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Diseases of the duodenum affect the entire body, because although it is small, the duodenum plays an important role in the digestive system. If you experience sudden and sharp upper abdominal pain radiating towards your spine, check for duodenal ulcer, duodenitis, or duodenogastric reflux.
Diseases of the duodenumhave serious consequences for the functioning of the entire system. Althoughduodenumis only 25 cm long (i.e. approximately 12 inches), it plays an important role in the body. There are ducts inside which lead the common bile (Latinductus choledochus ) and the pancreatic duct (Latinductus pancreaticus ), carrying digestive enzymes together with bile. As a result, food partially digested in the stomach is further "processed", and the nutrients contained in it can be easily absorbed by the body in the further parts of the small intestine.
Duodenogastric reflux
Duodenogastric refluxis a functional disorder of the gastrointestinal tract. The alkaline content of the duodenum along with the bile s alts, instead of moving to the small intestine, goes back to the stomach. There it mixes with digestive acids and has a toxic effect on the mucosa of this organ.
- Symptoms: acid reflux is manifested by upper abdominal pain accompanied by vomiting with bile.
- Causes: possibly disturbances in the work of the nerves reaching the duodenum and bile ducts (this is why reflux is common in patients after gallbladder removal).
- Diagnosis: is made on the basis of radioisotope tests (the so-called Hida test). The patient eats a meal containing an isotope marker, which stains the content of the duodenum, which is then visible on the radiograph taken later. It can be seen whether the contents of the duodenum are regurgitating into the stomach. The examination of the bilitec type can also be helpful. It is a measurement of the amount of bile in the stomach during the day. It is performed with a probe (inserted through the nose into the stomach under local anesthesia) connected to a Walkman-sized recorder. If bile retracts from the duodenum, it will note that the amount in the stomach increases.
- Therapy: reflux is usually treated with drugs that accelerate the peristalsis of the gastrointestinal tract,inhibit the secretion of gastric juices and neutralize bile s alts. Relatively rarely, reflux is treated surgically.
Inflammation of the duodenum
It often precedes duodenal ulcers.
- Symptoms:Usually these are sudden and quite sharp epigastric pain, sometimes radiating towards the spine.
- Causes:the most common symptoms are the result of acidity, stress and the use of certain medications, e.g. salicylates, anti-rheumatic agents. They cause hyperemia, swelling, and even slight damage to the duodenal mucosa, i.e. erosions. If you heed the warning signals, the wounds could get either bigger or deeper. The disease becomes chronic or leads to ulcers.
- Diagnosis:the diagnosis is made on the basis of gastroscopy. Gastroscopy consists in the fact that an endoscope is inserted into the duodenum (through the oral cavity, esophagus and stomach) under local anesthesia of the pharynx or, more often, under short anesthesia. It is a type of fiber optic probe that allows you to very accurately see the walls of the esophagus, stomach and duodenum. Gastroscopy enables the specialist physician to locate and size each wound.
- Therapy:the most important in diseases tormenting the digestive system is an easily digestible diet that allows the reconstruction of the damaged mucosa. It is also important to completely give up cigarettes and alcohol and to take medications that inhibit the secretion of gastric juices or neutralize hydrochloric acid.
Duodenal ulcers
The ulcer is usually located in the duodenal bulb, the part closest to the stomach. The disease worsens in autumn and spring, i.e. during periods of seasonal low mood and weakening of the body.
- Symptoms:sharp epigastric pains appearing about 2 hours after a meal. Ulcers often make themselves felt at night. They are the so-called hunger pains. The symptoms may be accompanied by vomiting, feeling sick and heartburn.
- Causes : stress, irregular meals, cigarettes and alcohol. Due to prolonged nervous tension, the stomach produces too much digestive juices, and duodenal juices are unable to neutralize them. If you eat irregularly and relieve tension by smoking another cigarette, you lead to local ischemia of the duodenal mucosa. Then it becomes susceptible to the action of stomach acids that begin to digest its walls. The effect of such a process is one - erosion. Over time, the erosion can reach the size of a peppercorn or a stonecherries. The cause of an ulcer may also be infection with one of the subtypes of the bacterial strain,helicobacter pylori . There are, among others, by contact with the host, e.g. during a kiss.
- Diagnosis : it is made on the basis of gastroscopy. The presence ofhelicobacter pylorican be confirmed with a test available in pharmacies (so-called helicobacter pylori ). The most accurate, however, is the histopathological examination of a section of the mucosa.
- Treatment : usually lasts 6 - 12 weeks. It is absolutely necessary to give up cigarettes and alcohol and change the diet; Eat five light meals a day and avoid hot spices. The doctor also prescribes drugs that inhibit the secretion of gastric juices and antibiotics.
- Complications:the most common is bleeding, which happens when an ulcer is close to a blood vessel and, as it grows larger, it opens and bleeds internally. This is manifested by a sudden malaise, weakness, dusty vomiting, and tarry stools. Then an endoscopic procedure is necessary, i.e. inserting a probe with an optical fiber and a set of micro-tools into the duodenum. Ulcers are injected with agents that stop bleeding. It is usually performed without anesthesia. Neglecting the prescribed treatment may also result in the perforation of the ulcer and the pouring out of the stomach contents into the peritoneal cavity - the so-called acute peritonitis. Then a quick operation is necessary. The puncture site is sutured and the peritoneal cavity is cleaned. This type of complication is often associated with the threat to the patient's life.