Duodenal ulcer is a disease characterized by the formation of ulcerative defects in the mucosa. A similar pathological process is diagnosed in women and men of different ages. There are many different factors that trigger the onset of this disease, which is why it is important to detect and eliminate them in a timely manner. The disease proceeds with stages of remission and exacerbation.
Features of the disease
The duodenum is the part of the gastrointestinal tract that runs from the stomach to the small intestine. Partially digested food from the stomach gets into it, and it is important in the digestion process. Duodenal ulcer is a disease of a recurring nature, in which there is a lesion of the mucosa with its subsequent scarring.
Often it occurs due to the defeat of the bacteria Helicobacter pylori. Previously, it was associated with malnutrition, and the main method of therapy was following a special diet. This disease is considered quite common and often is completely asymptomatic, which threatens with a transition to a more serious stage and the occurrence of complications.
Causes of occurrence
The main cause of duodenal ulcer is increased acidity. It causes serious damage to the mucous membrane, as a result of which destructive processes occur, leading to the development of this disease. Provoke the formation of ulcers can also factors such as:
- malnutrition;
- Helicobacter pylori;
- emotional overstrain and stress;
- genetic predisposition;
- alcohol abuse;
- taking certain medications;
- smoking
Quite often, people who abuse alcohol are diagnosed with this disease. Alcohol causes very serious damage to the cells of the mucosa, changing the nature of the release of hydrochloric acid. The protective functions of mucus in this case are significantly reduced.
The main symptoms
The very first symptom of peptic ulcer of the stomach and duodenum is the presence of severe pain. Pain can manifest itself or significantly increase with physical exertion, consumption of spicy foods, drinking alcohol, as well as prolonged fasting. With a typical course of an ulcer, pain sensations have a clear relationship with food intake, they occur during an exacerbation of the disease and are characterized by seasonality of manifestations.
In addition, a decrease or complete disappearance of pain when taking antacid drugs is characteristic. In addition, there may be other symptoms of duodenal ulcer, in particular, such as:
- heartburn;
- nausea and vomiting after eating food;
- weight loss;
- loss of appetite;
- decreased performance.
Painful sensations can be early, late, and nocturnal. Early pains appear immediately after eating food and decrease literally after 2 hours. They are characteristic of patients with ulcers localized in the upper part of the stomach. Later ones begin to appear 2 hours after eating food and are found in people with ulcers in the antrum.
Many patients with duodenal ulcer complain of irregular stools. Constipation can bother much more than pain.
Diagnostics
When treating a patient with characteristic symptoms, the doctor diagnoses duodenal ulcer, which begins with data collection. For this, the nature and localization of pain, heredity, anamnesis and many other factors are determined. During a visual examination, the doctor palpates the abdomen. In addition, the diagnosis implies:
- conducting a clinical analysis and determining the number of bacteria in the blood;
- measurement of acidity of the stomach;
- X-ray with a contrast agent;
- endoscopic examination;
- mucosal examination.
As a result of determining the presence of peptic ulcer and its localization, the doctor selects the method of treatment, taking into account the patient's condition and the features of the pathological process.
Treatment features
The treatment of peptic ulcer of the stomach and duodenum is based on two principles, namely, individuality and complexity. Therapy is mainly conservative. During the exacerbation, treatment is indicated for 6-8 weeks, and should be carried out exclusively in a hospital. Therapy includes:
- strict adherence to bed rest;
- medical nutrition;
- the use of medications;
- thermal procedures.
The first stage of treatment of duodenal ulcer is best done in a hospital. During this period, the patient should be provided with complete physical and psychological rest. Bed rest has a very good effect on intra-abdominal pressure and normalization of blood circulation in the digestive tract, which contributes to faster healing of ulcers. However, it is worth noting that prolonged rest can negatively affect the general functional state of the body, therefore, after eliminating the attack of acute pain, you need to gradually return to physical activity.
Clinical nutrition implies a diet with the exception of products that irritate the mucous membrane from the diet. In addition, it is important to undergo a course of drug therapy, which will normalize the patient’s well-being, eliminate an acute attack of pain, and also remove pathogenic microflora.
The use of drug therapy
In the presence of peptic ulcer of the stomach and duodenum, the doctor prescribes certain medications, in particular, such as:
- antibacterial;
- painkillers;
- blocking the production of hydrochloric acid;
- neutralizing hydrochloric acid;
- protecting the mucosa.
Antibacterial drugs are required if the disease was triggered by the bacterium Helicobacter pylori. Such drugs include Amoxicillin and Metronidazole. If after carrying out a course of antibacterial therapy it was not possible to eliminate the bacteria, then you need to choose a different treatment regimen.
Also, during the treatment of peptic ulcer of the stomach and duodenum, painkillers are prescribed. The most common drugs are: "Controlok", "Gastrozole", "Sanpraz". Their action is aimed at eliminating pain by reducing the amount of hydrochloric acid in the body.
Drugs are needed to help form a protective film on the mucous membrane. Such medicines include Maalox and Almagel. To quickly normalize the well-being of the patient, means are required that block the production of hydrochloric acid. Inhibitors are often prescribed, which include Omeprazole, Pantoprazole, Esomeprazole.
Drug therapy often lasts from 2 weeks to 1.5 months. In many ways, the course of treatment depends on the size of the ulcer and the well-being of the patient. It is worth remembering that only a qualified specialist should prescribe drugs and control the process of therapy, based on the characteristics of the course of the disease. That is why, if there is the slightest suspicion of a disease, you should immediately consult a doctor.
Surgical intervention
There are certain indications for surgical intervention in the presence of an ulcer. Such indications include:
- perforation of peptic ulcer;
- intense bleeding;
- pyloric stenosis in the acute stage.
Surgical intervention is recommended if a chronic benign ulcer does not heal for a long time, despite treatment with medications. Another indication is the presence of several stages of gastric bleeding in a patient.
When perforated, suturing or excision of the ulcer is performed with pyloroplasty. In the case of excessive bleeding from an ulcer, endoscopic hemostasis is initially performed, and then conservative therapy using hemostatic drugs is used. If the application of these techniques is ineffective, an operation to sew an ulcer or perform its resection with subsequent plastic surgery is indicated.
If deformity of the bulb is observed, then surgical intervention consists in plastic surgery or the application of an anastomosis.
Diet rules
If there is a peptic ulcer of the stomach and duodenum, the diet must comply with such principles as:
- providing the body with good nutrition;
- consumption of the most sparing products;
- strict adherence to diet.
Food should be soft and well chopped, have an average heating temperature. In addition, consumed foods should not be too salty, spicy or fatty. You need to eat often in small portions. The daily calorie intake should be no more than 2000 kcal.
Cooking needs only to be steamed or boiled. As drinks, it is advisable to consume mineral water without gas. In addition, it positively affects the mucous tea with lemon balm and mint. At least 2 liters of water should be drunk per day. Due to the observance of a special diet for duodenal ulcer, the intestine does not get an extra load, and food is absorbed much faster.
Traditional medicine
Some patients do not want to take medications and resort to alternative methods of therapy. It is worth remembering that when using non-traditional means, you must first consult with your doctor, as you can harm your condition and provoke an exacerbation of an ulcer.
For treatment, you can apply:
- propolis;
- medicinal herbs;
- beets;
- juice of viburnum;
- green tea;
- olive oil;
- flax seeds.
However, gastroenterologists recommend conducting complex therapy aimed at eliminating pathogens and reducing the level of acidity in the body.
What to do during an acute attack?
In the presence of severe abdominal pain, you must definitely seek medical help. Do not use any medications on your own, especially painkillers, as this can distort the clinical picture, which greatly complicates the diagnosis. Only after a comprehensive examination does the doctor prescribe treatment.
With exacerbation of peptic ulcer, it is very important to provide timely help and eliminate the Helicobacter pathogen. If you do not provide comprehensive assistance, then there may be a significant deterioration in well-being, which threatens the occurrence of pain shock.
What can be the complications?
Complications of peptic ulcer of the duodenum can be very dangerous for humans and include:
- bleeding;
- perforated ulcer;
- penetration of ulcers.
With a deep ulcer, acid can corrode blood vessels, leading to heavy bleeding. Sometimes it is so severe that it can cause a very life-threatening condition. Among the main symptoms of this disorder, vomiting, a drop in pressure, severe weakness, dizziness, heart palpitations, and dark stools can be identified.
In some patients, an ulcer can penetrate through all layers of the duodenum, resulting in an opening that connects the lumen of the intestine with the abdominal cavity. The main signs of this complication are sharp abdominal pain. The severity of the patient's condition is constantly deteriorating, while there is an increase in temperature, and the stomach becomes hard.
Penetration of an ulcer is its penetration into other organs, which causes the onset of the inflammatory process, which provokes the onset of the inflammatory process. Often, such an ulcerative formation penetrates the pancreas, which leads to very serious consequences. A healed ulcer with frequent exacerbations can cause damage to the duodenal bulb, which makes it difficult for food to pass through it.
Prophylaxis
The main measures for the prevention of duodenal ulcer are:
- Helicobacter pylori infection prevention;
- decrease in the release of hydrochloric acid;
- timely treatment of duodenitis and gastritis.
In order to carry out prevention, you need to abandon bad habits, observe the correct diet, and also eliminate the factors that provoke stressful conditions. If you suspect an ulcer, you must consult a doctor who will prescribe a diagnosis and, if necessary, treatment.