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Duodeno gastric reflux treatment, what drugs. Duodeno-gastric reflux

Duodeno- gastric reflux– a gastroenterological disease that is diagnosed in 15% of absolutely healthy people. Sometimes it occurs independently, but more often it accompanies and develops against the background of chronic gastritis, ulcers duodenum or stomach, gastroesophageal reflux disease.

What does duodeno-gastric reflux mean?

With this diagnosis, the contents of the duodenum are thrown into the gastric space. An independent diagnosis of duodenogastric reflux occurs only in 30% of all cases. In some patients, the disease occurs in outbreaks - it occurs suddenly during sleep or as a result of excessive physical activity. At the same time, no visible symptoms no, and negative influence The condition does not affect the digestive system. Because in similar cases GHD is not considered a disease.

Duodeno-gastric reflux - causes

The disease appears when there is a violation of duodenal patency. As a result, the pressure inside the duodenum increases, and the closing function of the pylorus is noticeably weakened. When the pyloric sphincter cannot perform its basic functions, food that has passed on to the next stage of the digestive cycle returns back to the stomach.

As in some cases of gastritis, duodeno-gastric reflux is caused by the following reasons:

smoking;
inflammatory processes in the pancreas or bile;
taking medications that reduce the tone of the smooth muscles of the esophagus;
helminthic infestations;
abnormal development of the duodenum;
congenital syndromes of incomplete intestinal rotation and short bowel;
lack of the hormone gastrin;
pregnancy.

The phenomenon of duodeno-gastric reflux has several main risk factors. In most cases, the problem develops due to:

excessive consumption of fatty and spicy foods;
unbalanced diet (dry food);
irregular meals;
taking non-steroidal anti-inflammatory drugs or antispasmodics for too long;
obesity;
diabetes;
pancreatic insufficiency.

Duodeno-gastric reflux – degrees

As with any other disease, GHD has varying degrees of development. Depending on how long ago and actively the disease progresses, the manifestations change various symptoms. The degree of duodenogastric reflux is determined by the amount of bile acids contained in different parts of the stomach. And what earlier illness diagnose, the easier it will be to deal with it.

DGR 1st degree

The “simplest” degree is the initial one. Duodeno-gastric reflux of the 1st degree is diagnosed when a minimal amount of bile is detected in the pyloric gastric section adjacent to the sphincter. Symptoms in the first stage may not appear at all. And if signs do arise, most patients do not pay attention to them, believing that the discomfort appeared as a result of overeating or eating “on the run” and will soon pass.

DGR 2nd degree

Many people learn about their diagnosis just when the disease enters the second stage. Duodeno-gastric reflux of the 2nd degree is diagnosed in those patients in whom bile is found in higher departments stomach - in the antrum or fundus. At this stage, the symptoms acquire clear outlines and constantly remind themselves, which forces the patient to consult a specialist.

DGR 3rd degree

This is the most difficult and running form diseases. Severe duodenogastric reflux is determined when the contents of the duodenum reach the fundus of the stomach and the lower esophageal sphincter. The third stage is characterized by the manifestation of all the main symptoms. Moreover, they are all clearly expressed and cause the maximum amount of discomfort.

Duodeno-gastric reflux - signs

The symptoms of GHD are in many ways similar to those of other organ diseases. digestive tract. This is explained by their relationship. Chronic duodeno-gastric reflux can be recognized by the following symptoms:

, which usually occurs after eating;
nausea and possible subsequent attacks of bile vomiting;
belching with air or a sour taste;
bloating and feeling of fullness in the abdomen;
cutting or cramping pain in the abdomen;
constant bitter taste in the mouth;
the appearance of a yellowish coating on the tongue.

Very often, duodeno-gastric reflux manifests itself as pain. Unpleasant sensations are usually concentrated in the upper abdomen. The pain is recurrent and generally tolerable. But some patients complain of too intense sharp and burning pain in the stomach, appearing almost immediately after eating, which unsettles you for several hours.

How to cure duodeno-gastric reflux?

In order for recovery to occur as quickly as possible, therapy must be comprehensive and should begin when the first signs appear. Before treatment is prescribed for duodenogastric reflux disease, specialists determine the cause of the problem. Regardless of why GHD appeared, the patient is recommended to reconsider his lifestyle: do not abuse alcohol and cigarettes, give up choleretic medications, caffeine, and Aspirin. If you have reflux, it is very important to control your weight and follow a diet.

Duodeno-gastric reflux - treatment with drugs

The main goal of drug therapy for GHD is to restore normal functions Gastrointestinal tract and control the motor-evacuation function of the affected sections digestive system. How to treat duodenogastric reflux should be determined by a specialist. Mostly doctors prescribe:

Prokinetics - or Domperidone - which promote rapid digestion of food, its absorption and movement through the ducts of the small intestine.
To protect the gastric mucosa from the irritating effects of the contents of the duodenum, Omez and Nexium are used.
Such remedies as Almagel, Phosphalugel, Gaviscon help to cope with heartburn.
Strengthen peristalsis upper sections The gastrointestinal tract is helped by serotonin receptor agonists – mosapride citrate.
UDCA (ursodeoxycholic acid) preparations are effective, which make the contents of the duodenum thrown into the stomach water-soluble and less aggressive (in practice, this leads to the elimination of bitter belching, vomiting, and pain relief).

Duodeno-gastric reflux - treatment with folk remedies

This disease is treatable alternative methods. But still, most experts recommend resorting to them only as part of complex therapy. When diagnosed with duodeno-gastric reflux folk recipes should be selected by doctors and only after determining the causes of the disease. Otherwise, the patient's condition may only worsen.

How to cure duodeno-gastric reflux with herbs?

Ingredients:

yarrow;
St. John's wort;
chamomile.

Preparation and use:

Mix the ingredients in any quantity in one bowl. You can use it “by eye”; you don’t need to follow precise proportions in this recipe.
The herbs are poured with boiling water and infused for 10-15 minutes.
It is recommended to drink the resulting tea every day, morning and evening.

Treatment of duodeno-gastric reflux with flax seeds

Ingredients:

flax seeds - 1 tbsp. l.;
water – 100 ml.

Preparation and use:

The seeds are filled with cool water.
The mixture should be infused until the seeds begin to swell. At this stage, beneficial mucus begins to secrete from them.
The resulting liquid should be drunk on an empty stomach, ¼ - ½ cup.

Calamus and sage against duodeno-gastric reflux

Ingredients:

calamus root – 50 g;
sage – 50 g;
angelica root – 25 g;
water – 1 glass.

Preparation and use:

Take one teaspoon of each dry mixture.
Boil water and add herbs.
The medicine needs to sit for about 20 minutes. After that, you can strain it and drink it.
To make the mixture more tasty, you can add honey to it.
You need to take the medicine three times a day, an hour after meals.

Despite the fact that a healthy lifestyle and proper nutrition today are becoming more and more popular, there are people who still do not pay due attention to their health, have bad habits, consume foods that can hardly be called healthy. And this, in turn, becomes the root cause of multiple digestive problems, which include gastric dysplasia.

Duodeno-gastric reflux is a condition in which the contents of the duodenum are refluxed into the stomach cavity. In this case, the patient often experiences discomfort, such as nausea, stomach pain, heartburn, and increased flatulence.

However, GHD is not always considered as an independent disease; it often develops against the background of other problems with the gastrointestinal tract. Moreover, the presence of duodenogastric reflux does not at all indicate any pathology of the digestive tract, since it occurs quite often in healthy people (in 15% of cases). In this case, the reflux of intestinal contents into the stomach is observed mainly at night.

About availability pathological processes can be said when this state persists for a long period of time during the day. In addition, patients experience a significant increase in acidity gastric juice even several hours after eating. The disease is most often a consequence of diseases of the organs of the initial sections of the gastrointestinal tract, but in 30% of cases there is an independent pathology. Often the disease becomes a consequence of previous injuries or operations.

GHD in the stomach most often occurs against the background of other diseases of the gastrointestinal tract. In this case, gender does not matter; the disease manifests itself equally in both men and women. Most often this happens in middle and older age.

Stages of development and types of disease

Depending on how much of the contents of the duodenum enters the stomach, three stages of the disease are distinguished:

A small amount (occurs in almost half of patients)
Moderate amount. In this case, the first symptoms of the disease may appear. At the same time, DGR often becomes the cause of other problems in the functioning of the gastrointestinal tract.
Acute stage, accompanied by characteristic symptoms. Considered the most dangerous, it can cause serious harm health and well-being of the patient.

Depending on the area of damage to the stomach, GHD is divided into the following types:

Surface type. The cells of the gastric mucosa are damaged. At the same time, the cells epithelial tissue remain untouched.
Catarrhal type. In the mucosal area, the presence of inflammatory processes is noted. In this case, the mucous membrane itself turns red, swelling and irritation occur.
Erosive type. Atrophy of the mucous membrane is noted, and its individual areas (foci) are affected.
Biliary type. The functioning of the biliary organs is disrupted.

Clinical picture of the disease

In most cases, GHD is asymptomatic, or its signs are quite mild. This makes it very difficult to diagnose the disease early stages its development. Clinical signs similar to the manifestations of diseases such as ulcers and gastritis. And this is not surprising, because specified diseases often serve as the root cause of DGR. However, there are a number characteristic features, the presence of which may indicate the presence of a disease:

Immediately after eating, the patient feels sharp pains in a stomach
Complaints of frequent and prolonged heartburn that occurs after eating and persists even 1–2 hours after eating
Bloating, heaviness in the stomach even when eating a small amount of food
Yellow coating on the surface of the tongue, bitterness in the mouth.

One of the most characteristic manifestations diseases serves bad smell from the patient's mouth, which persists even after hygiene procedures in the oral cavity. This sign indicates the entry of bile into the stomach cavity, especially after eating foods rich in carbohydrates.

Reasons for the development of the disease

The reasons for the development of DGR include:

Diseases of the digestive system, such as gastritis (acute or chronic form), peptic ulcer, gastroesophageal reflux, when stomach contents are refluxed into the esophagus
Structural features of the gastrointestinal tract, in particular, weakness of the stomach muscles, blocking its entrance and exit
Availability of new developments in the area hiatus aperture
Bad habits, poor nutrition(especially consumption of carbohydrate foods)
Uncontrolled intake of some medicines during pregnancy, when the growing uterus puts pressure on the gastrointestinal tract
Lack of physical activity. Thus, the risk group includes representatives of sedentary professions.
Mature age (however, cases of diseases are also known among children).

How to identify the disease?

Diagnosis of GHD becomes more complicated asymptomatic disease, or low intensity of manifestation of its symptoms.

The most reliable diagnostic method is considered to be intragastric pH-metry, that is, measuring the dynamics of changes in the acidity of gastric juice. The study is carried out throughout the day; it is especially important to take into account the dynamics of acidity at night, when the patient does not experience physical activity and does not eat food.

The condition of the gastric muscles is assessed using antroduodenal manometry. This method allows you to identify decreased muscle tone and impaired gastric motility.

It is necessary to conduct a study of the composition of gastric juice, which makes it possible to identify the presence of enzymes in it from other organs of the gastrointestinal tract.

Of great importance is also differential diagnosis, that is, methods to distinguish GHD from other diseases accompanied by similar symptoms.

Features of treatment

Effective treatment of GHD must be comprehensive. First of all, you will need to consult a gastroenterologist who will diagnose accurate diagnosis, will identify the cause of the disease and determine how to treat the disease.

Important! Positive result can be achieved using not only medications, the patient must change his lifestyle and diet.

Diet

Normalization of the diet is a must successful treatment. The patient should not overeat; food should be taken in small portions, but often enough, avoiding acute attacks of hunger. Three meals a day are recommended, with each meal alternating with a snack (a total of 2-3 snacks per day is needed). For snacks, it is best to choose bran, low-fat crackers, and bread in the form of crackers. Such products help remove excess bile.

As main meals, preference should be given to dishes such as vegetable purees, porridge, low-fat dairy products, jelly. Special attention You should pay attention to the consistency of the dishes. They should be pureed and as easy as possible to digest. Useful courses of medicinal mineral water, which contains a large amount of magnesium.

The list of prohibited foods for patients suffering from GHD is quite long. This list includes:

Fatty, fried foods
Herbs, spices, hot sauces
Sweets, baked goods
Citrus
Onions, garlic, apples, White cabbage, tomatoes
Coffee, alcohol.

Drug treatment

The patient is prescribed certain medications aimed at restoring the functioning of the digestive tract. There are the following groups of medicines:

Prokinetics (Motilium) improve the condition of the muscles of the gastrointestinal tract, promote easy to digest and food promotion
Ovenson (and its analogs) protect the gastric mucosa from the destructive effects of bile, restore damaged areas of the mucosa
Omeprazole (and its analogues) reduce the acidity of gastric juice and eliminate unpleasant symptoms of the disease
Almagel promotes rapid regeneration of the gastric mucosa in cases where the patient is diagnosed with atrophy of the mucous membrane.

Physiotherapy

Numerous physiotherapeutic methods help eliminate the symptoms of the disease, restore muscle tissue and the gastric mucosa. For GHD treatment apply:

Impact of dynamic currents. Helps restore stomach muscle tone, accelerates the healing process of the mucous membrane, and normalizes the nutrition of stomach tissue.
Ultrasound. Removes discomfort, pain, inflammation of the mucous membrane
UHF reduces the acidity of gastric juice, regulates the process of its production
Exposure to microwaves. This method is shown when severe pain. The procedure helps normalize gastric motility, reduces the amount of gastric juice produced, and eliminates inflammatory processes.

Traditional medicine recipes

Folk remedies, in combination with the methods indicated above, can quickly cure the disease. It is important to remember that the choice of a particular recipe is made individually for each patient, depending on the tolerability of the constituent ingredients. Popular recipes include:

Freshly squeezed celery root juice. Consume 1 tbsp before each meal (30 minutes before). l. juice
Place dandelion flowers tightly in a 3-liter jar. Sprinkle each layer of product with a small amount of sugar. When the flowers give juice, it must be separated and taken 1 tsp. in a day.

How to prevent

Preventive measures are quite simple. Necessary:

To refuse from bad habits
Limit consumption of strong coffee
Watch your weight
Limit the consumption of foods that cause an increase in the acidity of gastric juice (fresh baked goods, sweets, citrus fruits, spicy, fried, salty foods).

GDR can be cured only if all doctor's prescriptions are followed. This applies not only to taking medications, but also to diet. An incorrect diet will negate all therapeutic effect, which is given by medications and procedures.

GHD of the stomach is pathological condition stomach, in which the alkaline contents of the duodenum are thrown into the acidic contents of the stomach. This pathology provokes an imbalance in the gastric environment and is called duodeno-gastric reflux. The condition is rarely accompanied by intense symptoms and occurs more often during active physical activity of a person or at night during sleep.

Rejection of duodenal contents through the pylorus of the stomach occurs in approximately every ninth adult whose life is associated with low physical activity and consumption of large portions of food at once (office workers). Fast foods contribute to the progression of reflux. Under the influence of duodenal contents, inflammatory processes develop in the stomach.

Duodeno-gastric reflux accompanies such chronic diseases digestive system such as gastritis and peptic ulcers. This pathology is not considered an independent disease, therefore gastritis and duodenitis are considered to be the causes of disturbances in the unilateral conduction of food along the gastrointestinal tract. In turn, gastritis is associated with serious abnormalities in the functioning of the duodenum. Often, when DGR is detected, it is revealed complex disease- gastroduodenitis.

Several factors associated with the disorder can provoke the occurrence of pathology healthy image life:

tobacco smoke and drugs;
alcohol abuse;
use of unapproved medications during pregnancy.

DGR can be formed under the influence of internal

sources: insufficient tone of the circular muscles of the orifices of the stomach or hernia of the diaphragm in the esophagus. The sources of pathology may be the consequences of too high pressure in the duodenum: cholecystitis, pancreatitis, Botkin's disease. It is possible that pathology may be detected after surgical interventions in the abdominal region: removal of the gallbladder, anastomosis with fastening of intestinal loops. The concentrations in the gastric juice that are contained in the bile acids, pancreatic enzymes and enzymes that break down lecithin contribute to deviations from the norm.

Typologies and degrees of development of reflux

Depending on the progress of reflux, there are 3 degrees of pathology,

Rejection of gastric juice into the esophagus

identified by diagnostic methods when a concomitant disease is detected.

Half of the patients with reflux of duodenal contents had grade 1 GHD, in which the mixing of gastric contents with duodenal contents was insignificant.

With reflux disorder, four out of ten patients had a greater disturbance in the stomach, which corresponds to grade 2 pathology.

Approximately one patient out of ten showed, as a result of diagnosis, serious disturbances in the movement of duodenal contents into the stomach, which characterizes stage 3 of the disease.

It should be understood that gastric reflux is identical in type to gastroduodenitis. The following manifestations indicate gastroduodenitis:

halitosis;
heaviness in the stomach;
urge to vomit.

There are other signs of gastroduodenitis that make it similar to gastritis:

violation of stool both in the liquid direction and in the direction of constipation;
flatulence;
decreased appetite;
frequent belching.

According to the typology of the course destructive processes There are 4 types of reflux:

Superficial type, in which only the cells of the mucous membrane are affected. The integrity of the glandular exocrine epithelium is not impaired.
When reflux is accompanied inflammatory processes, swelling and redness of the mucous membrane, it is customary to talk about the catarrhal type of pathology.
With the erosive type of reflux, the mucous membrane is characterized by focal atrophy.
The biliary variety is associated with a violation of the outflow of bile from the gallbladder into the duodenum.

Reflux symptoms

Duodeno-gastric reflux in separate form It is not easy to detect, since the symptoms of the pathology repeat the symptoms of almost any disease of the digestive system. The most characteristic of DGR is:

intense, sharp pain in the epigastric region accompanying the digestion of food;
constant painful feeling of heartburn;
flatulence;
thick yellow coating on the surface of the tongue;
entry of bile acids from the duodenum through the stomach into the esophagus, resulting in belching and bitterness in the oral cavity.

If the patient's diet contains a large amount of carbohydrates, then with DGR there is bad breath. The foul odor is caused by the penetration of bile into the stomach from the duodenum through the pylorus.

Gastric reflux is also detected during diagnostic examinations that exclude suspicion of reflux of duodenal contents, for example, fibrogastroduodenoscopy or other diagnostic methods, revealing the presence of other pathological conditions of organs gastrointestinal tract.

The presence of reflux is also indicated by signs of dry hair and quickly breaking nails, unhealthy skin color, congestion and hyperemic corners of the mouth.

Diagnosis of reflux

GHD is detected during a visual examination of the patient and history taking. If the doctor has a suspicion, several referrals for examination are prescribed to refute or confirm the disease. Helps identify reflux:

Ultrasound of the abdominal organs. During the ultrasound examination, the nature and sources of disturbances in the stomach, gallbladder, pancreas or duodenum are revealed;
esophagogastroduodenoscopy is the most accurate picture for detecting reflux, when the data obtained allow cytological and histological assessment of the degree of damage to the mucosa and the nature of its damage (malignant or benign process);
chemical analysis of gastric juice, which makes it possible to determine by titration even small concentrations of pancreatic enzymes and bile acids;
during the day. If after eating the pH shifts to the alkaline side, it is judged that duodenal fluid has penetrated into the stomach and the two fluids have mixed.

How is reflux treated?

The treatment regimen for DRG is complex and only a qualified physician can do it. A problem discovered during diagnostic examinations is eliminated in a short time using correct selection treatment regimens, which will include drug treatment, physiotherapeutic procedures and normalization of diet. The influence of traditional medicine cannot be ruled out.

The goal of complex physiotherapeutic treatment is to restore the elastic state of the abdominal muscles. This direction includes not only physical exercise, but also procedures (electric myostimulator for the abdominal muscles).

Drug treatment has several objectives: to reduce the irritation of pancreatic juice on the gastric mucosa and restore intestinal motility to pass food unilaterally. To achieve these tasks, the doctor may prescribe the following medications:

prokinetics (Motilium, Passazhiks) restore the movement of food in a progressive manner and provide tone to the circular muscle muscles of the digestive tract;
Ovenson and Choludexan tablets and suspensions, as well as their analogues, help reduce the harmful effects of bile acids on the gastric mucosa;
Omeprazole and its analogues reduce gastric acidity, which creates a barrier to the activity of bile acids in the stomach;
When erosive reflux occurs, drugs such as Almagel or Pilorid are prescribed.

Drugs and physiotherapeutic procedures are effective only when the patient’s nutrition is normalized, so diet for reflux is the main direction in the treatment of pathology.

In case of detection of GHD, herbal medicine produces an effect, but the selection of herbs is carried out individually depending on the body’s individual tolerance of plant components, the degree of the disease and concomitant gastrointestinal disorders. Otherwise, you can aggravate the situation and cause irreparable harm to the body.

Celery root juice is one of the most simple means in the treatment of reflux. Half an hour before is enough
Take a spoonful of juice while eating. Another simple remedy - dandelion flower syrup is prepared from the flowers of the plant and 0.5 kg of sugar. If there are contraindications to sugar, it is replaced with fructose. The flowers of the plant are filled into a 3-liter balloon, until the juice is released and sprinkled with layers of sugar (fructose). Take a spoonful daily to prevent reflux. If DGR has already been detected, dosage is increased to 2-4 times a day. The same syrup is prepared from chamomile flowers with sugar to obtain syrup. Use in the same way as with dandelion.
Several decoctions are used herbal infusions. Here is one of them, which is not difficult to purchase and prepare. Mix 1 part chamomile flowers, 2 parts each wormwood and mint well, add up to 1 liter of boiling water and leave for 2 hours. After the specified time, filter the solution and consume 0.1 liter before eating.

Prevention of GHD

smoking and abusing “hard” drinks. At the moment of exacerbation of the disease, completely give up alcohol;
Avoid drinking drinks with high caffeine content, take medications only as prescribed by a doctor;
do not exceed normal body weight;
adhere to dietary nutrition.

Dietary nutrition involves excluding some foods from the daily diet and including others more. You should temporarily stop consuming:

chocolate products;
baked goods, especially soft warm bread;
smoked, salted, spicy and fried foods;
garlic and citrus fruits.

The daily diet should include fish products and lean meats, lactic acid products, vegetables, fruits and berries, puree soups containing large quantity vegetables

The number of meals per day should be increased and the portion size reduced. Thus, the pressure in the cavity of the duodenum is reduced. Should not be performed after eating physical work, as well as taking a lying position to prevent the reflux of duodenal contents into the stomach cavity.

Disease prognosis

In case of a serious violation of the diet, as well as the patient’s untimely request for a qualified medical assistance the development of gastric ulcers cannot be ruled out. Improper lifestyle and nutrition are the cause of neoplasms, including malignant ones.

If duodeno-gastric reflux is detected in time and correctly diagnosed, then its treatment produces the desired effect, in which symptoms and clinical picture pathologies are reduced and completely eliminated, i.e. The prognosis of the disease with proper treatment is favorable.

What kind of disease is this? Duodenogastric reflux appears against the background of gastritis, pancreatitis, ulcers, duodenitis. Also, this disease can appear if a person has undergone gastric surgery.

Symptoms

This is a disease in which the contents of the duodenum are thrown into the stomach cavity. Symptoms of the disease are expressed as follows:

coating on the tongue (yellow);

pain in the abdomen. Causes of pain: activity of the biliary tract and intestines, which leads to spasm;

heartburn (discomfort, burning behind the sternum). In some people, this may be expressed by a feeling of warmth, pressure, or fullness in the abdomen. Heartburn occurs with any acidity, but most often with increased acidity;

belching (food from the stomach entering the mouth). There are voluntary and involuntary belchings. Belching is accompanied by the release of sound and the release of air (from the mouth).

What complications does duodenogastric reflux cause?

A person suffering from duodenal gastric reflux for a long time may experience very severe complication. This:

chemical-toxic gastritis (type C),

reflux gastritis,

gastroesophageal reflux disease,

Symptoms and treatment of complicated duodenal gastric reflux. The disease leads to the formation of ulcers. A mixture of bile and pancreatic juice is aggressive environment, destroying the gastric mucous barrier. Moreover, over time, duodenogastric reflux causes metaplasia of the gastric epithelium. In addition, lysolecithin is formed, which has a toxic effect on the mucous membrane, gradually damaging it.

Diagnostics

This disease can only be detected through a (comprehensive) examination:

ultrasound examination abdominal cavity;

determination of the degree of acidity. This is very important, as it will allow the specialist to establish an accurate diagnosis and to what extent the disease is expressed;

conduct electrogastroenterography;

Treatment of the disease can only be prescribed by a specialist, based on the result confirmed by the examination.

Treatment

Treatment of duodenal gastric reflux should be prescribed by a specialist - a gastroenterologist. Treatment of this disease will be aimed at normalizing the proper functioning of organs - the stomach and duodenum. The specialist also prescribes a certain diet, which excludes everything fried, spicy and fatty.

To treat reflux, it is necessary to neutralize the effect of bile acid on the mucous membranes of the stomach and oral cavity, because bile has a very irritating effect. In addition, it is necessary to achieve accelerated emptying using medications, and you also need to increase the tone of the esophageal sphincter.

Symptoms and treatment of duodenal gastric reflux chronic form. Typically, drugs from the group of prokinetics are prescribed. Perhaps doctors will prescribe Metoclopramide, Domperidone, but for a short continuous period, that is, a maximum of three weeks. Negative point Such therapy may mean that after cessation of therapy, reflux symptoms may recur.

Complex treatment should consist of inhibitor drugs, if the disease is accompanied by increased level acidity. This group of drugs is able to neutralize the aggressive effects of acid on the mucous membrane. It is recommended to give preference to representatives latest generation, for example, the drug Pantoprazole. It has minimal side effect, is approved for use by pregnant women, as it is safe for health.

Home care tips

To prevent symptoms of the disease from tormenting you, do several useful tips:

eat more often, but little by little;

mouth treatment of duodeno-gastric reflux, rest more and sleep on the right side;

follow the regime;

spend more time in the air - this will ensure excellent digestion;

make a decoction of herbs (St. John's wort). Pour boiling water over one tablespoon (tablespoon) of St. John's wort herb. Let it brew for half an hour. Drink half a glass before meals (thirty minutes). Drink this decoction for two weeks.

It is recommended to increase your walks and stay outside as much as possible. fresh air(calm step), try not to get nervous over trifles. But everyone knows that all diseases come from nerves. Better smile, and then everything will be fine!

Using these tips, you will feel much better, the symptoms of the disease will appear much less.

Healthy diet

Almost every 5th person has a disease such as gastritis. For some it manifests itself in more expressed form(pain, spasms, nausea, etc.), for some to a lesser extent. If gastritis is not treated, it can lead to a disease such as duodenogastric reflux. The main component of the treatment of this disease is diet. It is also important in disease prevention.

Besides drug treatment It is extremely important to maintain a certain diet. This means that it is necessary to exclude from the diet: fried, spicy, fatty, citrus fruits, chocolate, cocoa, tomato, garlic. The following is recommended by specialists for the treatment of duodenogastric reflux:

vegetarian, low-fat soups meat broths;

vegetable and fruit salads;

include bran in your menu;

low-fat cottage cheese;

juice, mineral water, yoghurts.

The diet for duodenogastric reflux is generally accepted for the gastrointestinal tract, that is, it has not yet been fully developed, but there are a number useful recommendations, the implementation of which facilitates the course of the disease and prevents the development of complications. Here are some of these recommendations:

frequent split meals in compliance with the diet: 3 main meals for duodenogastric reflux and 2-3 “light” meals between them;

food for duodenogastric reflux should be easily digestible;

avoid overeating;

Food with symptoms of duodenogastric reflux should be chewed thoroughly;

During “snacks” in a diet for duodenogastric reflux, it is better to use crackers, crackers, cookies, and bran that promote the excretion of bile.

Nutrition rules

The following rules contribute to the effectiveness of the diet for duodenogastric reflux:

do not take after meals horizontal position not less than 1 hour;

If you have symptoms of duodeno-gastric reflux, do not allow physical activity for at least 1 hour after eating (especially those associated with bending over, tensing the abdominal muscles);

do not wear tight clothes and belts, so as not to contribute to the increase intra-abdominal pressure;

frequent walks in the fresh air, keeping active image life;

quitting smoking as a common cause duodeno-gastric reflux.

Sample menu for the diagnosis of duodenal gastric reflux

The diet includes:

avoid eating salty, spicy, fatty, smoked and fried foods;

exclude from the diet: citrus fruits, tomatoes, fresh bread, coffee, chocolate, garlic, onions and other foods that reduce the tone of the pyloric sphincter;

avoid in the diet for duodenogastric reflux foods that increase the acidity of gastric juice - for example, cabbage, apples;

use bran, which helps normalize the composition of bile for symptoms of duodeno-gastric reflux;

mineral water courses, rich in magnesium(for example, donate).

Diet for a complicated form of the disease

Since the occurrence of reflux is often caused by pathological conditions such as gastritis or peptic ulcer disease, for duodenogastric reflux the diet should be combined with the diets prescribed for this pathology. In this case, the following recommendations are added to the above recommendations:

“gentle” cooking: food should not be hot or cold, pureed soups and pureed porridges are recommended;

low-fat varieties meat and fish;

avoid sour foods (including fermented milk products), sour juices;

Dairy products in the diet for symptoms of duodeno-gastric reflux are recommended: milk, non-acidic sour cream and yogurt, fresh cottage cheese;

avoid sour fruits and berries.

Full list products allowed or not allowed in the diet for duodeno-gastric reflux (table No. 2) and peptic ulcer(table No. 1) you can check with your doctor.

Do not forget that treatment of duodenal gastric reflux should be comprehensive. First of all, it is necessary to stop the pathological condition that led to its occurrence, otherwise, even with proper nutrition, duodeno-gastric reflux will occur again. Therefore, along with a diet for duodenogastric reflux and performing general recommendations Various medications are indicated, the doses and courses of which are selected qualified specialist individually for each patient, depending on the etiology of the disease that led to the occurrence of reflux.

Causes of the disease

Why does duodenogastric reflux occur? As is known, duodenogastric reflux is a consequence of many common diseases of the stomach and esophagus. Duodenogastric reflux can be observed in chronic gastritis, ulcers and duodenum. In addition, this type of reflux is considered the main cause of development chemical gastritis or as it is popularly called type “C” gastritis.

The bottom line is that with duodeno-gastric reflux, the normal, normal movement of bile is disrupted. The bile that accumulates in the duodenum is released back into the stomach, which should not happen. At the same time, once in the stomach, bile and enzymes (digestive) cause irritation of the mucous membrane. The cause of the disease is a dysfunction of the pylorus.

Provoking factors

Pyloric dysfunction is caused by the following factors:

chronic duodenitis;

more high pressure(above normal) in the duodenum.

It also happens that bile, from the duodenum entering the stomach, remains there. A so-called burn of the stomach (mucous membrane) occurs. After all, the mucous membrane is not able to resist such active and aggressive enzymes. Therefore, duodeno-gastric reflux occurs. There are cases of “high” duodeno-gastric reflux. In this option, bile goes not only to the stomach, but also to oral cavity. This is “high” reflux. In these cases, both the mucous membrane (lining) of the stomach and the esophagus are damaged.

Video: Symptoms and treatment of duodenal gastric reflux

Contents of the article:

Duodenogastric reflux is a symptom of certain gastrointestinal diseases (gastritis or stomach ulcers). Sometimes he comes and independent disease. Bile from the duodenum is thrown into the stomach cavity. This reflux occurs in many people, almost 50% of the entire population, but is not always accompanied by unpleasant symptoms. About 15% are unaware that they have this disorder, in which case it is not considered a disease. We figured out what it is, we’ll tell you more about duodenogastric reflux.

Reasons for appearance

Gastroduodenal reflux often occurs with chronic gastritis and ulcers, and with stomach cancer. Often he suffers from patients who have undergone surgery to remove the gallbladder or have had a stomach ulcer sutured or have had a gastric resection. This pathology appears because duodenal patency, that is, the motor-evacuation functions of the duodenum, is impaired. The pressure in it increases, the closing function of the gastric sphincter decreases. Therefore, the contents of the duodenum enter the stomach.

Most often, such changes are a consequence surgical intervention, but they also occur due to other reasons: pregnancy, inflammation of the pancreas or gallbladder, diaphragmatic hernia, taking certain medications, and so on. If duodenal reflux is not treated, substances from the duodenum will corrode the gastric mucosa, which will cause the appearance of reflux gastritis or gastric ulcer.

Some doctors are confident that duodenogastric reflux is not a separate disease, but only one of the symptoms that accompanies gastritis or duodenitis. Sometimes gastroduodenitis is diagnosed with the same symptom.

Symptoms

If a person has duodenogastric reflux, the symptoms will be the same as with other diseases of the digestive system:

pain appears after eating;
he often has heartburn, he burps, burps;
patients complain of flatulence;
Nausea and vomiting occur, sometimes bile can be found in the vomit;
present in the mouth constant feeling bitterness;
distinctive feature - appearance yellow plaque on the tongue.

All these symptoms are very similar to signs of other stomach diseases: chronic gastritis, gastroduodenitis. In addition to duodeno-gastric reflux, which is often referred to as gastric reflux, there is also duodenogastroesophageal reflux or DGER. The release of bile and other substances is quite strong, and the entire contents of the duodenum reaches the esophagus, and not just the stomach.

This disease has never been considered normal, as it often causes diseases of the esophagus. One of his characteristic symptoms- This constant bitterness in the mouth.

Degrees of manifestation

Doctors distinguish 3 degrees of manifestation of duodenogastric reflux:

1st degree. Occurs in almost half of those who suffer from GHD. In the first degree, a small part of the contents of the duodenum enters the stomach, so it does not suffer much, the changes are insignificant.
2nd degree. In the second degree, the portion is larger, so inflammation of the gastric mucosa may occur, that is, gastritis. This occurs in approximately 10% of patients.
3rd degree. The gastric mucosa suffers greatly. It often resembles an exacerbation of gastroduodenitis, as the patient complains of frequent vomiting, heaviness, and an unpleasant odor coming from the mouth. Sometimes bile reflux manifests itself with symptoms the same as gastritis, that is, diarrhea appears, belching becomes more frequent, and a person’s appetite decreases.

Types of pathology

Duodenal gastric reflux is of several types:

Surface. This is the most harmless type of pathology, since only the cells of the mucous layer of the stomach are destroyed.
Catarrhal. In this case, the mucous membrane suffers much more, swelling, inflammation and redness of the stomach appears.
Erosive. It is also called the focal form. In this case, defects appear in the gastric mucosa.
Biliary. In this case, biliary dyskinesia is observed.

Diagnostics

Even if you visit a gastroenterologist, it will be difficult for him to make a final diagnosis, since similar symptoms may indicate that you have duodenitis or another disease of the gastrointestinal tract. Sometimes gastroduodenal reflux is diagnosed accidentally when gastrointestinal tract examinations are performed.

The most accurate diagnostic method is intragastric pH-metry. The doctor may also prescribe an ultrasound internal organs or esophagogastroduodenoscopy to examine the gastric mucosa. Only a comprehensive examination helps to detect the presence of GHD, as well as the degree of this syndrome. After examinations confirm the diagnosis, treatment can be prescribed.

Treatment

If you have gastric reflux, treatment is not necessarily carried out in a hospital. A patient may be admitted to a hospital, to a gastroenterology department, only to have full examination. Treatment does not mean just taking some medications and waiting for improvements, you will have to change your lifestyle.

Rejection of bad habits

To cure this disease, you need to reconsider your lifestyle. Patients should not smoke or drink alcohol; moreover, they will have to give up coffee. Obesity contributes to the appearance of this pathology, so it is important to normalize body weight and then adhere to proper nutrition.

Uncontrolled use should be avoided medicines, especially choleretic drugs and NSAIDs, you should take all tablets only on the recommendation of a doctor. Walking in the fresh air is very beneficial. But it is better to avoid tight clothing, as it may increase intra-abdominal pressure.

Nutrition

Treatment duodenogastric reflux– this is also proper nutrition. You need to eat in small portions, often. You need to give up smoked and fried foods, as well as everything spicy and sour.

What to eat? The menu should mainly include boiled food, good for the stomach, that is, all kinds of cereals, soups, meat is also allowed, dairy products, if the condition improves, vegetables and sweet fruits. As soon as you have eaten, you cannot lie down; you must sit or stand for at least an hour, so that the body is in vertical position. Avoid heavy exercise after eating.

Medications

How to treat this deviation, you need to find out from your attending physician, who will select medications specifically for you, taking into account the stage and type of the disease.

But most often part of drug therapy is:

Prokinetics (Motilium, Passazhix, Domperidone), which help normalize the functioning of the sphincters and promote the normal movement of food.
Drugs that neutralize aggressive bile acids and reduce them harmful effects on the stomach (Ovenson, Choludexan).
Medicines that reduce gastric acidity (Omeprazole). Bile acids are most harmful in an acidic environment; if the acidity is reduced, the irritation of the mucous membrane will not be so strong.
If erosions appear, bismuth preparations and Almagel are prescribed.

You can be treated and folk remedies, but only after consultation with your doctor.

The symptoms and treatment of duodenal gastric reflux are similar to the symptoms and treatment of other gastrointestinal diseases. If all recommendations are followed, the prognosis is favorable. If it wasn't timely treatment, then, most likely, type C gastritis will appear, and a stomach ulcer may also occur.