The most common disease of the duodenum - a duodenitis.
Duodenitis - an inflammatory disease of the mucous membrane of dystrophic duodenum. Thus there is a restructuring of the elements of the intestinal mucosa, the gradual atrophy of the glandular apparatus of the duodenum.
Acute duodenitis is uncommon, usually the process is chronic. There are primary chronic duodenitis, when the inflammatory process in the duodenum is a distinct disease, and secondary chronic duodenitis. In this case, duodenitis accompanies other diseases of the digestive system: gastritis, peptic ulcer disease, pancreatitis, cholecystitis, etc.
The inflammatory process may spread to the entire colon, then called the diffuse duodenitis. If the inflammatory process involves the duodenal bulb (Potatoes), a large papilla, through which the duct enters the duodenum from the gall bladder (papillitis), or nearest to the bowels of the duodenum - duodenitis considered local.
The primary chronic duodenitis is uncommon. The reasons for it are eating disorders treatment (irregular meals, eating spicy, acidic foods, lack of prozhevyvanie food, spirits, strong passion for coffee or tea). Under the influence of irritating foods increases the acidity of gastric juice and its damaging effect on the mucous membrane of the duodenum. Occasionally, primary chronic duodenitis develops after acute duodenitis. A factor contributing to the development of chronic duodenitis is smoking. Under the influence of substances found in tobacco smoke stimulated the secretion of gastric juice secretion and inhibits production of the duodenum, which has an alkaline reaction.
The mechanism of duodenitis is not fully understood. It is assumed that there is an infringement of aggression relationship factors, which include hydrochloric acid, enzymes, gastric juices, and protective factors, the formation of the alkaline environment of the duodenum, a good reducing ability of cells.
Secondary chronic duodenitis occurs much more frequently. It is believed that the main causes of secondary chronic duodenitis is H. pylori infection, duodenal ulcer, chronic gastritis, pancreatitis, cholecystitis, colitis. Secondary chronic duodenitis may occur in allergic diseases, the presence of worms in the intestine or biliary tract, diseases of other organs, accompanied by circulatory disturbance of the duodenum.
In the presence of H. pylori infection and the inflammatory process begins hroniziruetsya due to the damaging effect of Helicobacter pylori. Chronic liver disease and pancreatic cancer are accompanied by an imbalance of enzymes, their aggressive action on the mucous membrane of the duodenum. The inflammatory process may involve only the upper layers of the mucosa (superficial duodenitis). In this case, the mucous membrane swells. The upper layers of cells of the mucous thinner, disturbed nutrition of cells.
In the diffuse duodenitis degenerative processes apply to the entire thickness of the mucosa and invade cancer of the duodenum. In this secretory function can be improved.
Atrophic duodenitis is characterized by thinning of the intestinal mucosa and the extinction of its secretory function.
Sometimes there is and erosive duodenitis, which in the intestinal mucosa appear minor erosion.
Variants of the clinical course of duodenitis describe how yazvennopodobny, gastritopodobny, holetsistitopodobny, pankreatitopodobny mixed. In addition, duodenitis can flow seamlessly to the patient and do not show complaints, then it is called latency.
Patients with chronic duodenitis complain of pain of various kinds in the epigastric region. Pain may be aching, stabbing, cramping. Sometimes the pain may be given to the navel. Typically, these pains occur on an empty stomach or after 1-1.5 hours after ingestion. Most often, the pain better after eating or antacids. Sometimes you may receive a feeling of heaviness in the epigastric region.
Duodenitis upper duodenum may resemble stomach ulcer. The defeat of the lower parts give the complaints similar to cholecystitis or pancreatitis. Less commonly, patients vomiting, belching or heartburn frequently. Sometimes patients are concerned a sudden feeling of hunger. Often accompanied by signs duodenitis of the autonomic nervous system, weakness, sweating, dizziness, which occur 2-3 hours after ingestion. On examination, reveal furred tongue, pain in the epigastric region and under the xiphoid process.
The diagnosis of duodenitis set by fluoroscopic examination of the stomach and duodenum, fibrogastroduodenoscopy. We study the secretory function of gastric and duodenal ulcers, duodenal intubation.
Treatment of chronic duodenitis.
First of all assigned diet. In the period of acute assigned mechanical, thermal and chemical schazheniya mucosa. Nutrition should be a fraction 5-6 times a day. Medical treatment includes the appointment of antacids, which reduce the secretion of hydrochloric acid, drugs enhancing the regeneration of cells of the duodenum, drugs regulating the motility of the gastrointestinal tract. Must be appointed and recommended physiotherapy spa treatment.
