All of the duodenum has the form of a horseshoe and divided into:

• the upper portion (the bulb), which has a rounded shape and a length of 3-4 cm;
• descending part length of 9-12 cm, which offers the common bile duct (it outputs bile and pancreatic secretion) forming mucosal large (Vater) papilla;
• horizontal portion (gut turns to the left) the length of 1-9 cm;
• the upward part of the length of 6-13 cm, passing into the jejunum.

Duodenum with pancreas and liver occupies a central place in the digestion of food, carrying the secretion of digestive juices, motor and evacuation (bowel movements) of the function of the digestive tract. In addition to the secrets of the liver and pancreas to produce and secret 12 duodenal ulcer, which consists of a number of enzymes that activate production of the secrets of the other organs of the digestive system and regulate the overall metabolism Improves metabolism and losing weight without dieting .

Causes of duodenal ulcer

Duodenal ulcer - a chronic relapsing (recurring) disease characterized by the appearance of an ulcer in the duodenum due to the disorder of the nervous regulation mechanisms and blood supply. This results in malnutrition duodenal wall and forms an ulcer.

The causes of the disease may be different, they can be divided into predisposing and directly causing the ulcerative process.

Contributing factors include: heredity (especially the secretion of digestive enzymes), irritability of the nervous system, erratic power supply, the side effects of various drugs (such as steroids), bad habits (smoking), and so on. The immediate cause of the beginning of the process is the formation of ulcer bacterium Helicobacter pylori.

Diagnostics

The main diagnostic method in this disease is an X-ray examination of the duodenum, in which you can see in the image defect of the intestinal mucosa.

Directly mucosa ulcer can be seen when gastroduodenoscopy, during which the patient swallows a special tube through which the doctor can see the condition of the intestinal mucosa, take a piece of the mucous membrane in the study, and even stop some bleeding.

In addition, laboratory tests conducted secret common bile duct and defining it Helicobacter pylori.

Signs

For duodenal ulcers are characterized by cramping abdominal pain, vomiting, causing relief, heartburn and constipation.

If the ulcer is located in the duodenal bulb, the pain often appear fasting (hunger pains) or 1-2 hours after eating (the late pain). Postprandial pain subside. Patients often complain of persistent heartburn that occurs after 1, 5 - 3 hours after a meal and acid regurgitation content.

When the plague in other areas of the duodenum the patient has heartburn, belching Belching: why it happens and that means   and persistent abdominal pain Abdominal pain: Types and Symptoms , Extending to the left or right upper quadrant, the right shoulder or shoulder. Vomiting when such pain usually brings relief

The flow of duodenal ulcer is usually long, with seasonal (spring and fall) exacerbations. Exacerbations may also be at high physical or mental stress, stress and diet violation.

Complications of duodenal ulcer

Duodenal ulcer can be complicated by bleeding, perforation wall penetration, narrowing of the pylorus, and involvement in the process of other organs of the gastrointestinal tract.

Bleeding often are small. At the same time there is a weakness, paleness, chair black. Heavy bleeding is manifested in the form of bloody vomiting, with loss of consciousness occurs rapidly due to a sharp drop in blood pressure.

Perforation appears as a sudden sharp pain in the abdomen Acute abdominal pain . The patient is pale, lying on its side cross-legged in a semi-conscious state. If you do not provide timely assistance to the patient, in a few hours, the pain will decrease, but the high temperature will rise - a sign that the infection started in the abdomen.

Penetration (germination sores surrounding organs) there is severe pain and repeated vomiting, which does not bring relief.

Stenosis of the pylorus (the sphincter that separates the stomach from the duodenum 12) occurs when the scarring that leads to a decrease in permeability of the gatekeeper and the stagnation of food. This is manifested frequent vomiting.

Treatment of duodenal ulcers

In exacerbations of the disease is assigned to light diet, bed rest or polupostelny mode with the exception of physical and mental stress, smoking and alcohol consumption. Also prescribed drugs which reduce the excitability of the nerve, acidity, protect mucous membranes, muscles weaken and reduced immunity. After subacute appointed physiotherapy.

Complications of peptic ulcer disease is usually treated surgically, but it is better not to bring conducting timely treatment.

  Galina Romanenko

Treatment

Ulcerative colitis - an inflammatory bowel disease Inflammatory Bowel Disease: Symptoms and Treatment Characterized by inflammation of the digestive tract. Patients with this disease on a daily basis can experience symptoms such as abdominal cramps and diarrhea. Often the symptoms are worse and seriously impair quality of life. Fortunately, there are tools to ease this condition.

The problem of medical treatment - reduce inflammation, because of which there are unpleasant symptoms. Under the most favorable circumstances, this can lead not only to symptom relief but also to long-term remission. In the treatment of ulcerative colitis are also used surgical treatments.

Of course, the choice of treatment should take into account the individual characteristics of the patient: drugs, effective for one another may be useless, and the third - dangerous. Some drugs have serious side effects and is also required to be taken into account.

Anti-inflammatory drugs

These medications are often used as the first step in the treatment of IBD.

• Sulfasalazine (Azulfidine) effectively relieves symptoms of ulcerative colitis, but it has a lot of side effects, including nausea, vomiting, diarrhea, heartburn and headaches. It should not be taken if you are allergic to sulfa drugs.
• Mesalamine (Asacol, Rowasa and others), balsalazide (Colazal) and olsalazine (Dipentum) are not as many side effects as sulfasalazine. They are taken orally or rectally; sometimes prescribe a combination of different forms of the drug. Mesalamine relieves symptoms in 90% of cases of mild forms of colitis.
• Corticosteroids help reduce the inflammation, but they have many side effects, including weight gain, hair growth on the face, high blood pressure, Type II diabetes, osteoporosis Osteoporosis - he threatens you?   and increased susceptibility to infections. Usually, corticosteroids are issued only for moderate or severe IBD, who are not amenable to other treatments. They are not used for long-term treatment; As a rule, the course lasts 3-4 months.

They can also be used in combination with other drugs to induce remission.

Immunomodulators - medicines that suppress the immune system

These drugs also reduce inflammation, but they mostly act on the immune system than to treat inflammation itself.

• Azathioprine (Azasan, Imuran) and mercaptopurine (Purinethol). Due to the slow action of azathioprine and mercaptopurine (their effect is on average 3 months) recommended to take their first together with a corticosteroid. Among the side effects: allergic reactions, bone marrow suppression, infection, inflammation of the liver and pancreas Diabetes and pancreas - the things you need to know . Taking these drugs also slightly increases the risk of cancer. Patients who are taking these drugs should undergo regular medical examination, including to donate blood for analysis.
• Cyclosporine (Gengraf, Neoral, Sandimmune) is prescribed to people who do not help other medications or who because of severe ulcerative colitis need surgery. In some cases, cyclosporine can be used to delay the operation until the patient is completely ready for it; in other cases it is recommended to take as long as will act less toxic drugs. Action cyclosporine appears in 1-2 weeks, but it can have side effects such as kidney damage and fatal infections, so taking this medication should be really good reason.
• Infliximab (Remicade) is suitable for patients with moderately severe or severe ulcerative colitis in case of intolerance or ineffectiveness of other drugs. It neutralizes tumor necrosis factor (TNF) - a protein that is produced by the immune system. Infliximab TNF in the blood is then he will have time to cause inflammation in the intestinal tract.

People with heart failure, multiple sclerosis and cancer in a personal or family history should not take infliximab. Receiving this drug is associated with an increased risk of developing certain diseases, including tuberculosis and hepatitis. Furthermore, infliximab composition includes a protein that can cause severe allergic reaction in a few days or weeks after the beginning of reception.

Nicotine patches

The same patches enjoyed wishing to quit smoking How to Quit Smoking: Tips for Women Give short term relief from mild forms of ulcerative colitis. It is not known exactly how to act in this case, nicotine patches, and even their very effectiveness is disputed by some experts. In any case, before trying this remedy, talk to your doctor. One thing is certain - the harm that smoking causes, not comparable with the use of the action of nicotine, so do not start smoking, to treat ulcerative colitis.