Gastro - causes, symptoms, diagnosis and treatment
Gastroduodenit - Combined inflammation of the gastric mucosa (most of his pyloric department) and 12 duodenal ulcer, characterized by violation of secretion and motility of the gastrointestinal tract. Gastroduodenit proceeds as with the general (fatigue, paleness, weight loss) and local symptoms (pain, dyspeptic syndromes). Diagnosis is based on instrumental methods of inspection of the mucosa, the assessment of the functional state of the stomach and intestines, determining the extent of infection with H. pylori infection. The basis of treatment gastroduodenitis is diet, a healthy lifestyle, drug therapy antibacterial, antacids and other medications.
Gastroduodenit
gastroduodenitis in children of primary school age group found no fewer than 45% of secondary school age - at 73%. Reducing the incidence among high school students and 65% due to the transition of some chronic gastroduodenitis in gastric ulcer and duodenal ulcer. differences are also seen in the morphological substrate gastroduodenita in different age groups: children and adolescents gastro often occurs with increased acid-forming function, while the adult is more characteristic of atrophic process.
gastritis and duodenitis united inseparably related pathological process or a separate, independent diseases. The study found a common pathogenetic mechanism of development of inflammatory changes in the stomach and small intestine primary. The main factor in the initiation of inflammation considered H.pylori infection (HP), damage to the microorganisms of the gastric mucosa and duodenum, followed by disorder of the functions of the upper digestive tract. Nevertheless, the question of defining the role of H. pylori infection is still open - its prevalence among the population reaches 70%, while the incidence of a variety of inflammatory diseases of the stomach and duodenum are much lower. Scientists attribute this fact as to the specifics of the structure of the organism and its different degrees of pathogenicity, and with the innate characteristics of the human body - observed that gastro has a family history associated with the genetic weakening of the mucous barrier protective mechanisms.
The microorganism Helicobacter pilory has a tropism for gastric epithelium (ie. E. Affects only the body). Penetrating the mucosa, the bacteria begin to destroy cells of gastric glands, which leads to a change in the acidity of gastric juice. Disturbed regulation of the interrelated functions of the stomach, which is why there is no alkalinization of acidic gastric contents prior to its transition to the 12-duodenum. Permanent damage to the duodenal mucosa acidic stomach contents leads to metaplasia (rebirth) of the intestinal epithelium in the gastric epithelium. Thereafter duodenal mucosa becomes vulnerable to infection with H. pylori, because of what is activated and inflammation of the digestive tract.
The duodenum is involved in the regulation of the entire digestive tract through the development of biologically active substances and intestinal hormones. Against the backdrop of a chronic duodenal inflammation interferes with the normal production of hydrochloric acid and digestive juices in the stomach and duodenal segment, as well as the work of other organs of digestion, which leads to chronic inflammation in the digestive tract of these departments.
Great influence on the digestive system dysregulation has chronic stress, vascular dystonia in children and adolescents. Violation of the vegetative regulation change provokes production of gastric and digestive juices, reduce the protective functions of the mucous membrane, leading to persistent inflammation.
superficial catarrhal, erosive, atrophic and hyperplastic. When biopsy emit varying degrees of inflammation (an easy, moderate, heavy), atrophy and metaplasia of the epithelium. According to the brightness of the clinical manifestations distinguish worsening gastroduodenitis, complete or incomplete remission. Also differentiate acute and chronic gastroduodenitis, which differ in duration of clinical manifestations.
asthenia. The skin is pale, there is a decrease in body weight on the background of digestive disorders.
gastroduodenita leading clinic are pain and dyspeptic syndromes. Pain in epigastric increasingly associated with dyskinesia KDP, which is why there duodeno-gastric reflux from the reflux of intestinal contents into the stomach. The pain is dull, aching, often occurs a few hours after eating. It may radiate to the umbilical region, hypochondria. Pain when gastroduodenitis often accompanied by nausea, acid regurgitation or bitter, sometimes vomiting.
Depending on in which inflammation is localized section focus secrete various clinical forms gastroduodenitis. The most common variant yazvennopodobny usually characterized by inflammation of the duodenal bulb in combination with antral gastritis, stomach ulcers. The basis of the clinical picture of this option gastroduodenita lie in pain on the type of ulcer arising on an empty stomach or before meals, characterized by seasonal exacerbation. Gastritopodobny variant develops atrophy of the gastric mucosa of the body shell, which gradually extends to the duodenum and small intestine. The basis of clinical manifestations is malabsorption of nutrients and digestion. Holetsistitopodobny option gastroduodenita occurs against a background of stagnation in the duodenal segment; it conveys persistent pain in the epigastric region and right side of the abdomen, nausea, belching bitter, bloating and stomach rumbling. When inflammation of the duodenum papilla develops pankreatitopodobnaya gastroduodenita form in which bile and pancreatic juice outflow disrupted by common bile duct. It characterized by the appearance of pain after consuming fatty and spicy foods, yellowness of the skin and mucous membranes.
Clinical picture gastroduodenitis characteristic change of the phase of exacerbation and remission. Exacerbations usually occur in autumn or spring, provoked disturbances diet, concomitant diseases. The severity of the disease in the aggravation depends on the severity of the clinical picture, the brightness of endoscopic manifestations. Usually exacerbation lasts about two months. Symptoms regress within no more than 10 days, local tenderness on palpation of the abdomen is maintained for a further three weeks. After the disappearance of the symptoms occurs gastroduodenita remission - is incomplete in the absence of symptoms, but there are objective signs of moderate inflammatory changes during endoscopy. Complete remission is characterized by the absence of clinical and endoscopic signs of gastroduodenitis.
gastroenterologist is required for suspected any inflammation in the gastrointestinal tract. To confirm the diagnosis gastroduodenita require a number of additional studies function of the stomach and duodenum. Upper endoscopy can detect inflammation in the pyloric stomach and the initial section 12 duodenal ulcer. During this study produce endoscopic biopsy - using it revealed inflammation, atrophy, hyperplasia or metaplasia of the epithelium. Antroduodenalnaya manometry usually reveals spasm duodenum with increased pressure in the colon.
A must when gastroduodenite is conducting gastric and duodenal intubation with a fence from a sample study of the activity of enzymes and biologically active substances in the dose. To determine the acidity of the stomach and duodenum performed intragastric pH-meters - treatment with high and low acidity will be radically different.
Always made diagnosis of Helicobacter pylori infection: the definition of Helicobacter in the stool by ELISA, PCR diagnosis, determination of antibodies to Helicobacter pylori in the blood, breath test. Informative method of diagnosis of HP is a morphological study of biopsy material - in this case a large number of micro-organisms found in the mucous thicker.
To diagnose gastroduodenita Equally important is ultrasound of the abdomen - basically this method is used to identify comorbidities.
Gastroenterology. When an acute condition for the development of a complete cure only one course of therapy and adherence to a strict diet. Complaints repeated episodes of the disease require re-consultation of the gastroenterologist and the full treatment.
A patient with gastroduodenitis necessarily assigned therapeutic diet. In periods of exacerbation requires compliance with specific rules: the food must be mechanically, chemically and thermally gentle. You can not use sharp, smoked and extractives. In remission special diet is not required, sufficient healthy nutrition. To prevent relapse is recommended for all stop smoking, alcohol, carbonated drinks, strong coffee.
Drug gastroduodenita therapy depends on the clinical form of the disease. With increased acidity of gastric appointed antacids, proton pump inhibitors; at low - enzyme preparations and natural gastric juice. Detection of Helicobacter pylori infection requires the mandatory appointment of antibacterial drugs, which in combination with bismuth drugs and proton pump inhibitors can achieve almost complete eradication of the pathogen. Also, complex therapy should include antispasmodics, reparative preparations, phytotherapy. In the period of remission it recommended spa treatment, drinking mineral water.
The main problem in the conduct of gastroduodenitis is that many patients try to treat yourself, irrationally using symptomatic agents, casting started therapy at easing symptoms of the disease, without achieving a complete cure. Proper and timely treatment of chronic gastroduodenitis is the best prevention of peptic ulcer disease. Even after achieving stable remission requires continued compliance with the principles of a balanced diet, a healthy lifestyle to prevent recurrence.
Prediction and prevention gastroduodenita
The prognosis for a favorable gastroduodenite only with regular examination by a gastroenterologist and compliance with its recommendations on the proper diet and lifestyle. In patients who do not adhere to the diet, do not pass the full course of treatment of exacerbations, chronic gastro enters the stomach ulcer, which threatens a significant deterioration and serious complications.
Prevention gastroduodenita much in common with the basic principles of treatment. In order to prevent the disease is necessary to lead a healthy life, to give up bad habits such as smoking and alcohol intake, consumption of large amounts of strong coffee. It is necessary to eat correctly - include in the diet of more fresh vegetables and fruits, cereals, lean meat and fish. It is necessary to abandon the carbonated beverages, hot and spicy foods, fried foods. These recommendations are the key to the health and proper functioning of the digestive system.