home Folk remedies Symptoms and methods of treatment of chronic duodenitis. Acute duodenitis

Symptoms and methods of treatment of chronic duodenitis. Acute duodenitis

The human intestine consists of several sections, one of them is the duodenum. Its most common diseases include duodenitis. It develops in representatives of all age groups, even children. About 5 out of 10 people have experienced symptoms of duodenitis at least once. In males, the disease is diagnosed 2 times more often. This is due to an addiction to alcohol and unhealthy food, and lifestyle.

Physiology

In each part of the intestine there can be inflammatory diseases. The duodenum is an intermediate section between the stomach and small intestine. Because of this location, she is exposed to a double risk of infection - upward path from the lower intestinal sections and descending along with the contents of the stomach.

Duodenitis– this is inflammation duodenum. Most often the mucous membrane of this organ suffers.

According to the stages and duration of the course, duodenitis is divided into acute and chronic.

Acute duodenitis. It occurs unexpectedly, proceeds brightly and can pass quite quickly. The disease causes superficial inflammation of the mucous membrane, which can lead to the formation of erosions, ulcers, and sometimes phlegmon. At proper therapy and following a diet, you can get rid of it in a few weeks. If inflammation occurs again, there is a high probability of the disease becoming chronic. According to statistics, this happens in 90% of cases.
Chronic duodenitis. This form of the disease exists for a long time, has weak clinical manifestations. It can be an independent disease or the result of other pathologies (pancreatitis, cholecystitis, peptic ulcer, gastritis). The disease can lead to the formation of deep erosions and thinning of the upper layer of the intestine. From time to time, such duodenitis worsens, causing indigestion and severe pain syndrome. With this form of the disease, diet and long-term drug treatment are necessary.

It is also customary to divide duodenitis depending on the location of foci of inflammation. He can be:

Local – damage to the distal part (postbulbar duodenitis), proximal (bulbitis), inflammation of the major papilla (polyp).
Diffuse or widespread.

The disease is also classified according to the depth of damage to the mucous membrane. On this basis it is divided into:

superficial duodenitis – it is characterized by swelling and hyperemia;
atrophic – its sign is thinning and absence of mucous membrane in the area of inflammation;
interstitial - with it inflammation penetrates into the deep layers;
erosive duodenitis – this form of the disease is characterized by the formation of wounds and erosions on the intestinal walls.

IN separate group There are specific duodenitis that developed against the background of tuberculosis, Crohn's disease, fungal infections, immunodeficiency states and other diseases.

Symptoms and clinical manifestations

Signs of duodenitis largely depend on the cause of the disease, as well as the presence or absence of concomitant diseases of the digestive system. Inflammation of the upper section can occur without particularly pronounced symptoms, but more often they manifest themselves periodically or constantly.

The following complaints should be the reason to consult a doctor:

Painful sensations in upper area belly in the center.
Discomfort in the abdomen. Most often, the feeling of overeating and heaviness in the stomach occurs after meals.
Indigestion. Due to disruption of the synthesis of digestive enzymes, the contents of the intestines begin to ferment and rot. This process usually accompanied by decreased appetite, diarrhea, increased gas formation, rumbling in the stomach, nausea.
General weakness and increased fatigue. These are signs of intoxication of the body, which is caused by decay products. Acute form The disease may also be accompanied by an increase in body temperature.
Bitter belching. Vomiting with bile is also possible. These signs are associated with the fact that with duodenitis of the duodenum, its contents do not move into the intestine, the intestine becomes overcrowded and food is thrown into the stomach.
Irregularities at work nervous system. With prolonged duodenitis, atrophy of the mucous membranes, as well as the glands that produce enzymes, develops. Such pathologies lead to a deterioration in the absorption of food, as a result of which a person begins to experience a lack of nutrients. To improve digestion, the body increases blood flow to the intestines and stomach, but at the same time, blood circulation in the lower extremities and brain becomes worse. The so-called dumping syndrome occurs, the signs of which are a feeling of heat in the upper part of the body, drowsiness, weakness, dizziness, tinnitus, trembling in the hands, hormonal deficiency develops, in turn, this negatively affects the functioning of the autonomic nervous system.
Jaundice of the skin. During inflammatory processes in the papilla of Vater and narrowing of the bile duct, bile does not exit into the intestine, overflows the gallbladder, and then enters the blood.

Pain may vary depending on the form of the disease. In such situations general symptoms duodenitis, are supplemented by the following symptoms:

With duodenitis associated with impaired patency of the duodenum, pain occurs when the intestines are full. They are paroxysmal in nature and can be acute twisting or bursting.
Inflammation in the area of the papilla of Vater leads to disruption of the outflow of bile, so the disease is also accompanied by signs of renal colic - acute pain in the left or right hypochondrium.
For chronic duodenitis Characterized by dull pain, which may intensify after eating food after 1-2 hours. This is due to swelling and inflammation of the intestinal wall.
When the cause of the disease is gastritis with high acidity, pain appears approximately a quarter of an hour after eating. They are caused by the entry into the intestines of food mixed with acidic gastric juice.
With ulcerative duodenitis, which is caused by the bacteria Helicobacter pylori, intense pain occurs on an empty stomach.
When inflammation covers the lower areas of the intestine, the pain “moves” from the stomach area below, to the large and small intestine.

Causes of pathology

The main cause of duodenitis is damage to the duodenal mucosa. In most cases, this happens when gastric contents enter it with high concentration acids. Acid gastric juice after penetration into the intestines causes irritation of its mucous layer, which causes acute inflammation.

Secondary duodenitis accompanies diseases of the stomach, liver, gall bladder, etc. Often occurs due to food retention in the duodenum. This results in decreased tone of the intestinal tube wall (duodenostasis). Because of this, the contents of the stomach remain in the upper section for a long time, which negatively affects the mucous membrane.

The following factors contribute to the occurrence of acute duodenitis:

abuse of food and drinks that irritate the mucous membranes digestive organs– smoked, spicy, fried, fatty, coffee, alcohol;
food poisoning;
mucosal damage foreign objects, for example, ingestion of indigestible food particles.
entry into the duodenum of infections - staphylococci, Helicobacter pylori, clostridia, enterococci;
diseases of the digestive organs - peptic ulcer, pancreatitis, cirrhosis, hepatitis, colitis;

The following leads to the development of chronic duodenitis:

chronic diseases of the stomach, for example, gastritis with high acidity, in this case, hydrochloric acid, acting on the intestinal walls, gradually damages its cells, which causes thinning of the mucous membrane;
intestinal dysfunction - poor peristalsis, impaired innervation, adhesions, chronic constipation;
chronic diseases of the gallbladder, liver, pancreas, pathologies of these organs disrupt the flow of enzymes into the duodenum, as a result protective properties intestines decrease and malfunctions occur.

There are also a number of predisposing factors that, acting over a long period of time, lead to the occurrence of a chronic form of the disease and periodic inflammation of duodenitis. These include:

unhealthy and irregular diet;
bad habits;
severe stress;
chronic diseases of various organs;
taking some medicines.

Diagnosis of the disease

If you have any of the above symptoms, you should visit a gastroenterologist. After collecting anamnestic data and palpating the abdomen, the doctor may suspect intestinal duodenitis. However, for staging more accurate diagnosis, clarifying the nature of the disease and excluding other diseases, laboratory and instrumental examinations. Laboratory tests usually include a stool sample and a blood test.

Instrumental studies for duodenitis usually use the following:

Fibrogastroduodenoscopy – a probe equipped with a video camera is inserted into the patient’s mouth. This allows you to inspect internal surfaces stomach, esophagus and duodenum.
X-ray contrast study - the patient takes a fluoroscopic substance, after which several x-rays. This procedure allows you to clearly view the lumen of the duodenum.
Radiography is the most painless examination that is well tolerated by patients. However, it does not make it possible to detect changes in the mucous membrane, but only allows you to see gross violations in the work of the organ.

Instrumental examinations allow us to identify the type of disease:

swelling of the duodenal mucosa;
uniform redness of the mucous membrane - indicates superficial or catarrhal duodenitis;
smoothing of folds - occurs with reduced intestinal tone;
focal or uniform atrophy of the mucous membranes - indicates an atrophic form of the disease;
small nodules – nodular inflammation of the duodenum;
star-shaped hemorrhages are typical for hemorrhagic form diseases;
ulcers or erosions on the mucosa are a symptom of erosive duodenitis or duodenal ulcers.

Also, with the help of research, it is possible to determine what caused the disease, this will subsequently simplify treatment and minimize the risk of relapse.

Features of treatment

How to treat duodenitis depends on many factors - the form of the disease, the nature of its course, the presence of concomitant diseases. The basis of therapy is:

Taking medications. Depending on the form of the disease, inhibitors may be prescribed proton pump, antacids, antibiotics, multienzyme drugs, prokinetics, H2-histamine blockers, antispasmodics.
Dieting. IN successful treatment Diet plays a big role in duodenitis. In case of acute or exacerbation of a chronic disease, the patient is prescribed a very strict diet for 3-5 days, consisting of pureed soups, mucous decoctions of cereals, and liquid milk porridges. In the future, the diet expands somewhat.
Physiotherapeutic procedures. They are used as an auxiliary therapy and only outside of exacerbation of the disease. Similar procedures activate blood supply and lymph flow to the abdominal organs, reduce pain, improve secretory function, and reduce inflammation.

What diet is prescribed for duodenitis?

Successful treatment of inflammation of the duodenum is impossible without nutritional therapy. It, like taking medications, is an integral part of therapy.

A diet for duodenitis helps reduce inflammation, promotes the healing of wounds, ulcers and erosions, and reduces pain.

Nutrition in the first days after an exacerbation

During the first 3-5 days after the onset of acute or exacerbation of chronic duodenitis, the patient must follow a very strict diet. It provides maximum protection of the gastrointestinal mucosa from mechanical, temperature and chemical irritation. Therefore, foods and dishes that are poorly digested, stimulate secretion, have a strong effect on the walls of the stomach and intestines, as well as cold and hot foods are completely eliminated from the diet. All food consumed should have a liquid or mushy consistency.

The menu is allowed to include only the following dishes and products:

Soups. They should be pureed and slimy. It is recommended to cook soups in water with rice, oatmeal and semolina, you can add an egg-milk mixture, butter, cream.
Dairy products. Of these, only milk, cream, steamed soufflé made from non-acidic pureed cottage cheese are allowed.
Meat and fish dishes. These products should be cooked only after grinding (passed through a meat grinder several times). You can make soufflé or puree from fish and meat (rabbit, turkey, chicken, veal, beef).
Side dishes. Only liquid pureed porridges made from buckwheat and rice or liquid porridges made from oatmeal, buckwheat and rice flour are allowed. You can add milk, butter, and cream to these dishes.
Beverages. Sweet juices diluted with water, rosehip decoction, weak tea with milk.
Sweet dishes. You can eat sweet jelly from berries, fruits or milk, honey, jelly, sugar.

Cooking food is only allowed by steaming or boiling. Meals for duodenitis should be fractional - you need to eat food at least 6 times a day in small portions.

Coarse cereals - pearl barley, barley, corn, millet.
Bread, pastry, any bakery and pasta products.
Smoked meats, sauces, pickles, marinades, canned food, everything spicy.
Stewed and fried dishes.
Carbonated drinks, strong coffee, cocoa, tea, kvass, compotes, concentrated and sour juices.
Fermented milk products (except those allowed), sharp cheeses.
Broths of fish, mushrooms, meat.
Sour berries and fruits.
Vegetables, especially raw ones, the most undesirable are legumes, spinach, radishes, White cabbage, radish, turnip, tomatoes, cucumbers, onions, sorrel.
All types of alcohol.

Meals in the following days

On days 4-6 after exacerbation of duodenitis, the diet expands. During this period, nutrition for inflammation of the duodenum may differ slightly, depending on the form and characteristics of the course of the disease, the attending physician should tell you in detail about it. However, there are general recommendations that it is advisable for all patients to adhere to. They are as follows:

All food consumed must be at a neutral temperature; hot and cold are not allowed.
You should eat at approximately the same time, at least 5-6 times a day, in small portions. The interval between meals should not be more than 4 hours; skipping meals is very undesirable.
Preference should be given to pureed or well-cooked liquid and semi-liquid dishes; consumption of soft foods is allowed, without rough connective tissue, meat and fish whole piece.
The diet should consist of simple dishes, with a minimum amount of ingredients.
The preferred method of preparing dishes is steaming or boiling; baking is allowed, but such food should be consumed without a crust.
Eating must be stopped 1.5 hours before bedtime; before going to bed, you can drink a glass of milk.
You need to chew your food thoroughly, this will improve it machining and speed up the onset of saturation.

The diet for duodenitis allows the consumption of all dishes and products allowed in the first days after an exacerbation; in addition to them, the following can be added to the diet:

Puree vegetable soups, vegetable puree, weak meat broths.
Boiled or steamed vegetables;
Fermented milk products - yogurt, kefir, yogurt:
Small pasta;
Fruits without seeds and peels, baked and mashed, or jelly made from them;
Dried bread, crackers, dry biscuits;
Mousses, jam, caramel in small quantities;
Lean meat and fish, in whole pieces, the meat must be cleaned of tendons and skin;
Vegetables, fruit juices, especially useful with a high content of vitamin C;
Weak tea with milk, herbal teas, fruit drinks.

If you have duodenitis, you should definitely avoid foods that stimulate gastric secretion and foods that contain coarse plant fibers. The following is prohibited:

Fresh bread, pastries, muffins, puff pastry products;
Strong broths from fish, mushrooms, meat;
Vegetable soups such as borscht, cabbage soup, rassolnik, okroshka;
Fatty poultry (goose, duck) and fish (mackerel), fatty, tough, stringy meat;
Any canned food, pickles, marinades.
Fried foods, smoked foods;
Onions, peppers, horseradish, garlic, mustard;
White cabbage, rutabaga, sorrel, turnip, daikon, radish, radish;
Barley, pearl barley, millet cereals, legumes;
Raw fruits and vegetables;
Butter creams, ice cream, sweets, chocolate;
Carbonated drinks, cocoa, coffee, alcohol.

It is recommended to adhere to such a diet for duodenitis from two weeks to a month (the exact time of the diet should be determined by the doctor). After this, the diet can be expanded even further - add high-quality sausages (not smoked), crumbly cereals, raw fruits, and vegetable salads. And here harmful products, which negatively affect the gastrointestinal tract, should be removed from your life forever. First of all, this applies to smoked meats, fatty and fried foods, fast food, a variety of snacks, store-bought semi-finished products and, of course, alcohol. It would also be a good idea to quit smoking.

Folk remedies

Depending on the type of duodenitis, appropriate treatment tactics are selected. Typically, the basis of therapy is special diet And medications. Treatment of duodenitis is also acceptable folk remedies. However, under no circumstances should they replace traditional therapy, they can only be used as a supplement and only after agreement with a specialist.

Before starting treatment for duodenitis, it is necessary to confirm the diagnosis. Due to the fact that this disease has symptoms similar to those of many other diseases digestive system, only a specialist can do this.

In addition to making a diagnosis, the doctor will give the necessary recommendations for treatment. If you have duodenitis, in addition to taking medications, you must follow a diet. Without this measure, treatment may be ineffective. Special food will help restore the duodenum and promote speedy recovery. It involves the complete exclusion from the diet of food that can mechanically or chemically injure the mucous membranes, as well as poorly digestible and secretion-stimulating dishes and products.

Herbs with anti-inflammatory and regenerating properties show good results in the treatment of both acute and chronic duodenitis. These include chamomile, calendula, yarrow, St. John's wort and others. Medicinal plants will also be useful for this disease, providing sedative effect, for example, valerian, lemon balm. All these herbs can be taken separately, but they give a much better effect as part of a mixture. Let's look at some of them:

Mix mint leaves, chamomile and oregano in equal proportions. Pour 20 grams of the mixture into a glass of boiling water, leave it for 40 minutes, then strain. You need to take this remedy for two weeks in the evening and in the morning; in addition, you can drink it during the day as tea.
Combine 2 parts each of calendula and chamomile and 1 part each of fennel fruit and cumin seeds. Pour a glass of water into a small saucepan, bring it to a boil, then add a teaspoon of the prepared mixture. Boil the product for about five minutes over low heat, after cooling, strain it and drink. This decoction should be taken twice a day.
Mix equal amounts of nettle leaves, yarrow herb and buckthorn bark. Immerse a teaspoon of the mixture in a glass of boiling water, after forty minutes, strain the mixture and drink. Traditional treatment duodenitis with this remedy should be continued for two weeks. The infusion should be taken morning and evening.
Mix 2 parts each of fennel fruits, nettles, chamomile and 1 part each of licorice, calamus rhizomes and oregano. Pour 50 grams of the mixture with a liter of boiling water and simmer the mixture for half an hour over low heat. Leave the broth to infuse for 3 hours, then strain. Take the product three times a day, 150 ml.

Aloe products

This indoor plant has a pronounced anti-inflammatory, antibacterial and wound-healing effect. So that aloe fully opens its beneficial features, it must be prepared correctly. Before trimming the leaves, it is advisable not to water the flower for 3 days. The cut leaves should be washed well, dried, wrapped in paper and placed for a week on the bottom shelf of the refrigerator. If urgent treatment is necessary, you can do without such preparation.

Recipes with aloe:

Oatmeal decoction with aloe. Squeeze the juice from the aloe leaf. Two tablespoons oatmeal combine with 300 ml. water and leave for half an hour. After this, boil the oatmeal over low heat for 20 minutes. Strain the resulting porridge so that only a slimy broth remains. When the broth has cooled, mix it with 50 ml. prepared aloe juice. This remedy should be taken half a glass 30 minutes before meals three times a day. It can be stored for no more than a day in the refrigerator.
Aloe drink. This tool well suited for the treatment of chronic duodenitis. To prepare it you need 500 grams of aloe leaves and 0.5 liters of liquid honey (thick honey can be melted) and red wine. Grind the aloe using a blender or meat grinder, then squeeze the juice out of the resulting pulp. Mix the juice with other ingredients, pour the mixture into a dark glass container and place in the refrigerator for a week. During this time, shake it periodically. This folk remedy for duodenitis should be taken after meals, an hour later, three times a day according to the following scheme: 1 week, 1 teaspoon, 2-3 weeks, 1 tablespoon, 4 weeks, again, 1 teaspoon, in this amount the drink should be taken for another month.

Treatment with jelly

If you have duodenitis, it is very useful to consume jelly, and you can drink it from the first days after the onset of the disease. Especially good effect they give for superficial and erosive duodenitis. Medicinal jelly prepared from various products that have healing properties, the only exception is cranberries. Rosehip jelly will be especially useful. To prepare it:

Pour a glass of fruit into liter jar, fill the container to the top with boiling water and leave for an hour.
Drain the liquid from the jar into a separate container, combine the remaining fruits with half a liter of water, boil for a quarter of an hour, then let the broth cool.
Remove the rose hips, chop them, then squeeze the juice out of them using gauze folded in several layers.
Pour the infusion, juice and broth into one pan and put on fire.
When the liquid boils, pour starch diluted in a small amount of water into it in a thin stream.

Drink jelly throughout the day, regardless of meals.

You can treat duodenitis with folk remedies made from oats. This product is also suitable for making jelly. To do this, pour a glass of oats into a saucepan, fill it with 5 glasses of water and place on the fire. Cook the mixture over low heat until it acquires a slimy consistency. Cool the finished product and strain. To improve it therapeutic properties You can add nettle leaves to it. To do this, steam a tablespoon of dry leaves with a glass of boiling water. After forty minutes, remove the leaves, chop thoroughly and add to oatmeal jelly. The remaining infusion can be consumed instead of tea.

What to do?

A patient who exhibits signs of duodenitis should immediately seek medical advice. qualified help. Self-medication, and even more so treatment with folk remedies, can aggravate the situation.

Inflammation of the duodenum, or duodenitis, is rare in isolation - in most cases this disease is combined with other diseases gastrointestinal tract(gastritis, ...). This pathology is diagnosed in people of different age groups, and affects both men and women equally.

Classification

According to the generally accepted classification, duodenitis occurs:

by etiology – acute and chronic; acute, in turn, is divided into catarrhal, ulcerative and phlegmonous, and chronic is divided into primary (an independent disease) and secondary (a disease accompanying another pathology digestive tract);
by localization of foci - local, diffuse, bulbar, postbulbar;
according to the level of structural changes - superficial (affects only the superficial layer of the mucous membrane), interstitial (the inflammatory process spreads to the deeper layers of the intestine) and atrophic (thinning of areas of the mucosa, absence of glands in the affected areas);
according to the endoscopy picture - erythematous, erosive, hemorrhagic, atrophic, hypertrophic, nodular;
special forms duodenitis - fungal, immunodeficiency, tuberculosis, Crohn's disease...

Etiology of duodenitis

Alcohol abuse quite often leads to duodenitis.

Most common reasons acute duodenitis are:

food poisoning;
excessive consumption of spicy foods and alcoholic beverages;
mechanical damage to the intestinal mucosa by a foreign body.

Chronic duodenitis is often the result of irrational and irregular nutrition.

Factors provoking the onset of the disease are the presence of the Helicobacter pylori bacterium in the stomach cavity and duodenostasis (impaired movement of food through the duodenum). In addition to the above factors, the development of duodenitis is promoted by:

ascariasis;
giardiasis;
foci of chronic infection in the oral cavity, in the genital area.

Pathogenesis

Acute and primary duodenitis occur as a result of damage to the mucous membrane of the duodenum by gastric contents of high acidity. If the number of protective factors in the duodenum is reduced, hyperacid juices have an irritating effect on the intestinal mucosa, causing inflammation in it.

Secondary duodenitis is a consequence of duodenostasis: the contents of the stomach, falling into the duodenum, remain in it for a longer period than necessary, which means it irritates the mucous membrane for a longer time, which leads to inflammation.

Symptoms of inflammation of the duodenum

Acute duodenitis is characterized by patient complaints of:

severe pain in the epigastric region 1.5–2 hours after eating, night pain;
nausea and vomiting;
general weakness.

The symptoms of chronic duodenitis are more smoothed out and vary greatly depending on different forms diseases. Patients are usually concerned about:

constant aching, Blunt pain in the epigastric region;
feeling of fullness, heaviness in the upper abdomen after eating;
and belching;
nausea, in some cases – vomiting;
decreased appetite;
general weakness, irritability, headaches and other so-called general symptoms.

With duodenostasis, pain in the epigastrium or in the right hypochondrium is pronounced, twisting, bursting, and paroxysmal in nature; Patients also complain of rumbling in the stomach, a feeling of bloating, bitterness in the mouth and vomiting bile.

If duodenitis is combined with duodenal ulcer, the symptoms of the above disease come to the fore, namely - intense pain in the epigastric region on an empty stomach.

In cases where duodenitis is combined with another intestinal disease, it manifests itself primarily intestinal symptoms(pain along the intestines, bloating, frequent loose stools).

If the disease lasts for a long time, the mucous membrane of the duodenum atrophies and the synthesis of enzymes that contribute to normal digestion is disrupted. As a result, profound disorders arise not only in the gastrointestinal tract, but also in many other systems of our body, including the central and autonomic nervous systems.

Diagnosis of duodenitis

Patient complaints, medical history and objective examination will help the doctor suspect duodenitis. On palpation it will attract attention varying degrees pain in the epigastric region. To clarify the diagnosis of duodenitis and differentiate it from other gastrointestinal pathologies, the patient may be prescribed:

EGDS (esophagogastroduodenoscopy) – examination of the upper part of the digestive organs through a probe; may be performed with or without biopsy;
Ultrasound of the abdominal organs;
study gastric juice(determination of its acidity and composition);
X-ray of the stomach and duodenum;
coprogram;
biochemical analysis blood (liver tests, amylase and other indicators).

Duodenitis: treatment

The food of a patient with duodenitis should be mechanically and thermally gentle, and it is recommended to prepare it by steaming, boiling or baking.

The main point in the treatment of duodenitis is diet.

Food should be as thermally, chemically and mechanically gentle as possible; therefore, sour, spicy, fried, cold and hot foods, as well as alcohol, canned food and smoked foods are completely excluded for 10–12 days.
Grinded food prepared by boiling or steaming should form the basis of the diet, and it should be taken in small portions 5-6 times during the day.
Recommended for consumption: day-old wheat bread, cereals cooked in water or milk (rice, buckwheat, semolina, rolled oats), small pasta, cereal puddings or casseroles, low-fat varieties meat and fish, soft-boiled eggs or in the form of a steam omelet no more than 2 per day, dairy products, whole milk, dry biscuit, vegetables (potatoes, beets, broccoli, cauliflower, zucchini, carrots).
Excluded from the diet: legumes, millet, barley, large pasta, fresh bread, muffins, pancakes, fried or hard-boiled eggs, fatty dairy products, salty or sharp cheeses, overcooked butter, fatty meat and fish, sweets, carbonated and strong drinks .

Diets must be followed throughout life, but acute period of the disease, it should be as strict as possible, and as the signs of exacerbation fade, the patient should gradually expand the diet (of course, within the limits of what is permitted).

The phlegmonous form of acute duodenitis is an indication for surgical treatment followed by antibiotic therapy.

Prevention

Main preventive measures with duodenitis are:

Which doctor should I contact?

If symptoms of duodenitis appear, you should contact a gastroenterologist who will prescribe EGD. Additionally, consultation with a parasitologist or infectious disease specialist may be required. In addition, for complete treatment, you need to consult a nutritionist who will help you create the right menu.

Duodenitis is inflammation of the mucous membrane of the duodenum. It digests food evacuated from the stomach with the help of pancreatic juice and bile. In addition, the duodenum produces hormones that regulate the activity of the digestive tract.

There is an acute and chronic form of the disease. In 90% of cases it is the second option that occurs. The disease is dangerous because it can be complicated by intestinal bleeding, pancreatitis and other diseases.

Causes of the disease

There are many factors leading to duodenitis. The most common are the following:

poor nutrition (abuse of spicy, sour, smoked, fried foods);
bad habits (drinking alcohol, smoking);
Helicobacter Pylori infection;
uncontrolled use of certain medications (in particular anti-inflammatory drugs);
gastritis and peptic ulcer;
disruption of the blood supply to the organ;
chronic liver diseases (cirrhosis, hepatitis, etc.);
anatomical features, leading to obstruction of patency;
Crohn's disease;
helminthiasis and others.

Symptoms of acute and chronic duodenitis

The acute course of duodenitis lasts 7-10 days, all symptoms are quickly relieved with medications. Chronic duodenitis occurs over a long period of time and can recur several times a year. Clinical signs are not so pronounced.

Symptoms of acute duodenitis:

Pain in the epigastric region (night pain, after eating, when feeling hungry).
Feeling of bloating, flatulence.
Belching with a bitter taste and heartburn.
Decreased appetite.
Diarrhea, vomiting.
Abdominal muscle tension.

In the absence of timely and adequate assistance, the disease can become chronic. Characteristic signs diseases in the chronic stage:

Disruption of the digestive process.
Painful sensations in the epigastrium of an aching nature.
Pain in the right hypochondrium, radiating to the back.
Feeling of fullness in the stomach.
Belching and bitter taste in the mouth.

Methods for diagnosing duodenitis

Diagnostics plays an important role. An incorrect or inaccurate diagnosis will affect the entire treatment. Therefore, do not be afraid and refuse diagnostic procedures which are prescribed by the doctor.

EGDS (esophagogastroduodenoscopy)- using a flexible probe equipped with a video camera, the doctor examines the esophagus, stomach and duodenum. By using this method you can see redness and swelling of the mucous membrane, erosion, and with a decrease in tone - smoothing of folds, the presence of nodules, hemorrhages and other signs by which a diagnosis of duodenitis can be made.
Radiography using contrast agent(barium sulfate), which allows you to identify anatomical disorders, signs of inflammation, obstruction, the presence of an ulcer or tumor, signs of impaired intestinal tone and motility.
Ultrasound diagnostics allows you to evaluate nearby organs, diseases of which can lead to duodenitis.
A laboratory examination is ordered ( general blood analysis, biochemical analysis, testing for the presence of Helicobacter pylori infection and others).
Fecal occult blood test to make sure there are no bleeding ulcers or erosions.
General stool analysis (coprogram), which helps to identify signs of disturbances in duodenal digestion.

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Treatment of duodenitis

First of all, it is necessary to normalize your diet. As a rule, a therapeutic diet is prescribed (table No. 1 in acute stage and No. 5 - in chronic).

At acute course diseases, it is allowed to consume weak tea, cocoa, low-fat cottage cheese, eggs, oatmeal and semolina porridge, puree soups. Prohibited: mushrooms, peppers, sweets, coffee, fatty meat and fish, buns. During chronic exacerbation Vegetable soups, bread, lean meats (beef, chicken), and non-acidic fruits are allowed. The same things are prohibited as in the acute stage. During the period of remission, you can eat any food, but in moderation. Preference should be given to a healthy and proper diet and not to overeat.

Medicines are prescribed depending on the cause of the disease.

Antibiotic therapy for Helicobacter Pylori infection
Medicines to reduce acid production in the stomach.
Preparations with an enveloping effect.
Anti-inflammatory drugs.
Pancreatic enzymes.
Medicines aimed at restoring the mucous membrane (cytoprotectors).
Antispasmodic drugs.
If helminths are present, take medications to get rid of them.
With high psycho-emotional stress, sedatives may be prescribed.

Attention! All medications are prescribed only by a doctor based on an analysis of the medical history, examination and research. Self-medication is unacceptable. Information about medicines is given for informational purposes.

Complications of the disease

Since the disease is not always pronounced, many people let the disease take its course. When taking painkillers, do not rush to see a doctor. But relief of symptoms will never replace proper treatment, and its absence can lead to the following adverse consequences:

duodenal ulcer with perforation (a through hole in the intestinal wall);
intestinal bleeding;
acute pancreatitis(inflammation of the pancreas);
jaundice (if the secretion of bile from the ducts into the duodenum is impaired, bilirubin in the blood increases);
duodenal dystrophy.

Prognosis and prevention

A timely diagnosis and prescribed treatment will help solve the problem of acute duodenitis. If the disease progresses to chronic stage, then you need to be regularly monitored by a gastroenterologist. Optimally – 1-2 times a year. In general, the prognosis is favorable.

– persistent polyetiological dystrophic lesion of the duodenal epithelium, characterized by inflammation, transformation, metaplasia and atrophy of the intestinal glands. Signs of the disease are nonspecific: pain in the upper abdomen, dyspepsia, autonomic symptoms(weakness, trembling fingers, sweating, sudden heartbeat, etc.). The diagnosis is made based on x-ray examination stomach and duodenum, endoscopy, duodenal intubation, antroduodenal manometry. Treatment includes etiotropic therapy, diet and daily routine; according to indications - surgery (for duodenal obstruction).

General information

Therapy for chronic duodenitis in the period of exacerbation is carried out in the gastroenterology department. A therapeutic fast is prescribed with a gradual transition to table No. 1. Symptomatic and pathogenetic treatment includes the use of antispasmodics, antacids, astringents; replenishment of vitamin and protein deficiency. With a long course of this pathology with severe dyspeptic syndrome, the prescription of antidepressants may be required.

Surgical treatment of chronic duodenitis is required when its phlegmonous variant is detected; rapid weight loss combined with severe pain and dyspepsia; detection of duodenal obstruction.

is an inflammation of the mucous membrane of the duodenum. With lesions in the upper sections, the symptoms of the disease resemble gastric ulcers; duodenitis in the lower sections causes symptoms similar to pancreatitis or cholecystitis. The disease is accompanied general weakness, pain in the stomach, heartburn, belching, nausea, vomiting. Acute inflammation, when following a gentle diet (sometimes fasting), usually ends within a few days. Repeated diseases become chronic, complicated intestinal bleeding, perforation of the intestinal wall, development of acute pancreatitis.

General information

Duodenitis is an inflammatory disease of the mucous membrane of the wall of the duodenum (duodenum). There are acute and chronic form. Acute duodenitis is characterized severe symptoms inflammations that completely subside after therapy and leave no noticeable structural changes in the mucosa. Chronic duodenitis is a disease with a long, relapsing course, characterized by the development of foci of inflammation in the mucosa followed by pathological restructuring of its structure. It is the most common lesion of the duodenum. 94% of all inflammatory processes in KDP they purchase chronic course. Chronic duodenitis occurs more than twice as often in men than in women.

Causes of duodenitis

Reasons primary inflammation specialists in the field of modern gastroenterology consider eating disorders, consumption of foods that irritate the gastrointestinal mucosa (sour, smoked, spicy, fried); alcohol, smoking, coffee abuse. Clinical cases Primary duodenitis is much less common than secondary processes (developed as a result of another pathology).

The causes of secondary duodenitis are considered to be infection of the duodenum by Helicobacter Pylori, chronic gastritis of various etiologies, peptic ulcer of the duodenum, impaired blood supply to the duodenum, deterioration of trophism, innervation and tissue respiration in the intestinal wall. Pathology can be provoked by chronic diseases of the intestines and digestive organs: liver, pancreas (colitis, hepatitis and cirrhosis of the liver, acute and chronic pancreatitis of various etiologies, inflammatory diseases of the mesentery, etc.).

Pathogenesis

The mechanism of development of inflammation of the duodenum is associated with damage to the intestinal mucosa by hyperacid juice coming from the stomach. Increased acidity, combined with a decrease in the protective properties of the intestinal wall, leads to irritation and then inflammation of the mucous membrane. If acute inflammation occurs without pronounced symptoms, then it develops into a chronic process, acquires a cyclic recurrent course, and degenerative and atrophic processes begin in the intestinal wall.

In the case of secondary duodenitis, the main pathogenetic link in the development of the disease is duodenostasis - a consequence functional disorders digestion, insufficient peristalsis, adhesions, compression obstruction of the duodenum. Chronic diseases of the liver, gallbladder and pancreas cause enzyme imbalances, which provoke a change in the homeostasis of the internal environment of the intestine, reduce the protective properties of the mucosal epithelium, and become the basis chronic inflammation. Damage to the duodenal papilla is usually the result of pathological processes V bile ducts.

Classification

Chronic duodenitis is classified according to several criteria. Based on their origin, they distinguish between primary and secondary processes, and based on the localization of foci of inflammation - bulbar, postbulbar, local or diffuse variants of the pathology. According to the endoscopic picture, erythematous, hemorrhagic, atrophic, erosive, and nodular duodenitis are distinguished. Based on the degree of structural changes, superficial, interstitial, and atrophic types of the disease are considered. There are also special forms (specific duodenitis: tuberculous, Whipple's disease, immunodeficiency, fungal, intestinal amyloidosis, Crohn's disease, etc.). Clinical classification includes:

Chronic acidopeptic bulbitis, usually combined with type B gastritis.
Chronic duodenitis in combination with enteritis and various kinds enteropathies.
Duodenitis, as a result of duodenostasis.
Local process (peripapillary diverticulitis, inflammation of the papilla).

Symptoms of duodenitis

Symptoms vary for different clinical forms of the disease. Acidopeptic duodenitis associated with antral bacterial gastritis is often accompanied by peptic ulcer of the stomach and duodenum, which causes the presence of an ulcer-like syndrome - severe pain in the epigastrium on an empty stomach, at night or a couple of hours after eating.

Duodenitis combined with enteritis is manifested primarily by intestinal symptoms (digestive disorders, dyspepsia, malabsorption syndrome). Duodenostasis is characterized by a pronounced pain syndrome - paroxysmal, bursting and twisting pain in the epigastric region or in the right half of the abdomen, a feeling of bloating, rumbling in the abdomen, bitter belching, nausea and vomiting with bile.

With local damage, the outflow of bile is disrupted, resulting in symptoms of biliary dyskinesia. Pain in the area of duodenal projection may radiate to the right or left hypochondrium, acquire an encircling character. Characteristic is the development of signs of jaundice, slight yellowness of the skin (cholestatic jaundice is characterized by a brownish tint) and sclera, lightened to white (with complete obstruction of the biliary tract) stool. There is bilirubinemia in the blood.

For long lasting chronic process characterized by a violation of the synthesis of secretin, enkephalins and other gastrointerstitial enzymes. This is due to a decrease in the secretory properties of the mucosal epithelium due to its degeneration. These peptides are extremely important in digestive activity, and their deficiency leads to profound disorders not only of the digestive tract, but also of other body systems, including disorders of the autonomic and central nervous systems.

There are several clinical forms of the disease. In the ulcer-like form, there is a “night” and “hungry” pain in the epigastrium or in the area of the projection of the duodenum of a pulling nature without irradiation. It is controlled by eating and taking antacids and gastroprotectors. Heartburn and bitter belching often occur. With a gastritis-like form, there is pain almost 15-20 minutes after eating, dyspeptic syndrome - nausea, vomiting, belching, rumbling in the stomach, diarrhea, flatulence, lack of appetite.

In cholecyst-like and pancreatic-like forms, the pain is acute, severe, located in the right or left hypochondrium, prone to irradiation, proceeds as biliary colic, there are signs of cholestasis and dyspeptic disorders. In patients with the neuro-vegetative form, autonomic asthenoneurotic disorders and deping syndrome come to the fore - consequences of duodenal hormonal insufficiency. The mixed form combines the features of different clinical forms of duodenitis. The asymptomatic form is detected using functional diagnostic methods during examination for other pathologies.

Diagnostics

Duodenitis can be diagnosed based on the endoscopic picture during gastroscopy. Additional diagnostic methods are radiography of the stomach and duodenum; study of gastric juice - biochemical and pH determination. In addition, duodenal intubation, biochemical blood testing, and coprogram are indicated. If malignancy of the affected areas of the mucosa is suspected, a biopsy specimen is examined.

Treatment of duodenitis

Treatment of chronic duodenitis is carried out by a gastroenterologist, varies depending on their clinical form. For acidopeptic chronic duodenitis, treatment involves a complex action in three areas: eradication of Helicobacter; mucosal protection: decreased secretion of hydrochloric acid(proton pump blockers, H2 blockers, antacids) and gastroprotection (enveloping drugs); restoration of digestion with the help of enzyme preparations.

In case of duodenitis with enteritis, treatment of exacerbation is primarily aimed at eliminating from the diet foods that are poorly digested (primarily milk, cereals), using enzyme preparations to restore the digestive function of the intestine, normalizing intestinal flora. During periods of remission, correct balanced diet. Treatment and preventive measures should be carried out taking into account the clinical variant of chronic duodenitis and the nature of concomitant diseases.

In case of duodenitis against the background of duodenostasis, the aim is always to eradicate the cause of duodenal obstruction. Functional duodenostasis is treated conservatively - frequent meals in small portions with the exclusion of foods that promote bile secretion, drugs that bind bile, drugs that help regulate intestinal motility. Effectively duodenal intubation with washing of the duodenum.

In cases of persistent obstructions as a result of pronounced adhesions, mechanical barriers, as well as in case of functional obstruction, intractable therapeutic treatment, the operation is shown. Treatment of duodenal obstruction is always carried out in inpatient conditions to prevent possible serious complications.

Prognosis and prevention

Primary prevention of duodenitis is a proper balanced diet, quitting smoking and moderation in alcohol consumption. Timely detection and treatment of gastrointestinal diseases, use of medications strictly as prescribed. Prevention of relapse consists of regular monitoring and annual outpatient examination, spa treatment. Prognosis with regular monitoring and timely treatment favorable; in case of duodenitis caused by duodenostasis, after measures aimed at eliminating stagnation, inflammatory symptoms subside and, as a rule, a cure occurs.

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