this case is powerless. A patient with congenital stenosis undergoes pylomyotomy with a laparoscope. This method is considered minimally invasive. The child recovers after the operation, and the likelihood of relapse is extremely small.
Prevention
A very important preventive method for stenosis is considered to be a proper and balanced diet, which involves the following recommendations:
- The use of products in grated form. It eliminates damage to the gastric or intestinal walls.
- Regular fractional nutrition at least five times a day in small portions.
- At one time you need to eat no more than 200 grams.
- You can eat boiled, stewed or baked food, but not fried.
- You can drink mineral water without gas, teas and fruit drinks.
- Fatty foods are strictly prohibited.
- Spicy dishes and a large number of spices are not welcome.
- Alcoholic drinks are not recommended.
Conclusion
By following these nutritional recommendations, the patient can maintain normal digestive processes for a long time. It is important to monitor the state of health and regularly undergo preventive examinations by a gastroenterologist. Timely detection of the disease is the key to effective treatment. Do not delay with going to the doctor at the first sign of stenosis.