Duodenitis: Symptoms, Treatment, Diet, Folkfacilities

Update: December 2018

Content:

  • Structure
  • Functions
  • What causes acute duodenitis?
  • What causes chronic duodenitis?
  • Clinic
  • Diagnostics
  • Treatment
  • In accordance with the form of duodenitis recommend


Duodenitis is an inflammation of the mucous layer of the duodenum.
The overall prevalence of pathology among the population is
5-10%, 2 times more often the disease is found in men, which
associated with greater adherence to addictions.

There are acute and chronic forms of the disease. Acute
duodenitis occurs more often in cases of poisoning and eating
spicy dishes, manifested by inflammation of the mucous membrane, the development
erosion (surface epithelium defect, healing without the formation of
cicatrices) less often – phlegmonous cavities filled with pus.
The disease is manifested by digestive disorders, pain
syndrome. If you follow the diet and doctor’s prescription, you can
recover in 1-2 weeks. With повторном  возникновении о.
duodenitis risk of chronicity is 90%.

Chronic duodenitis develops on the background of chronic pathology.
digestive tract (gastritis, gastric ulcers, pancreatitis),
prolonged violation of the diet. Atrophy gradually develops
mucous (atrophic duodenitis) or its erosion (erosive
duodenitis). Under the action of provoking factors occurs
exacerbation of the disease. Treatment более длительное, чем при острой
form.

Structure

After the pylorus follows the 12-gut. She like
horseshoe, rounds the head of the pancreas (PJ), continuing into
jejunum. Its length is 25-30 cm. Fixation to
the walls of the abdominal cavity at the expense of connective tissue
fibers. The duodenum is located in the projection of the XII thoracic – III
lumbar vertebrae.

Departments: upper (onion or ampoule), descending,
horizontal, ascending. Mucosa bulbs provided with longitudinal
folds, the remaining sections – transverse. With their reduction
происходит передвижение lump пищи в jejunum.

In the cavity of the duodenum opens a large or Vater nipple. is he
formed by merging the main duct of the pancreas and the common bile
duct. Vaterov papilla has a sphincter with which
regulated intake in the intestines of bile and juice of the pancreas. In the area of
the output of the additional duct of the pancreas is a small nipple.

Functions

The duodenum has several functions:

  1. Neutralization of acidic gastric contents. Food ball,
    mixed with acidic gastric juice, neutralized in alkaline
    environment. Due to this, there is no irritation of the epithelium.
    intestine.
  2. Regulation of the formation of enzymes of digestion, bile, juice of the pancreas. AT
    Duodenum is analyzed content and transmitted
    proper command of the digestive glands.
  3. ATзаимосвязь с желудком: дуоденум обеспечивает открытие и
    closing of the pylorus of the stomach, the arrival of a new portion of food
    lump в тонкий кишечник. This happens as it neutralizes
    the next amount of gastric contents in the cavity
    duodenal ulcer.

What causes acute duodenitis?

The causes leading to the development of f. duodenitis:

  1. Eating dry, eating food with an irritating effect on
    epithelium of the digestive tract: coffee, smoked meats, roasted,
    fatty, spicy. For the processing of such food in the stomach is formed
    increased amount of hydrochloric acid, which reduces the protective
    epithelial properties duodenum.
  2. Foodborne Disease Infections Caused by Helicobacter Bacterium
    pylori (which causes ulcers), staphylococci, enterococci,
    clostridia, as well as giardiasis, helminthiasis. Pathogenic bacteria
    lead to the development of inflammation in the mucous
    duodenum, damage to epithelial cells and their death.
    AT просвет кишечника выходит большое количество жидкости, что
    manifested by diarrhea.
  3. Diseases of the digestive system: colitis, hepatitis,
    cirrhosis, pancreatitis, ulcer, gastritis. ATоспаление рядом расположенных
    organs leads to the transition of the inflammatory process and the development
    duodenitis (pancreatitis-duodenitis, gastritis-duodenitis). Other
    the mechanism causing inflammation of the duodenum is
    violation of the production of bile and pancreatic juice, without which
    impracticable normal functioning of this body.
  4. Reflux or reflux of the contents of the underlying segments
    intestinal duodenum. This may be due to
    spasm or impaired patency (due to a tumor or other
    causes) jejunum. Bacteria from the lower divisions of the thin
    intestines enter the duodenum, causing reflux duodenitis.
  5. Alcohol consumption.
  6. Ingestion of chemicals (acids, alkalis,
    chlorine-containing compounds) leading to burn epithelium
    intestine.
  7. Mechanical damage to the duodenal mucosa
    due to ingestion of foreign bodies.

What causes chronic duodenitis?

Withчины, приводящие к появлению хронического duodenitis:

  1. Intestinal pathology leading to impaired peristalsis, stagnation
    intestinal contents, wall stretching and mucosal atrophy
    duodenum: prolonged constipation, intestinal adhesions, violation
    кровоснабжения и нервной регуляции intestine.
  2. Chronic gastritis with high acidity causes
    acid damage to the intestinal epithelium with the gradual development of it
    atrophy. Gastritis-duodenitis is formed.
  3. Anomaly of the liver, gallbladder and pancreas leads to
    violation of the release of enzymes into the lumen of the duodenum, which
    impairs its functioning.
  4. Регулярное violation диеты и режима питания.
  5. Food allergies.
  6. Prolonged stress
  7. The use of a large number of drugs.
  8. The presence of bad habits (alcohol, smoking,
    substance abuse).

Clinic

Manifestations of duodenitis depend on the cause of its occurrence and
presence of comorbidities. Often the disease is hidden under
mask of other ailments: stomach ulcers, gastritis, cholecystitis.

Symptoms of duodenitis in adults:

  • Painful sensations in the pit of stomach, aggravated by
    palpation (palpation) of the abdomen. Pain has its own characteristics when
    различных формах duodenitis:

    • chronic form – constant, aching, aggravated on an empty stomach
      and 1-2 hours after a meal;
    • при дуодените, вызванном violationм проходимости кишечника,
      bursting pain, paroxysmal, occurs when overflow
      intestines;
    • with gastritis-duodenitis with high acidity – develops
      10-20 minutes after eating, which is explained by the arrival in
      intestinal acidic gastric contents;
    • for ulcer-like form caused by helicobacter pylori,
      characteristic pain relief;
    • with local inflammation around the nipple Vater violated outflow
      gall from the gallbladder, there is a clinic similar to the attack
      hepatic colic: soreness in the right hypochondrium.
  • Increased fatigue, weakness. This is due to the action
    toxic substances formed in the process of inflammation.
  • ATозможно небольшое повышение температуры тела (до
    37-380).
  • Digestive disorders (dyspepsia):
    • nausea;
    • decreased appetite;
    • increased gas formation (flatulence);
    • belching, vomiting with a bitter taste (due to ingress of bile) –
      throwing food back into the stomach;
    • upset stool (diarrhea or constipation).
  • Yellowing of the skin and mucous membranes. Edema of the Vater papilla leads to
    decrease the lumen of the bile duct, the stagnation of bile and
    getting her into the blood.
  • Dumping syndrome. ATозникает после обильной еды. With
    overflow duodenum occurs redistribution of the bloodstream
    (blood flow to the digestive organs, outflow from the head). Manifests itself
    dizziness, drowsiness, feeling of fullness in the stomach,
    heat in the upper torso.

With бессимптомном течении заболевания жалобы могут
absent, the detection of pathology is an accidental finding with
conducting gastroduodenoscopy.

Diagnostics

The diagnosis of duodenitis is made in the presence of a combination of data:

  1. The presence of characteristic complaints described above.
  2. Inspection. With пальпации (ощупывании) живота отмечается
    soreness in the projection of the 12-stalk intestine.
  3. Data of instrumental examination:
  • EGD (fibrogastroduodenoscopy) – scopic examination
    stomach cavity, duodenum. With наличии дуоденита определяются
    characteristic signs: (swelling of the mucous membrane, redness). For each
    forms of duodenitis characterized by their own characteristics EGD – pictures:

    • a) with catarrhal (or superficial) duodenitis – uniform
      epithelial redness;
    • b) the presence of erosion – in the form of erosive;
    • c) the smoothness of the folds indicates a decrease in tone
      intestines;
    • g) nodules on the mucous – about the nodular form;
    • e) hemorrhages – about hemorrhagic;
    • e) epithelium atrophy – atrophic.
  • X-ray contrast study – fluoroscopy
    or graphs after patient use of a contrast agent
    (barium sulfate). With таком исследовании можно выявить грубые
    violations in the structure and work of the body, the restructuring of the mucous thus
    by detect fails. With патологии дуоденум обнаруживают
    a number of signs:

    • a) areas of contraction indicate a tumor, adhesive
      process, developmental abnormalities;
    • b) areas of expansion speak about a decrease in a tone, obstruction
      downstream intestine, violation of the passage of food,
      nervous regulation;
    • c) a niche symptom is observed during erosion, ulcer;
    • d) when mechanical obstruction is detected accumulation
      gases;
    • e) smoothness of the folds – with edema, inflammation;
    • e) reflux – throwing the contents from the duodenum back to
      stomach.
  1. Laboratory data:
  • In general, a blood test can determine the increase in ESR,
    indicating inflammation and anemia, as a sign of internal
    bleeding;
  • biochemical blood test: in the initial stages of duodenitis
    Enhancement of enzymes will be observed (etherokinase and alkaline
    phosphatase), further their activity decreases;
  • analysis of fecal occult blood (will be positive if there is
    bleeding, may be with erosive form).

Features in children

Withчиной дуоденита у детей чаще всего является сухоядение,
violation режима питания, а также аллергические реакции,
genetic predisposition (the presence of the disease in
parents), various toxicoinfections, parasitic diseases
(helminthiasis, giardiasis), catarrhal diseases.

Small children cannot correctly localize pain, they are more often
just show on belly and say it hurts. Among
symptoms are the most common malaise, weakness, pain in
stomachache, nausea, belching, heartburn, constipation. Exacerbation of duodenitis more often
found in the fall and spring. Older children (10 years or more)
the clinical picture is not significantly different from adults.

Treatment комплексное. If the cause of duodenitis was helminthiasis,
deworming is essential.

Treatment

Основные задачи при лечении duodenitis:

  • elimination of inflammation;
  • prevention of chronization of the process;
  • normalization of the work of the duodenum;
  • restoration of normal digestion.

Most often, treatment is carried out in the clinic. For recovery
It is necessary to comply with a number of conditions:

  • stick to a diet;
  • observe the regime of work and rest;
  • avoid stress;
  • give up bad habits (smoking, alcohol).

Indications for inpatient treatment:

  • exacerbation of the disease;
  • suspected tumor formation;
  • danger of bleeding (with erosive form);
  • severe general condition.

Treatment Components:

  • health food;
  • народные facilities;
  • medicines;
  • physiotherapy;
  • application of mineral waters.

Nutrition

Menu with duodenitis plays a pivotal role in therapy. If not
adjust nutrition – recurrences of the disease will occur again
and again.

With обострении хронической формы или о. duodenitis first 3-5
days should observe the table 1a by Pevzner. Same diet
used to treat acute gastric ulcers. Allowed to eat
mucous cereal broths (rice, oatmeal), pureed soups,
liquid porridge in half milk (first, the croup is boiled soft
water, so it swells faster and becomes more mucous, then
add milk, the ratio of water and milk 1/1).

The basic principles of nutrition:

  • food should be: rubbed, not hot, cooked on
    a couple
  • frequent meals – 6 times a day, in small portions
  • eliminate overeating and big breaks in eating

For example, we give a diet 1a, painted for one day.

Withем пищи Recommended dishes
1st breakfast Buckwheat porridge cooked in half milk (buckwheat –
50, milk and water – ½ cup, butter – 10), milk –
1 glass
2nd breakfast Milk – 1 cup
Dinner Cereal milk soup (oatmeal flakes – 40, milk – ¾ cup,
eggs – ¼ pcs, butter – 10, sugar 2, water – 1¾ cups),
meat puree (boiled lean beef – 100, milk – 1/4 glass,
butter – 10), compote of dried apples (water – 200, apples
dried – 20, sugar – 15)
Afternoon tea Milk – 1 cup, яйцо всмятку
Dinner Rice porridge cooked in half milk (rice – 50,
milk and water – ½ cup, butter – 10), egg “in
bag “, milk – 1 cup.
2nd dinner Milk – 1 cup

Then the diet is gradually expanded.

In accordance with the form of duodenitis recommend:

  • ulcer-like form – table number 1;
1st breakfast Rice porridge on milk, sweet compote
2nd breakfast Yogurt
Dinner Noodle soup, zrazy, beet salad, bread, jelly.
Afternoon tea Pear compote
Dinner Milk noodles
2nd dinner Milk – 1 cup
  • gastritis-like option – table number 2;
1st breakfast Cheese curd, 1 glass of milk
2nd breakfast Baked Pumpkin
Dinner Vegetable soup, meatballs with mashed potatoes, compote
dried fruit.
Afternoon tea Crackers, rowan decoction
Dinner Pollack stew with vegetables
2nd dinner 1 glass of milk
  • pancreatic and cholecysto – a similar form – table number 5.
1st breakfast ATинегрет, ломтик вчерашнего хлеба, чай с молоком
2nd breakfast Carrot juice
Dinner Vegetable soup, seasoned with low-fat sour cream
 mashed potatoes with boiled fish, dried apricots compote
Afternoon tea Milk 1 cup
Dinner Cottage cheese casserole, weak tea with sugar
2nd dinner Kissel 1 cup

Recommended products:

  • boiled lean meat minced through a meat grinder or
    ground blender;
  • milk and lactic products (milk, kefir, ryazhenka,
    yogurt);
  • boiled or baked vegetables, peeled from the skin, vegetable
    mashed potatoes;
  • boiled eggs or cooked in the form of an omelet;
  • fats (butter, vegetable oil);
  • juices;
  • Yesterday’s bread and crackers (digest easier than fresh
    bakery products);
  • natural sweets (honey, mousse, jelly).

Prohibited products that stimulate gastric secretion,
containing hard to digestible fibers:

  • raw fruits and vegetables;
  • canned food, smoked meats;
  • spicy dishes, seasonings, onions, garlic;
  • saturated fish, meat, mushroom broths;
  • fatty meats and fish (duck, pork, carp,
    mackerel);
  • ice cream;
  • carbonated drinks;
  • alcohol.

General nutritional advice for duodenitis:

  1. Eat should be fractional, in small portions, 4-6 times a day.
    You should not wait for the onset of hunger to eat, otherwise they may
    there is a “hungry pain.”
  2. Food should be warm, but not hot or cold.
  3. Preferably gentle cooking method, to exclude
    mucosal irritation duodenum. These are soups, porridges, steam dishes.
  4. Exclude overeating, eating at night.

Folk methods

Treatment народными facilitiesми имеет вспомогательное значение.
The main goal is to suppress the aggressive effects of salt
acid, epithelial protection duodenum.

For this purpose, suitable medicinal plants: coltsfoot,
sage, nettle, tutsan, peppermint, oregano, plantain,
strawberry leaves, chamomile inflorescences, fennel seeds, fruits
wild rose, eucalyptus leaves.

In the period of remission use fees: lingonberry leaves, grass
Hypericum, licorice root, flax seed, oregano grass, nettle root
chamomile.

Recipes for the preparation of healing drugs for duodenitis:

  • 2 tbsp. spoons raw Hypericum holed pour 200 ml
    boiling water, heated in a water bath for 0.5 hours, insist 15 minutes,
    filter, drink 1/3 cup 3 times a day for 0.5 hours before
    food;
  • 3 tbsp. Spoon of plantain juice is mixed with 1 teaspoon of honey,
    take on 1st. spoon 3 times a day before meals;
  • 50g of propolis is poured over 2 cups of alcohol, the resulting mixture
    put in a dark place for 3 weeks to insist, take out
    exacerbations, before meals, 1 tbsp. spoon, pre-mixing
    from 1 tbsp. a spoon of milk;
  • 2 tbsp. spoons of Hercules are boiled in 2 liters of water, filtered, in
    decoction add ¼ cup of aloe juice. Drink ½ cup 3 times
    in a day;
  • 1 teaspoon of flax seeds is poured with 1 cup of boiling water, insist
    15 minutes, consumed on an empty stomach during the month.
  • 0.5 kg sea buckthorn fray, pour unrefined
    sunflower oil and insist for a week in a glass
    Bank, take 1 tbsp. spoon on an empty stomach.

Drug therapy

How to treat duodenitis? According to the form of the disease
apply various combinations of groups of drugs:

Drug group Impact mechanism Representatives How to apply
IPP – proton pump inhibitors Blocks the production of hydrochloric acid (HCl), thereby reducing
mucosal irritation duodenum.
  • Emanera 20 mg
  • Omeprazole 20 mg
  • Ultop 20 mg
  • Zulbex 20 mg
20 mg 1-2 times a day, for 7-10 days.
Antibiotics, antibacterial agents When infection is detected, Helicobacter pylori.
  • Doxycilin 100-200 mg
2 times a day, 7-10 days.
  • Clarithromycin 500 mg
  • Amoxicillin 1000 mg
  • Metronidazole 500 mg
2 times a day, 7-14 days.
H2 – histamine blockers Inhibit the secretion of HCl.
  • Ranitidine
0.15 – 2 times a day, a course of 1 – 1.5 months.
  • famotidine
0.02 g – 2 times
Antacids Neutralize HCl. Envelop the mucous, have local
analgesic effect.
  • Almagel
  • Maalox
  • Gastal
With heartburn, up to 3 times a day.
Prokinetics Regulate peristalsis, help the promotion of food
lump
  • Ittomed
  • Ganaton
1 tablet 3 times a day.
Enzyme products Contain RV enzymes, help better digestion
  • Pancreatin
  • Creon 10,000
After every meal.
Antispasmodics Relieve spasm, relieve pain
  • No-spa (Drotaverinum)
  • Platifillin
  • Duspatalin
1 tablet – 3 times.
Sedatives Calming effect Valerian tablets, motherwort The course is 10-14 days.

Separately, it is worth touching the drug De-nol. He combines
antacid, antibacterial (directed against Helicobacter
pylori), anti-inflammatory, astringent, protects
mucous duodenum, contributes to its recovery. Adults him
take 1 tablet 4 times a day (3 times after meals, 4th – on
night). Wash down the drug with water (milk can not be washed down due to
formation of insoluble compounds). Children under 12 are prescribed
1 tablet 2 times a day. Reception course – up to 8 weeks.

In each case, the combination of drugs selected individually.
In the presence of helicobacter pylori – must be assigned
antibiotics. If the disease is provoked by exposure to stress
– connect sedatives. With increasing acidity is not
do without antacids, IPP, histamine blockers.

Physiotherapy

Apply magnetic therapy, ultrasound, phonophoresis.

Mineral water application

Low-mineralized alkaline water is used, not
containing carbon dioxide: Borjomi, Yessentuki No. 4,
�”Smirnovskaya number 1″, “Slavyanovskaya”, “Luzhanskaya”, “Berezovskaya”. Before
By using mineral water, it is slightly heated and gases are released.
Take 1-1.5 hours after meals.

All these treatments together help to relieve symptoms.
inflammation, to achieve sustained remission of duodenitis.

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