The duodenum performs many different functions. It represents the initial section of the small intestine, but it is connected with the stomach, and with the liver, and with the pancreas through special ducts that enter the sphincter of Oddi. Therefore, the diseases of this organ have their beginnings in the dysfunction of various parts of the digestive tract.
Statistics observes "rejuvenation" of patients who suffer from pathologies of the duodenal zone, as well as an increase in prevalence among adolescents. The relevance of the study of the structure and physiology of this organ is associated with the need to establish the causes of damage to the intestinal sections and the choice of optimal therapy methods.
Favorable results of treatment of the duodenum help prevent dysfunction and problems of the organs that are involved in the digestive processes with it. There is no separate classification of pathologies.exists, and diseases are usually included in the same category as ailments of the esophagus and stomach.
Types of diseases
Clinical medicine, however, divides diseases of the stomach and duodenum into the following:
- Dyskinesias, which are a variety of functional disorders.
- Inflammation, in case of relation to the gastrointestinal tract they are called duodenitis.
- Peptic ulcer.
- Malignant tumors (cancer).
- All kinds of anomalies in the structure.
Anomalies of physiological development include congenital stenosis of the intestine and diverticulum (protrusion) of its wall. These phenomena are observed quite rarely and may be accompanied by some other malformations of the digestive system. Before talking about inflammation of the duodenum, it is necessary to consider the anatomy.
Anatomy and functions
The name of this organ comes from its length, equivalent to 12 fingers, which is approximately 30 cm. This intestine is separated from the stomach by the pyloric sphincter. Taking into account its curves, 4 departments stand out.
Sphincter of Oddi is an internal papilla in the lower zone. The ducts of the pancreas and gallbladder also fit here. The inner lining of the intestine is covered with special villi, between the cells of the epithelium there are goblet cells that are capable of producing mucus. The muscular layer of the duodenum provides its motility and tone.
The main tasks of this body are:
- Neutralizationgastric juice and pancreatic contents, as well as chemical treatment of the incoming food bolus.
- Further grinding of food particles, as well as the creation of the necessary conditions for the full access of bacteria living in the intestine to its underlying sections.
- Regulation with the help of feedback from the center of the brain of the amount of necessary production, as well as the entry of enzymes produced by the pancreas into the intestines.
- Coordination with stomach juice synthesis.
Violation of these functions leads, as a rule, to the manifestation of clinical symptoms of common diseases of the duodenum.
Helicobacteria are able to pass from the stomach to the intestine through the pyloric section in case of antral gastritis and peptic ulcer.
Causes of pathologies
The causes of diseases of the duodenum are almost no different from the general factors that are prerequisites for the occurrence of lesions of other digestive organs. These include:
- Violation of the normal diet, as well as the quality of food, for example, too long breaks between meals, frequent overeating, fasting, dieting, eating fatty, fried and spicy foods.
- Alcohol abuse, as well as excessive stimulation of mucosal functions resulting from the ingestion of nicotine decay products.
- Eating poor quality food with expired dates, which causes frequent poisoning,which, in turn, contribute to mucosal damage.
- Swallowing infection from nasal secretions and carious teeth.
- helminthic and parasitic invasion from the lower intestines in the form of giardia, ascaris, pinworms.
- Pylloric atony.
- As a result of metabolic and autoimmune diseases - gout, renal and hepatic failure with cirrhosis of the liver, diabetes mellitus.
- Traumatization of the inner layer with hard or piercing objects, as well as fish bones.
- Violation of regulatory functions that can cause stressful situations and a variety of endocrine diseases.
- Long-term use of medications that have irritating properties (Analgin, Aspirin, some drugs to eliminate headaches, as well as corticosteroids, ascorbic acid and anti-flu mixtures).
- Congenital structural anomalies.
- Hereditary factor.
A person who has two or more causes is susceptible to diseases of the stomach and duodenum. The main signs of such pathologies should be considered on examples of specific ailments.
Dyskinesia
Nervous breakdowns and a variety of stressful conditions lead to such a disease. Innervation damage can also occur during gastric surgery. In another way, this phenomenon is called duodenostasis.
The main essence of violations of this nature is the retention of contents in the intestine, which is notgoes to the following departments. The patient has the appearance of dull arching pains in the epigastrium, as well as in the hypochondrium on the right. There are also phenomena of nausea and loss of appetite, prolonged constipation during exacerbations. The duodenum becomes inflamed quite often.
Duodenitis
This pathology is an inflammation that occurs, as a rule, in a chronic or acute form. Acute duodenitis occurs in a few days if the patient takes certain strong drugs or herbal tinctures. Pathology often accompanies infectious forms of gastroenteritis. Chronic duodenitis almost never occurs in an isolated form. It is usually accompanied by various diseases of the stomach, pancreatitis or cholecystitis.
Pathology is manifested by aching pain in the abdomen without determining the exact localization, without irradiation. Patients feel very bad on an empty stomach, after sleep. Improvement occurs after eating. With the development of this disease, constipation often occurs, and since it is a very long process, blockage and spasms of the sphincter of Oddi may accompany it, which occurs with the presence of cramping pain and vomiting. These are very unpleasant symptoms. Treatment of the duodenum will be discussed later.
Bulbit
This disease is one of the varieties of duodenitis. The inflammatory process is localized in the upper part of the intestine - in the bulb, so the disease often becomes the result of gastritis of various origins. In form, catarrhal bulbitis and erosive are distinguished. Atcatarrhal bulbitis, aching pains are noted, sometimes cramping, and they appear on an empty stomach. Accompanying these symptoms are heartburn, bad breath, sour belching, bitter taste in the mouth, and nausea.
Erosion of the duodenum, or erosive bulbitis is characterized by prolonged debilitating pain in the epigastrium, which usually appears some time after eating. In some cases, vomiting with bile and bitter belching may occur. Patients often complain of weakness, insomnia, excessive salivation, cephalalgia.
Morphological studies have shown that against the background of hyperemic intestinal mucosa, there are cracks and macerations, which are located exclusively in the surface layer and do not penetrate into the muscle wall. For the chronic form of the course of this disease, periods of exacerbations are typical during the change of seasons of the year and remission at the rest of the time. These are the main symptoms. The duodenum is often prone to peptic ulcer disease.
Ulcer
Ulcerative lesions of the duodenum are observed as one of the forms of complications and the next stage of duodenitis or erosive bulbitis. The prevalence of this disease among women is higher than among men.
Morphological studies have established the difference between this type of pathology and erosion by deeper penetration into the muscle layers of the intestine, as well as vascular damage.
In severe forms of the disease, bleeding, perforation (perforation) of the wall, as well aspenetration into neighboring organs. The ulcer is localized most often in the region of the bulb. Perhaps the formation of two ulcers that lie on opposite walls (in the terminology of radiologists - "kissing" ulcers).
Symptoms manifest as follows:
- Intense epigastric pain radiating to the back, hypochondrium, which occurs after eating or early in the morning (“hunger pain”).
- Sucking in the pit of the stomach.
- Heartburn, which, as a rule, bothers the majority of patients, and is associated with reflux of gastric juice into the esophagus.
- Vomiting, which greatly relieves the patient's condition.
- Bouts of nausea.
- In the vomit may be an admixture of blood, less often it is detected in the feces.
- Patients, oddly enough, do not suffer from appetite. Sometimes there may be an aversion to food. There is no weight loss observed. Treatment of the duodenum should be comprehensive and timely.
Parasitic diseases
The following parasites can live and multiply in the small intestine: roundworm, pinworm, lamblia, fluke, trichinella, tapeworm. Infection occurs through unwashed vegetables, dirty hands, swimming pools, etc. The presence of helminths in the body can be judged by the following characteristic features:
- Itchy skin, acne and pimples.
- Frequent constipation or diarrhea.
- Dryness and pigmentation of the skin.
- Frequent bloating and rumbling in the stomach.
- Pain injoints and muscles.
- Prone to allergic reactions.
- Weight loss.
- Restless sleep with frequent awakenings.
- Increase in colds due to lower immune defenses.
Parasites feed on intestinal contents, and some of them are able to penetrate the walls of this organ into the bloodstream.
Malignant and benign tumors
Neoplasms in the duodenum are extremely rare. Nevertheless, they arise, and from benign ones, various adenomas, papillomas, fibroadenomas, lipomas, hemangiomas, neurofibromas can be noted. There are also tumor formations of the duodenal papilla. Visually, they can resemble multiple or single polyps growing on a stalk. Such pathological processes are asymptomatic and are usually detected by chance. If they reach a large size, they can cause symptoms of intestinal obstruction, squeezing of the biliary tract and, as a result, obstructive jaundice.
Oncology is only a small part of all possible tumors of the digestive system. In most cases, cancer occurs in the descending areas above the duodenal papilla, as well as around it and, most rarely, on the bulb.
Most often the disease occurs in older men. Cancer neoplasm belongs to the category of late metastasizing. The tumor grows, as a rule, in the nearest lymph nodes, as well as in the tissues of the pancreas and liver. Other metastases are extremely rare.
Clinical signs of cancer of this organ:
- Excruciating pain.
- Appetite reduction and weight loss.
- Symptoms of mechanical obstruction in the intestines (persistent vomiting and dehydration).
- When the tumor collapses, severe forms of bleeding occur.
- Yellow skin.
What other diseases of the duodenum are there?
Intestinal obstruction
The symptoms of this disease can be caused by the following factors:
- Congenital structural anomalies.
- Atypical twist.
- Increased mobility.
- Inverted shape.
- Obstruction of the neoplasm of the duodenum or squeezing of the pancreas.
- Stone migration.
Hernias
Hernia - a protrusion of a section of the intestinal wall. This phenomenon is found in people after 50 years with a sedentary lifestyle. A hernia is formed as a result of a decrease in the tone of the muscle layer. The disease occurs with the occurrence of reflux of acid into the esophagus, and patients often complain of heartburn, belching and flatulence.
Treatment of stomach and duodenum
Therapy of this pathology is carried out with the help of certain medications or, if they are ineffective, with a surgical method.
First of all, you should undergo the necessary diagnostics, which includes not only laboratory, but also instrumental techniques, after which the treatment of these pathologies should be carried out exclusively by a specialist in a narrowprofile.
Several groups of drugs are used in the treatment.
- Antisecretory agents - inhibit gastric secretion and reduce the aggression of gastric juice. These include proton pump inhibitors, H2-histamine receptor blockers, anticholinergics.
- Bismuth-based preparations are effective for ulcers caused by Helicobacter pylori. As a result, the vital activity of bacteria is inhibited, a film is created on the surface of the intestinal mucosa, which protects it from the aggression of gastric juice. This group of medicines includes Vikalin, De-Nol, Vikair and others.
- Antibiotics and antiprotozoal drugs inhibit the vital activity of Helicobacter pylori. Most often prescribed "Clarithromycin", "Amoxicillin", "Metronidazole", "Tetracycline" and others.
- Prokinetics - improve duodenal motility, and also relieve nausea and vomiting. Apply with a feeling of heaviness and overflow of the stomach, heartburn, early satiety.
- Antacids are taken symptomatically for heartburn. They have an adsorbing and astringent effect.
- Gastroprotective drugs cover the affected duodenal mucosa, prevent the aggression of hydrochloric acid and digestive enzymes.
- Other drugs (analgesics, antispasmodics, drugs that improve the nutrition of the intestinal mucosa).
Duodenal Diet
The diet is sparing,aimed at protecting the body from mechanical, chemical and thermal effects. A special group of therapeutic diets No. 1 has been developed, they are recommended at the stage of exacerbation of the disease.
Fractional nutrition is important (up to six times a day in small portions). As products - boiled meat, fish, heavily boiled cereals, non-acidic dairy products, mashed vegetables without coarse fiber, dried white bread, mashed non-acidic fruits and berries, coffee and cocoa with milk, weak tea, rosehip broth.
Fried, pickled, spicy, s alty foods, vegetables with coarse fiber, smoked meats, canned food, all sour, fatty meat and fish, mushrooms, strong coffee, sour juices, carbonated drinks should be completely excluded.
