Chronic duodenitis. Chronic duodenitis: causes, symptoms and treatment in adults, diet Chronic active duodenitis treatment

Content

Inflammation of the mucous membrane of the duodenum (duodenitis) is the most common disease of the initial part of the small intestine. According to statistics, 10% of the world's population has experienced symptoms of this disease at least once in their lives. Duodenitis equally affects representatives of different age groups, but in men it is diagnosed 2 times more often.

What is duodenitis

The initial part of the small intestine is the duodenum, which plays an important role in digestion. The organ is located next to the stomach at the level of 1-3 lumbar vertebrae. Sometimes the pathology of this section of the small intestine develops on its own, but more often it is the result of chronic inflammation in other parts of the digestive system. The chronic course of the disease is characterized by a variety of symptoms that make it difficult to make a correct diagnosis.

Causes

Inflammation of the duodenum can be the result of an unhealthy lifestyle. This form of the disease is called primary. Secondary duodenitis develops as a result of inadequate treatment of gastritis, ulcerative lesions of the duodenum and stomach. As a rule, the primary form of the disease is due to:

There are factors that can provoke chronic duodenitis. The disease can form against the background of:

pancreatitis (inflammation of the pancreas);
liver pathology;
intestinal diseases;
diseases of the biliary tract;
immunodeficiency;
renal failure;
cardiovascular diseases.

Classification

Chronic duodenitis is divided according to several criteria: localization, clinical picture, etiology, morphological (tissue) signs, phase of the disease. In terms of prevalence, inflammation of the duodenum is total (the entire organ is involved) or local (limited). In addition, there are the following forms:

diffuse (the mucous membrane of the entire organ is inflamed);
focal (a small area is inflamed);
interstitial (there is no atrophy of the digestive glands of the intestine);
erosive and ulcerative (there are wounds on the mucosa).

Morphological signs are the same for all types of pathology, the difference is only the prevalence of the process. A special type of chronic form of duodenitis is superficial, which is characterized by thickening of the mucous membrane and organ and is the most common form of the disease. According to visual data during endoscopic examination, the following types of disease are established:

erythematous (the mucous membrane turns red and swells);
hemorrhagic (hemorrhages are detected);
atrophic (signs of thinning of the mucous membrane, translucent vessels, etc.);
nodular (in the presence of small formations resembling nodules in structure);
erosive (with partial or complete destruction of the surface of the mucous membrane).

The clinical picture of duodenitis of the chronic stage differs in variety. If the inflammatory process occurs in the area of the duodenal bulb (proximal form), then it is called bulbitis. Sometimes the pathology is localized in the back of the bulb (distal, or postbulbar form of duodenitis). Rarely, inflammation extends to the major duodenal papilla (papillitis), and even more rarely covers the entire organ (diffuse duodenitis).

Frequent signs of a chronic disease are pain in the stomach, dyspeptic disorders (difficulty digestion, heaviness in the stomach), vomiting, and nausea. During the period of exacerbation observed:

headache;
cramping soreness in the epigastrium (upper abdomen);
feeling of heaviness in the stomach;
vegetative disorders (sweating, palpitations, dilated pupils, and others);
general malaise.

Symptoms of duodenitis

Pain in duodenitis may appear suddenly or increase gradually. Often the disease manifests itself after eating fatty foods, excessive amounts of alcohol. In chronic duodenitis, the symptoms are less pronounced than in the acute phase of the disease. Inflammation of the duodenum in a sluggish stage is difficult to distinguish from other pathologies of the digestive system, because it is characterized by similar clinical signs:

pain of varying intensity that occurs in the upper abdomen, hypochondrium, behind the sternum during meals;
stool problems (alternating constipation and diarrhea);
signs of gastric dyspepsia (burning, heaviness, discomfort in the epigastric and epigastric region, bloating, distension of the abdomen, nausea, belching, heartburn, coated tongue, bitterness in the mouth);
psycho-emotional disorders (tearfulness, unmotivated irritability).

Diagnostics

A specialist may suspect chronic duodenitis after the first conversation and examination of the patient. The patient's complaints, anamnesis (history of development) of the pathology are taken into account. For the final verification of the diagnosis, a comprehensive examination is required. Depending on the clinical situation, the doctor may recommend several of the following studies:

Treatment of chronic duodenitis

The therapeutic regimen includes a comprehensive treatment of duodenitis. It consists of several activities:

elimination of symptoms with the help of medicines of different groups;
a diet aimed at enriching the body with proteins and vitamins;
with prolonged exacerbation and ineffectiveness of anesthesia, the appointment of antidepressants;
auxiliary treatment with folk remedies.

All activities are held at home. For a speedy recovery, the patient should stop smoking and drinking alcohol, avoid stressful situations. The patient needs proper sleep, rest, light physical activity and regular walks in the fresh air. During the period of remission (weakening or absence of signs of the disease), spa treatment is indicated.

Diet

Even severe duodenitis can be cured with dietary adjustments. A big role is given not only to the correct choice of products, but also to the method of their preparation, the mode of eating. It is necessary to eat 5-6 times / day. Products should be steamed, boiled or consumed baked. Fried, spicy, smoked dishes are strictly prohibited. The diet limits the daily intake of table salt to 10 g. Forbidden foods:

cream, biscuit confectionery;
coarse fiber: peas, lentils, beans and other legumes;
fatty meats: pork, lamb, beef;
acidic foods; sauerkraut, lemons, vinegar, currants;
fresh bakery;
strong coffee, tea;
sauces, incl. mayonnaise, ketchup;
horseradish, radish, ginger.

A diet for chronic duodenitis implies an increased content of wholesome food in the diet. A menu with varied and delicious dishes can be made up of the following products:

Kashi, cereal soups. Rice and oatmeal are especially useful. Oatmeal jelly has an enveloping effect. It is recommended to cook cereals and soups with diluted milk.
Vegetables in the form of puree. For lunch, it is allowed to eat carrots, pumpkin, cabbage, potatoes.
Fish, meat with low fat content. Veal, chicken, rabbit, river fish are allowed.
Bread. Breadcrumbs are allowed.
Eggs. You can boil them soft-boiled or cook omelettes.
Milk products. Cottage cheese and fat-free kefir are especially useful.

Medical therapy

Treatment of duodenitis with medicines includes the appointment of different groups of drugs. In most cases, an integrated approach is carried out by the simultaneous administration of several drugs. The following groups of medicines are used to treat inflammation of the duodenum:

Antibiotics. Used in the detection of Helicobacter pylori. The antibacterial course includes oral administration of 2-3 drugs for 10 days. Among them are Metronidazole, Amoxicillin, Tetracycline.
Antispasmodics. Apply with severe soreness and pronounced discomfort. Medicines reduce the intensity of pain, inflammation is eliminated. Take orally or intramuscularly for 1-3 weeks. Doctors prefer myotropic antispasmodics, which, as a result of a direct relaxing effect on the smooth muscles of the organ, alleviate pain and discomfort. No-shpa, Papaverine, Drotaverine.
Antacids. Drugs that effectively fight high acidity in the digestive tract. Medicines are produced in the form of tablets, emulsions, gels, solutions. The average course of treatment is 2-4 weeks. The most effective drugs: Maalox, Phosphalugel, Gaviscon.
Histamine blockers. These are drugs that reduce secretion (production of hydrochloric acid). The course of treatment with tablets is 3-4 weeks. Popular antisecretory agents: Omeprazole, Pantoprazole, Ranitidine.
Prokinetics. Drugs that regulate intestinal motility. Accelerate the passage of feces through the gastrointestinal tract, improve peristalsis, stimulate smooth muscles. The course of treatment with tablets is from several days to several months. Among them are: Itomed, Cerucal, Motilium.
Enzymes for digestion. Normalize the process of splitting proteins, fats, carbohydrates. After ingestion, the process of digestion of food is normalized. The course of treatment is 10-14 days. The best polyenzymatic drugs: Creon, Pancreatin, Mezim.
proton pump inhibitors. The action of the tablets is aimed at reducing the production of gastric juice. Always used in complex therapy with antibacterial drugs. The course of treatment - from several days to several months. The best medicines: Acrylanz, Gastrozol, Omez.

Folk remedies

Chronic duodenitis after consultation with a doctor can be additionally treated with medicinal herbs. Restoring the functions of the duodenum and normalizing digestion will happen quickly if you use the following recipes:

Herbal decoction number 1. Take one part of common tansy, calamus roots and valerian, anise fruits. Pour 0.5 liters of water with 5 g of the collection, boil for 15 minutes over low heat. Let the broth brew for 2 hours, then strain and take 0.5 cup 3 times a day 1 hour before meals for 14 days.
Herbal decoction number 2. Mix equal amounts of centaury herb, calamus and dandelion roots, wormwood. One st. l. collection, boil in 200 ml of water, then let it brew for 20 minutes, strain, apply 1/3 cup 3 times a day. The course of treatment is 2 weeks.
Sea buckthorn oil. Take 500 g of fresh sea buckthorn, wash, dry, mash. Pour crushed berries with 0.5 liters of any vegetable oil, let it brew for a week. Then strain the product, wipe the cake through a sieve, use 1 time per day on an empty stomach, 1 tbsp. l. Treat with sea buckthorn for 2 weeks. After 7 days, therapy can be repeated.

Prevention

It is necessary to follow a number of rules to prevent the occurrence of chronic duodenitis. Each potential patient must:

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Due to pathologies of the gastrointestinal tract, chronic duodenitis may develop. Its occurrence may be associated with bad habits, malnutrition. It also appears with the wrong approach in the treatment of stomach ulcers, duodenal ulcers and gastritis. Chronic duodenitis, unlike the latter, goes beyond the stomach and spreads to the mucosa of the intestine adjacent to it.

Etiology of the disease

Chronic duodenitis occurs due to ineffective treatment of gastrointestinal ailments. Most often it occurs in the representatives of the stronger sex. It can be localized in the duodenal region in the form of papillitis and diverticulitis (local), as well as in the entire intestinal region. In the latter case, they speak of widespread duodenitis. The duodenum is connected to the entire human digestive tract. Due to this, the disease spreads through the gastrointestinal tract, affecting nearby organs.

Classification

There are the following types of chronic duodenitis:

Hyperplastic is observed with a large area of the lesion.
Erosive - with the appearance of small wounds on the intestinal walls.
Interstitial form - the lesion reaches the deep layers of the organ.
Atrophic, on the other hand, is detected in violations of the secretory activity of gastric juice with thinning of the walls of the duodenum.
Superficial duodenitis is manifested when the mucous membrane of the upper parts of the duodenum is damaged.

By variability, this disease is divided into the following types:

With duodenostasis - is a complex form, the treatment of which is carried out during the hospitalization of the patient.
The combination of enteritis, chronic duodenitis and gastritis is a complex treatment, a longer period of flow.
Bulbitis - minor duodenitis of acidopeptic origin, with a clear localization.
Papillitis - develops in a small area, mainly manifests itself as peripapillary diverticulitis.

signs

Symptoms of chronic duodenitis coincide with those of many other gastric ailments. It is characterized by the following features:

nausea and vomiting;
constipation and diarrhea;
bloating and rumbling in the intestines;
mild pain on palpation;
weight loss with persistent or increased appetite;
sleep disturbance;
fast fatiguability;
discomfort in the navel area;
white coating on the tongue with a feeling of bitterness or a metallic taste;
increased irritability;
pain syndromes in the pancreas.

A distinctive symptom is the appearance of heartburn. With an exacerbation of chronic duodenitis, a aching pain syndrome appears, localized in the stomach, which intensifies during fasting and after eating. Pain can also be felt at night.

The disease can exacerbate the following pathologies:

metabolic disorders;
nervous and vegetative exhaustion;
diseases of the digestive organs.

With the local nature of the disease, the following are exacerbated:

dyskinesia of the bile ducts;
cholecystitis;
pancreatitis.

Therefore, duodenitis can be confused with these pathologies. Its external signs are yellowing of the epithelium and subicteric sclera. Symptoms of chronic duodenitis and treatment should be interrelated.

The intensity of pain is determined by impaired motor and secretory functions. If the latter is elevated or normal, then pain syndromes are constantly present. The equivalent symptom of chronic duodenitis in adults is rapid satiety.

Lighter signs are characteristic of a superficial type of pathology. At the same time, the treatment of symptoms of chronic duodenitis is aimed at normalizing the processes of digestion and eliminating irritants. In this form, atrophic phenomena are not observed.

The most painful are the signs of erosive duodenitis. The foci of inflammation are numerous and are located in the intestines and stomach. There are also small sores called erosions. In this case, blood and mucus may be present in the vomit.

Symptoms depending on the variant of the pathology

There are the following clinical forms of duodenitis:

latent;
neurovegetative;
gastritis-like;
pancreatitis-like;
cholecystic;
ulcerative;
mixed.

The latent form is characterized by an asymptomatic course of the disease.

With neuro-vegetative, the following signs are noted:

headache;
general weakness;
increased excitability;
fast fatiguability.

With gastritis-like duodenitis, the following symptoms are characteristic:

prostration;
anorexia;
loss of appetite;
nausea;
belching with a feeling of bitterness;
feeling of heaviness;
bloating;
aching dull pains.

With pancreatitis-like form, the following symptoms are noted:

vomiting, sometimes with bile;
there is a yellow coating on the tongue;
eructation with bitterness;
girdle pain syndromes radiating to the back.

Cholecystic disease is characterized by the following symptoms:

diarrhea alternating with constipation;
nausea;
bitterness in the mouth;
pain syndromes in any hypochondrium, aggravated after eating eggs or fatty foods;
hunger and night pains that subside after eating.

The ulcer-like form is characterized by the following features:

weakness that appears 2-3 hours after eating;
headache;
vegetative-vascular disorders;
violation of appetite, in which its absence is replaced by periods of its hyperincrease;
pain behind the sternum, which may be accompanied by a violation of swallowing;
nausea and vomiting;
heartburn;
constipation;
belching sour;
night pain in the epigastric region;
cramping hungry or aching pains.

With mixed duodenitis, various symptoms are observed from different forms of this disease.

Diagnostics

To prescribe the treatment of chronic duodenitis in adults, symptoms are detected using the following studies:

fibrogastroduodenoscopy and biopsy, which is not performed with phlegmonous duodenitis;
stool analysis;
carrying out pH-metry;
duodenography using a probe.

Secretory secretions of gastric juice may also be examined. With high acidity, the presence of acidopeptic duodenitis can be suspected. If it is accompanied by gastritis and enteritis, then the acidity of gastric juices will be reduced. To assess the condition of the pancreas and liver, a biochemical blood test is performed. Accurate diagnosis is performed using a wide range of tools.

Treatment of chronic duodenitis

It is carried out identically to that in relation to gastritis:

In order to reduce acidity, patients are prescribed H2-blockers of histamine receptors ("Ranitidine").
Drugs to regulate motor function ("Motilium") may be used.
Three-component therapy for one week or a decade to suppress the activity of Helicobacter pylori (Omeprazole, Clarithromycin, Amoxicillin).
In the first days of exacerbation, diet No. 1 is prescribed, subsequently they switch to the fifth table, with remission, a full and balanced diet is shown.
With an exacerbation within a week, bed rest may be prescribed.

Medical therapy and surgery

How to treat chronic duodenitis? In order to determine this, you need to find out the reasons causing it. Treatment of chronic gastritis and duodenitis largely coincides:

antibiotics to fight Helicobacter pylori;
agents that reduce the secretion of hydrochloric acid in the gastrointestinal tract ("Ranisan");
antacids to reduce acidity ("Maalox");
chemotherapy for helminthiasis;
enzymes ("Festal");
coating preparations.

With mucosal atrophy, bismuth preparations ("De-Nol") are prescribed. It may be necessary to normalize the functioning of the nervous system. For this purpose, sedatives are prescribed, as well as herbal remedies. In the secondary form of the disease, which appears against the background of concomitant diseases, the drugs are selected depending on the disease that caused the pathology of the duodenum.

With increased motility of the latter, bile ducts and gallbladder, patients have frequent loose stools and severe pain syndromes. Food is poorly digested. Vomiting may occur. In order to eliminate pain syndromes, injections of analgesics are used:

"Tramal";
"Analgin".

With moderate pain, antispasmodics are prescribed.

The cause of increased motility is a spasm of the smooth muscles of the ducts and intestines. To eliminate it, intramuscular solutions are administered:

"Platifillina";
"Atropine".

In order to improve the absorption of food, antiemetics and enzymes are prescribed ("Bimural", "Cerukal").

In the case of a decrease in the motility of the intestines and biliary tract, stagnation of the contents in the digestive organ and bile occurs. In this case, the absorption of food is disturbed, as well as its transportation to the small intestine. Treatment is aimed at eliminating congestion and improving the contractile function of the digestive organs.

In this case, the following drugs are prescribed:

with constipation - laxatives;
mineral waters and salicylic acid preparations to increase the liquid part of bile;
"Holenzim" and "Allahol" for choleretic action;
enzymes;
"Motilium" - to improve the evacuation of food;
"Duspatalin" - for the selective removal of spasm of the smooth muscles of the ducts and intestines without reducing contractile activity.

The duration of the course of treatment is 1 month.

In the case of the presence of various obstacles, due to which obstruction occurs (mechanical barriers, adhesions), which are not amenable to drug treatment, the symptoms of chronic duodenitis are eliminated by surgical intervention. In this case, complications may occur, manifested in the form of intestinal bleeding, thinning of the walls of this digestive organ, acute pancreatitis. Rehabilitation involves sanatorium treatment of patients.

Folk remedies

They are used in combination with drug therapy. You can use the following treatments:

decoctions of yarrow and chamomile - herbs are poured with hot water and infused for 30 minutes, taken 100 ml 30 minutes before meals;
juice is squeezed out of a crushed fresh aloe leaf, the intake is carried out every hour before a meal, 1/2 tsp;
in the same dose and at the same time take honey;
to reduce the viscosity of bile and stimulate the emptying of the gallbladder, a decoction of corn stigmas is taken, which is prepared in the same way as the first decoction.

Diet for chronic duodenitis

You can reduce inflammation with the help of a properly selected diet. At the same time, food intake during the day should be fractional (5-6 times a day), it should be crushed. The diet for chronic duodenitis in adults depends on concomitant diseases and the form of duodenitis.

The following foods should be excluded:

strong tea, coffee, too hot and cold drinks;
garlic and onions;
mustard, pepper and other spicy spices;
alcohol;
ice cream;
smoked meat;
canned food.

The diet includes the following dishes:

rosehip decoction;
fruit and vegetable diluted juices;
tea with milk;
boiled fish and chicken;
lean meat;
cheese, milk, cottage cheese, sour cream;
fruits that do not contain a lot of acid, it is better to eat them baked;
vegetable puree from beets, carrots, zucchini, potatoes, pumpkins;
they are in the form of soups cooked in broth from low-fat fish or meat;
milk soups.

With an ulcerative form or a combination of duodenitis with chronic enteritis, diet No. 1 is prescribed, if the underlying disease is accompanied by gastritis with secretory insufficiency - diet No. 2, with concomitant pathologies of the biliary tract and liver - diet No. 5, with pancreatitis-like duodenitis - diet No. 5l.

Prevention and prognosis

Gastroduodenitis has a favorable prognosis, subject to the recommendations of a gastroenterologist on the use of a certain diet and a healthy lifestyle. If the full course of treatment is not completed and the diet is not followed, chronic gastroduodenitis can turn into a stomach ulcer. In this case, more serious complications and worsening of the patient's condition will be noted.

Finally

Chronic duodenitis is a disease that occurs against the background of untreated gastrointestinal pathologies or may be associated with malnutrition and bad habits. It has its own forms, each of which is characterized by its inherent features. The disease can be misdiagnosed due to the similarity of symptoms with other pathologies of the gastrointestinal tract, however, drug treatment is in many ways similar to that in relation to gastritis. In this case, you can combine conservative treatment with folk remedies. It is also necessary to follow a diet, the number of which is determined by the doctor. With ulcerative duodenitis, the most stringent first diet is used. Basically, the fifth number is used.

Inflammatory processes occurring in the mucous membrane of the duodenum are called duodenitis. The disease often develops against the background of gastritis, cholecystitis, pancreatitis, and can also develop into a chronic form, which is fraught with serious complications: bleeding, ruptures in the intestinal walls.

The duodenum receives food partially processed by the stomach. The task of the small intestine is to prepare the incoming mass for absorption. The organ itself actively works, contracting and relaxing, and uses the help of pancreatic enzymes.

Here, the primary absorption of elements occurs, and some hormones are produced that stimulate the activity of the entire human digestive system.

Small bowel problems may be associated with:

incorrect location of the organ;
a low level of hormone production that would protect the mucosa from the effects of acidic gastric juice;
eating disorders: eating a large number of salty, spicy and fatty foods;
abuse of alcoholic beverages, coffee and tobacco;
poisoning or infection of the body;
weak peristalsis and various disturbances in the movement of food through the digestive system;
intestinal injury.

Bacteria that cause gastritis and stomach ulcers (Helicobacter Pylori), and roundworms that poison the human intestines with their waste products, giardia, diseases of the gallbladder, liver, and pancreas can also contribute to the development of the disease.

The acute form of this pathology is short-term and after treatment does not leave behind any unpleasant consequences. In most cases, the disease is diagnosed only in the chronic stage, when inflammatory foci grow, the structure of the intestinal mucosa changes.

Classification of chronic duodenitis

By origin, there are primary (associated with malnutrition, smoking) and secondary (developing against the background of existing inflammation) stages.

According to the degree of transformation of the intestinal structure:

superficial - capturing the upper sections of the mucous membrane of the small intestine;
interstitial - not affecting the glands;
atrophic - with a significant thinning of the protective shell.

Symptoms of the inflammatory process

The defining symptom of this disease is pain. Pain can take on a different character and localization.

The ulcer-like form is characterized by pronounced pain in the stomach, which occurs on an empty stomach or during the night and is relieved by eating. Heartburn and belching with a bitter taste are not excluded.
Gastritis-like is distinguished by pain that appears within half an hour after eating, attacks of pain twist the entire central part of the abdomen or its right side; dyspeptic disorders - rumbling, increased flatulence, bloating, nausea, bitter belching, vomiting with bile, diarrhea. The patient's appetite decreases.
Cholecyst-like and pancreatic-like occur against the background of acute pain in the hypochondrium, there are signs of dyspepsia.
Neuro-vegetative develops with atrophic duodenitis. Painful symptoms may be absent, but the person quickly gets tired, weakens and suffers from headaches.
When asymptomatic, inflammation is diagnosed incidentally during studies for the presence of other pathologies. It is especially common in older people.
Mixed includes various signs.

Symptoms of disturbances in the functioning of the gallbladder appear with the local development of pathology: girdle pains in the lower umbilical region also radiate to the hypochondrium, due to an increase in the bile pigment in the blood, the skin acquires a yellowish tint, the stool brightens.

In addition to the above symptoms, they also manifest themselves:

loss of appetite, up to a complete refusal of food;
exacerbation of uncomfortable sensations in spring and autumn;
a slight increase in body temperature;
long-lasting hiccups;
rapid pulse;
the presence of blood particles in the stool.

With a prolonged course of the disease, the mucous membrane of the duodenum becomes thinner, its absorption function is disturbed. In addition, epithelial cells cease to produce enough enzymes, as a result of which both the digestive system and the entire body as a whole suffer: negative consequences can even affect the central nervous system.

Diagnostic measures

To visit a doctor, you need to prepare with all seriousness. After all, the symptoms of duodenitis resemble signs of other diseases of the gastrointestinal tract. To exclude other pathologies and correctly establish the diagnosis, the doctor must clarify all the points regarding the course of your illness:

Get ready to answer the questions: have you or your immediate family suffered from diseases of the digestive system (gastritis, ulcers, and so on); what is the nature of the pain syndrome, when exactly and how often does it occur and whether its appearance is associated with meals; whether heartburn or belching torments; whether the consistency of the stool has changed recently.
During examination and palpation, try to determine the place that is especially sensitive to pressure;
Be attentive to the collection of material for analysis (feces, urine, blood), follow the preliminary recommendations. You will be prescribed general urine and blood tests, a biochemical blood test, a coprogram, and if bleeding is suspected, a stool test for blood;
Responsibly approach instrumental studies, pay attention to preliminary preparation: ultrasound and computed tomography of the abdominal organs, EFGDS, a test for the pH balance of gastric juice, colonoscopy, radiography of the stomach and small intestine using a contrast agent.

How to treat duodenitis

After the diagnosis is made, treatment is prescribed depending on the causes that led to the development of the disease.

Medical therapy

indicated for the detection of bacteria Helicobacter pylori (the fight is carried out with the help of antibiotics), Giardia (antimicrobial drugs are used); when prescribing antibiotics, I will also prescribe agents that normalize the intestinal microflora;
anthelmintic drugs are prescribed to destroy worms;
protection of the mucous membrane of the small intestine is carried out with the help of drugs that reduce the acidity of gastric juice, and gastroprotectors;
in order to restore normal digestion, enzymes are recommended;
with severe pain syndromes, drugs are prescribed that relieve acute pain and spasms.

If obstruction of the small intestine associated with a functional disorder of the gastrointestinal tract is detected, the therapy will be conservative in nature: it is necessary to adhere to a diet, eat often in small portions.

Of the drugs recommended are those that contribute to better intestinal motility, while at the same time preventing the active secretion of bile. One of the effective methods is the examination of the duodenum with a special probe and washing the organ.

In the case of blockage of the intestine, in the event of various kinds of mechanical obstructions, and also in the case when the cure of functional obstruction by traditional methods is not observed, surgical intervention may be necessary.

Treatment of acute duodenitis

The acute form, first of all, requires adherence to the regimen. When all the recommendations are followed, the disease recedes within a few days. The main thing is to prevent a relapse, otherwise the disease can go into a chronic stage.

in the first two days you will have to starve;
in some cases, gastric lavage is prescribed with a small amount of potassium permanganate (potassium permanganate) diluted in water, after which it is necessary to clean the intestines (to prepare a solution for a glass of water, use a 25-gram bag of magnesium sulfate);
from day 3, food is resumed, but foods that irritate the mucous membrane (sour and spicy, too hot and cold dishes) and poorly digestible (dairy products, roughage, cereals) are excluded from the diet; food is best steamed, but you can also boil it, chop well (wipe or puree) before use;
coating drugs are recommended to protect the walls of the duodenum;
with severe pain syndrome - painkillers and antispasmodics.

Diet

One of the most important factors in the successful treatment of both acute and chronic forms of pathology is proper nutrition:

in the first one and a half to two weeks, the diet should be as light as possible, so everything spicy, sour, salty, as well as fried and smoked is prohibited. Food should not burn and, conversely, be too cold. Alcoholic beverages and canned food will also have to be abandoned;
you should eat often, but little by little, steamed or water-cooked foods. It is better to eat all food in a mushy state;
the diet includes liquid cereals with water and low-fat milk, weak chicken broths, dishes from low-fat meats and fish, dried white bread, oatmeal, rice or semolina soups that have an enveloping effect, steamed vegetables, soft-boiled eggs (maximum 2-3 per day), jelly, dairy and sour-milk products, weak tea;
for a long period, canned food, fresh pastries and especially muffins, legumes, sweets, soda, coarse cereals (millet, pearl barley), fatty meats and fish, as well as fatty milk are contraindicated. Get in the habit of not frying anything, especially in the same oil, and don't go overboard with seasonings and salt.

These nutritional basics will help your intestines recover and perform all their functions again. But we must understand that, most likely, the diet will have to be followed all my life, making it more strict during periods of exacerbation of the disease.

Talk to your doctor about adding new foods to your diet.

Traditional medicine

Herbal teas and decoctions will maintain the necessary balance during the remission period, supplement the diet with vitamins and trace elements, however, before applying these or those folk tips in practice, do not forget to consult a doctor.

St. John's wort. For one glass of boiling water, take two tablespoons of dry grass, simmer in a water bath for about half an hour. Do not bring to a boil! Let the broth brew for 15 minutes, then strain. Drink one glass a day, dividing it into 3 doses (before meals).
Oatmeal jelly. A glass of oats (cereals) is used per liter of water. Oats can be steamed in a thermos or boiled like porridge until mucus is released. Strain the mucus and take it without fail on an empty stomach, as well as 2-3 times during the day before meals.
Plantain. For half a liter of boiling water, take 50 grams of plantain. Insist for half an hour, take half a glass before meals.
Chicory. Dry the root of the plant, grind, pour 200-250 ml of boiling water. The recommended intake is half an hour before meals, 4 times a day.

Prevention of duodenitis

The main preventive measures to prevent the disease are:

balanced diet. Your diet should also include all the necessary vitamins. Beware of overeating and long intervals between meals!
giving up bad habits: booze, cigarettes, useless snacks in the form of chips, spicy, salty or fatty sandwiches, carbonated drinks;
timely detection of diseases of the digestive tract, taking medication strictly as directed!
regular visits to the doctor for examination, spa treatment.

A pathology noticed in time will not cause you serious inconvenience, of course, provided that you adhere to the prescribed therapeutic measures. Take care of yourself and be healthy!

Duodenitis- an inflammatory disease that is localized in the area. The features of the clinical picture of the disease differ depending on which part of the organ the pathological process develops. By the presence of specific symptoms, it is necessary to assume the presence of a pathological process and consult a specialist.

There are several classifications of duodenitis.

With the flow

Depending on the speed of development of the pathology, the characteristics of the progression of the disease, acute and chronic duodenitis are distinguished.

The acute form of the disease, in turn, is divided into the following types:

Catarrhal duodenitis. Pathology is characterized by the development of an inflammatory process, which is manifested by swelling of the intestinal wall.
Ulcerative duodenitis. In the pathomorphological picture of the pathology, ulcerative lesions of the mucosa of the organ predominate.
Phlegmonous duodenitis. The most severe form of the disease, which is characterized by the appearance of purulent inflammation in the intestinal wall.

Chronic duodenitis is divided into primary and secondary. The primary form of the disease occurs in isolation, without any previous changes. Secondary duodenitis develops against the background of other diseases of the digestive tract and is considered their complication.

By localization

In another classification, the forms of the disease are distinguished by the localization of pathological changes:

local duodenitis. A strictly delimited lesion is formed.
Diffuse duodenitis. Inflammation spreads over the entire area of the duodenum.
Bulbar duodenitis. Pathology is localized in the area of the duodenum.
Postbulbar duodenitis. Inflammation occurs in more distant parts of the organ.

Depth of structural changes

Depending on the characteristics of structural changes in the wall of the organ, the following forms are distinguished:

surface form. Changes affect only the uppermost layer of the intestinal wall.
interstitial form. The lesion reaches the deep layers of the organ.
atrophic form. It is characterized by deep disorders that lead to thinning of the intestinal wall and disruption of its functional activity.

Separately, there are also special forms of diseases that occur against the background of some specific infections. These include fungal, tuberculous, immunodeficient types of duodenitis.

Symptoms

Acute course

chronic course

constant pressing or aching pain in the epigastric region;
after eating, there is a feeling of fullness, heaviness in the upper sections of the abdominal wall;
loss of appetite, weight loss;
constant heartburn, belching sour;
nausea and vomiting may occur, but less frequently than in the acute form of the disease;
common symptoms are weakness, irritability, lethargy, headaches and dizziness.

Causes and risk factors

Diagnostics

Treatment

Treatment of duodenitis should be complex. It includes general measures, primarily nutritional advice, and specific drug therapy.

Diet

In the treatment of duodenitis, the patient's nutrition should comply with the following principles:

Medical treatment

For the treatment of duodenitis, the following groups of drugs are used:

In severe phlegmonous form of duodenitis, which is accompanied by intestinal destruction, surgical treatment is possible. It involves the surgical removal of the affected fragment, the imposition of an anastomosis on the ends of the intestine and massive antibiotic therapy to prevent the recurrence of the disease.

Possible consequences and prognosis for life

With timely detection and rational treatment of the disease, the prognosis for life is favorable. In most cases, a complete remission occurs and the patient's quality of life is restored.

In severe pathology and phlegmonous forms, complications may occur. In extremely rare cases, phlegmonous duodenitis can be complicated by inflammation of the peritoneum.

If left untreated, this condition can be fatal.

Prevention

Duodenitis of the stomach, what is it? Symptoms and treatment in adults

Duodenitis is an inflammation of the mucous membrane of the duodenum. The course of the disease can be acute or chronic. Depending on the area of the pathological process, widespread and limited duodenitis is distinguished.

With lesions of the upper sections, the symptoms of the disease resemble stomach ulcers, and duodenitis of the lower sections causes symptoms similar to pancreatitis or cholecystitis. The disease is accompanied by general weakness, pain in the stomach, heartburn, belching, nausea, and vomiting.

Acute duodenitis with a sparing diet (sometimes fasting) usually ends in a few days. Repeated diseases become chronic, complicated by intestinal bleeding, perforation of the intestinal wall, and the development of acute pancreatitis.

What it is?

Duodenitis is an inflammatory process in the mucous membrane of the duodenum (duodenum), causing structural changes in the mucous membrane, and leading to functional disorders of the organ. According to statistics, more than 10% of the population experienced the symptoms of duodenitis - this is the most common pathology of the initial small intestine.

Acute duodenitis

A prerequisite for the rapid development of acute duodenitis is poisoning, or a love for oriental spicy dishes. Against their background, inflammatory reactions on the mucous surface of the duodenum provoke the formation of ulcerative and erosive foci, sometimes ulcerative cavities filled with pus (phlegmon) form on the surface layer of the intestine.

Symptoms of duodenitis in adults at the stage of acute course are manifested:

Acute pain in the stomach area;
indigestion;
Vomiting, nausea and weakness.

The development of an acute process almost always provokes inflammatory reactions in the intestine or stomach. Often this is diagnosed as gastric duodenitis, which is fundamentally wrong, inflammation of the mucous membrane of the stomach cavity has its own name - gastritis.

A provocative role that contributes to the development of pathological reactions of inflammation in the mucous structure of the duodenum is played by a violation of mobility or peristalsis, which makes it difficult to move the thickened contents of the small intestine to the outlet (duodenostasis). If the treatment is properly selected and the patient follows a sparing diet, the inflammatory process in the duodenum stops quite quickly. But, in case of repeated inflammation of the intestinal walls, the stage of the chronic course of the disease develops.

Chronic duodenitis

Chronic duodenitis can be primary and secondary. Primary chronic duodenitis occurs with malnutrition (eating spicy, irritating, hot food, alcohol), smoking. Secondary chronic duodenitis is more common - it develops against the background of already existing inflammatory diseases, for example, chronic gastritis; duodenal ulcer; improper treatment of acute duodenitis.

According to the degree of structural changes, several variants of chronic duodenitis are distinguished:

atrophic (thinning of the mucous membrane of the duodenum with the extinction of its secretory function);
superficial (the inflammatory process captures only the upper layers of the mucous membrane);
hyperplastic (with excessive tissue growth);
interstitial (without damage to the glands); erosive-ulcerative (characterized by the appearance of small erosions and ulcers on the mucosa).

Symptoms of chronic duodenitis

heartburn,
burp,
a feeling of fullness in the upper abdomen ("in the pit of the stomach"),
decreased appetite,
sometimes nausea or vomiting with bile,
constipation.

Periods of exacerbation - constant pain in the stomach, aggravated by fasting or 1.5-2 hours after eating. There are night pains. Some patients complain of headaches, weakness, irritability, shortness of breath and palpitations, which are associated with a violation of the hormonal function of the duodenum.

How to treat?

Treatment of chronic duodenitis during periods of exacerbation of the disease is carried out in a hospital. Treatment is prescribed depending on the cause that provoked the disease.

When a Helicobacter pylori infection is detected, antibiotics are used.
In the presence of giardiasis and helminthiases, appropriate chemotherapy is prescribed (flagyl, furazolidone, chloxin).
To protect the mucosa, enveloping preparations (de-nol, sulfacrat) are prescribed. For anti-inflammatory purposes, it is recommended to use decoctions of chamomile and yarrow. Enzyme preparations are prescribed to restore digestion.
With increased acidity - drugs that reduce the secretion of hydrochloric acid (omeprazole, ranitidine) and antacids that neutralize the acidity of gastric juice (almagel, maalox, phosphalugel).

If the cause of duodenitis was a violation of the motility of the duodenum (duodenostasis), for example, obstruction, it is necessary to establish its cause. If it is associated with a violation of any functions of the digestive system, the treatment of duodenitis is conservative. Frequent meals in small portions are shown, drugs that bind bile and promote its secretion (choleretic). Effectively duodenal sounding with washing of the duodenum.

In the presence of adhesions, mechanical obstructions and other kinds of obstruction that is not amenable to therapeutic treatment, surgical treatment of duodenitis is indicated. With secondary duodenitis, treatment of the underlying disease is necessary.

Symptoms of duodenitis

Duodenitis in adults can begin both suddenly and gradually. Often it manifests itself after some kind of dietary excess, alcohol consumption, stress. Duodenitis is usually difficult to distinguish from other ailments of the digestive system.

After all, duodenitis is characterized by the same clinical symptoms as for most other gastroenterological ailments:

signs of gastric dyspepsia (heaviness, burning or discomfort in the epigastric zone; belching, nausea, bloating);
pains (weak or very intense pains are associated with the type and time of eating, occur in the upper areas of the abdomen: the epigastric zone, hypochondria);
psycho-emotional disorders (unmotivated irritability, tearfulness, rapid emotional exhaustion, etc.);
stool problems (chronic diarrhea or systematic constipation, their alternation).

Depending on the combination of symptoms, duodenitis may have the following clinical forms:

asymptomatic (established in the case of the complete absence of clinical manifestations, common among elderly patients);
cholecystic (pain similar to biliary colic, a feeling of bitterness in the mouth, vomiting of bile);
gastritis-like (pain occurs after eating, they are often accompanied by the phenomena of gastric dyspepsia);
neurovegetative (sweating, episodes of lightheadedness and weakness, palpitations, etc.);
pancreatic-like (patients have pain mainly in the left hypochondrium, “girdle” pains, diarrhea, vomiting can be observed);
mixed (with this form, patients show signs of various other forms of duodenitis);
ulcer-like (the most common variant, "night" and "hungry" pains in the upper abdomen are extremely reminiscent of those characteristic of peptic ulcer, they are combined with sour belching and persistent constipation).

Diagnostics

The clinical picture of duodenitis is diverse and non-specific, in addition, isolated duodenitis is very rare, as a rule, it is combined with other diseases (chronic gastritis, peptic ulcer, enteritis, pancreatitis, diseases of the biliary tract). Therefore, reliable diagnosis of chronic duodenitis is possible only with the help of instrumental research methods, such as:

fibrogastroduodenoscopy with biopsy;
duodenoscopy;
pH-metry;
floor manometry;
impedancemetry.

In parallel with the diagnosis of duodenitis, it is necessary to conduct a study of the digestive organs associated with the duodenum.

Complications

In case of untimely seeking medical help or non-compliance with the diet for chronic duodenitis, complications such as:

ulcer of the duodenal bulb, including complicated by bleeding,
adhesive small intestinal obstruction due to the growth of connective tissue at the site of constant inflammation on the mucous membrane and in submucosal structures,
malabsorption of nutrients (malabsorption), leading to weight loss, unstable stools, impaired activity and dystrophy of internal organs.

Prevention of the development of complications is the treatment started on time and compliance with the recommendations of the attending physician.

Treatment of duodenitis

In adults, the treatment of duodenitis includes several areas:

elimination of acute inflammation;
preventing the transition of the disease to the chronic stage;
restoration of functions of the duodenum;
normalization of digestion.

Indications for hospitalization for duodenitis:

exacerbation of duodenitis;
suspected tumor of the small intestine;
severe general condition of the patient, advanced cases of the disease;
inflammation of the serous cover of the duodenum 12 (periduodenitis) and nearby organs;
the presence or threat of bleeding (erosive or ulcerative form of duodenitis).

Mostly treatment is carried out at home. For a speedy recovery, proper sleep, rest, diet, walks, light physical activity in the absence of pain are necessary. It is necessary to avoid stress, quit smoking and alcohol. Such measures help to normalize blood circulation in the duodenum, restore the protective properties of its mucosa.

Medical therapy

Treatment of duodenitis in adults includes the appointment of the following groups of drugs:

antibiotics that are recommended to be taken when Helicobacter pylori bacteria are detected;
proton pump inhibitors that block the glands that are responsible for the secretion of hydrochloric acid (for example, omeprazole);
antacids that have an enveloping and local anesthetic effect, since they neutralize hydrochloric acid (Almagel, Maalox);
H2-histamine blockers used in the presence of ulcer-like duodenitis; drugs from this group suppress the production of hydrochloric acid (Ranitidine, Famotidine);
polyenzymatic preparations that promote the assimilation of food and normalize digestion;
prokinetics prescribed when gastritis-like duodenitis is diagnosed; they affect intestinal motility, have an antiemetic effect;
antispasmodics that relieve intestinal spasm and eliminate pain.

An individual scheme of pharmacological therapy is selected for each patient, depending on the form and clinical features of the disease.

Diet for duodenitis

Proper nutrition plays a key role in the treatment of duodenitis. In acute inflammation or exacerbation of chronic duodenitis, the first 3-5 days, you must adhere to a strict diet 1A. Its basis is mucous decoctions from cereals (rice, oatmeal), pureed soups, liquid milk porridges (semolina, from buckwheat flour) and baby food. Chicken or low-fat fish (perch) in the form of mashed potatoes or steam soufflé is allowed once a day. Fractional nutrition: 6 times a day, in small portions.

ulcer-like duodenitis - diet number 1;
gastritis-like duodenitis (with reduced gastric secretion) - diet No. 2;
cholecysto- and pancreatitis-like duodenitis diet - No. 5.

When signs of duodenitis appear, one should not self-medicate with various folk remedies, which can only be additional methods of therapy. Otherwise, severe complications are possible in the form of intestinal bleeding, malabsorption syndrome, peptic ulcer or intestinal obstruction. It is important to remember that duodenitis is a disease that responds well to traditional treatment, so it is important to consult a doctor in time.

Forecast

The prognosis for acute and chronic forms of the disease is favorable. Complete recovery after acute duodenitis almost always occurs if factors that irritate the duodenal mucosa are excluded.

If the patient develops complications, the prognosis for life remains favorable, but for health it is doubtful due to impaired function of the internal organs. In some cases, in the presence of cicatricial lesions of the intestinal bulb, with frequent exacerbations of peptic ulcer (3-4 times a year or more), with a decrease in body weight by more than 15%, anemia and other laboratory abnormalities, dystrophy, and also, if necessary, surgical treatment, the patient may be assigned a disability.