Bulba - causes, symptoms, diagnosis and treatment
Bulba - Catarrhal inflammation or erosive department bulbar duodenum. In most cases, the etiological factor is the bulbita Helicobacter infection. Clinical signs of disease include pain of varying degrees of intensity, dyspeptic syndrome in severe ulceration, and the presence of possible bleeding. Bulbita Diagnosis is based on the results of endoscopy and biopsy, pH meters, test for the presence of H. pylori, contrast radiography. Therapy is the use of H. pylori antibiotics, drugs to reduce the production of hydrochloric acid and the regeneration of the mucosa.
Bulba
Gastroenterology there is a tendency to reduce the incidence of Helicobacter-dependent bulbita, which is associated with the implementation of effective eradication therapy, but the incidence of idiopathic forms (not associated with H. pylori) is still high. In this case there are complications can threaten the life of the patient and require surgical intervention.
Crohn's disease, Zollinger-Ellison syndrome, celiac disease. Receiving alcoholic beverages abuse chemically, mechanically irritating food injures the mucosa, causing catarrh. Acute bulbit as a local form of duodenitis, developed with shigellosis infections (dysentery), viral hepatitis A, salmonellosis.
erosive Bulba there are pronounced pain on an empty stomach and 10-15 minutes after eating. Patients notice decreased appetite, nausea, sometimes vomiting occurs, bringing relief, bitter belching and heartburn.
If, during the progression of erosive process of forming ulcers and damaged blood vessels may develop bleeding with the characteristic features: high-intensity pain, vomit mixed with blood, severe general weakness; with abundant hemorrhage possible hemorrhagic shock.
Acute bulbit arising on a background of food poisoning, accompanied by fever, severe nausea, frequent vomiting, chair disorder. The general condition of the patient is suffering greatly. Due to the lack of enzymatic food processing, symptoms of digestive disorders. Perhaps the feeling of discomfort in the abdomen, upset chairs, signs of dysbiosis.
biochemical blood tests reveal nonspecific for bulbita changes: reduction of red blood cells, hemoglobin (with erosive form with bleeding), changes in the level of liver and pancreatic enzymes. If you suspect a bleeding shall fecal occult blood.
If bulbit developed against the background of hyperacid gastritis, pH monitoring detects gastric hyperacidity, and specific tests reveal helicobacter. In order to confirm the presence of H. pylori urease breath test is performed, enzyme immunoassay, PCR diagnosis of Helicobacter, study biopsy taken during endoscopy.
Compulsory method of diagnosis is bulbita esophagogastroduodenoscopy - endoscopy, allows you to visually assess the state of the mucous membrane of the stomach, duodenum and in particular bulbar card, reveal erosion and determine the degree of damage and the conduct endoscopic biopsy for histological evaluation of tissue KDP. Often superficial bulbit is a godsend and is detected as a diffuse mucosal hyperemia and edema.
Conducting survey abdominal radiography at Bulba makes it possible to identify violations of the topographical relationships of the stomach and duodenum, that is, while maintaining the embryonic mesentery and the formation of loops. After the contrast in the picture visible ulcers. Radiography passage of barium through the small intestine to evaluate the motility of the KDP. For this purpose also carried antroduodenalnaya manometry.
The diagnostic program ultrasound of the abdomen may be used for Bulba. This method does not directly determine the state of the duodenum, but provides the opportunity to explore the liver and pancreas.
gastroenterologist, in case of complications - a surgeon. Make sure the diet is appointed. Acute period involves a complete rejection of mechanical, thermal and chemical roughage. Recommended liquid and pyurirovannye dishes. Meals should be fractional - at least 6 times a day. Outside the period of exacerbation bulbita diet gradually expanded. However, the general recommendations of the patient must adhere permanently. It is necessary to exclude products with preservatives and chemical additives that irritate and provoke the aggravation.
The basis of drug therapy is the eradication of the pathogen. For this purpose, appointed H. pylori antibiotics, proton pump inhibitors and bismuth preparations. To reduce the acidity of gastric juice are used antacids, anticholinergics M, H2-histamine blockers. For the healing of erosive mucosal defects using drugs to accelerate the repair processes (rosehip oil, sea buckthorn, aktovegin, solkoseril, dalargin), and means that increase mucus production (licorice root, biogastron, likviriton).
bulbita Physiotherapy includes the appointment of magnetic therapy, electrophoresis with analgesics and antispasmodics (procaine, papaverine). Outside the period of exacerbation, patients should undergo biannual spa treatment with mineral water. Phytotherapy at Bulba includes the use of fees, which include the celandine, chamomile, yarrow, St. John's wort, fennel, lime. we recommend the use of mineral waters Esentuki №17 and №4 «Borjomi" At home.
Surgical treatment bulbita, accompanied by the formation of ulcers, is to perform vagotomy - surgical intervention which is intended to parasympathetic denervation of the gastroduodenal zone and reduction of production of hydrochloric acid. It can be used truncal vagotomy (the denervating full stomach) or selective proximal vagotomy (denervating acid-forming area). Emergency surgery is to stop the bleeding gastroduodenal by clipping or ligation of bleeding vessels at gastroduodenoscopy. If endoscopy bleeding source was not found, and suturing is performed duodenotomiya ulcer 12 duodenal ulcer.
gastritis with compulsory tests after treatment to confirm eradication of the pathogen. Even outside of exacerbations should regularly attend medical examination. Many drugs are aggressive towards the mucous membrane of the stomach, duodenum, so when Bulba all drugs should be used only after consulting a doctor. In order to prevent Helicobacter infection should observe food hygiene, wash hands thoroughly before eating.