Erosion of the duodenum: symptoms, methods of treatment

Erosion is damage on the inside of the intestinal wall, which can be small or involve all of the mucous membrane. This pathological process occurs for various reasons and almost always causes considerable discomfort to its wearer. Fortunately, in most cases, erosion can be cured without leaving a trace.

The prevalence of the disease is very high. Throughout his life, almost every person, at any age, meets with him. The inflammation does not affect the muscle layers and does not lead to perforation, but without treatment it can develop into an ulcer.

The disease is not as well understood as a stomach ulcer, because without a phonendoscope it was difficult to diagnose it, and the symptoms are similar to an ulcer. And if in the last century doctors did not see any other way out than surgery, today it is quite possible to do without it. New techniques allow you to quickly make a correct diagnosis.

The reasons for the development of pathology

The stomach and duodenum (Duodenum) are constantly at work and are influenced by a variety of factors. Doctors identify several main reasons that contribute to the development of a destructive process.

1. Reproduction on the mucous membrane of Helicobacter pylori bacteria that have entered the body.
   

   Helicobacter pylori is the main cause of mucosal lesions

2. Eating disorder. Eating potentially hazardous foods. Lack of food intake.
3. Taking medications not agreed with the doctor, or erroneous treatment.
   

   Taking medications must be agreed with the doctor.

4. Nervous strain.

Some drugs are potentially dangerous. To clarify the diagnosis, their history must be mentioned.

1. Aspirin (acetylsalicylic acid), which older people take to prevent strokes and thrombosis.
   

   Long-term use of aspirin has an irritating effect on the mucous membrane and often leads to erosion.

2. Non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen, Ketoprofen).
   

   Diclofenac and other NSAIDs also have a negative effect on the mucous membrane.

3. Antibiotics (uncontrolled intake of which is always dangerous).
   

   Antibiotics when taken uncontrolled are dangerous for the gastrointestinal tract

In the human body, everything is so interconnected and interdependent that diseases of one organ inevitably affect its neighbors. Thus, chronic pancreatitis or liver disease can trigger duodenal erosion, exacerbating the general condition. However, you need to remember about feedback. In turn, erosion of the duodenum can lead to the following diseases:

• pancreatitis - inflammation of the pancreas;
  

  Launched duodenal erosion can provoke the development of pancreatitis

• cholecystitis - inflammation of the gallbladder;
  

  Against the background of erosion of the duodenum, cholecystitis may develop

• cholecystocholangitis - inflammation of the gallbladder ducts.
  

  Diseases of the duodenum lead to inflammation of the bile ducts

It turns out a vicious circle, which will help to break a complete examination of all internal organs, the identification and treatment of all pathologies that have arisen in the body.

A certain danger is reflux, in which the contents of the small intestine are thrown back into the duodenum, instead of going further down the digestive tract. The cause may be obstruction of the lower parts of the intestine, or these parts may be spasmodic, due to which bacteria enter the duodenum, provoking inflammation.

Poisoning with chemicals, for example, alcohol (even a single alcoholic intoxication), and expired products can provoke inflammation. Bad habits play their negative role. Coarse, poorly chewed food harms not only the delicate membranes of the duodenum, but also other digestive organs, therefore, the culture of food intake is important, which ensures its correct digestion.

Mechanical damage to the mucous membrane is possible with accidental ingestion of a foreign body, or ingestion of indigestible particles. Dry and coarse food is also important.

Important! To prevent the development of duodenitis, and any pathologies of the digestive tract, it is necessary to eat on time and chew food thoroughly. This simple action will save you from many problems.

The course of the disease

The reasons that trigger the erosion process lead to the appearance of two forms of duodenitis. Acute develops rapidly, against the background of a single poisoning, or the use of very spicy food. By this time, the organ has already been weakened by a hitherto hidden destructive process.

Duodenitis forms	Specifications
Acute duodenitis	Inflammation is indicated by sudden, sharp pain. It can be given to the back, or it can become encircling. As a rule, the first severe attack takes a person by surprise. Sudden stress and fear only aggravate the pain syndrome. In this case, hospitalization is most often required. In the hospital, doctors stop the attack and prescribe treatment. If it was correct, recovery occurs in a few days. However, with a second attack, the disease can become chronic.
Chronic duodenitis	The chronic form of the disease is slow, sometimes even asymptomatic, as a result of diseases of other digestive organs. However, sooner or later, the time comes for obvious manifestations of the ulceration process, because this type of duodenitis gradually thinns the walls of the duodenum, and erosion becomes deeper.

Throughout life, calm periods (remissions) are replaced by sudden exacerbations that occur after a diet disorder. With chronic erosion, it is important to prolong the remission as long as possible.

Important! So that the pathology does not remain forever, it is important to comply with all the doctor's prescriptions precisely at the time of the manifestation of the disease.

Varieties of erosion

Depending on the localization of erosion on the duodenal mucosa, several types of disease are distinguished.

1. Diffuse duodenitis - the entire mucous membrane of the duodenum becomes inflamed.
2. Focal - the inflammation is localized in one place.
3. Proximal - the area of ​​the organ near the stomach (bulb) becomes inflamed.
4. Distal - inflammation appears at the transition to the small intestine.

Signs

The pathological process in the duodenum for a long time may not declare itself in any way, before it manifests (first manifests itself) in an already neglected state. But sometimes patients may complain of pain in the stomach that occurs shortly after eating.

Nausea and vomiting accompanying pain are not uncommon. There is a decrease in appetite and weight loss. However, such symptoms are typical for many diseases, therefore, it is necessary to clarify the diagnosis. For any digestive disorder, you should immediately consult a doctor. The sooner treatment is started, the sooner recovery will come.

The first and most striking symptom of the disease is pain, which does not always depend on food intake. It can be strikingly different in character and intensity, but it appears in any case, sooner or later. Most often, it is the pain that leads the patient to the doctor.

The nature of the pain depends on the location of the erosion. If the bulb is damaged, then it begins to hurt within an hour after eating. Proximal duodenitis develops more often than duodenitis of other parts of the organ, and it is this inflammation that is most dangerous, since the vagus nerve is located next to the bulb. If inflammation affects it, neurological complications will arise. The chronic course of the disease is characterized by dull pain due to swelling of the inflamed mucosa. The pain is constantly present, intensifying after eating and at night.

If the patency of the duodenum is impaired, the pain syndrome is paroxysmal in nature: the spasms seem to twist and burst. When settling in the organ of Helicobacter pylori, pain appears on an empty stomach. In this case, attacks during the night are characteristic, which can be relieved by a glass of milk or a small portion of food. Such pain generally distinguishes the lesions of the lower parts of the duodenum.

Due to an excess of acid, belching appears sour. Heartburn, diarrhea, or diarrhea are almost inevitable. Due to a violation of the tone of the vagus nerve passing next to the duodenum, heart beats are reduced, which leads to weakness and increased sweating. The situation is aggravated by general intoxication of the body, in which the body temperature sometimes rises.

Against the background of disruption of the duodenum and stomach, frequent nausea and vomiting are common, which do not bring any relief. The appearance of blood in vomit serves as an alarming signal about the development of a hemorrhagic form of erosion.

If the main process is complicated by bleeding, the feces become black, vomiting with dark masses is possible. Anemia develops, which is characterized by pallor and headache. The level of hemoglobin decreases. The hemorrhagic form of duodenitis is dangerous because the bleeding does not always manifest itself as a pain syndrome, as in the ulcerative form, and the consequences can be very sad. Here you need to pay attention to the color of the stool.

In rare cases, bleeding from the anus is noted, which often takes on a protracted nature. Patients report constant bloating, rumbling, and fullness, even on an empty stomach.

Diagnostics

It is enough for the doctor to palpate the epigastric region to detect soreness of the duodenum. To clarify the diagnosis, the patient's complaints are analyzed, the medical history is studied. A genetic predisposition also affects the likelihood of pathology, therefore, consideration of a family history is encouraged.

1. Blood tests, clinical and biochemical tests are required: bilirubin, amylase, etc. are examined.
   

   To diagnose the disease, a blood test is required.

2. Stool analysis is very important as it can reveal occult blood.
3. An organ is probed to assess its secretory capacity. A biopsy is taken to determine the type of erosion.
   

   Fibrogastroduodenoscopy with biopsy of mucosal tissue

4. The gastric juice is tested for acidity.
5. Special tests determine the presence or absence of Helicobacteria.
   

   Helicobacter pylori infection breath test

6. Fluoroscopy excludes cancer, lymphomatosis, and polyps.

Treatment

The main goal of therapy in this case is always to protect the mucous membranes of the duodenum and stomach from the activity of acids and enzymes. Gastric juice should irritate the damaged intestinal lining as little as possible, so that healing occurs faster. Here, in addition to medicines, diet will be a good help.

Drug therapy

To neutralize stomach acid, antacids are used, which numb and envelop the inflamed membrane, for example, "Almagel". At the same time, they suppress the secretion of gastric juice, reduce the level of hydrochloric acid, regulate the work of the stomach and activate the immune system.

If pathogenic bacteria are found in the mucous membrane, then it becomes necessary to use antibiotics. When there is a threat of internal bleeding, it is advisable to use blood coagulants that increase its coagulability, for example, "Fibrinogen" intramuscularly, or "Vikasol" inside.

For the process of digesting food, hydrochloric acid is needed. In addition to the breakdown of food itself, it performs the functions of a kind of "orderly" of the stomach, thanks to which all particles of organic residues are destroyed without a trace, and do not remain to rot. But sometimes its production becomes excessive, it begins to corrode the walls of the stomach and duodenum 12. And there are unpleasant and painful sensations.

A proton pump, or a proton pump, a special protein, is responsible for the synthesis of acid. Its excessive activity can be suppressed. An indispensable inhibitor of the proton pump is "Omeprazole", indicated for any erosive processes of the stomach. It was replaced by new drugs on the market: Pantoprazole, Esomeprazole and Rabeprazole.

The histamine blockers "Famotidine" and "Ranitidine" reduce the irritating effect of hydrochloric acid. With severe pain syndrome, you can take painkillers and antispasmodics - "Drotaverin" or "Papaverin". To normalize digestion, "Pancreatin" is used.

To restore normal intestinal microflora take "Linex" or "Hilak Forte". For a successful recovery, you must strictly follow all the doctor's prescriptions. You can be treated at home, under medical supervision. The need to place a patient in a hospital arises only in the event of complications, or when the disease begins. Additional examinations are also carried out there.

ethnoscience

Traditional medicine does not contradict drug therapy. Sea buckthorn oil, which has antiseptic properties and helps to heal wounds, has become a classic remedy that has long established itself. Previously, it was released in bottles, which is not very convenient. The oil is now available in capsule form. Three capsules a day are sufficient to relieve symptoms. Additionally, they take sea buckthorn juice mixed with olive oil.

Medicinal herbs are also used: yarrow, mint, chamomile and St. John's wort, which have a calming effect. Equal parts of the herbs are poured with boiling water and the decoction is taken before meals.

Important: herbal treatment is unacceptable in case of acute development of erosion, or when bleeding occurs.

Carrot juice can be called a tasty and medicinal addition. The beneficial effect of regular consumption of raw chicken eggs has been noted. Honey is useful in pure form, or dissolved in water. Very often honey is mixed with butter, noting its healing effect on the damaged surface of the wall of the duodenum.

The mucous tincture of walnut heals well. However, it must be remembered that irritating alcoholic tinctures are unacceptable.

Surgical intervention

As a rule, surgery for duodenitis is not required; it is resorted to only in severe cases, when profuse bleeding from organ erosion opens, or a large vessel located next to intestine. Usually, laser coagulation of the vessel is performed.

Sometimes erosion itself is cauterized with a laser, after which a small scar remains.

Health food

Any treatment for duodenal erosion will come to naught if you do not follow a diet. If with other diseases you can still afford indulgence, then the pathology of the gastrointestinal tract does not forgive a single slip. The diet is followed until the symptoms that bothered the patient completely disappear, but in any case, not less than two months. It is important to follow a few rules.

1. Overeating is just as bad as fasting. It is optimal to eat 5-6 times a day, in small portions.
   

   Meals should be fractional, at least 5-6 times a day, always in small portions

2. Coarse, coarsely chopped food is not allowed. It is better to eat food grated, or in the form of mashed potatoes.
3. Salt intake should be kept to a minimum. Salt acts as an irritant.
4. Nothing fried or smoked! Only boiled, stewed and baked dishes. Better yet, steamed.
   

   Smoked and fried foods are completely excluded from the diet.

5. No pickles and marinades.
6. Food should not be too cold or too hot.
   

   Nutritional rules for the treatment of duodenal erosion

Products that can be consumed without fear, and which it is better to refrain from, are selected individually, but there are general rules that must be followed.

Nutrition for inflammation of the duodenum can be presented in the form of a table.

Approved for use	Allowed with restriction	Forbidden to use
Milk and fermented milk products, lean meat, lean fish cereals and pasta, raw eggs, oil, honey (preferably on an empty stomach) and propolis, fortified foods, porridge and jelly.	Bread, butter rolls, raw vegetables and fruits, sugar and sweets, juices, crushed dried fruit in compote, foods containing fiber (cabbage, carrots, apples).	Mushrooms and mushroom soups, hard boiled eggs pickles and canned food, margarine, fatty meat broths, carbonated drinks and alcohol, tea and coffee, sour fruits and vegetables, spices and spices, onions, garlic and radish.

Diet is extremely important from the very first day of treatment. Subsequently, it can be weakened, but not stopped until it is completely cured. The menu includes mashed soups with various cereals, mashed potatoes and steamed meat once a day. Juices are replaced with jelly. Juices can be drunk later, after stabilization.

Shredded vegetables, steam cutlets and omelet are good for health. It is impossible to overestimate the importance of oatmeal and jelly. Oatmeal is not only beneficial, but also promotes the healing of the ulcerated surface of the membrane, thanks to its enveloping, mucous structure.

Not always, but quite often, a properly prescribed diet is enough for treatment. If complications have not developed, for example, a bowel ulcer, scrupulous implementation of all nutritional points accelerates the healing of irritated mucous membranes.

Important: strict adherence to the diet from the moment the disease manifests itself will prevent its transition to a chronic form and help to quickly recover.

Prophylaxis

Erosive inflammation most often occurs due to improper nutrition, therefore quality control of the products is of paramount importance. It is necessary to minimize the consumption of fried and smoked, spicy and fatty. Refuse alcohol, carbonated drinks and coffee.

You can't gorge yourself or starve. If possible, eliminate stress. Timely treat emerging ailments of the gastrointestinal tract, at least once a year to undergo examinations of the digestive system. In the case of postponed duodenitis, if clinical remission has occurred, it is important to prolong it as long as possible. It is advisable to undergo a prophylactic endoscopy every three months. If the disease has become chronic, then the procedure is carried out three times a year.

Forecast

Erosion of the duodenum, with timely and correct treatment, safely passes one or two weeks after the first attack is stopped. The possibility of a complete cure is highly probable. In the chronic form of the disease, long-term remission can be achieved. If left untreated, an ulcer can develop, which in turn leads to cancer. A frivolous or careless attitude to the recommendations of doctors can result in dire consequences.

Video - Erosion of the duodenum