Ulcer of duodenal bulb: description, causes, symptoms and features of treatment

Ulceration of the bulb of the duodenum (ICD 10: K26) is a fairly common disease, diagnosed already in advanced stages. This is because people are accustomed to any uncomfortable sensations in the stomach attributed to stale food or a violation of the diet. A person suffers pain, drowns out her medicines, and meanwhile the disease progresses. To a doctor, such a sick person will fall when he ignores his organism and becomes unbearable.

Epidemiology

Ulceration of the bulb of the duodenum, as a rule, is secondary to the lesion of the gastric mucosa. Therefore, the diagnosis is usually written "stomach and duodenal ulcer", without specifying the localization.

About 5% of all people on Earth have this pathology. In men, it occurs four times more often than the fair sex. And the ratio of townspeople and rural residents is about 2 to 1. Most likely, this is due to the quality of food, food habits and work activities of residents of urbanized areas.

Causes

Ulceration of the bulb of the duodenum arises from the corrosive action of hydrochloric acid (which is part of the digestive juice) on the mucosa of the small intestine. There are several reasons for increasing acidity:

• Excessive release of gastrin (a hormone regulating digestion);

• Enthusiasm for acute, bitter, salty, sour, fried and fatty foods;

• Insufficient food intake during the day and overeating in the evenings;

• Long-term use of hormonal or anti-inflammatory drugs;

• Regular exposure to stress;

• Smoking and drinking alcohol, especially on an empty stomach.

In rare cases, the appearance of erosions and ulcers in the duodenum may be associated with an increase in the level of calcium in the body, a decrease in liver and kidney function, and chronic obstructive pulmonary diseases.

Pathogenesis

Ulceration of the bulb of the duodenum is manifested by a wave-like course with alternations of remission and exacerbation. Three stages are conventionally distinguished:

• Acute course (symptoms are pronounced, there are ulcers and erosions on the mucous membrane);

• Attenuation of the process (no complaints, sores are scarred);

• Remission (symptoms are absent, scars are epithelialized).

The main role in the appearance of an ulcer is the violation of acid-base balance on the intestinal mucosa. If hydrochloric acid is formed more than alkali, it does not completely neutralize and damages surrounding tissues. Cells break down, release enzymes and increase damage. This area of the mucosa forms inflammation, which is intensified with each new portion of chyme. In addition, an increase in peristalsis and an increase in the number of secretory cells in the stomach allows the secretion of the acid even outside food intake.

Symptoms

How does the ulcer of the bulb of the duodenum manifest itself? Symptoms and treatment of it are closely related, so it is important to understand which syndrome prevails. Clinical phenomena are very intense and cause the patient a lot of inconvenience.

The very first and main sign is pain in the peripodal region. It can be both acute and aching, it all depends on the quantity and quality of meals. In addition, at first it is easy to get rid of it by drinking antacids. Sometimes the pain can return at night and irradiate in the lower back.

Every ulcer knows: to get rid of nausea, belching or pain you just need a snack. It is desirable something like a jelly. But this remedy is not universal, because vomiting can come back after eating, "bringing" with itself as a "bonus" heartburn and a feeling of heaviness. Periodically, these people suffer from disorders of the stool in the form of constipation and flatulence.

Complications

Acute ulcer of the bulb of the duodenum is a life-threatening and health-threatening disease. In severe cases, severe bleeding, perforation of the intestinal wall and the formation of sepsis are possible.

The ulcer can not only erode the wall of the hollow organ, but also seep into the neighboring organ. For example, from the bulb of the duodenum, the pathological process passes to the pancreas, forming fistulas and abscesses.

Chronic complications include stenosis (narrowing) of the intestinal tract. This makes it difficult to pass food, provokes her stagnation and putrefaction in the stomach. In humans, this is manifested by a feeling of heaviness, weakness, pallor, exhaustion, lack of appetite. In some cases, there may be vomiting with pieces of undigested food, eaten a few days ago.

Diagnostics

Ulcers of the duodenal bulb are diagnosed quite easily, given that patients seek help from a doctor already at the height of the disease, when discomfort prevents them from living normally.

First, the doctor collects an anamnesis and conducts an examination. Of course, the palpation of the abdomen does not give high information, but it is possible to suspect, with a high degree of probability, an ulcerative process is possible. Then the patient goes to take a blood test, biochemical markers, feces analysis for latent blood, and also determine the level of gastrin and activity Helicobacter pylori.

The most common diagnostic procedure is esophagogastroduodenoscopy, or, more simply, EGDS. It allows to examine the mucous membrane of the digestive tube, to cauterize all the ulcers revealed, to take tissues and fluids for examination. Informative is also radiography. In pictures with contrast, ulcers and the condition of the stomach and duodenal ulcers will be clearly visible.

Treatment of duodenal bulb ulcers

First of all, you need to prepare yourself for the fact that this is a long and laborious process, consisting of a diet, physiotherapy and taking medications. Do not be afraid, all this must be done not at the same time, but according to a clearly developed plan and consulting with a doctor.

To begin with, the gastroenterologist determines the cause that caused the ulcer and directs all forces to get rid of it. For this, there is drug therapy. These include antacids, prokinetics, proton pump inhibitors, and many other pharmacological miracles. In addition, light sedatives and hypnotics can help in the fight against a stress ulcer, but they should be used with caution. Against Helicobacter pylori excellent antibiotics penicillin series and macrolides.

At the stage of recovery to maintain the body's strength, the patient is shown balneological procedures, novocaine electrophoresis and warming.

Folk remedies

Treatment of ulcers of the bulb of the duodenum with folk remedies is fraught with unpleasant consequences for health. Therefore, before starting this kind of experiments, tell your doctor. He will be grateful to you for this.

On the Internet, as well as our grandmothers have many recipes for the treatment of ulcers. In order to reduce acidity and increase the resistance of the mucosa, people drink fresh potato juice, a mixture of honey and butter or simply dissolve honey in warm water and eat before eating. There are also more exotic recipes, for example, the use of oil from the sea buckthorn bones on a teaspoon before each meal.

All these methods can remove uncomfortable phenomena, some even contribute to the healing of ulcers, but still the preference should be given to traditional methods of treatment.

Diet with ulcer of the bulb of the duodenum

During periods of exacerbation of the disease, patients must adhere to a sufficiently strict diet, which will help reduce the intensity of pain, and speed up recovery. Some tips for a similar diet:

1. Fractional meals every 3 hours in small portions.

2. Eat slowly, chewing food carefully.

3. Food should be warm, so as not to irritate an already sensitive bowel.

4. The selected products should not stimulate additional production of hydrochloric acid, so nothing fried, spicy, salty, pickled and spicy.

From some delicacies and pickles, you may have to give up for life. But milk, fruits, mashed potatoes and kissels, steamed vegetables and eggs can be eaten in unlimited quantities.