Duodenitis how to treat. Duodenitis: symptoms, treatment, diet, folk remedies

Date of: 20.06.2020

The inflammatory process of the duodenal mucosa leads to the development of a chronic disease - duodenitis. Treatment of duodenitis with folk remedies often helps to eliminate the disease.

Not a single digestive process is complete without the participation of the duodenum, which anatomically is a vessel or cavity with a channel for draining digestive juices and enzymes. This organ serves to digest food absorbed by microvilli, further processing and distribution of nutrients throughout the body.

In addition, the duodenum produces up to 30 hormones necessary to maintain normal several important systems at once: endocrine, cardiovascular, digestive and nervous.

Infection by viruses and bacteria leads to the development of inflammation in the duodenum, a decrease in functionality, atrophic changes in the walls of the cavity, and the appearance of erosive areas. As the inflammatory process develops, it begins to go beyond the walls, affecting the muscular membrane and the entire intestine as a whole.

Reasons for the development of duodenitis

The main causes of duodenitis are directly related to nutrition. These include meals on the go, dry food, large portions, or irregular meals with long intervals between meals. Often duodenitis develops as a result of the use of semi-finished products, fast food, canned food, coffee, salty, fried and spicy foods in large quantities.

Provoking factors can be:

persistent malnutrition;
alcohol and smoking;
intake of hot food, carbonated drinks, spicy dishes.

These are the reasons for the development of initial duodenitis with an acute course.

If measures are not taken to revise nutrition and lifestyle in general, the disease becomes secondary and chronic.

Symptoms of duodenitis

The disease manifests itself in different ways. The main symptom in the development of an acute inflammatory process in the colon is acute pain in the stomach, bouts of nausea and vomiting. With the transition of the disease into a chronic form, the pain becomes dull, pressing under the spoon of the stomach, bursting at the top of the abdomen, usually together with heartburn, vomiting after eating.

There is bloating and rumbling, the appearance of bitter belching and constipation. With inflammation of the upper intestines, the symptoms are similar to an ulcer, when the stomach starts to hurt about 0.5 hours after eating.

If pain occurs 2 hours after a meal, then a bowel ulcer can be suspected.

If the stomach hurts on an empty stomach or at night, weakness, headache, irritability and lack of appetite are observed, this indicates the development of a local form of duodenitis.

For chronic duodenitis:

pain in the right hypochondrium;
the integuments of the skin turn yellow due to a violation of the outflow of bile;
there are hungry pains in the epigastric part of the stomach;
there are signs of dyspepsia, intestinal disorders;
digestion is disturbed.

Symptoms and treatment for the development of inflammation in the duodenum are very similar to an ulcer, gastritis, cholecystitis or pancreatitis. This often leads to difficulties in making a definitive diagnosis. A number of diagnostic procedures are carried out: x-ray of the stomach, endoscopy of the esophagus and duodenum, duodenal sounding, examination of the secretion of the intestine and stomach in case of suspected infection with Helicobacter pylori infection.

The disease is more common in men, and not many people rush to see a doctor when they experience stomach pain. However, most of the patients are interested in how to treat duodenitis with folk methods. This is quite possible, but it is necessary to follow a diet, adjust the diet, chew food thoroughly, eat in small portions up to 5 times a day.

Treatment with folk remedies

Treatment of duodenitis is carried out with medicinal herbs sold in pharmacies in the form of tea bags in a wide range. Before you start taking it, you first need to consult a doctor, undergo an examination.

The following herbs are used:

eucalyptus - suitable for eliminating existing symptoms, stimulating digestion, eliminating stomach pain;
cardamom (seeds) - to calm the nerves and stomach;
chamomile flowers - to relieve disorders in the stomach, improve blood circulation;
cinnamon, ground - to eliminate pain in the stomach, increase appetite;
fennel (seeds) - to reduce pain and bouts of nausea;
ginger root - to relax the intestines;
kava-kava root - to improve mood, relieve pain in the stomach;
lemon mint - for the treatment of duodenitis;
sage (leaves and flowers) - for pain relief, relaxing effect;
valerian root - to improve digestion;
licorice root - to increase appetite;
yarrow - to improve digestion, stimulate the production of gastric juice.

Folk recipes

In the chronic stage of duodenitis, treatment with folk remedies can be carried out with the following compositions:

insist fennel fruits and centaury (50 g each), take 1 tbsp. portions up to 4 times a day;
insist peppermint (40 g), eyebright grass (20 g) and drink 1/3 tbsp. 3-4 times a day before meals;
collection of sage, peppermint, lavender flowers (15 g each) brew with boiling water, insist and drink in portions before meals;
insist peppermint (15 g), chamomile flowers (50 g), fennel fruit (10 g), valerian root (10 g), drink 1 tbsp. for 1 dose, if there are colic and heaviness in the stomach;
insist peppermint (20 g), chamomile flowers (30 g), buckthorn (30 g), anise fruits (10 g), take 1 tbsp.;
insist on vodka for 7 days in a dark place juniper (10 g), chamomile and peppermint (25 g each), take 1/2 tbsp. 2 times a day and at night.

Doctors advise at home to eliminate unpleasant symptoms in chronic duodenitis to constantly drink tea from the above herbs, but together with a diet and a well-balanced diet. The treatment is long.

You need to drink herbal teas daily for at least 2 months.

As a result, it is possible to achieve healing of ulcers and erosion, reduce the inflammatory process in the gastric mucosa, reduce the effect of irritating factors on the duodenum, relieve symptoms of inflammation in the epigastric region of the stomach.

To relieve inflammation, eliminate unpleasant symptoms, along with a diet, the following fees give a therapeutic effect:

Licorice, buckthorn root, marshmallow root, shepherd's purse, chamomile, lavender, lemon balm flowers, cinquefoil erect (10 g each), chop, pour boiling water (1 tbsp), insist. Then strain and drink 3-4 times a day in portions.
Prepare tea from cinquefoil (1 tbsp of dry raw materials, brew 0.5 liters of boiling water), insist and drink before meals 3-4 times a day.
Sea buckthorn oil should be taken for a healing effect. Pour sea buckthorn with sunflower oil, insist in a dark place in a sealed container for 7 days. Then strain, squeeze the resulting cake, wipe through a sieve. Take the resulting slurry on an empty stomach, 2 tbsp. before every meal.
Plantain (dry leaves) brew with boiling water (0.5 l), leave for 30 minutes, strain and drink 0.5 tbsp. before meals 6-7 times a day.
To relieve inflammation and improve the activity of the duodenum, pour oatmeal with cold water, insist on taking it in the form of liquid porridge for breakfast.
Chop the aloe, squeeze out the juice, mix with a decoction of oatmeal, take in the form of jelly 0.5 cups 3-4 times a day (first dose in the morning on an empty stomach).
You can cook aloe with May honey on grape natural wine. Squeeze juice from aloe, add liquid honey heated to 60 ° C, mix, keep up to 7 days in a cool place, shaking occasionally, then strain. Drink a course for 3 months.
Propolis tincture. Pour alcohol (100 g) propolis (150 g), insist 10 days in the dark, shaking occasionally, take 15-20 drops of propolis with the addition of milk 3 times a day. Instead of propolis, you can use flax seeds.
Pour boiling water (0.5 l) calamus root, common tansy, valerian root, leave for 2 hours, take 0.5 cup 3-4 times a day.
Any ready-made product can be stored in the refrigerator for several days.
You can cure duodenitis by taking 1 tablespoon of sea buckthorn oil on an empty stomach. 2 times a day and for 2 weeks. Then you need to take a break for 2 weeks and repeat the course of treatment.

Proper nutrition

With duodenitis, the symptoms can be completely different, and only a doctor can establish the correct diagnosis based on the examination, prescribe a full-fledged complex treatment and develop a diet. The energy value of the menu should be at least 3000 kcal per day. It is important that the diet is balanced, with a complete rejection of spicy, sour, fried, smoked foods, alcohol and salt restriction (no more than 2 tsp per day). You need to drink at least 1.5 liters of water per day.

You need to cook food only for a couple.

To alleviate the condition, eliminate pain in the stomach and other symptoms of inflammation, the diet should be varied. It is recommended to take dried bread, lean buns, dry biscuits or cookies with the exclusion of fresh yeast products, pancakes, pies, muffins from the diet.

To give strength, you can cook any cereals from semolina, rice, buckwheat, oatmeal on the water. Make casseroles and puddings from cereals with the exclusion of legumes and pasta from the diet.

With duodenitis, a sufficient amount of protein is required to enter the body, so be sure to eat soft-boiled eggs, cook omelettes, scrambled eggs. Low-fat meats, chicken, veal, rabbit, turkey are recommended to be boiled and taken in pureed form.

Useful boiled or mashed beets, potatoes, carrots, cabbage, broccoli, boiled zucchini. Pickled and salty foods, chocolate, nuts, kvass, coffee, sour juices, alcohol and beer should be excluded from the diet.

Gradually, the diet can be expanded.

The main rule is to prevent exacerbations, to minimize any irritation of the products of the gastric mucosa.

The inflamed intestine requires recovery, so the treatment is long, the diet must be followed constantly. Overeating should not be allowed, eat 2 hours before bedtime, you need to monitor your well-being, cook foods for a couple, limit salt intake to 8 g per day, and drink more fluids.

Thanks to the diet and the constant intake of herbal teas, noticeable relief should come in a couple of weeks.

Duodenitis is an inflammation of the duodenum, often only the mucous membrane, accompanied by a long course of the process, a change in its structure, a common disease that is more common in men.

If only the mucous membrane of the duodenal bulb is affected, the disease is called bulbitis, the region of the large duodenal papilla (Vater's papilla) is sphincteritis or odditis. The disease is often combined with inflammation of the gastric mucosa (gastroduodenitis).

As for the symptoms, its expression depends on the form of duodenitis, as well as the disorder that caused such an ailment. The main, and often one of the first signs, is a strong pain syndrome.

What it is?

Duodenitis is an inflammatory disease of the mucous membrane of the wall of the duodenum (duodenum).

There are acute and chronic forms. Acute duodenitis is characterized by severe symptoms of acute inflammation, which completely subside after therapy and do not leave noticeable structural changes in the mucosa. Chronic duodenitis is a disease of a long relapsing course, characterized by the development of foci of inflammation in the mucosa with subsequent pathological restructuring of its structure.

This is the most common of the diseases of the duodenum. 94% of all inflammatory processes in the duodenum become chronic. Chronic duodenitis is more than twice as common in men as in women.

Classification

In their daily work, various specialists (clinicians, endoscopists, pathologists) use different classifications of duodenitis. However, all stand out:

acute form - characterized by a sudden and vivid manifestation of symptoms, which, if detected in the early stages, can be eliminated within a few days, often thanks to diet therapy. Acute duodenitis can be caused by bad habits and malnutrition;
chronic form - is a consequence of untimely treatment of the previous form, and is also formed due to the chronic course of diseases associated with other organs of the gastrointestinal tract. The basis of therapy is the use of medications, and during the period of remission, compliance with a sparing menu.

According to the endoscopic picture, inflammation of the duodenum is divided into:

atrophic duodenitis - in which thinning or death of the cells of the mucous membrane of the affected organ occurs, which causes a violation of the secretion of digestive juices;
hemorrhagic - characterized by the detection during the diagnosis of duodenal bleeding;
erythematous - expressed by significant swelling and severe redness of the mucosa;
erosive or hypertrophic duodenitis - accompanied by the appearance of erosions, of various amounts and depths;
nodular;
hyperplastic duodenitis - characterized by increased division and proliferation of mucosal tissues. During endoscopic examination, a bumpy surface of the shell is noted;
reflux duodenitis - during which there is a reverse reflux into the duodenum of the contents of the small intestine.

As the disease process spreads, such a disorder is divided into the following types:

superficial or catarrhal duodenitis - characterized by a slight inflammation of the upper layers of this organ;
proximal duodenitis is the complete opposite of the previous form, since inflammation spreads to the deeper layers of this organ, and the bulb of the duodenum is also involved in the process;
distal duodenitis - almost completely similar to the proximal one, the only difference is that the bulb is almost unchanged;
total or diffuse - with damage to the entire surface of the mucosa;
focal duodenitis or limited - during the diagnosis, it is expressed by one or more foci of inflammation in various parts of the duodenal membrane;
papillitis - this condition is said when the inflammatory process affects the major duodenal papilla.

In addition, there are several specific and most rarely encountered types of inflammation of the duodenum 12. These include:

tuberculous duodenitis;
immunodeficient;
caused by Whipple's or Crohn's disease;
fungal;
follicular duodenitis;
consequence of intestinal amyloidosis.

Reasons for development

The main reasons leading to the development of the inflammatory process in the duodenal mucosa are:

abuse of fried, spicy, smoked and sour foods;
abuse of drinks with a high content of caffeine (energy drinks, coffee, strong tea, cola);
smoking;
alcoholism.

All of the above factors contribute to increased secretion of hyperacid gastric juice, that is, containing an increased concentration of hydrochloric acid. It enters the cavity of the duodenum, causing irritation at first, and then acute inflammation of its mucous membrane. When the disease becomes chronic, atrophic and degenerative processes occur in the intestinal wall.

Duodenitis often develops as a secondary process against the background of a number of the following pathologies of the digestive system:

peptic ulcer of the stomach and duodenum;
chronic gastritis;
infection of the stomach and duodenum with the bacterium Helicobacter Pylori;
violation of blood supply and innervation of the walls of the duodenum;
chronic colitis, enteritis, pancreatitis, hepatitis;
cirrhosis of the liver;
helminthic invasions (giardiasis, ascariasis).

Symptoms of duodenitis in adults

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

Symptoms of duodenitis in adults:

Pain in the epigastric region, aggravated by palpation (palpation) of the abdomen. The pain has its own characteristics in various forms of duodenitis:
- in the chronic form - constant, aching, aggravated on an empty stomach and 1-2 hours after a meal;
- with duodenitis caused by a violation of intestinal patency, the pain is arching, paroxysmal, occurs when the intestines are full;
- with gastritis-duodenitis with high acidity - develops 10-20 minutes after eating, which is explained by the entry of acidic gastric contents into the intestine;
- for the ulcer-like form caused by Helicobacter pylori, fasting pains are characteristic;
- with local inflammation around the Vater nipple, the outflow of bile from the gallbladder is disturbed, a clinic similar to an attack of hepatic colic occurs: pain in the right hypochondrium.
Increased fatigue, weakness. This is due to the action of toxic substances formed in the process of inflammation.
Perhaps a slight increase in body temperature (up to 37-38 0).
Digestive disorders (dyspepsia):
- nausea;
- loss of appetite;
- increased gas formation (flatulence);
- belching, vomiting with a bitter taste (due to bile ingestion) - throwing food back into the stomach;
- stool disorder (diarrhea or constipation).
Yellowing of the skin and mucous membranes. Swelling of the papilla of Vater leads to a decrease in the lumen of the bile duct, stagnation of bile and its entry into the blood.
Dumping is a syndrome. Occurs after a large meal. When the duodenum overflows, a redistribution of the bloodstream occurs (blood flow to the digestive organs, outflow from the head). Manifested by dizziness, drowsiness, a feeling of fullness in the stomach, fever in the upper body.

With an asymptomatic course of the disease, there may be no complaints, the detection of pathology is an accidental finding during gastroduodenoscopy.

Clinical forms

Ulcer-like ("night" and "hungry" pain in the epigastrium or in the area of the projection of the duodenum of a pulling nature without irradiation. Stopped by eating and taking antacids and gastroprotectors. Often there is heartburn and bitter belching.).
Gastritis-like form (pain almost 15-20 minutes after eating, dyspeptic syndrome - nausea, vomiting, belching, rumbling in the abdomen, diarrhea, flatulence, lack of appetite).
Cholecystic-like and pancreatic-like forms (pain is acute, severe, located in the right or left hypochondrium, prone to irradiation, proceeds like biliary colic, there are signs of cholestasis, dyspeptic disorders).
Neuro-vegetative form (vegetative asthenoneurotic disorders come to the fore, deping syndrome is a consequence of duodenal hormonal insufficiency).
Mixed form (combines signs of different clinical forms of duodenitis).
Asymptomatic form (usually in the elderly - detected by functional diagnostic methods during examination for other pathologies).

Complications of the disease

If symptoms are ignored, treatment is started late, or the course of inflammation of the duodenal membrane is chronic, there is a possibility of the formation of complications such as:

Intestinal obstruction is a condition in which the passage of food through the intestines is partially or completely stopped. It is accompanied by sharp pains in the upper abdomen, 15 minutes after eating, repeated vomiting with an admixture of bile. This phenomenon can be caused by the proliferation of connective tissue and the formation of adhesions at the site of the inflammatory process.
Maldigestion / malabsorption syndrome - a violation of the absorption of nutrients through the intestinal mucosa due to enzyme deficiency. The development of a complex of symptoms is associated with a violation of the glands of the digestive tract. This condition in the early stages is manifested by diarrhea. In the future, exhaustion appears, changes in the composition of the blood - anemia, immunodeficiency - a decrease in the body's resistance to infections. In children, there is a noticeable lag in physical development.
Peptic ulcer of the duodenum. A deep defect is formed on the wall of the duodenum - an ulcer. Its appearance is associated with the action of hydrochloric acid and pepsin on a weakened mucous membrane. It is manifested by pain in the upper half of the abdomen against the background of long breaks between meals, with the use of alcohol and physical exertion. Digestion is also disturbed: bloating, alternating diarrhea and constipation.
Intestinal bleeding can be a consequence of erosive duodenitis. It is manifested by weakness, dizziness, a drop in pressure, blood in the stool (the discharge becomes black).

But, despite the high likelihood of such complications, the prognosis of duodenitis is favorable. If the disease is detected in the early stages, a complete cure is achieved.

Diagnostics

A competent specialist is able to suspect duodenitis after a conversation with a patient who came to him and his examination. But for the final verification of this not too frequent diagnosis, a comprehensive and comprehensive examination is necessary.

If during the diagnosis the doctor suspects malignant tumors located in the mucous membrane area, the doctor will prescribe another examination. In this case, the biomaterial is examined in the laboratory of the oncology department.

Diagnosis is based on instrumental research methods:

fibrogastroduodenoscopy (FGDS) with biopsy;
duodenoscopy;
pH-metry;
radiography of the stomach and duodenum;
biochemical blood test;
study of feces;
ultrasound examination (ultrasound)

With the help of research, it is possible to establish what caused the disease, this will subsequently simplify the treatment and allow whistling to minimize the risk of relapse.

How to treat duodenitis?

In adults, the treatment of duodenitis includes several areas:

elimination of acute inflammation
preventing the transition of the disease to the chronic stage
restoration of the functions of the duodenum 12
normalization of digestion

Mostly treatment is carried out at home. For a speedy recovery, proper sleep, rest, diet, walks, light physical activity in the absence of pain are necessary. It is necessary to avoid stress, quit smoking and alcohol. Such measures help to normalize blood circulation in the duodenum, restore the protective properties of its mucosa.

Indications for hospitalization for duodenitis:

exacerbation of duodenitis
suspected small bowel tumor
severe general condition of the patient, advanced cases of the disease
inflammation of the serous cover of the duodenum 12 (periduodenitis) and nearby organs
the presence or threat of bleeding (erosive or ulcerative form of duodenitis).

Acute treatment

Acute catarrhal and erosive-ulcerative duodenitis usually do not require special treatment and, if the correct regimen is followed, disappear within a few days, but in case of repeated manifestations, the disease can become chronic.

The patient is prescribed bed rest and hunger for 1-2 days. Sometimes it is recommended to wash the stomach with a weak solution of potassium permanganate. After washing to cleanse the intestines, drink 25-30g of magnesium sulfate diluted in a glass of water. Starting from the third day, the patient is prescribed a therapeutic diet No. 1 (food that irritates the intestinal walls is limited, dishes are prepared pureed, boiled in water or steamed, very cold and hot dishes are excluded). Astringents and enveloping drugs are prescribed, with pain - antispasmodics (No-shpa, drotaverine, papaverine).

With phlegmonous duodenitis, surgical treatment, antibiotic treatment is indicated. Possible complications - intestinal bleeding, perforation of the intestinal wall, acute pancreatitis.

Treatment of chronic duodenitis

During periods of exacerbation, treatment of chronic duodenitis is carried out in a hospital. Treatment is prescribed depending on the cause that provoked the disease.

In the presence of giardiasis and helminthiases, appropriate chemotherapy is prescribed (flagyl, furazolidone, chloxin).
When a Helicobacter pylori infection is detected, antibiotics are used.
With increased acidity - drugs that reduce the secretion of hydrochloric acid (omeprazole, ranitidine) and antacids that neutralize the acidity of gastric juice (almagel, maalox, phosphalugel).
To protect the mucosa, enveloping preparations (de-nol, sulfacrat) are prescribed. For anti-inflammatory purposes, it is recommended to use decoctions of chamomile and yarrow. Enzyme preparations are prescribed to restore digestion.

If the cause of duodenitis was a violation of the motility of the duodenum (duodenostasis), for example, obstruction, it is necessary to establish its cause. If it is associated with a violation of any functions of the digestive system, the treatment of duodenitis is conservative. Frequent meals in small portions are shown, drugs that bind bile and promote its secretion (choleretic). Effectively duodenal sounding with washing of the duodenum.

In the presence of adhesions, mechanical obstructions and other kinds of obstruction that is not amenable to therapeutic treatment, surgical treatment of duodenitis is indicated.

With secondary duodenitis, treatment of the underlying disease is necessary.

Nutrition for duodenitis

When diagnosing duodenitis, the doctor prescribes a diet. It is understood that in the acute form of the disease, the patient will be given the following instructions:

limit the use of cocoa, chocolate and black coffee;
exclude from the diet alcoholic beverages, pickled and salty foods, smoking and preservation, bacon and fresh pastries, sorrel and spinach, fatty meats and fish, mustard and other seasonings;
it is allowed to use mashed soups, semolina / buckwheat / oatmeal porridge, cottage cheese, eggs, weak tea and wheat bread baked yesterday.

Such a diet should be followed not only during the period of the immediate course of acute duodenitis, but also within a month after the main treatment is over - this will help the intestines recover and work normally.

If the patient is diagnosed with chronic duodenitis, then the instructions of the nutritionist will be somewhat different:

it is strictly forbidden to eat sorrel, spinach, fatty fish and meat, mustard, fresh baking, not only during periods of exacerbation of the disease, but also during remission;
it is allowed to enter into the menu cereals, soups, weak broths, butter and vegetable oils, milk and dairy products, low-fat varieties of fish and meat in boiled and baked form, fruits and vegetables, compotes, jelly, weak tea and coffee.

Folk remedies

Treatment of duodenitis with folk remedies is indicated along with the main therapy prescribed by the doctor after the diagnosis. The following are considered effective:

Plantain juice and honey. To prepare the composition, you need to take 3 large spoons of plantain juice and 1 small spoon of honey. Mix everything and take in the amount of 3 large spoons 3 times a day. This remedy is especially effective for erosive duodenitis.
A decoction of oats and nettles. To prepare this folk composition, you need to take a glass of unpeeled oats and add 5 glasses of cold water to it. Put the oats on a slow fire and cook until a slimy decoction appears in the container. After it needs to be cooled and carefully strain through cheesecloth. Still need to prepare a decoction of nettles. It is prepared very simply: a glass of dry nettle leaves is taken and 750 ml of boiling water is poured. Then you need to wait 40 minutes until the broth is infused, and strain. The presented recipe involves the use of both leaves and decoction. The infusion can be taken as a tea, and the leaves are finely chopped and added to oatmeal. Take ½ cup before meals.

Prevention

The main factor in prevention is a properly balanced diet and moderation of bad habits. Contribute to the prevention of the disease - timely examination and treatment of pathological processes in the gastrointestinal tract, the use of drugs only as directed.

Prevention of relapses is possible only with regular examination and monitoring of the condition by a doctor.

Duodenitis is a disease that is manifested by inflammation of the duodenum and is accompanied by a significant thinning of the mucosa. In most cases, for the treatment of such a disorder, gastroenterologists prescribe conservative therapy, which consists of following a diet, taking medications and using traditional medicine. However, it is worth considering that if the patient continues to lead an unhealthy lifestyle, then the positive effect of the treatment may not occur.

Depending on the type of disease, different groups of medicines will be prescribed. For example, the phlegmonous form requires a rather long and serious therapy with antibiotics, for a catarrhal form, or antisecretory and antacid substances are required. But in most cases, the treatment of duodenitis with medications requires an integrated approach and involves the simultaneous administration of several groups of drugs, which are rarely prescribed alone.

Often the course of their use does not exceed a three-week period, but depending on the form of the disease, the duration may vary. So, in cases, lifelong medication is indicated, but only during periods of exacerbation.

Treatment with tablets without fail is carried out in a hospital, under the supervision of a specialist. With duodenitis, patients may be prescribed:

antacids;
antimicrobial agents;
antibiotics;
anti-inflammatory drugs;
painkillers and antisecretory drugs;
vitamin complexes and enzymes.

If the disease proceeds in a chronic form or is accompanied by the manifestation of symptoms from the vegetovascular system, then the above group of drugs is supplemented with sedative medications.

Treatment regimens

Gastroenterologists have developed several treatment regimens that are used only in cases where the pathological effect of the bacterium Helicobacter pylori has been detected. There are several options:

When diagnosing secondary forms of duodenitis, that is, formed against the background of other diseases of the gastrointestinal tract, first of all, the elimination of the underlying disease, which caused destructive changes in the duodenal region, is required.

Also, drug therapy of duodenitis consists of several areas:

etiotropic treatment- aimed at eliminating pathogens. Depending on the reasons, various substances are prescribed;
pathogenetic- used against the inflammatory process;
symptomatic- relieves the rest of the symptoms of such a disorder.

Antibiotic therapy

Antibiotic treatment is necessary only in cases where a pathogenic bacterium has been identified. The optimal course for eliminating inflammation of the duodenum must necessarily consist of a combination of two or three antimicrobial drugs. With duodenitis, drugs such as:

Amoxicillin;
Clarithromycin;
Metronidazole;
Furazolidone.

In addition, the elimination of duodenitis is facilitated by:

Klacid;
Alpha Normix;
Amoxicar;
Omephez;
Promez.

The approved course duration is no more than two weeks. Since Helicobacter pylori can adapt to some drugs, in cases where such a microorganism is found after the specified period, antibiotic analogues are prescribed by the doctor.

Such drugs can only be prescribed by the attending physician, since some of them have a destructive effect on the intestinal wall. It is for this reason, without fail, after taking antibiotics, it is necessary to use probiotics and prebiotics - to restore the intestinal microflora. These funds include - Linex, Bifiform, Probifor and Hilak-forte.

Antispasmodics for duodenitis

The use of this group of drugs relaxes the smooth muscles of the walls, reduces the manifestation of pain spasms and discomfort, which very often accompany the inflammatory process of the duodenum.

The most effective drug is Platifillin, aimed at eliminating soreness in the organs of the digestive system, which is why it is widely used not only for duodenitis, but also for other gastrointestinal disorders.

No less popular and effective medicine is No-Shpa, which eliminates spasms. In addition, patients may be prescribed:

Papaverine;
Duspatalin;
Drotaverine is an analogue of No-Shpa.

You can drink these tablets, regardless of the meal, three times a day. However, they have several contraindications, the main ones being asthma and kidney failure. It is for this reason that only the attending physician prescribes medications, and the entire course of treatment takes place in a hospital.

Antacids

A similar group of drugs, thanks to several active ingredients, has a positive effect on acidity in the gastrointestinal tract, i.e., reduces it. In addition, it has an enveloping and mild antispasmodic effect. They can be used both for duodenitis and for other ailments of the gastrointestinal tract.

The most effective medicine of this group is Almagel. It not only neutralizes the action of hydrochloric acid, but helps to restore injured tissues of the duodenal lining.

Other such substances include:

Omez;
Rutacid - in addition to the main effect, it protects the mucous membrane from aggressive irritants;
De-Nol - is used for almost all diseases of the gastrointestinal tract, envelops and heals the shell of the affected organ. Often, doctors prescribe a well-known analogue of this drug - Vis-Nol;
Maalox;
Gaviscon;
Phosphalugel;
Altacid.

The main contraindications to the use of the above funds are the presence of renal failure, the period of childbearing, as well as the age of the patient up to three years.

Antisecretory substances

Proton pump inhibitors are considered the most effective means to reduce secretion. This group differs from other drugs in harmlessness and therapeutic effect.

With inflammation of the duodenum 12 shows the reception:

Omeprazole;
Rabeprazole;
Lansoprazole;
Esomeprazole - the most slowly excreted from the body, which is why its dosage will be somewhat smaller. This medicine is considered the most effective PPI and lasts for fourteen hours.

However, in addition to such medications, for the treatment of duodenitis, drugs will be required to improve the functioning of the gastrointestinal tract. Often they are prescribed for exacerbation of the chronic course of the disease. They not only promote motility, but also accelerate the passage of food masses, but do not affect the level of gastrin. Among these funds, the most famous are:

Motilac;
Motilium;
Ganaton;
Itomed;
Passagex.

Vitamin complex

The appointment of vitamins is indicated for inflammation of the duodenum to normalize or maintain the level of the immune system. Vitamin complexes A, B and C are considered the most valuable for the organs of the digestive system.

They can be ingested with food, but it is recommended to drink them in the form of tablets, so they will bring great benefits. Some funds may be in the form of a vaccine - Beplex is considered the best multivitamin remedy.

Some of the above medicines can be used as a prophylaxis for this disorder. These drugs include:

Omez;
pantoprazole;
misoprostol;
Famotidine;
Alpha Normix;
Rofecoxib;
Celecoxib.

Only the attending physician can prescribe certain medications, as well as set their dosage. Only a specialist will be able to determine the nature of the course and the causes of such a disease, as well as to find out the content of hydrochloric acid. Self-medication can only aggravate the course of the disease and cause the formation of undesirable consequences.

What is duodenitis

The duodenum is located in the upper section, adjacent to the stomach and becomes the first stage of the food journey after it has been treated with acid and enzymes and leaves the primary digestive section. At the junction there is a special valve that prevents the reflux of caustic acid into the intestine, the mucosa of which is not adapted to an aggressive environment.

Normally, processed food comes already in a fermented, but “safe” form, and the upper section is responsible for the gradual absorption of nutrients. Symptoms of duodenitis indicate that the process is broken.

Physiologically, during an attack of the disease, the following occurs:

For some reason, gastric juice enters the intestines. The hydrochloric acid contained in it acts on the mucous membrane of the intestinal walls.
This causes irritation and then, due to cell death, an inflammatory process.
Since food continues to flow, the process can be repeated many times, aggravating the condition of the intestinal walls.
Symptoms of duodenitis can also occur regardless of exposure to gastric juice, if the causes of inflammation are not directly related to the toxic effects of hydrochloric acid and enzymes.

In any case, the main characteristic of duodenitis of the stomach and upper duodenum is an inflammatory process. Its degree can vary from mild damage to the upper layer of the absorbing epithelium to deep damage up to intestinal perforation.

Duodenitis often occurs against the background of gastritis, stomach ulcers, colitis and other pathologies of the gastrointestinal tract - pancreatitis, cholecystitis, liver diseases. Since the entire system is interconnected, the inflammatory process is transmitted from one department to another. That is why people suffering from chronic gastritis always remain at risk for the development of comorbidities.

A subspecies of gastric duodenitis, when only the duodenal bulb is affected, is called bulbitis. It is most often associated with gastritis and bile stasis in the gallbladder, and it is also associated with pancreatic changes in the pancreas.

Since all organs are localized in approximately one place, only a specialist should make an accurate diagnosis. It is very difficult to distinguish gastritis from symptoms of duodenitis without appropriate qualifications, moreover, one disease can be closely related to another.

Classification

You can also find the following classification options:

Superficial duodenitis

Also called catarrhal duodenitis. This is a disease in which only the upper part of the intestinal mucosa is affected. It can be primary or secondary, that is, develop independently or as a complication of another disease.

Local (diffuse)

According to the width of distribution and the number of foci. The most common local catarrhal duodenitis, which appears in the immediate vicinity of the junction with the stomach. This condition is also called duodeno gastric reflux. It is worth remembering that the local form can develop into a diffuse one due to an increase in the number of foci of inflammation.

erosive

A form of the disease in which the mucosa that covers the walls of the intestine gradually degenerates. This condition is classified as dangerous, because without timely medical intervention, this form of the disease is fraught with ulcers. Sometimes, against the background of chronic duodenitis, which has flowed into the ulcerative type, intestinal perforation occurs.

atrophic

The most severe type of erosive duodenitis, characterized by the gradual death of intestinal cells. As a rule, it progresses against the background of duadenostasis, that is, the inability of the intestine to perform the functions of digestion and absorption of food.

Doctors note that primary inflammatory processes are quite rare, secondary chronic duodenitis is much more common. In parallel, patients are diagnosed with gastritis, pancreatitis, colitis. Often, pathological processes such as Crohn's disease, Will's disease, and sometimes intestinal tuberculosis are found.

The classification is intended to determine the source and degree of neglect of pathogenesis. Correct diagnosis also affects the methods of treating duodenitis, allowing you to remove provoking factors and determine the treatment strategy.

Causes

The combination of factors affecting the normal functioning of the gastrointestinal tract creates conditions for the appearance of first superficial duodenitis, and subsequently more severe forms of the disease. The dietary style, lifestyle, even the patient's personality traits place him at risk for this disease.

Any doctor must check the patient with duodenitis for related diseases. The only exceptions will be acute forms that are caused by mechanical damage to the intestinal walls, for example, as a result of the absorption of foreign bodies.

Symptoms

Gastroduodenitis is closely related by clinical manifestations to other disorders of the functions of the gastrointestinal tract - enteritis, pancreatitis, diseases of the stomach and liver. Therefore, the diagnosis and strategy of how to treat duodenitis is selected taking into account possible concomitant factors. Specifically, this disease manifests itself in this way:

Paroxysmal twisting pains, as a rule, appearing an hour and a half after eating - that is, when food leaves the stomach and begins to move through the intestines. Almost always, patients complain of nausea, sometimes vomiting occurs.
Signs of biliary dyskinesia are characteristic - yellowing of the sclera of the eyes, stabbing pains in the hypochondrium, a bitter taste in the mouth, combined with an unpleasant odor.
Often there are "hungry" pains. Therefore, the patient must adhere to a special diet for duodenitis, which simultaneously excludes both overeating and lack of food, because both conditions cause retraumatization of the mucous membrane.
Neurovegetative manifestations are often connected - weakness, dizziness, chronic fatigue syndrome. Patients almost always experience loss of appetite and a sharp decrease in body weight.
Violations of intestinal motility - constipation alternates with diarrhea, as the disease progresses, liquid frequent stools predominate, intestinal bleeding may open. The feces are dark, indicating ulceration in the upper sections.

Diagnostics

An important diagnostic principle in the treatment of adults is the collection of anamnesis. Since the disease almost always appears against the background of systematic dietary disorders, such as excessive consumption of alcohol, fatty and sweet foods, and irregular meals, this should be taken into account when compiling a medical history.

To detect duodenitis, methods are used:

duodenal sounding;
radiography of the stomach;
biochemical blood test;
analysis of coprogram and composition of gastric juice.

Be sure to carry out accompanying diagnostic measures to examine the stomach, esophagus, lower intestines, liver and pancreas. It is desirable to carry out diagnostic measures in a complex manner, without significant time gaps.

Treatment

Treatment of duodenitis involves a combination of complex therapy with diet and lifestyle changes. In acute forms, hospitalization is recommended for 1-2 days, after which outpatient therapy is prescribed using:

Anthracids - Almagel, Phosphalugel, Maalox. They simultaneously help to reduce the acidity of the stomach and prevent the impact of aggressive acid on inflamed areas, and also help to envelop the incoming food.
Antibacterial drugs are almost always prescribed, which are aimed at destroying the Helicobacter pylori bacteria.
Proton pump inhibitors are drugs that prevent hypersecretion of gastric juice. Among the most popular - Omeprazole (Omez), Emanera, Neo-Zext.
Histamine H2 receptor blockers - Nizatidine, Aksid. These drugs are prescription drugs, you can not drink them without a doctor's prescription.
Often used drugs to protect the liver and biliary tract - Essentiale, Hepa-Merz, Resolut.
Analgesics and antispasmodics are used, for example, No-Shpa and analogues to get rid of pain.

Depending on the severity of the disease, enzymes can be used to help digest food, as well as drugs to correct the work of the pancreas and other parts of the intestine.

Diet for duodenitis

One of the key points of therapy is a diet for duodenitis. Depending on how carefully the patient adheres to the recommendations, all other treatment will be effective. Medicines have a full effect only if the diet is observed.

The rules of the diet are:

Completely excluded: alcohol, coffee, smoked foods, spicy, salty, chocolate. Some types of food are temporarily removed, others, such as alcoholic beverages, are recommended not to be consumed at all.
Indigestible foods are prohibited: fresh vegetables, sour fruits and berries, legumes, fresh bread, fried foods, fast food. Often there is intolerance to dairy products, it is recommended to remove fresh milk.
Allowed: sour-milk drinks, yesterday's bread, steamed omelettes, juices from non-acidic fruits and berries, puddings, cereals. It is advisable to use white meat, for example, chicken, after removing the skin from it. Useful lean fish in baked form.
Food should not be too cold or hot. Medium temperature recommended.

Anorexia is often observed in patients suffering from this disease. However, a competent diet for duodenitis involves regular meals 5-6 times a day in small portions, it is forbidden to starve and skip meals. With a pronounced lack of appetite, it is recommended to take enzyme preparations that improve digestion.

Prevention

Since duodenitis, as a rule, occurs against the background of other disorders of the gastrointestinal tract, the best prevention will be the prevention of these diseases. Proper nutrition with a minimum amount of alcohol, complete cessation of smoking and junk food such as fast food all contribute to the health of the stomach, liver and other digestive organs. At the first sign, you should reconsider your lifestyle.

Treatment in adults is often started with advanced forms, since in the early stages the pathogenesis manifests itself only as periodic discomfort in the epigastric region, which people get used to stopping with antacid (anti-acid) drugs. Unfortunately, this method does not eliminate the problem, but only exacerbates it.

Duodenitis is an inflammatory process that affects the mucous membrane of the duodenum. This is one of the most common gastroenterological diseases. Women get sick twice as often as men. In 95% of cases, duodenitis becomes chronic.

Duodenitis - inflammation of the mucous membrane of the duodenum

Causes and risk factors

The main reasons leading to the development of the inflammatory process in the duodenal mucosa are:

abuse of fried, spicy, smoked and sour foods;
abuse of drinks with a high content of caffeine (energy drinks, coffee, strong tea, cola);
smoking;
alcoholism.

Duodenitis often develops as a secondary process against the background of a number of the following pathologies of the digestive system:

peptic ulcer of the stomach and duodenum;
chronic gastritis;
infection of the stomach and duodenum with the bacterium Helicobacter Pylori;
violation of blood supply and innervation of the walls of the duodenum;
chronic colitis, enteritis, pancreatitis, hepatitis;
cirrhosis of the liver;
helminthic invasions (giardiasis, ascariasis).

Forms of the disease

Depending on the duration of the course of the disease and the activity of the inflammatory process, acute and chronic duodenitis are distinguished. Acute, in turn, is divided into catarrhal, ulcerative and phlegmonous.

The phlegmonous form of acute duodenitis is an indication for surgical intervention.

Chronic forms of duodenitis are classified according to different criteria:

according to the localization of the lesion (diffuse, local, postbulbar, bulbar);
due to the occurrence (primary or secondary);
according to the degree of morphological changes (atrophic, interstitial, superficial);
according to the features of the endoscopic picture (nodular, erosive, atrophic, hemorrhagic, erythematous).

There are also special forms of the disease (tuberculous, fungal, immunodeficient duodenitis).

According to the features of clinical manifestations, the following forms of duodenitis are distinguished:

Ulcerative. The patient complains of intermittent "hungry" or night pains in the epigastric region, which are stopped by taking antacids or food. Bitter belching and heartburn are often observed.
Gastritis-like. Pain occurs 20-30 minutes after eating. Expressed dyspeptic syndrome (lack of appetite, nausea, vomiting, flatulence, unstable stool, belching).
Pancreatitis-like and cholecyst-like. The clinical picture resembles an attack of biliary colic. Patients complain of severe acute pain in the left or right hypochondrium, dyspeptic disorders.
Neurovegetative. It develops as a result of hormonal duodenal insufficiency and is manifested by dumping syndrome, asthenoneurotic vegetative disorders.
Mixed. In the clinical picture of the disease, there are signs of various clinical forms.
Asymptomatic. Most often seen in elderly patients. It proceeds without any signs and is detected by chance during examination of the gastrointestinal tract for another pathology.

Symptoms

One of the first symptoms is cramping, aching or stabbing pains localized in the epigastric region. In some patients, they occur on an empty stomach, while in others - a short time after eating. Also for duodenitis are characteristic:

taxation of the tongue;
heartburn;
belching;
nausea, vomiting;
excessive sweating (hyperhidrosis);
general weakness, dizziness.

Diagnostics

Basically, the diagnosis of duodenitis is carried out according to FEGDS. As additional methods apply:

contrast radiography of the gastrointestinal tract with barium sulfate;
probing of the stomach with a laboratory study of gastric juice (determination of pH, a number of biochemical tests);
duodenal sounding;
laboratory tests - complete blood count, blood biochemistry, coprogram.

Duodenitis is one of the most common gastroenterological diseases. Women get sick twice as often as men. In 95% of cases, duodenitis becomes chronic.

Treatment

The treatment regimen for duodenitis includes:

Diet therapy is of great importance in the treatment of duodenitis.

In acute duodenitis and exacerbation of chronic, table No. 1 according to Pevzner is assigned. Alcohol, black coffee, chocolate, ice cream, pepper, mustard, fatty fish and meat, spinach, sorrel, lard, fresh pastries, smoked meats, pickles and mushrooms are excluded from the diet. The basis of the diet is oatmeal, buckwheat and semolina, mashed soups, eggs (1-2 pieces per day), lean meat, low-fat cottage cheese, yesterday's wheat bread, weak tea.

In chronic duodenitis in remission (in the absence of digestive disorders and pain syndrome), treatment table No. 5 according to Pevzner is recommended. The diet includes sweet fruits, crumbly cereals, boiled chicken or lean beef, vegetable broth soups, fat-free cottage cheese, wheat bread, compotes, rosehip broth, weak tea. Alcohol, black coffee, ice cream, spices, fatty fish and meat, fresh pastries, strong meat broths, spinach, lard, sorrel are prohibited.

The phlegmonous form of acute duodenitis is an indication for surgical intervention.

Possible complications and consequences

The main complications of duodenitis:

periduodenitis (inflammation of the serous membrane surrounding the duodenum);
development of erosive and ulcerative defects of the duodenal mucosa;
ulcer perforation;
ulcer bleeding;
malignant tumors of the duodenum;
stenosis of the pylorus of the stomach (narrowing of the place where the stomach passes into the duodenum);
achlorhydria (a sharp decrease in the acidity of gastric juice);
hormonal duodenal insufficiency;
high intestinal obstruction (partial or complete);
peritonitis (with perforation of an ulcer or the development of phlegmonous duodenitis).

Forecast

With timely and adequate treatment, the prognosis is generally favorable.

Prevention

Prevention of duodenitis includes:

balanced diet;
quitting smoking and drinking alcohol;
timely detection and treatment of diseases of the gastrointestinal tract;
regular moderate exercise.

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