What is pyloroduodenal stenosis? This is a narrowing of the duodenum. Or the pyloric part of the stomach. This disease is a complication after the development of an ulcer of the above organs. This disease progresses in 40% of people with this pathology. Certain factors of this disease have not been studied, we are talking about prevention. That is why you should pay special attention to your well-being, and also try to prevent violations of the gastrointestinal tract. Accordingly, it is necessary to eat only he althy food, lead a proper lifestyle. It is quite difficult to cure this disease. You can read more about this in this article. It describes the causes, methods of treatment, as well as the classification of this disease.
Etiology
The cause of the disease is considered to be a peptic ulcer that affects either the stomach or intestines. As a rule, in the vast majority of cases, duodenal ulcers are the source of the disease, a little less often - neoplasms on the gastric mucosa. The least likely reason for thisdiseases can be squeezing of the duodenum by other organs - those that are in the stage of inflammation. The following reason is the least common: blockage of the intestinal lumen of the membrane. She goes down. This is how pyloroduodenal stenosis manifests itself. The pathogenesis of this disease is that ulcers and scars lead to deformation of the lumen and to its narrowing. Because of this, inflammation can be localized not only in the nearest section, but also in other areas of the duodenum. Due to the fact that cicatricial narrowing occurs, the contents of the stomach hardly pass further through the body. At the same time, this organ is stretched, slightly lowered, and these are already serious deviations. They can be fatal. Scarring is a pathological process that cannot be reversed. Because of it, there is an imbalance of all types of functioning in the body. Including even the water-s alt and protein balance are disturbed.
Classification of pyloroduodenal stenosis
This disease occurs in several stages. Consider them.
Compensation stage. It is characterized by the fact that the disease has no symptoms or is expressed to a small extent. As a rule, such discomfort can appear after eating.
The next stage of pyloroduodenal stenosis is subcompensation. It differs from the previous one in that the signs of the disease are already becoming pronounced or intensifying, but they are not yet so unbearable.
The stage of decompensation is different in that the diseasegoes very hard. Unpleasant sensations and the clinical picture as a whole have a pronounced shade. Moreover, already at this stage, treatment practically does not bring any positive effect, complications occur in most cases. This stage can proceed both with the preservation of the function of the affected organ, and with its violations.
You can also divide this process into three types, depending on the localization. We are talking about the bulb of the duodenum, duodenal, and also violations of the gastric mucosa. Moreover, pyloroduodenal stenosis was classified according to one more factor.
- The functional form develops due to deformation of the intestinal bulb or the pylorus of the stomach.
- The organic form appears due to the tumor process and quickly transforms into the stage of narrowing of the pyloroduodenal region.
- The transient form of the disease is characterized by the fact that the gastric contents begin to pass rather slowly into the intestine, an inflammatory process occurs, as well as spastic contractions. It is worth noting that during this form of the disease, the passages are narrowed, and motor function is severely impaired.
Symptomatics of the compensated stage
It is worth noting that the symptoms and the overall clinical picture are maximally dependent on the stage of the disease. The compensated form is considered the easiest. That is why its symptoms may not appear. But still, in some cases, the following points are distinguished. There is a feeling of fullness in the stomach. And this despite the fact that a person could consume a very small amount of food. There is constant heartburn, as well as belching with a sour smell of recently eaten food, in rare cases there may be vomiting, and there are also short pains. This stage develops from 2 weeks to several years. After that, it changes into another form. Treatment of pyloroduodenal stenosis in this form is the easiest.
Symptomatics of the subcompensated stage
The following symptoms of increased severity are characteristic of the subcompensatory form:
- Burps already smell like rotten eggs. This is due to the fact that food lingers in the stomach for a long time.
- The pain syndrome is very strong. Many patients report that the pain is stabbing.
- There may be rumbling in the stomach, which is not inherent in normal hunger.
- Vomiting is usually relieved.
- Also, a person loses weight quickly.
This period may last for several years.
Symptomatics of the decompensated stage
Decompensated stage, unfortunately, leads to the fact that the condition deteriorates sharply. Vomiting of undigested food may occur. Very often, people cause food rejection in an artificial way, hoping that this will bring them relief. But in 90% of cases it does not occur. Often a person feels intense thirst, the stool is disturbed, diarrhea appears. Sore brightexpressed, in comparison with the previous stage, the body is very weak, the person is not efficient. If the patient allowed the disease to this stage, he needs to be prepared for the fact that it is a prerequisite for severe complications. As a rule, ulcerative pyloroduodenal stenosis leads to this form.
Diagnosis of disease
First of all, a person needs to undergo an instrumental examination. But before that - diagnostic measures.
Firstly, the gastroenterologist should interview the patient to identify symptoms. So he will understand the degree of intensity of the disease, as well as the time of its development. Moreover, it is necessary to get acquainted with the history of the disease of this patient, as well as conduct a thorough examination. Accordingly, the doctor must palpate the anterior wall of the abdomen.
Laboratory methods are of no use, so often doctors do not prescribe certain tests. But in some cases, the diagnosis may indicate that complications have already appeared.
Instrumental diagnostics
Instrumental diagnostic measures must be carried out without fail. You need to perform an endoscopic procedure called EGD. It involves the examination and evaluation of all internal surfaces of the organs that make up the digestive system.
Moreover, X-rays are taken. During this procedure, doctors can see how the organs are expanded and the pyloroduodenal zone is narrowed. Moreover, thanks to this researchyou can find out how long it takes the body to get rid of foreign substances. Through these studies, it is possible to find out which therapy will be most beneficial.
Treatment
It is worth noting that this disease is mainly treated only with the help of surgery. Before the process to combat pyloroduodenal stenosis, preoperative preparation is mandatory. What is included here? First you need to normalize the water-electrolyte balance. This is done with the help of special medicines. In order to check the effectiveness of such treatment, blood biochemistry is performed. Moreover, enteral nutrition is prescribed, aspiration of gastric contents is performed. This is done with a probe. Anti-ulcer therapy is also prescribed. The course of such treatment lasts 3 weeks.
Surgical treatment is carried out using several methods. A vagotomy is performed. Most often, it is performed together with additional methods. The stomach is resected. As a rule, the last stage of this disease due to this passes into a milder form - decompensation. Antrumectomy may also be performed.
Vagotomy
In the event that there is stenosis with sufficient patency of the pyloroduodenal zone, doctors can perform a vagotomy. If during the operation it is not possible to stretch a thick probe, then this process is carried out using pyloroplasty. Well, if the ability of the stomach muscle to contract is preserved, a vagotomy is performed withdrainage.
Complications
If you ignore the symptoms and do not start treatment on time, you must be prepared for the occurrence of complications. We are talking about dehydration of the body, up to the most severe stage. Perhaps a decrease in chlorine in the blood, a lack of potassium, a decrease in calcium, a decrease in plasma volume, convulsive seizures. In the most severe cases, chlorhydropenic coma occurs. As a rule, it is the result of serious violations of the water and electrolyte balance. Its causes also include vomiting, diarrhea, adherence to a s alt-free diet table, uncontrolled intake of diuretics, acute renal failure, and fairly frequent gastric lavage.
Prevention
Prevention of this disease does not exist. Unfortunately, doctors have not yet identified what can help in the fight against the possible development of this disease. It is only recommended to undergo a preventive examination by a gastroenterologist several times a year. And also in a timely manner to treat diseases that can lead to the formation of this disease.
Summing up
Considering this disease, it is worth saying that it is easier to prevent it than to treat it. It should be noted that many people miss the beginning of the described disease, thereby complicating their lives. Do not neglect the examination by doctors, because the treatment of this disease is not only difficult, but also expensive. In its absence, a person will not live long and will suffer from rather unpleasant symptoms. The causes of this disease have already been described, so I just want to add thatyou should eat right, stop drinking alcohol, reduce tobacco consumption, and also monitor the condition of the stomach and duodenum in order not to cause ulcers. You can prevent this disease with the help of timely treatment of ulcers, if any have already arisen. Only with the help of the operation it is possible to deal with pyloroduodenal stenosis. Surgery, however, is not a 100% guaranteed cure.
At the genetic level, this disease is not transmitted, so young parents have nothing to fear. Due to the fact that there is no prevention of this disease, it is becoming more common and affects most of the people. Often, when patients turn to doctors already in the later stages of the disease, treatment does not make sense, since irreversible consequences are possible after surgery. That is why it is necessary to immediately consult a doctor when identifying the first symptoms. It is better to make a mistake several times than to miss the beginning of such a serious illness. Many patients who have experienced this disease unanimously declare that it is quite difficult to live with constant symptoms, they had to leave work and also hire nurses. If you avoid treatment, you can wait until the moment when food stops passing through the stomach into the intestine. This will lead to a painful death.
