Chronic gastritis duodenogastric reflux. Duodeno gastric reflux: how to treat

Duodeno gastric reflux manifested by the throwing of alkaline contents from the duodenum 12 into the acidic environment of the stomach, which causes an imbalance in the gastric environment. The pathology generally does not have pronounced symptoms; it occurs in most cases during sleep, as a result of a late dinner or relaxation of the pyloric sphincter at night, sometimes with physical activity.

Experts consider the condition to be a pathology if the acidity gastric juice, determined during daily pH measurements, is more than 5, which indicates a shift in the alkaline environment not caused by food intake. The disease accompanies various chronic diseases of the digestive system (gastritis and peptic ulcers). The pathology is quite common, often manifests itself as a sign of other gastrointestinal diseases, and is rarely considered as an independent pathology with a separate nosology.

The danger of the disease is that almost all types of gastric pathology can develop against its background: ulcerative, inflammatory, tumor. Pathology can develop after surgery on the gastrointestinal tract, mainly after removal of the gallbladder, stitching of an ulcer of the duodenum 12, surgical treatment of the pancreas, surgery related to the bile ducts.

According to statistics, gastroduodenal reflux is found in more than 15% of the world's population. With GHD, the contents of the duodenum are refluxed into the stomach cavity. Each section of the digestive tract is separated by sphincters (pyloruses). The function of the sphincters is to open only in one direction, in a normal state reverse process impossible. Such a mechanism should be shared between the stomach and intestines. Reflux duodenitis is a process when intestinal contents are thrown into the stomach cavity as a result of dysfunction of the sphincter. The disease appears due to inflammation of the duodenal mucosa, as well as as a result of anatomical changes in the pylorus itself.

The merging of two different environments (the intestinal contents are alkaline, the stomach contents are acidic) causes a conflict. Isolated cases are not dangerous to the body, however, when the disease is aggravated by improper diet, physical inactivity, overeating and consumption of fast foods, the pathological condition can recur regularly and lead to inflammation of the gastric mucosa. The condition is accompanied by a change in the level of acidity in the stomach, which complicates the digestion process and negatively affects the mucous membrane.

The causes of duodenal gastric reflux are conventionally divided into external and internal. A person’s behavior, his diet, and pace of life are external factors. GHD often occurs as a result of physical inactivity, poor diet, smoking and regular use alcohol, taking medications during pregnancy, as well as under other circumstances, as a result of which the tissue structures of the stomach are damaged, despite the mucous barrier that protects them. Such conditions include decreased muscle tone of the gastric openings, diaphragmatic hernia, increased pressure of the duodenum, cholecystitis, pancreatitis and Botkin’s disease.

Pathology also develops as a result of:

1. Incomplete closure of the pylorus at the border of the 12th rings of the intestine and stomach;
2. Chronic form of duodenitis;
3. Increased pressure in the cavity of the duodenum;
4. Chronic or prolonged gastritis.

Experts distinguish functional and anatomical reasons appearance of DGR. Functional disorders include disorders that are directly related to the work of the sphincter and give corresponding symptoms. Anatomical tumors include neoplasms that are localized at the junction of the duodenum and the digestive organ.

What it looks like, photo

Pathological changes in the gastric mucosa during GHD depend on the type of pathology. With the superficial form of duodeno-gastric reflux, destruction of the mucosa can be observed, without damage to the glandular exocrine epithelium. When a catarrhal type of pathology is detected, an inflammatory process is observed; in the photo you can see swelling and redness of the mucous membrane.

The erosive appearance is expressed by the initial processes of atrophy, the mucous membrane atrophies in places. With biliary duodeno-gastric reflux, there is an incomplete transfer of the required amount of bile to the duodenum.

Symptoms

Duodenogastric reflux is quite difficult to identify, since the symptoms of the disease are similar to various diseases of the digestive system. Characteristics of DGR are sharp and intense pain in the epigastric zone during the digestion process. The patient complains of constant heartburn and flatulence. A yellow coating appears on the surface of the tongue. When bile acids from the 12 rings of the intestine enter the esophagus through the stomach, belching and bitterness appear in the oral cavity. Possible girdling pain, hunger pain, and nausea.

When a patient's diet includes a large number of carbohydrates, DHR is manifested by halitosis. The condition is caused by the penetration of bile into the stomach from the 12 rings of the intestine through the pylorus.

The disease causes indirect symptoms such as dry hair, brittle nails, and pale skin.

Stages and types

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

1. superficial, only the cells of the mucous membrane are affected;
2. catarrhal, accompanied by an inflammatory process;
3. erosive, foci of atrophy form on the mucosa;
4. biliary, when the outflow of bile from the gallbladder into the duodenum is impaired.

There are 3 degrees of development of duodenogastric reflux:

1. The first degree of GHD is a moderate process. Characterized by this phase throwing in a small amount of the contents of the duodenum. Irritation of the gastric mucosa manifests itself in an unexpressed way. About 50% of people may experience this problem.
2. The second degree is characterized by the introduction of a large amount of alkaline medium. At this stage, the development of an inflammatory process is often observed, which leads to new gastrointestinal diseases. This degree of disease occurs in 10% of people.
3. The third degree is a pronounced process, which is accompanied by pain, nausea, and vomiting. An unpleasant odor appears from the mouth, the patient complains of heaviness in the stomach. An examination by a specialist makes it possible to record a clear clinical picture of the development of pathology.

The danger of duodenal gastric reflux is that the disease can cause ulcers to appear on the gastric mucosa. This occurs as a result of mixing bile and pancreatic juice, which form an aggressive environment, destroying the mucous membrane.

Advanced duodenal gastric reflux can lead to serious consequences(peptic ulcer, digestive system disorder).

ICD 10 code

According to ICD 10, diseases of the digestive system are listed under code K 00 - K 93. Duodenitis gastric reflux, according to the generally accepted classification medical diagnoses, developed by the World Health Organization, is defined under code K 29.

Treatment

Treatment for GHD begins after accurate diagnosis. The doctor initially probes the patient's abdomen. Palpation of different areas of the abdomen helps to find out the cause of the pain syndrome and determine the source of inflammation of the digestive tract. Particular attention is paid to the epigastric zone, which is located below the sternum and just above the navel. At inflammatory process caused by reflux, the patient feels pain in this area.

For a more accurate diagnosis, instrumental examination is prescribed:

1. FGDS. The examination uses a probe equipped with video equipment. During the study, symptoms of the disease are identified and the degree of pathology is clarified.
2. Radiography. Allows you to identify inflammation and changes in the size of the digestive organs, as well as determine the reflux of food mass from the duodenum into the stomach, narrowing or expansion of the intestines, and the presence of edema of the esophagus.
3. Manometry. Used to obtain data on organ motility.
4. Ultrasound of the abdominal organs. Helps to find out the nature and sources of malfunction in the stomach, gallbladder, pancreas or duodenum.
5. Biopsy. During the examination, a tissue scraping sample is taken to determine the presence of malignant neoplasms in the organs.

Laboratory tests are also important:

1. pH – metric. Gives the opportunity to determine the level of secretion. The procedure is carried out using a rubber probe, with which gastric juice is taken for analysis.
2. Blood analysis. Helps identify elevated ESR and anemia.
3. Stool analysis. Necessary to identify possible internal hemorrhages that indicate ulcers or erosions.

Treatment of reflux-duodenitis involves complex therapy, which is aimed at eliminating one or more causes that provoke the pathology. Certain groups of drugs are used:

• painkillers;
• enveloping;
• proton pump inhibitors;
• antacites;
• cholinomimetics;
• prokinetics, which help normalize the progressive movement of food and provide tone to the circular muscle muscles of the digestive tract.

In some cases, medications are prescribed to help improve bowel movements.

Duodeno gastric bile reflux

This pathology is expressed by spontaneous reflux of liver secretions into the stomach. In most cases, the disease accompanies other gastrointestinal pathologies (duodenitis, ulcers, gastritis). Basically, the disease is asymptomatic; some doctors do not classify it as a pathology. Usually reverse stroke bile occurs at night when a person is lying down.

DGR of bile can occur after ulcer surgery or cholecystectomy. The problem can be provoked as a result of chronic duodenitis, weakening of the sphincter of the bile duct, and increased pressure in the duodenum. The disease can be caused by gastrointestinal pathologies, in particular problems with the gallbladder, diaphragm hernia, chronic inflammatory pathologies digestive system, inadequate functioning of the muscles separating the intestines from the stomach. The cause of the development of bile DGR can be bad habits, dysbacteriosis, prolonged use of drugs that weaken the smooth muscles of the digestive organs, and pregnancy. Treatment of bile DGR is carried out in accordance with the cause that provokes the disease.

The disease occurs with certain symptoms: after eating, a spasm appears in the epigastric zone, and appetite decreases. The patient feels a feeling of fullness in the stomach after eating, even if he has had a snack, there is a yellow coating on the tongue, and there is a bitterness in the mouth. Worries about heartburn, nausea, belching air or acid. Skin become pale, and if an inflammatory process occurs in the stomach, body temperature may increase.

There are three degrees of development of bile DGR:

• Initial phase. A small amount of bile enters the stomach. Signs of the disease are either absent or unexpressed.
• Second phase. It is expressed by the reflux of a significant amount of liver secretion, as a result of which the walls of the stomach become inflamed.
• Third phase. The symptoms are pronounced. There is pain in the epigastric zone and impaired digestion of food.

There are types of bile DGR depending on the degree of damage to the mucous membrane:

• Surface. The integrity of only the mucous membrane is compromised.
• Catarrhal. The entire gastric mucosa is affected. Swelling is observed and the inflammatory process begins. May be a consequence of prolonged use of certain medications or allergies to certain foods.
• Erosive. It is characterized by the appearance of ulcers or erosion on the mucous membrane. May fade in the background mental disorders, overuse alcohol.
• Biliary. It appears as a result of pathological changes in the process of bile excretion.

Bile reflux can occur without clear symptoms and is often detected during the examination of other gastroenterological diseases. For diagnosis, similar studies are carried out as for GHD. Studies of the stomach contents are carried out to identify traces of bile.

Treatment for bile dysplasia is complex. Therapy is based on the treatment of underlying pathologies that provoke the reflux of bile into the stomach cavity. Drugs are used that help normalize the functioning of the gastrointestinal tract. It is important to follow a special diet, normalize weight and get rid of bad habits (smoking, drinking alcohol).

The treatment course includes drugs that help normalize peristalsis in the upper zones of the digestive system (Trimedat), drugs that neutralize the negative effect of bile on the walls of the stomach (Omez, Rabeprazole capsules).

Prescribe prokinetics that stimulate motor activity stomach, which helps move food to the intestines (Cerucal, Domperidone tablets), medications that reduce the acidity of gastric juice (Maalox tablets and Almagel syrup).

As additional funds take enzymatic preparations that promote the digestion process (Festal, Creon).

The complex treatment of bile dysplasia also includes physiotherapeutic procedures that help normalize blood flow to internal organs and eliminate changes in the stomach.

Drugs for treatment

Conservative therapy includes:

1. Taking anthracites, which are used to eliminate heartburn, belching and bad taste in the mouth. Smecta, Almagel, Gevixon, Phosphalugel are prescribed.
2. Prokinetics. Regulate and enhance gastric motility, accelerating its emptying. Such drugs include Cerucal, Domperidone, Reglan, Motilium.
3. Antisecretory drugs. Suppress education of hydrochloric acid, and activate the restoration of damaged mucosa. Famotidine, Ranitidine, Omeprazole are prescribed.
4. Enzyme agents are prescribed when DGR is combined with pancreatic diseases. Such drugs include Creon, Festal.
5. Stimulants of gastric secretion and agents that improve blood supply to the walls of the stomach. Pentagastrin, Eufillin, Trental are used.
6. Ursodeoxycholic acid, which neutralizes toxic bile acids. In order to neutralize the effect of duodenal contents on the walls of the stomach, Nexium and Omez are used.

Folk remedies

Used to treat GHD folk recipes. Methods alternative medicine are also recommended by doctors. However, before using infusions and decoctions, it is necessary to undergo examination by a specialist and consult with him.

Celery root juice is considered one of the simplest, but effective means for the treatment of GHD. Take 1 tbsp. l. before meals, three times a day.

Dandelion flower syrup

Requires 300 g of dandelion flowers and 0.5 kg of sugar (can be replaced with fructose). The flowers of the plant are filled into a jar (3 liters) to extract the juice. Sugar is poured in layers. Use daily (once a day) for prevention. If the patient has a confirmed diagnosis of GHD, the number of appointments can be increased to 2–4 times a day. Similarly, you can prepare medicinal syrup from fresh chamomile flowers.

Medicinal fee

1 part chamomile flowers, 2 parts wormwood and mint each, mix, pour 1 liter of boiling water. The composition is infused for 2 hours. Take 100 ml three times a day, before meals.

Flaxseed oil (seeds)

Flax seed oil has an enveloping property. It should be drunk before meals, 1 tsp. You can cook from flax seeds at home healing composition. 1 tbsp. l. flax seeds are poured into 200 ml of boiling water, after the seeds begin to secrete mucus, the infusion is considered ready for use. Take on an empty stomach, before breakfast.

Herbal collection

Requires 1 tbsp. l. dry herbs St. John's wort, sage, chamomile flowers. The collection is poured into 250 ml of boiling water, left for 2 hours, and taken three times a day.

Drink to normalize intestinal motility

Take 1 tbsp. l. dry grass plantain, buckthorn. The collection is poured into 250 ml of boiling water, left for an hour, taken 3 times a day.

• Rue leaves. The leaves of the plant are used fresh. After each meal you need to chew a few leaves.
• Aloe. Before each meal, drink 1 tsp. freshly squeezed juice from the leaves of the plant.
• Infusion of fume grass. 2st. l. dried herbs pour 0.5 liters of boiling water. The resulting composition is infused for an hour. The finished infusion is taken in 50 ml doses every 2 hours.

Prevention

During treatment, as well as to prevent the development of GHD, it is important to follow a special diet. It is necessary to follow a diet, especially if you are predisposed to the development of pathology. You need to eat 5 times a day, in small portions. Overeating and fasting should be avoided. The former causes the liver to overproduce bile. Fasting can cause stagnation of secretions in the bladder.

It is necessary to keep your weight under control. Excess weight body can cause an increase in pressure inside the stomach with a subsequent release of acid into the esophagus. Fat begins to put pressure on the gallbladder, causing reflux of liver secretions.

An active lifestyle helps speed up the metabolic process and provide oxygen to internal organs, which has a positive effect on the condition of the stomach and the digestive tract as a whole.

It is necessary to give up bad habits. It is not allowed to take after eating horizontal position or go to bed within an hour.

If there is pathology of the digestive tract, it is important to maintain them in a state of remission, avoiding exacerbations. You need to be regularly examined by a doctor, which will help identify the disease at an early stage and avoid possible complications.

Possible complications

DGR is quite - serious illness, neglect of which can lead to certain complications:

• gastritis type C, as a result of which the gastric mucosa is affected under the influence of chemicals.
• stomach ulcer. The tissues of the digestive organ are affected.
• adenocarcinoma. It is a malignant neoplasm of the esophagus.
• gastroesophageal reflux. Characterized by reflux of stomach contents into the esophagus.

Diet

You need to steam the dishes, then grind the resulting mass in a blender to obtain a puree.

It is necessary to take crushed meals, in small portions, every 4 hours. Portions should be balanced, that is, proteins, fats, and carbohydrates should be present in each serving, which helps reduce the load on the digestive tract. Rough food should be completely avoided. In order to reduce stomach acidity, it is necessary to avoid acidic foods and dishes (citruses, cabbage, tomatoes, garlic, apples, plums).

The use of drinks containing caffeine, chocolate, baked goods, especially warm bread is not allowed.

You need to exclude smoked, fried, salted foods from your diet, and give up canned foods.

Gastric reflux duodenitis can be completely cured at an early stage. Proper nutrition, active image life, regular examination by a specialist will help prevent the development of pathology, and in the presence of GHD, avoid its exacerbation.

Duodeno-gastric reflux is the backflow of the contents of the duodenum into the stomach. This pathological condition often accompanies other diseases of the digestive tract, such as gastritis or duodenal ulcers. Less commonly, duodenogastric reflux occurs as independent disease. To eliminate the problem, you need to know what it is and what drugs are used for treatment.

DGR and its causes

Duodenogastric reflux (DGR) occurs in more than half of the population. In 10–15% of people, this condition occurs occasionally, for example, during severe physical activity or during sleep. This condition does not appear clinical symptoms and is not considered a pathology.

Prevalence medical information led to the fact that the term “duodeno-gastric reflux” began to be distorted. In some information publications you can find duodenal gastric reflux or gastroduodenal reflux. These options are incorrect.

The cause of the disease is a decrease in the closing function of the gastric sphincter. In such cases, increased pressure in the duodenum causes reflux of bile, pancreatic enzymes and other components of intestinal secretions into the stomach. This causes irritation of the gastric mucosa and the appearance of unpleasant symptoms.

Long-term and frequent episodes of GHD can lead to irreversible changes in the gastric mucosa, the formation of ulcers and the development of chronic gastritis. Most cases of pathological duodenogastric reflux appear in patients who have undergone gastrectomy.

Other factors contributing to the problem:

• alcohol intoxication and smoking;
• pregnancy period;
• inflammatory diseases of the gallbladder, pancreas and liver;
• taking certain medications that affect the smooth muscles of the intestines and stomach;
• stressful situations and dietary errors;
• excess weight.

Symptoms of duodeno-gastric reflux

The clinical manifestations of GHD are nonspecific and similar to most other pathological conditions of the gastrointestinal tract. GHD is often combined with gastroesophageal reflux (reflux of stomach contents into the esophagus), since these two diseases have common contributing factors.

Clinical signs of the disease depend on the individual characteristics of the patient and the severity of the disease. GHD may present with the following symptoms:

• heartburn and regurgitation;
• pain behind the sternum and in the epigastric region;
• painful swallowing;
• bad aftertaste and bad breath;
• feeling of fullness in the stomach;
• bloating;
• nausea, less often – vomiting mixed with bile;
• with concomitant damage to the esophagus, disruption occurs respiratory tract(hoarseness, dry cough, sore throat) and destruction of tooth enamel.

Unfortunately, the severity of GHD does not always correspond to the severity of symptoms. More than 80% of cases of pH changes in the stomach and esophagus are not accompanied by subjective sensations. The patient more often learns about the disease when irreversible changes in the mucous membrane develop, an ulcer, gastritis or other complications appear.

Diagnostic criteria

To diagnose DGR, use:

• long-term pH measurement, which allows you to record the frequency, duration and severity of reflux;
• radiography using contrast agent, through which it is possible to detect the penetration of contrast from the duodenum into the stomach, as well as detect hernia of the diaphragm;
• electrogastroenterography, which provides information about the contractile activity of the stomach and duodenum;
• FGDS (fibrogastroduodenoscopy), which allows to assess damage to the mucous membrane of the stomach and esophagus, identify the presence of ulcers, erosions and assess the severity of the pathological process.

If, during a planned FGDS, a patient is diagnosed with duodenogastric reflux, which is not accompanied by changes in the gastric mucosa and clinical signs, then it is ignored and not considered as a pathology.

How to treat duodeno-gastric reflux?

Most patients wonder if this problem can be cured. The disease responds well to treatment in the early stages, when irreversible restructuring of the gastric mucosa has not begun and the process has not become chronic. In these cases, adequate treatment and prevention will protect against the development of complications of GHD. The goals of therapy are to eliminate symptoms, improve the patient’s quality of life, soothe irritated gastric mucosa, and avoid or eliminate complications of the disease.


Recommendations for diet and diet:

• after eating, do not lean forward or take a horizontal position;
• during sleep, the head end should be raised as much as possible;
• do not eat before bedtime;
• avoid tight and tight clothing, corsets and belts;
• eat small portions;
• a diet for this disease involves avoiding fats, coffee, chocolate, alcohol and citrus fruits;
• control your weight;
• Avoid the use of medications that can provoke reflux (sedatives, nitrates, beta blockers, tranquilizers, etc.).

Conservative therapy includes:

1. Reception antacids such as Smecta, Almagel, etc. These drugs are used to eliminate the symptoms of heartburn, belching and unpleasant taste in the mouth.
2. Prokinetics (Cerucal, Reglan, Motilium). These drugs regulate and enhance gastric motility, accelerating its emptying.
3. Antisecretory agents (ranitidine, omeprazole). Suppress the formation of hydrochloric acid and accelerate the process of mucosal regeneration.
4. Taking enzyme preparations (Creon, Festal, etc.) is prescribed when DGR is combined with pancreatic diseases.
5. Stimulators of gastric secretion and agents that improve blood supply to the stomach wall (Pentagastrin, Eufillin, Trental).
6. Ursodeoxycholic acid, which displaces toxic bile acids.

Therapy with folk remedies

Traditional medicine preparations are used in a complex treatment regimen together with medications. To treat the disease use:

• decoctions medicinal herbs with a calming effect (chamomile, sage, St. John's wort);
• a little flaxseed has enveloping properties and soothes the inflamed gastric mucosa;
• Plantain tincture and buckthorn tea enhance motility and promote gastric emptying.

Treatment folk remedies should be carried out in conjunction with drug therapy and under the supervision of a specialist, so as not to aggravate the course of the disease and achieve a lasting positive effect.

Characteristic symptoms are diffuse pain and dyspeptic disorders in the form of heartburn, belching, nausea with vomiting, and the formation of a yellow coating on the tongue. For diagnosis, EGDS, electrogastroenterography, and 24-hour intragastric pH-metry are used. Treatment is complex with the use of prokinetics, acid-lowering agents, and antacids.

Description of the pathology

Duodeno-gastric gastric reflux implies a painful condition of the organ in which the intestinal alkaline environment is thrown into the stomach containing digestive juice with hydrochloric acid. As a result, a conflict between different environments develops, against the background of which arose unpleasant symptoms. The clinical picture is usually blurred and intensifies with active physical activity or at night when all muscle structures in the body are relaxed and the gastrointestinal tract is straightened.

Gastro-duodenal reflux through the pyloric zone of the stomach worries every 9th adult. At high risk are office workers whose lives are inactive, and people who consume large portions of food at one time. Duodeno-reflux aggravates the addiction to fast foods and quick snacks. If gastro-duodenal reflux occurs constantly, inflammation of the mucous membrane on the walls of the stomach develops.

Reasons for appearance

There are external and internal factors influencing the development of duodeno-gastric reflux into the stomach:

1. Exogenous causes:
   • poor nutrition – addiction to fast foods, unhealthy, fatty foods;
   • quick snacks, one-time consumption of large portions of food;
   • a sedentary lifestyle or, conversely, intense work immediately after eating;
   • sleep immediately after a meal.
2. Endogenous causes:
   • gastrointestinal pathologies - chronic ulcer, duodenitis, gastritis or gastroduodenitis;
   • muscle weakness of the sphincters;
   • diaphragmatic hernia.
3. Other provoking factors:
   • frequent alcohol abuse;
   • uncontrolled use of medications, especially during pregnancy;
   • frequent smoking, particularly immediately after meals.

Degrees and varieties

There are 3 degrees of development of duodenogastric reflux:

• I degree - minor violations, when only a small amount of duodenal contents is thrown into the stomach and causes irritation. This degree is typical for 49% of patients.
• II degree, when a large portion of an alkaline environment from the intestines is thrown into the stomach, causing inflammation and the development of other pathologies. This degree develops in 10% of patients.
• III degree, when the gastric mucosa suffers significantly due to alkalization of intestinal contents. A vivid clinical picture develops with vomiting, heaviness in the stomach, unpleasant smell from the mouth, which often resemble the stage of exacerbation of gastroduodenitis. This degree occurs in 1 patient out of 10. Symptoms often develop that are identical to gastritis, when diarrhea, flatulence, decreased appetite, and increased belching are observed.

According to the nature of destruction, there are 4 types of duodenogastric reflux:

1. Superficial, when destruction concerns only the cells of the mucous layer, and the integrity of the glandular exocrine epithelium is preserved.
2. Catarrhal, when inflammation, swelling and redness of the mucous membrane joins the process.
3. Erosive, when a focal form of atrophy is observed.
4. Biliary, when inflammation of the mucous membrane is accompanied by a disruption in the supply of bile from the gallbladder to the duodenum.

Symptoms of duodeno-gastro reflux

Feature clinical picture Duodeno-gastric reflux of the stomach is similar to other gastrointestinal pathologies. Characteristic features DGR are considered:

• strong, sharp pains in the epigastrium, caused by food digestion processes;
• chronic severe heartburn;
• pronounced flatulence;
• belching with a bitter taste, provoked by the reflux of bile from the duodenum into the stomach and esophagus;
• a dense mass of yellow coating on the tongue;
• bad odor from the mouth due to the predominance of carbohydrate foods in the diet.

Indirect signs of gastroduodenal reflux are:

• brittle nails and dry hair;
• unhealthy skin tone;
• presence of swelling and hyperemia in the corners of the lips.

Diagnostics

Duodeno-gastric reflux is discovered accidentally - during fibrigastroduodenoscopy for the diagnosis of another pathology. It is possible to determine the presence of GDR in the stomach when comprehensive examination person. For these purposes the following is carried out:

1. Visual examination of the patient, assessment of the collected anamnesis.
2. Ultrasound of the abdominal area. The method allows you to determine the nature and source of dysfunction of the stomach, duodenum, pancreas, and gall bladder.
3. Esophagogastroduodenoscopy. An endoscopic examination allows you to obtain accurate information about reflux, identify its cyclicity, check the cytology and histology of the affected mucosa, the type of its damage (to differentiate malignancy from benignity).
4. Chemical analysis of digestive juices. It is carried out to detect even minimal concentrations of pancreatic enzymes and bile acids in gastric juice by titration.
5. Daily measurement of gastric pH, subject to familiar image. This is necessary to determine the exact cause and timing of reflux.

Additional techniques are:

• radiography;
• acoustic contrast of the stomach.

Treatment

The therapeutic regimen for DRG is comprehensive and complex, aimed at eliminating the cause of the development of the pathology using medicinal, physiotherapeutic approaches and the basics of proper nutrition. As an auxiliary measure it is prescribed traditional treatment. The goal of complex physiotherapy is to restore the elasticity of the anterior abdominal muscles through special physical training and the use of electromyostimulation procedures.

Drugs

Basics drug treatment:

• relieving irritation from the gastric mucosa resulting from the effects of pancreatic juice;
• restoration of intestinal peristaltic ability in one direction.

The following medications are used for this:

1. Prokinetics, such as Motilium, Passazhiks, which are necessary to correct the conditions for the gradual movement of food in the right direction, ensuring the tone of the circular sphincter of the gastrointestinal tract.
2. Tablet form and suspension "Ovenson", "Choludexan" - for eliminating harmful influence bile acids on the stomach.
3. "Omeprazole" - to correct the level of acid in gastric juice, creating a barrier against the active effects of bile acids in the main digestive organ.
4. "Almagel", "Pylorid" - for treatment erosive form reflux.

Traditional treatment

In combination with drug therapy, folk remedies give high positive result. For the treatment of gastro-disorders caused by reflux, the following recipes are recommended:

• An infusion of herbal mixture consisting of equal quantities of St. John's wort, chamomile, yarrow, taken without reference to proportion and poured with boiling water. This tea should be drunk twice a day to relieve heartburn, alleviate the symptoms of gastritis and GHD, and eliminate dysbiosis.
• Slime infusion of flax seeds. Prepared in proportion - 1 tbsp. l. in 100 ml cool water with infusion until mucus is released. Used on an empty stomach.
• Infusion of 2 tbsp. l. fumes/marshmallow rhizomes in 500 ml of boiling water (infused for an hour/5.5 hours, respectively). Take 50 ml every 2 hours. These medications help prevent bilious vomiting.
• Rue leaves for chewing after meals, 1–2 pcs. help improve intestinal motility.
• A mixture of sage and calamus root (50 g each), angelica rhizome (25 g) in the amount of 1 tsp. pour 200 ml of boiling water. Take 1 hour after meals three times a day.

Diet

The success of treatment depends on proper nutrition and regimen. The principles are as follows:

• food – frequent, but in small portions;
• refusal of hard, unhealthy, spicy foods;
• avoiding alcohol and smoking;
• refusal of foods that reduce the tone of the pyloric sphincter, such as garlic, tomatoes, onions, sweets, fresh baked goods, coffee, citrus fruits;
• exclusion from the menu of cabbage and apples, which provoke an increase in acidity in the stomach;
• enriching the menu with magnesium-containing mineral water;
• inclusion of bran in the diet.

If GHD is accompanied by complications, the principles of slightly different diet therapy are applied:

• low-fat fish and meat varieties are allowed;
• cottage cheese, yogurt, milk, non-acidic sour cream are included in the diet;
• Sour berries and fruits and juices from them are prohibited;
• pureed porridges and pureed soups are consumed.

Any food should be steamed, baked in the oven or boiled in water. Dishes should be at room temperature.

Prevention

To prevent the development of GHD in the stomach? It is recommended to constantly eat right, monitor your health and lifestyle. For this it is important:

Forecast

The outcome of treatment with timely detection of GHD is favorable. To prevent relapse, it is important to follow your doctor’s recommendations and preventive measures.

What is reflux gastroduodenitis?

When is gastroduodenitis reflux diagnosed? The gastrointestinal tract consists of separate sections through which food moves. In them it is digested and absorbed, and waste products are then eliminated from the body naturally. When this process is disrupted and food backflows, reflux occurs. If food from the stomach flows back into the esophagus, a diagnosis of reflux gastritis or gastroesophageal reflux disease (GERD) is made; if the contents of the duodenum flow back into the stomach, reflux gastroduodenitis occurs.

Clinical picture of duodeno-gastric reflux

Until recently, reflux gastroduodenitis was perceived official medicine only as a symptom accompanying other diseases of the gastrointestinal tract. And only in 30% of patients does it occur independently, without showing any clinical signs. In such cases, the pathology does not have a negative effect on the gastrointestinal tract. Therefore, few people know what gastroduodenitis DGR (duodeno-gastric reflux) is; its symptoms are similar to those of other pathological conditions that occur in the stomach or duodenum. Here are the most common ones:

• Cramping pain that appears an hour after eating.
• Constant feeling of fullness in the stomach, bloating after eating.
• Heartburn.
• Sour belching.
• Bitter taste in the mouth, reminiscent of the taste of metal.
• Yellow coating on the tongue.

Gastritis and duodenitis have similar signs. Only fibrogastroduodenoscopy helps to detect gastroduodenitis reflux. If the described phenomenon occurs on its own, its treatment comes down to following a strict, gentle diet. It is built on the basis of several rules, which are worth discussing separately.

Treatment of reflux gastroduodenitis

There are diseases that are easy to treat. One of them is gastroduodenitis reflux, its treatment is a long process. The patient will need to change his lifestyle, learn to eat right, eat five or six times a day in small portions, completely give up alcohol, and forget about gastronomic excesses.

The menu for DGR and GERD will have to include only easily digestible dishes. The main volume of food should be divided into three parts; it is important to organize snacks between them. They will prevent starvation - the main provocateur. For snacks, it is better to choose foods that help eliminate bile. These are crackers, rye crackers, bran and oatmeal livers.

If a patient has gastroduodenitis of the DGR, all food must be thoroughly chewed during meals and ensure that the food on the table is warm.

• You should not take a horizontal position for an hour after the main meal.
• You cannot exercise or perform heavy physical activity for an hour after lunch and dinner.
• You should not wear clothes for a long time that can create high intrauterine pressure (clothes with wide, tight belts).
• It is necessary to lead an active lifestyle, take more walks fresh air.
• Fans of alcohol and smoking will need to forget about their bad habits when chronic form diseases.

What can you eat if you have reflux gastroduodenitis?

When choosing products, you need to understand that gastroduodenitis, duodenogastric reflux is a pathology that combines two diseases: gastritis and duodenitis. Therefore, when following a diet, you need to take into account the characteristics of the two ailments and look for the points that unite them.

So, for example, in both places you can eat only lean varieties of meat and fish; they need to be steamed. Fermented milk products and sour juices are prohibited. Dairy products allowed: milk, skim cheese and curdled milk. You can create a menu by studying the “Table No. 1” and “Table No. 2” diets, and coordinate all unclear points with a gastroenterologist.

It is important to understand that diet will not help if the causes of the disease have not been eliminated. Almost all symptoms will return immediately after it ends. This is why it is so important not to self-medicate. You should always remember that the first mild stages of pathology, such as superficial reflux-gastroduodenitis, are easy to treat. If you do not take any steps towards recovery, the superficial form of the disease quickly develops into a chronic form, which is characterized by a protracted course.

Dealing with them will be much more difficult. You will have to call for help drug therapy. It is complex in nature. The doctor will advise you to take prokinetics, antacids, histamine receptor blockers. Physiotherapy and traditional medicine help well. But they must be paired with medications.

Duodeno gastric reflux: what is it, symptoms, treatment

Duodeno-gastric reflux (DGR) is a disorder of the digestive system that is accompanied by ingestion of contents small intestine into the stomach. As a rule, the disease indicates pathological condition one or more organs of the digestive system, but is also diagnosed as an independent disease.

The spellings found: duodeno-gastric, duodenal-gastric or gastric reflux are not correct.

DGR - what is it?

The disease occurs independently quite rarely - in 30% of cases. As a rule, DGR is accompanying symptom gastrointestinal pathologies: chronic gastritis, ulcerative lesions stomach and duodenum (duodenum), gastroduodenitis, duodenitis.

Pathology can also develop as a result of surgery - after excision of the gallbladder, suturing perforated ulcers stomach or duodenum.

There are signs of duodenogastric reflux disease and healthy people. In 15% of the population, food from the upper intestines can return to the stomach, which does not always mean an abnormal condition of the gastrointestinal tract.

Most often, reflux occurs at night and during physical exertion, without causing an increase in the acidity level of the gastric environment and without causing discomfort.

However, prolonged occurrence of gastroduodenal reflux is dangerous for the condition of the digestive system. Active enzymes contained in bile aggressively act on the walls of the stomach, injuring the protective lining. Over time, something like this chemical exposure leads to reflux gastritis - “corrosion” of the protective layer and inflammation of the walls of internal organs.

In addition, pressure in the stomach increases, and intestinal contents can be pushed even further. Unlike conventional GDR (1st degree), when food does not rise above the stomach, GRD of 2nd degree is characterized by reflux of duodenal contents into the esophagus (duodeno-gastro-esophageal) or into the oral cavity (duodeno-gastro-esophageal-oral reflux).

Why does the disease occur and how does it progress? Among the leading causes of pathology are:

• gastroduodenal stenosis - low patency of the pyloric part of the stomach, narrowing of the outlet leading to the duodenum;
• increased pressure in the upper region of the small intestine;
• disorder of motor activity of the stomach and duodenum;
• chronic inflammatory processes occurring in the gastrointestinal tract (gastritis, stomach ulcers, cancer), as well as long-term exposure to unfavorable factors on the mucous membrane (smoking, alcohol abuse, prolonged use of medications);
• poor nutrition;
• consequences of surgery;
• Pregnancy can contribute to weakening of the esophageal muscles.

Often, several factors influence the development of pathology.

What are the signs of duodenogastric reflux?

It is not easy to identify clear symptoms of the disease, since they are similar to the manifestations of other pathologies in the functioning of the digestive system. Sometimes a person does not feel any discomfort, and the disease is diagnosed randomly when complaining of other problems.

Signals indicating retrograde reflux of duodenal contents into the stomach are:

• cramping pain in the upper abdomen following meals;
• feeling of bloating, fullness of the stomach, increased gas formation;
• heartburn and regurgitation with a sour taste;
• belching air;
• bitterness in the mouth;
• nausea, vomiting (food debris with bile);
• thick yellow coating on the tongue.

The danger of GDR is that, while asymptomatic, it can provoke complications: gastroesophageal form, reflux gastritis, intestinal metaplasia stomach or esophagus, growth of cancerous tumors.

The respiratory system is also negatively affected: as a result of DGR, some patients develop asthma, bronchitis, and lung damage.

All these serious changes are associated with the aggressive effect of intestinal enzymes and bile on the mucous membrane of the stomach and esophagus, which are subject to chemical burns.

Diagnosis of the disease

It is not always possible to determine GHD based on external signs and patient complaints. To exclude similar disorders in the gastrointestinal tract, it is necessary to undergo an esophagogastroduodenoscopy (EGD) procedure - examination of the stomach and small intestine with a probe with a special camera. This study helps to establish the condition of the mucous membrane, but it itself can provoke GHD.

Most accurate diagnostic method To verify pathology, daily pH measurements of the gastric environment are used. Fluctuations in the acidity of gastric juice during the night are carefully analyzed, since they are not associated with meals and physical activity.

The diagnosis of GHD is made if the gastric pH rises above 3. And when examining the gastric juice, bile impurities should be detected in it.

Electrogastroenterography and antroduodenal manometry provide information about the motor function of the stomach and duodenum.

Treatment of duodenal gastric reflux

First of all, it is necessary to eliminate accompanying illnesses, resulting in DGR: gastritis, gastroduodenitis, ulcers, duodenitis.

Normalization of the functioning of the gastrointestinal tract is possible only with an integrated approach: the use of medications, lifestyle changes, and giving up bad habits.

Drug therapy

How to treat gastroduodenal reflux depends on the cause of its occurrence. Commonly prescribed drugs include:

• medications that normalize peristalsis of the upper gastrointestinal tract (Trimedat);
• prokinetics, stimulating the motor activity of the stomach and duodenum and promoting better movement of food through the digestive tract (Cerual);
• drugs that neutralize the effect of bile in the stomach (Rabeprazole, Nexium, Omez);
• drugs that lower the acidity level of gastric juice, as well as relieve unpleasant symptoms, such as heartburn (Almagel, Maalox).

Duodeno-gastric reflux will have to be treated with both pills and diet:

• it is important to follow a diet - you should eat at the same time 4-6 times a day, if possible, reduce portions so as not to get used to overeating;
• food must be steamed or boiled; Baking in the oven is allowed. Fried foods should be completely excluded from your diet;
• optimal temperature for prepared food degrees. Too hot or too cold can harm your mucous membranes;
• It is better to eat crushed food or chew it well;
• After eating, you should not lie down; it is better to take a half-hour to an hour walk, while avoiding heavy loads;
• you need to avoid foods that irritate the mucous membrane - salty, spicy, sour, pickled foods, smoked and canned foods, yeast bread, citrus fruits, tomatoes, onions and garlic, soda, coffee;
• the diet should be dominated by pureed soups and cereals, lean meat and fish, as well as low-fat milk; the use of bran helps the movement of duodenal contents through the intestines, fresh vegetables(except cabbage, cucumbers, green beans) and fruits (not sour).

Giving up bad habits - alcohol, smoking - will be an effective step on the path to recovery.

You should also stop taking medications unsystematically (especially choleretic and non-steroidal anti-inflammatory drugs - aspirin, ibuprofen, diclofenac) or consult a doctor about replacing them.

Folk recipes

Traditional medicine can provide additional assistance in the treatment of GDR:

Herbal tea: St. John's wort, chamomile, yarrow. Proportions are chosen according to taste. Take twice daily. This infusion also helps with inflammatory processes in the digestive tract.

Soaked flax seeds. Pour flax seed with water at room temperature (half a glass of water for 1 tablespoon). Take on an empty stomach after the flax releases mucus, which protects the walls of the internal organs.

Smoke leaves help against vomiting (2 tablespoons per half liter of boiling water). Leave for an hour. Take 50 ml every two hours.

Rue leaves, which can be chewed or added to tea, help restore motor function of the gastrointestinal tract.

Please note that folk remedies are not the basis of treatment! First of all, you need to visit a gastroenterologist or therapist!

Prevention of duodenogastric reflux

Poor nutrition and its consequence, obesity, provoke the development of GHD. Therefore, keeping your body in good shape and paying attention to the food you eat are the main preventive measures in maintaining your health.

In addition, you should promptly apply for professional help in case of unpleasant symptoms, treat diagnosed diseases of the digestive system, listen to the advice of doctors, following their recommendations.

Duodeno-gastric reflux

Duodeno-gastric reflux is the reflux of the contents of the duodenum into the stomach cavity. As an independent disease, it is rare; much more often it is a symptom of another gastrointestinal pathology. It manifests itself as pain and dyspeptic syndromes: with duodenogastric reflux, vague diffuse abdominal pain, heartburn, belching, nausea, vomiting, and a yellowish coating on the tongue occur. Diagnosis is not difficult: EGDS, electrogastroenterography, and 24-hour intragastric pH-metry are used for this. The treatment complex includes prokinetics, drugs to reduce stomach acidity, and antacids.

Duodeno-gastric reflux

Duodeno-gastric reflux is a condition that is not always a sign of pathology of the digestive tract - the reflux of duodenal contents into the stomach is detected in approximately 15% of the healthy population, mainly at night. Duodeno-gastric reflux is considered pathological if, during daily intragastric pH-metry, there is an increase in the acidity of gastric juice above 5, not associated with food intake and persisting more than 10% of the time. Duodeno-gastric reflux accompanies many diseases of the initial parts of the digestive tract, but in approximately 30% of patients it can be considered an isolated pathology. This condition accompanies functional and organic diseases of the gastrointestinal tract, and also quite often develops in postoperative period cholecystectomy, suturing duodenal ulcer. Some authors note that duodenogastric reflux occurs in all chronic diseases of the stomach and duodenum. Men and women suffer from duodenogastric reflux to the same extent.

Causes of duodeno-gastric reflux

Several factors are important in the development of duodenogastric reflux: insufficiency of the pyloric part of the stomach with gaping of the pylorus, impaired motility of the stomach and duodenum, increased pressure in the initial parts small intestine, aggressive effect of duodenal contents on the gastric mucosa. Bile acids and pancreatic enzymes damage the protective barrier of the gastric mucosa; provoke reverse diffusion of hydrogen ions into the deep layers of the stomach wall (this leads to increased acidity); stimulate the production of gastrin by the antral glands and damage the lipid membranes of cells, increasing their sensitivity to the components of gastric juice. In addition, due to the retrograde reflux of duodenal contents, the pressure in the stomach cavity increases, which can lead to the occurrence of gastroesophageal reflux.

Duodeno-gastric reflux often accompanies diseases such as chronic gastritis, peptic ulcer of the stomach and duodenum, stomach cancer, impaired tone of the sphincter of Oddi, duodenostasis. Often, duodenogastric reflux occurs in patients who have undergone surgery to remove the gallbladder or suturing a duodenal ulcer. Impaired motility of the stomach and initial parts of the small intestine is the root cause of duodeno-gastric reflux in functional diseases of the gastrointestinal tract, and in organic pathology, impaired motility is secondary.

Discoordination of motility leads to impaired evacuation of the contents of the stomach and duodenum, which leads to gastro- and duodenostasis, reverse peristalsis, and reflux of duodenal masses into the stomach cavity. Dysmotor disorders may occur in various departments digestive tract, combined with pylorus pathology: normal gastric tone, accompanied by pylorospasm and duodenostasis, or gastric hypotension in combination with pylorus gaping, duodenal hypertension.

Previously it was believed that duodeno-gastric reflux is defensive reaction on the inflammatory process in the stomach and the increased acidity of the gastric juice entering the duodenum: allegedly, duodenal juice, when it enters the stomach, alkalizes its contents, which prevents further damage to the duodenal mucosa. However, today it has been proven that bile acids contained in duodenal juice, as mentioned above, not only damage the mucous barrier of the stomach, but also provoke reverse diffusion of hydrogen ions into the submucosal layer and stimulate the secretion of gastrin by the antral glands, which ultimately leads to further greater increase in acidity in the stomach. Thus, the ulcerogenic effect of duodeno-gastric reflux was substantiated and the theory of its protective nature was refuted.

Symptoms of duodeno-gastric reflux

Symptoms of duodenogastric reflux are nonspecific and are characteristic of many diseases of the gastrointestinal tract. First of all, these are diffuse vague pains in upper sections abdomen, most often spasmodic, occurring some time after eating. Patients complain of increased flatulence, heartburn (with any acidity of the stomach), regurgitation of acid and food, belching of air, vomiting with bile. Mandatory for duodeno-gastric reflux is a feeling of bitterness in the mouth, a yellowish coating on the tongue.

Long-term duodenogastric reflux can cause serious changes in the stomach and esophagus. Initially, an increase in pressure in the stomach cavity leads to the development of gastroesophageal reflux disease. Subsequently, bile acids and pancreatic enzymes cause specific changes in the esophageal mucosa, intestinal metaplasia, which can lead to the development of adenocarcinoma - one of the most malignant tumors of the esophagus.

The most likely outcome of duodeno-gastric reflux if not timely diagnosis and lack rational treatment– toxic chemical gastritis type C. To the emergence of this disease predisposes to constant reflux of bile into the stomach and chemical damage to the mucous barrier.

Diagnosis of duodeno-gastric reflux

It can be difficult to make a diagnosis of duodenogastric reflux during a consultation with a gastroenterologist, since this disease does not have specific signs. Quite often, duodeno-gastric reflux is discovered by chance, during examinations for other diseases of the digestive tract.

To verify the diagnosis, a consultation with an endoscopist is required: only he will be able to determine the required scope of examination and make a differential diagnosis with other pathologies of the stomach and duodenum (gastritis with high acidity, erosive gastritis, duodenitis, stomach ulcer). It should be remembered that esophagogastroduodenoscopy itself can cause duodeno-gastric reflux. A distinctive sign of induced endoscopy and pathological reflux will be the presence of bile in the stomach in the second case.

The most reliable method for diagnosing duodenogastric reflux is round-the-clock intragastric pH-metry. During the study, all fluctuations in the acidity of gastric juice are recorded, especially those not related to meals. To obtain more accurate results, the study of fluctuations in gastric juice pH is carried out over a night period of time, when the patient does not eat or experience physical activity.

Electrogastrography and antroduodenal manometry will help confirm the diagnosis - when conducting these studies, discoordination of gastric and duodenal motility, hypotension of the initial parts of the digestive tract can be detected. Gastric juice is also examined to identify pancreatic digestive enzymes and bile acids. Ultrasound of the abdominal organs will help to exclude other diseases of the digestive system that have symptoms similar to duodenogastric reflux (acute cholecystitis, pancreatitis, cholangitis, cholelithiasis, etc.).

Treatment of duodeno-gastric reflux

Typically, patients with duodenogastric reflux do not require hospitalization, however, to conduct a full examination, a short stay of the patient in the gastroenterology department may be necessary. To date, clear clinical recommendations have been developed for the treatment of duodenogastric reflux. They include the prescription of drugs that normalize the motility of the initial parts of the digestive tract, modern selective prokinetics (increase the peristalsis of the stomach and duodenum, improving the evacuation of their contents), bile acid inhibitors, proton pump blockers and antacids.

However, drug treatment of duodenogastric reflux alone is not enough; the patient must be warned about the need for a radical change in lifestyle. You should stop smoking, drinking alcohol and coffee. Uncontrolled use of medications is also a predisposing factor in the development of duodenogastric reflux, so the patient must be warned against unauthorized use of NSAIDs, choleretic drugs and other medications.

Malnutrition and the resulting obesity are of great importance in the development of duodenogastric reflux. To achieve the desired therapeutic effect, body weight should be normalized and obesity should be prevented in the future. You need to give up spicy, fried and extractive foods. IN acute period The disease requires a special diet: food should be consumed in small portions, at least 4-5 times a day. After each meal you should save vertical position for at least an hour, avoid heavy physical activity. The diet gives preference to lean meats, cereals, fermented milk products, vegetables and sweet fruits.

The prognosis with timely diagnosis and careful adherence to all recommendations of the gastroenterologist is favorable. Prevention of duodeno-gastric reflux consists of following a proper diet that ensures normal motility of the gastrointestinal tract. Avoiding alcohol and cigarettes is of great importance in preventing this disease.

Duodenogastric reflux is a phenomenon in which part of the contents of the duodenum is thrown into the stomach. As a rule, duodenogastric reflux accompanies diseases of the gastrointestinal tract such as chronic gastritis, peptic ulcers of the duodenum and stomach.

Duodenogastric reflux. Possible consequences

The ducts of the liver, as well as the pancreas, exit into the duodenum, for this reason its secretion contains a large amount of bile and pancreatic juices. When these liquids are thrown into the stomach, its mucous membrane is not able to neutralize bile and pancreatic enzymes, inflammation begins and there is a possibility of a serious burn to the gastric mucosa. The result of this can be a disease such as reflux gastritis (another name is chemical gastritis type C).

Duodenogastric reflux. Symptoms

Symptoms accompanying duodenogastric reflux are not always obvious. Sometimes this phenomenon can be completely asymptomatic, but is discovered during an electrogastroduodenoscopic examination.

Typically, duodenogastric reflux is accompanied by symptoms such as belching, bitterness or dry mouth, lack of appetite, nausea and weakness after eating.

Duodenogastric reflux. Treatment

To decide on a treatment method, it is necessary to discover the original, true cause of its occurrence, undergo a series of examinations to identify the presence peptic ulcer, gastritis, duodenitis. Treatment of reflux, as a rule, begins with treatment of the diseases that caused it. Often, if the underlying disease is eliminated, duodenogastric reflux also disappears.

However, there are often cases when solving this problem causes significant difficulties, especially if the root cause of reflux is surgical intervention in the gastrointestinal tract,

In this case, the doctor should prescribe medications that neutralize the effect of bile on the stomach and its mucous membrane, as well as medications that promote accelerated emptying of the esophagus and stomach and increase the tone of the esophageal sphincter. For this purpose, prokinetic drugs, such as metoclopramide, domperidone, are prescribed for a continuous short period, usually up to 3 weeks. One of the negative aspects of this treatment is the possible resumption of reflux symptoms after stopping the medication.

The course of treatment for reflux should also include the use especially for diseases that are characterized by increased level acidity. This group of drugs helps neutralize the aggressive effect of hydrochloric acid on the gastric mucosa. It is worth giving preference to the latest generation drugs, such as pantoprazole. They have very few side effects and are approved for use even by pregnant women.

Another group of drugs used for duodenogastric reflux are antacids. They bind bile chemically, but do not affect the level of hydrochloric acid. And besides, antacids protect the gastric mucosa, thereby enhancing therapeutic effect. Data medicines Available in the form of suspensions or gels.

Today, ursodeoxycholic acid drugs are often used to treat reflux. With their help, they are converted into water-soluble forms. This reduces negative action bile on mucous membranes. Usually the drug is prescribed twice a day.

In general, for treatment duodenogastric reflux a course lasting at least two months is required. The full effect of treatment can only be achieved with sufficient long-term use drugs.

Each section of the digestive tract is separated by sphincters (pyloruses). Their job is to open only in one direction. As an example, food and absorbed liquid from the esophagus enters the stomach. In a normal physiological state, the reverse process is impossible. The same mechanism is shared by the stomach and intestines. Reflux duodenitis is a process when the contents of the intestine are thrown into the cavity of the organ.

During reflux of this type the alkaline contents of the intestines enter the stomach and irritate its mucous membrane, causing inflammation. With a long course of the disease, the patient may experience more complex duodenitis-gastric reflux.

Reflux duodenitis occurs due to inflammation of the duodenal mucosa. It is also possible that the disease may occur due to anatomical changes in the pylorus itself. In this case, the sphincter is not able to block the flow of the contents of the esophagus into reverse side- to the stomach.

Important: To correct reflux, it is imperative to undergo treatment using not only medications prescribed by a doctor, but also using traditional methods, as well as gentle nutrition.

Symptoms and signs of the disease

Signs of the disease are very few and quite vague. The patient thus cannot independently determine which particular gastrointestinal disease is causing his symptoms, which are distinguished by features common to many diseases of the digestive system. Symptoms characteristic of reflux duodenitis include:

• Soreness. Mostly spasmodic pain occurs in the epigastric region. Typically, cramps appear after eating. Symptoms are also characteristic of the disease reflux gastritis.
• Dyspepsia. Usually manifests itself in the form of heartburn and belching with an unpleasant taste or odor. This sign Reflux duodenitis is also characteristic of gastritis.
• Feeling of heaviness. It may be accompanied by bloating and excessive gas formation.
• Yellow coating on the tongue. Small ulcers in the oral cavity may also appear, associated with damage to the mucous membrane, due to duodenitis and gastric reflux.

Other symptoms may also occur, such as sharp, girdle pain, nausea and hunger pain. That is why it is worth getting diagnosed by a qualified doctor and undergoing treatment for duodenitis.

Causes

There are several possible reasons reflux of duodenal contents into the gastric cavity, among them the most common and key are:

• Incomplete closure of the pylorus at the border of the duodenum and stomach. Thus, the content is thrown in the opposite direction.
• Chronic form of duodenitis.
• High level of pressure in the cavity of the duodenum. The most common causes of this are certain diseases, including cholecystitis, hepatitis and chronic pancreatitis.
• Chronic or long-term gastritis.

In medical practice It is customary to divide the reasons into two subtypes:

1. functional;
2. anatomical.

Functional disorders include disorders that are directly related to the work of the sphincter and give corresponding symptoms.

The second group includes tumors that are located at the junction of the duodenum and the stomach. Tumors provoke duodenogastric reflux.

It is these factors that provoke complex lesions in the part of the mucous membrane of the organ that is adjacent to the duodenum.

Important: Under the influence of bile acids, salts, pancreatic enzymes and the contents of the duodenum, gastritis develops in the stomach, which is based on chemical-toxic root causes.

Diagnostic measures

Timely diagnosis is very important for maintaining the health of the patient’s digestive system and treating duodenitis. Initially, the doctor palpates the patient’s abdomen. Palpation of different areas helps to understand the cause of the pain syndrome and which part of the digestive tract is inflamed.

When palpating, special attention is paid to the epigastric region. It is located below the sternum and just above the navel. With the inflammatory process caused by reflux, the patient will feel pain in this area.

Instrumental studies

FGDS - the most important of instrumental studies. It is mandatory. The procedure allows you to examine the cavity of the organ, esophagus and intestines. A probe equipped with video equipment is used for the study. The examination may reveal the following signs of the disease:

• Swelling of the mucous membrane and duodenum;
• Erosion and ulcers of the mucous membranes of the stomach and duodenum;
• Mucosal atrophy and much more.

Radiography - second most important among all instrumental methods diagnostics X-ray examination can detect inflammation and enlargement of the digestive organs, as well as identify signs of disease such as:

• Throwing food mass from the duodenum into the stomach;
• Narrowed or dilated parts of the intestine;
• Edema of the esophagus.

Important: X-rays are more acceptable for both adults and young patients. The procedure is completely painless and does not affect the general condition of the patient in any way.

Patients may also be prescribed other equally important types of diagnostics, including:

• manometry - a procedure used to obtain data on organ motility;
• biopsy - a procedure in which a tissue scraping sample is taken to determine the presence of malignant cells in the organs;

An obligatory part of the diagnosis is the examination of the stomach and esophagus. In this way, a problem such as duodeno-gastric reflux can be identified.

Laboratory research

There are also several types of laboratory research:

• pH - metry - mandatory research, which determines the level of secretion. The patient needs to insert a rubber probe, which will collect gastric juice. Subsequently, the juice is studied in the laboratory;
• a blood test is necessary to detect elevated ESR and anemia in the patient;
• stool analysis is needed to detect internal hemorrhages, which indicate ulcers or erosions.

After passing all the diagnostic methods prescribed by the doctor, the patient can begin treatment.

Treatment

Treatment of patients diagnosed with reflux duodenitis or gastric reflux duodenitis involves A complex approach to therapy. In most cases, doctors are able to identify the cause of the disease. It is with the elimination of one or more causes that treatment begins.

Patients should be very careful about using any medications that were not prescribed by a doctor. These include caffeine, some bile preparations, and even aspirin. Before taking it, you should definitely consult a doctor.

Traditionally, therapy for gastric reflux duodenitis and other types of reflux is carried out by eliminating dysfunction of the digestive system and each of its organs separately. Among the drugs that can be prescribed are:

• painkillers;
• enveloping drugs;
• proton pump inhibitors;
• antacids (heartburn medications);
• cholinomimetics;
• prokinetics and more.

Patients are also often prescribed medications that can improve bowel movements.

In addition to these drugs, doctors very often prescribe traditional methods to patients, which can replace some of the pills and improve the general condition of the patient. If the doctor has not prescribed such remedies, the patient can consult with him on this issue independently and find out which folk methods will reduce symptoms and speed up recovery.

Folk remedies

Many plants and herbs can help overcome symptoms caused by duodenitis and gastric reflux.

The most effective and in a safe way The treatment for duodenitis is a decoction of flax seeds. It is a natural antacid. The decoction can reduce acidity no worse than medicine. The following herbs are also useful:

• lemon balm - normalizes the state of the nervous system;
• chamomile - removes inflammatory processes;
• rose hips - heals tissues and mucous membranes;
• sea ​​buckthorn oil - relieves pain.

Products with beneficial properties

Among healthy products especially worth highlighting potato juice. The starch contained in the product envelops internal organs Gastrointestinal tract and relieves pain. Fresh juice can be taken on an empty stomach or immediately after breakfast.

Fermented milk products can also relieve symptoms of reflux and duodenitis. Kefir, milk and low-fat fermented baked milk can help with healing. But the main property of these products is to fight heartburn. Just a sip of milk can soothe your internal organs and reduce acidity.

Traditional methods are harmful

There are a number of plants, decoctions and compositions of which should never be used during inflammation. Among them:

• Rowan;
• mint;
• plantain;
• dandelion.

Important: These plants stimulate the production of gastric juice and significantly improve appetite. You can relieve the symptoms of reflux at home, but you need to do it with extreme caution so as not to make it worse for yourself. The most important thing is to coordinate each method with your doctor, and not to start taking any medications without the permission of the treating doctor.

Prevention

The patient must get rid of all the harmful factors that led him to this state. Many components of everyday life will have to be reconsidered.

1. Nutrition . If you have duodenitis, you should pay special attention to portion sizes. Don't overeat. You need to eat 5-6 times a day. You can't eat on the go. Snacks should include dairy products, vegetables and fruits and salads. Also, after eating, you should give the body half an hour to digest the food. No need to jump, run, or lift weights. Also, do not lie down immediately after eating. In this case, the patient is almost guaranteed heartburn.
2. Alcohol intake . The amount of alcohol consumed should be reduced, and alcohol should be completely eliminated during treatment. Interestingly, much more harm It is precisely the drinks that are brought to a person “on holidays.” In such cases, a person takes large amounts of alcohol and food, thereby causing irreparable harm to himself personally.
3. Smoking . Smoking, like alcohol, is very dangerous to human health. Cigarette smoke affects not only our lungs, but also the digestive system. Heartburn, bloating and the same duodenal and gastric duodenitis type of reflux.
4. Passive lifestyle. A passive lifestyle leaves its mark. Mobility and walks in the fresh air also ensure a healthy digestive system. It is necessary to pay attention to physical activity, which also reduces excess weight, which negatively affects the gastrointestinal tract and the functioning of the cardiovascular system.
5. Treatment. If any suspicious and glaring symptoms from the gastrointestinal tract occur, a person should not waste time. You should consult a doctor even with mild epigastric pain, heartburn or bloating. All these, at first glance, fairly harmless signs, can lead to more complex consequences and chronic diseases. You can solve emerging health problems only with the help of a qualified doctor and timely visit to the clinic.