Stenosis of the stomach and duodenum, also known as pyloric stenosis, is a pathology of the digestive tract, which occurs as a result of narrowing of the lumen of the gastric pylorus. As a result, there is a violation of the process of passage of food from the gastric cavity to the intestines. In its advanced form, the disease can cause severe pathologies, as well as make changes to homeostasis.
Stenosis is an acquired disease, but in rare cases there are congenital pathologies.
Causes of this disease
Gastric stenosis is inherently a complication of peptic ulcer disease. Healing of ulcers occurs, as a rule, through the formation of scar tissue. The scar that appeared at the site of the ulcer affects the connective tissues, thereby deforming the damaged walls of the stomach.
There are several reasons that lead to the development of gastric stenosis:
- Presence of hernia in the opening of the esophagus.
- Cholecystitis,calculous type.
- Gastritis in a chronic course.
- Toxemia of pregnancy.
- Getting a chemical internal burn.
- Mechanical damage to the esophagus.
- Complication after surgery.
Factors provoking this pathology
In addition, doctors identify a number of factors that can provoke the appearance of stenosis of the stomach and duodenum:
- Unbalanced and irregular meals.
- Poor quality of food used.
- Alcohol abuse.
- Prolonged use of medicines.
- Following mono-diets for a long time.
- Presence of malignant tumors.
Careful attention to nutrition in case of stomach disease
A balanced diet involves not only eating the right and high-quality foods, but also observing the regularity of meals and the amount of food consumed. If the course of stenosis is characterized as severe, you need to carefully approach the issue of nutrition. This will eliminate the possibility of relapse.
Stages
Gastric stenosis according to ICD-10 (international classification of diseases) is indicated by the code K-31.2. Passes through three stages of development, each of which has its own characteristics of manifestation and treatment:
- The first stage of pathology. The manifestations of the disease are insignificant, have a low degree of severity. hole betweenthe intestines and stomach are only slightly closed. The patient may complain of a sour taste in belching, as well as a feeling of fullness in the stomach after taking even a small amount of food. In some cases, relief comes only after cleansing the contents of the stomach by inducing a gag reflex. In general, the patient's condition is described as satisfactory.
- Second stage. It is described as compensatory and is accompanied by a feeling of fullness in the stomach constantly, even in the absence of food intake. In addition, there is pain and belching. After eating, vomiting often opens, which brings relief, but short-term. The patient is characterized by unreasonable loss of body weight.
- Third stage. It is also called decompensation and is characterized by a sharp progression of stenosis. There is a strong stretching of the stomach, accompanied by exhaustion and dehydration. Quite often, in the third stage, vomiting is observed, which has an unpleasant odor, with the remnants of undigested food for several days.
Treatment can give a result at any stage of the development of pathology, however, with early diagnosis, the chances for the absence of complications are much greater.
Symptoms
Pyloric stenosis, characterized by narrowing of the lumen between the duodenum and the stomach, can manifest itself in different ways depending on the type of pathology and the stage of its development. Experts identify the following symptoms of the disease:
- Compensated stenosis is characterized by a slight narrowing of the muscles of the organ. The patient complains of a feeling of fullness in the stomach, often experiencing severe heartburn, which has to be stopped by regular intake of antacids. Occasionally, the patient begins vomiting, which brings relief and eliminates discomfort until the next meal. X-ray examination allows you to see the acceleration in peristalsis and slowing down in the process of intestinal emptying. Symptoms of gastric stenosis may appear for several years, but do not increase in intensity.
- Subcompensated form of stenosis is manifested by profuse and frequent vomiting, which helps the patient eliminate the discomfort of stomach fullness. With the transition to this form, stenosis becomes more pronounced. The main sign of a subcompensated form of stenosis is belching of rotten foods that were eaten the day before. In addition, the patient may complain of pain in the epigastric region. X-ray examination reveals peristalsis from the left side to the right. Another characteristic sign of decompensated stenosis is the expansion of the stomach and the violation of its transport function. These changes can only be detected during an x-ray, when the contrast agent remains in the stomach for a long time. The duration of the stage can be several years. Symptoms of pyloric stenosis should not go unnoticed.
- Decompensated form of stenosis is determined by severe violations of the evacuation capacity of the gastrointestinal tract. Quite often, the period of decompensation indicates the presenceulcerative stenosis of the stomach. The patient complains of regular heaviness in the stomach, frequent urge to vomit. The skin of the patient becomes sagging, facial features are sharpened. In the area under the pit of the stomach, the outlines of stretched stomach tissues appear, and there are no signs of peristalsis on the x-ray. On palpation, the doctor can detect the sound of splashing. X-ray also shows the presence of a large amount of food in the stomach and a decrease in the propulsive capacity of the stomach. The presence of frequent vomiting that is difficult to stop can cause electrolyte loss and severe dehydration, which, in turn, can cause hypochloremic coma.
Diagnosis of a pathological condition
If you find the symptoms of stenosis of the stomach and duodenum described above, you should definitely consult a doctor. After the examination, the specialist will prescribe a number of studies, including:
- X-ray examination of the stomach. According to the obtained image, it is possible to determine the increase in the size of the organ, as well as the degree of decrease in gastric motility and see the presence of a narrowed lumen between the duodenum. In addition, x-rays reveal the amount of time it takes for the stomach to move food to the intestines.
- Esophagogastroduodenoscopy. Shows the stage of development of the pathological process, as well as the degree of deformation and narrowing of the lumen between the duodenum and stomach. In addition, the study will provide information about the expansion of the stomach.
- Study of the motor function of the organ. Produced throughelectrogastroenterography and allows you to determine the activity, tone, frequency and nature of peristalsis during meals and on an empty stomach.
- Ultrasound.
After receiving the results of the examination and confirming the diagnosis, the doctor prescribes treatment for gastric stenosis.
Drug treatment of this pathology
Surgery is considered the best option for treating pathology. If the disease was detected at an early stage, and surgery is not possible, medical treatment is prescribed, which involves the use of drugs to relieve symptoms of stenosis, including:
- Antibacterial drugs that have a detrimental effect on the microorganisms that provoked the appearance of an ulcer.
- Preparations with antacid properties. Helps fight belching and heartburn.
- Sorbents that promote the removal of toxins from rotten products from the body.
- Painkillers for pain relief.
- Prokinetics. The action of this group of drugs is focused on restoring the motility of the stomach and intestines.
Other therapeutic measures
In addition, conservative treatment of gastric outlet stenosis involves the following activities:
- Treatment of metabolic disorders.
- Body weight reduction.
- Therapy of pathologies that could provoke the development of stenosis.
To speed up the healing process of ulcerative formations in the duodenum and stomach, drugs with wound healing properties are prescribed, including draft herbal remedies and vegetable oils.
Traditional medicine
In some cases, it is allowed to use traditional medicine methods to eliminate the symptoms of gastric stenosis. These prescriptions should be used after consulting a doctor and only as an additional therapeutic agent. There are several recipes for the treatment of diseases of the gastrointestinal tract:
- Flowers of coltsfoot (5 g) are poured with a glass of boiling water and infused for several hours. Then the resulting infusion is strained and taken 100 ml in the morning and evening. The plant helps to get rid of heartburn.
- Celery root (30 g) finely chopped and pour boiling water over. The mixture is infused for half an hour, then taken 50 ml before meals. Celery speeds up the healing process of ulcers inside the stomach.
- In equal quantities, mix motherwort, St. John's wort and valerian, pour half a liter of water. The mixture is infused in a thermos for four hours. It is taken after meals. It is allowed to sweeten the drink with honey. This mixture has a sedative effect and normalizes the functions of the digestive system.
It is not recommended to use traditional recipes as monotherapy for gastric stenosis, as this will not give the expected result.
Surgical treatment
Sometimes doctors are forced to decide to perform an operation whenstenosis of the stomach. The most commonly used endoscopic method, which allows you to inflate the narrowed lumen between the organs. At the same time, the work of the pylorus of the stomach stops, however, it is possible to restore the patency of the organs.
If it is not possible to get rid of gastric stenosis through drug treatment, an abdominal operation is prescribed. There are quite a few methods of carrying out, but most often preference is given to gastroscopy, followed by bougienage of the pyrolytic area.
Congenital stenosis
Congenital stenosis (which is quite rare), is characterized by a significant narrowing of the lumen and is treated only with surgery. Medical therapy in this case is powerless. A patient with congenital stenosis undergoes a pilomyotomy using a laparoscope. This method is considered minimally invasive. The child recovers after the operation, and the likelihood of a relapse is extremely small.
Prevention
A very important preventive method for stenosis is a proper and balanced diet, which involves the following recommendations:
- Use grated products. Helps prevent damage to the stomach or intestinal walls.
- Regular fractional meals at least five times a day in small portions.
- Eat no more than 200 grams at a time.
- You can eat boiled, stewed or baked food, but not fried food.
- You can drink mineral water without gas,teas and compotes.
- Fatty food is strictly prohibited.
- Spicy dishes and a lot of spices are not welcome.
- Alcoholic drinks are not recommended.
Conclusion
Following these nutritional recommendations, the patient can maintain normal digestive processes for a long time. It is important to monitor the state of he alth and regularly undergo preventive examinations with a gastroenterologist. Timely detection of the disease is the key to effective treatment. You should not delay going to the doctor at the first sign of stenosis.
