Gastric and duodenal ulcers are considered a fairly popular pathological process. According to statistics, approximately 5-10% of people worldwide are affected by this disease; males suffer from it several times more often than women. One of the main disadvantages of the disease is that it often affects people at a young, working age, depriving them of their ability to work for a long time. To choose the right treatment for the disease, you should conduct a proper examination and promptly identify the symptoms of a peptic ulcer.

Causes of ulcers

The main role in the formation of the disease is played by the harmful microorganism Helicobacter pylori, which affects the mucous membrane of the stomach and duodenum. This bacterium is found in more than half of the population, but not everyone is susceptible to ulcers. The infection is responsible for more than half of duodenal and gastric ulcers. It survives in the acidic environment of the stomach due to the urease produced by the microorganism, which decomposes urea and releases ammonium ions, which in turn neutralize hydrochloric acid. Initially, helicobacter pylori provokes acute inflammatory processes in the prepyloric part of the stomach, which after about a month become permanent, and hypergastrinemia, causing intense release of hydrochloric acid, which is of particular importance in the formation of duodenal ulcer pathology.

It should be noted that an ulcer does not form without certain accompanying factors:

• stressful situations, anxiety and depression. In addition, there are disruptions in the functioning of the vegetative nervous system, where the tone of the vagus nerve predominates. This provokes spasms in the muscles and blood vessels of the stomach. As a result, the organ will be left without proper nutrition and will become susceptible to the influence of hydrochloric acid: the walls are digested by caustic gastric juice. An ulcer forms.
• genetic predisposition;
• improper diet: use of rough and spicy foods. At this time, the production of hydrochloric acid increases;
• excessive use alcoholic drinks. Alcohol increases the aggressive characteristics of gastric juice and reduces the protective characteristics of the mucous membrane;
• smoking. Nicotine increases the production of hydrochloric acid, creates an obstacle to the proper processing of food, affects the gastric walls, and leads to disruption of the production of protective factors of the gastric mucosa inside the pancreas;
• chaotic use of certain medications.

Symptoms of the disease

Symptoms of peptic ulcer disease are quite varied and individual. When the disease has entered the remission stage, the patient is not worried about anything, he can lead a normal life. When a duodenal ulcer worsens, the following symptoms may occur:

Diagnosis of ulcers

Despite the severe symptoms, an examination of peptic ulcer disease is carried out by a specialist. Within the scope of diagnosis, the following measures are taken:

Treatment of the disease

Therapy for this disease is long-term, and a gentle diet will need to be followed for the rest of your life. Experts warn about the likelihood of a zigzag diet: during an exacerbation, the diet is as limited as possible and is as gentle as possible, and during a long-term remission it is permissible to eat harmful products.

Diet for ulcers

When a duodenal ulcer is detected, it is necessary to remember which foods increase the content of hydrochloric acid inside the stomach:

The above products should be removed from the menu not only during an exacerbation, but also during a period of prolonged remission. It is worth giving preference:

• soups with milk or with vegetables;
• boiled meat and fish;
• stale white bread;
• porridge on cereal.

The mucous membrane of the stomach and duodenum is irritated by vegetables with hard-to-digest fiber - white cabbage, radishes, radishes, beans, peas, corn. Particularly harmful are meat cartilages, fruits with thick skins and too hard pulp, and wholemeal flour.

Patients suffering from ulcers should adhere to following rules dietary nutrition:

When a duodenal ulcer worsens, experts advise the most gentle dietary nutrition - the menu will include only ground porridge, meat soufflé and steamed cutlets, steamed fish. Vegetables and fruits are prohibited during this period, and rosehip decoction is drunk as a drink.

Drug therapy

Patients with peptic ulcers often use medications at the acute stage. Medicines include:

• antacids - reduce the acidity of gastric juice;
• antisecretory agents - reduce the content of secreted gastric juice;
• antiseptic medications - remove inflammation and have an astringent effect (de nol);
• antibiotics - to counteract harmful bacteria.

The duration of therapy during an exacerbation of a stomach ulcer reaches up to 5 weeks, often during this period patients are hospitalized.

When a patient complains of severe pain, he is prescribed antispasmodics (no-spa), and for prolonged constipation, a laxative or an enema.

Traditional medicine methods

Folk remedies help to significantly improve the patient’s well-being even during an exacerbation of duodenal ulcer. It should be remembered that they will not solve all problems and do not guarantee the introduction of the pathological process into remission or complete recovery.

Before taking any medication, you should find out the recommendations of your doctor.

Among the most famous folk recipes used in the treatment of peptic ulcers are:

Among the herbal infusions, the most popular are the following:

Likely consequences

Often the prognosis during the formation of a stomach ulcer is positive - it can be put into a stage of prolonged remission and further scarring.

When the help of doctors was not provided, this provokes various unfavorable complications:

• bleeding from the duodenum - characterized by vomiting “coffee grounds”, black feces, unconsciousness;
• perforation of an ulcer (the walls of the duodenum are torn in the area where the ulcer is located) - stabbing pain, nausea, gag reflex and tension in the abdominal muscles;
• peritonitis – inflammation in the peritoneal cavity as a result of perforation of an ulcer;
• chronic duodenitis (inflammation in the duodenum);
• scarring of the duodenum;
• malignancy – neoplasms of a malignant nature.

Disease prevention

Preventive measures that are aimed at preventing the formation of the disease are as follows:

Ulcers of the duodenum and stomach are quite often detected ailments during examination. The pathological process requires extremely careful attention, since a short-term deviation from dietary nutrition, especially during periods of exacerbation, can provoke the rapid development of adverse consequences. Therefore, it is extremely important to promptly pay attention to emerging symptoms and immediately consult a doctor.

Duodenal ulcer is a chronic disease of a recurrent nature, the manifestations of which consist in the formation of an ulcer concentrated in the wall of the affected organ. Duodenal ulcers, the symptoms of which appear in patients mainly due to infection with the bacterium Helicobacter pylori, tend to progress, as a result of which the pathological process can also invade the stomach and other organs of the digestive system.

general description

Statistics on this disease indicate that duodenal ulcers, as, by the way, are much more common among urban residents than among rural residents. The reason for this can be determined by the influence exerted by a special abundance of stress, which provokes the development of these diseases.

In people with hypersensitivity, duodenal ulcers appear due to the impact on the mucous membrane small intestine in the area of ​​the initial section of pepsin (an enzyme produced by the gastric mucosa) in combination with stomach acid. Due to this effect, the duodenal mucosa is transformed, which is accompanied by a violation of its integrity.

The course of peptic ulcer disease, as we noted above, is recurrent in nature; accordingly, the disease is characterized by periods of alternating exacerbations with “calm” (that is, with remission).

Mostly, duodenal ulcers appear in men; on average, according to global indicators, this disease affects 10% of the population. It should also be noted that ulcers appear in the duodenum much more often than ulcers in the stomach. If inflammation occurs with simultaneous damage to both the stomach and duodenum, then there is already we're talking about about the so-called combined ulcers.

Ulcerative processes can begin to develop not only under the influence of the above-mentioned bacteria, but also with regular use of certain non-steroidal anti-inflammatory medications (diclofenac, ibuprofen, acetylsalicylic acid (aspirin), etc.). Often such drugs are used for muscle pain, and aspirin is also used as a protective agent against the formation of blood clots. Meanwhile, it is important to consider that these drugs in some cases are the main factors of the destructive effect on the duodenum.

Poor diet, alcohol and smoking can also contribute to the development of duodenal ulcer. Night shifts at work, according to several studies, increase the risk of ulcer formation by 50%.

Causes of duodenal ulcer

In the vast majority of cases, duodenal ulcers occur precisely against the background of exposure to the previously noted bacterium Helicobacter pylori. The peculiarities of its vital processes occur not only with the production of substances that damage the mucous membrane of the duodenum and stomach, but also with the production of ammonia, which, in turn, leads to increased production of hydrochloric acid by the body.

Until relatively recently, the bacterium Helicobacter pylori was considered exclusively a pathogen (its chronic form), but later its role in the occurrence and development of stomach ulcers and, accordingly, duodenal ulcers was proven. Considering this fact, treatment of a duodenal ulcer cannot be called adequate if it is not focused on appropriate measures to destroy this bacterium.

In addition to the previously noted smoking, alcohol, use of certain medications and other factors, heredity cannot be ruled out as possible precursors to the onset of this disease in the future. Statistics indicate that the presence of an ulcer in parents determines their child’s predisposition to it in the order of 40%.

As for the causes of relapses of peptic ulcer disease in the area under consideration, bleeding can be identified as such, as well as the patient’s violation of the instructions that the doctor has determined for him.

Types of duodenal ulcers

Acute duodenal ulcer:

• with bleeding;
• with perforation;
• with perforation and bleeding;

Chronic duodenal ulcer:

• unspecified with bleeding;
• unspecified with perforation;
• unspecified with perforation and bleeding;
• without perforation or bleeding.

Unspecified duodenal ulcer, without perforation or bleeding, either acute or chronic.

To begin with, let's look at the symptoms accompanying the main disease, and below we'll look at what an ulcer with bleeding and an ulcer with perforation are individually.

Duodenal ulcer: symptoms

A duodenal ulcer has a number of symptoms. In particular, these include the following:

• Painful sensations upper abdomen, slightly below the sternum. This symptom is quite common with the disease in question. Often the pain appears during hunger (so-called “hunger pains”), stopping after eating. In some cases, the nature of the pain can be defined as piercing or strong, in others – as aching. In addition, the pain can radiate to the heart or to the back.
• Often hunger appears after just a few hours from the moment of eating.
• Patients often note frequent night awakenings due to severe abdominal pain. By the way, pain in sleep It is also one of the most common symptoms of duodenal ulcer – about 80% of patients experience it. This pain is explained by the fact that the production of hydrochloric acid in the stomach reaches its peak volume at about two o'clock in the morning, and it is for this reason that night pain can be considered as a normal protective reaction on the part of the body to a situation with increased acidity.
• Nausea .
• Belching .
• Bloating .
• Flatulence .
• Vomiting blood . This symptom of a duodenal ulcer indicates an advanced stage of the disease, whose development has reached such manifestations due to the lack of proper treatment. In addition, blood can also be detected in the patient’s stool. In general, the appearance of blood indicates internal bleeding, which cannot be ignored - it is at this stage of the development of the disease that a fatal outcome is possible with a duodenal ulcer.
• In some cases, the disease in question does not manifest itself at all, that is, there are no symptoms of an ulcer as such. Accordingly, we can talk about a latent form of its course, which also happens quite often, especially in cases of morbidity among elderly patients.

Summarizing the consideration of general symptoms, it can be noted that in general this disease is characterized by a wide variety of clinical pictures, and therefore only on the basis of a comprehensive diagnosis can one correlate a duodenal ulcer with symptoms relevant to the patient.

Duodenal ulcer with bleeding: symptoms

Returning to the characteristics of the types of duodenal ulcers, I would like to dwell on perforated ulcers and ulcers with bleeding. First, let's look at the symptoms of a bleeding ulcer and, in particular, what it is.

In case of a duodenal ulcer, the development of bleeding is provoked by the formation of neutrophic lesions in the area of ​​the walls of this organ, as well as K, R and S, mental and physical stress, vascular lesions against the background of atherosclerosis in the gastroduodenal area, trauma and the abdomen, etc. As for statistical data regarding the prevalence of such manifestations as bleeding in duodenal ulcer, there are certain discrepancies on this score - in some sources the data is reduced to 4.4%, in others it reaches 37% or more.

Complications of ulcers by bleeding are primarily observed in men; for the most part they occur in people 40-50 years old. Mortality due to such bleeding is still more than high, reaching various countries and ages of the order of 1-24%, and most often a similar outcome is observed in persons 45 years of age.

It should also be noted that the patient’s previous bleeding puts him at greater risk of re-bleeding; predicting possible risks against this background is not possible. An extremely severe complication of duodenal ulcer disease is early recurrent bleeding, which occurs within the first six weeks from the end of the acute previous bleeding. Accordingly, late recurrent bleeding occurs already after 6 weeks from the moment of such previous bleeding.

Early recurrent bleeding indicates a fairly high mortality rate, and this is true even if the patient undergoes emergency surgery. The risk of death increases with each subsequent bleeding, and their prediction is also impossible.

Peculiarities of bleeding in patients with duodenal ulcers:

• Sudden massive bleeding . Indicates another exacerbation.
• Minor bleeding . As a rule, it occurs as a result of excessive use of medications that are contraindicated for use. A small ulcer can bleed almost daily; blood loss occurs in the patient’s stool (without changing its color to black). In this case, the only symptom is often severe fatigue, not dictated by anything.

The clinic accompanying massive ulcerative bleeding has quite characteristic features. So, this includes loose black stools, nausea and slight chills, some cases indicate fainting after or during bowel movements.

When blood loss exceeds 350 ml, its total volume decreases, therefore, corresponding compensatory reactions arise in the form of vascular spasm, a rapid drop in blood pressure, and pallor. If an ECG is performed, myocardial hypoxia may be detected.

As a result of massive bleeding, vascular collapse quickly develops, which, in turn, is accompanied by dizziness and weakness of the patient, pallor and low blood pressure. The temperature is low-grade (37.5-38°C), pain may cease.

Vomiting of blood is accompanied by the release of dark clots, which is explained by the effect of hydrochloric acid from the stomach on hemoglobin.

It is noteworthy that before tarry stools with bloody vomiting, internal bleeding can also be determined based on its general signs (which is possible in the absence of severe cardiovascular diseases in the patient). Thus, gastroduodenal bleeding is not accompanied by characteristic muscle tension in the abdominal area, or other pronounced symptoms indicating irritation of the peritoneum. When conducting tests, a decrease in the number, hematocrit level and is determined.

The prognosis of duodenal ulcer is often quite difficult, especially when bloody vomiting appears along with tarry black stools.

The nature of the pain before and after bleeding also determines its significance in the prognosis; the age of the patient is not overlooked. For example, an erosive artery that has hardened and lost its inherent elasticity, which has also undergone sclerotic changes, loses the ability to contract (which is important for elderly patients); accordingly, the chances of stopping bleeding are significantly reduced, even if conservative therapy methods are used.

It should also be noted that abdominal pain, which is so debilitating for the patient before bleeding, often disappears after it. If this does not happen, then the prognosis, accordingly, worsens. The fact is that here we are talking about a callous or penetrating ulcer; each of these ulcers, in turn, determines the insignificant chances of the bleeding ending on its own or of a positive result in stopping it using biological or chemical therapy.

Perforated duodenal ulcer: symptoms

A perforated duodenal ulcer is an extremely severe complication of this disease; its development occurs as a result of the formation of a through defect in the wall of the organ in question, opening into the space abdominal cavity or into the retroperitoneal space.

Most often, perforation of an ulcer is observed among men, and their age mainly falls within the age category from 20 to 40 years, although in general this manifestation is not excluded among patients representing other age groups.

Diagnosis of this condition is quite difficult in some cases. For example, if we are talking about a covered perforation or perforation to the area of ​​the omental bursa. Such difficulties are also relevant when trying to establish a diagnosis in elderly patients and patients in a weakened state.

Mostly perforation of an ulcer is the result of a long course of peptic ulcer disease; about 10% of cases are perforation of the so-called “silent” ulcer, most often observed in young patients, as well as in the elderly. Perforation and its symptoms, in particular, can develop against the background of bleeding from a peptic ulcer, which, accordingly, turns the doctor’s attention to the latter manifestation.

The symptoms of a perforated ulcer determine a separate classification:

• Etiology. Depending on the characteristics of the etiology, chronic perforation or acute symptomatic perforation (stress, hormonal, etc.) is determined.
• Localization. Bulbar or postbulbar.
• Clinical form. 1) perforation to the abdominal cavity (covered and typical perforation); 2) atypical perforation (to the omental bursa, to the greater or lesser omentum); 3) combined perforation, occurring in combination with bleeding in the gastrointestinal tract.
• Clinical periods. Corresponds to the peritonitis phase (primary shock, imaginary well-being, severe abdominal sepsis).

There are three stages of the course of this disease, that is, clinical periods noted in the classification:

• I stage. This is the stage of shock, which occurs in the first 6 hours. It is characterized by symptoms in the form of sharp pain in the epigastric region, similar to the “strike of a dagger,” vomiting at the very beginning, and immobility of the patient. IN frequent cases patients are in a position with their legs brought up to their stomach. There is pallor of the skin and slight cyanosis (blueness) of the lips, shallow breathing, and cold sweat. The pulse at this stage is either normal or slightly low, arterial pressure also downgraded. When tapping the abdominal area, sharp pain is noted. Palpation determines the tension in the buttocks area, the stomach becomes rigid, which reveals an analogy with a board.
• Stage II. This stage is characterized by an imaginary improvement. Its onset occurs within the next 6 hours from the end of the previous stage. As can be understood from the initial characteristics, the patient’s condition stabilizes somewhat within this stage, pain decreases, muscle tension subsides, which allows us to judge a general improvement. Here it is important to pay attention to symptoms indicating development, which consists of the phenomena of tachycardia and euphoria, dry tongue and increased temperature, possible retention of gases and stool due to paresis, which is relevant for the intestines. , which was not present in the first stage, gradually increases in this stage. Palpation determines the greatest degree of pain on the part of the iliac region (on the right); as a result, the patient’s condition may be misinterpreted and diagnosed against the background of such manifestations of acute.
• III stage. It develops about 12 hours after the completion of the previous stage; this stage corresponds to the pronounced clinical manifestations of diffuse peritonitis. Establishing the cause that became the initial factor in the development of the disease is significantly complicated; for this, it is necessary to rely in conjunction on the entire anamnesis collected on the patient’s condition. His condition at this stage of the disease is rapidly deteriorating. The first symptom indicating this stage is vomiting, which is systematically repeated and leads to gradual dehydration of the patient and loss of strength. The patient is noted to be restless, dry mucous membranes and skin. The temperature rises, the pressure drops, the pulse reaches 120 beats per minute. Breathing becomes rapid. Again, bloating occurs. The tongue becomes dry and a dirty brown coating appears on it. Determining the diagnosis, as well as providing surgical care, become not only belated actions, but also, one might say, useless.

Diagnosis

The most common and reliable method for making a diagnosis today is endoscopy. Despite the fact that the procedure is quite unpleasant to implement, it is with its help that the doctor has access to a complete picture of the patient’s condition and the processes occurring in his stomach at a specific stage.

Modern equipment used for endoscopy is equipped special devices, with the help of which a sample of the gastric contents and tissues in it can be taken, which, in turn, will identify the infection that provoked the disease (Helicobacter pylori). In addition, this method allows you to study gastric juice for indicators of its acidity level.

Special testing is also used to determine the bacterium Helicobacter pylori, which includes tests on vomit, blood and stool, or material obtained previously during a biopsy.

An additional role in diagnosing the disease is played by x-ray examination, which, despite its certain obsolescence, also complements the picture of the disease. And finally, palpation (palpation of the relevant areas), which, when used by a good diagnostician, makes it possible to make a diagnosis, eliminating the need for additional research methods.

Treatment of duodenal ulcers

Treatment of the disease in question is determined comprehensively, based on general condition patient, laboratory data and a number of other conditions, accordingly, the definition of specific treatment options in our article is inappropriate due to their exceptional complexity and extreme individuality in selection.

Let us only note that surgical treatment, once so popular in the fight against ulcers, is today carried out only in cases of bleeding or perforated ulcers. As for pharmacological therapy, it is focused on destroying the bacterium Helicobacter pylori, restoring the mucous membrane of the affected organ and preventing complications due to this disease. The main drugs used in treatment include Omez and De Nol, as well as some antibiotics.

To diagnose a duodenal ulcer if the listed symptoms are relevant for the patient, you must contact a gastroenterologist. The occurrence of critical conditions ( severe pain, bloody vomiting) requires an immediate call for an ambulance.

– a chronic disease that constantly progresses. The patient develops serious lesions on the intestinal mucosa. In most cases, the disease manifests itself periodically in autumn and spring period. According to statistical data, peptic ulcer disease is very common, it mainly affects men. This disease occurs more often among urban residents.

Pathogenesis of peptic ulcer

Duodenal ulcer is not so easy to treat

The cause of a peptic ulcer in most cases is a bacterial infection that enters the body through the mouth, settles in the intestines and multiplies. In this case, tissue damage to the intestinal mucosa occurs. In addition to this factor, the development of the disease can be affected by:

• Hereditary factor
• Poor nutrition
• Features of the body
• Stressful situations
• Some medications
• and smoking

The increase in cells that synthesize hydrochloric acid, as well as the stimulation of the production of protective mucus, is influenced by a hereditary factor or genetic predisposition. Due to the fact that the body does not produce enough mucus, the intestinal walls are predisposed to inflammation.

Often, the disease can progress against the background of neuropsychic overload in easily excitable people. Excessive mental stress weakens the immune system and, as a result, the development of the disease. The functioning of the entire body depends on nutrition; a lack of vitamins and essential nutrients weakens it protective function.

Eating fried, sour and salty foods has a depressing effect on the entire digestive system. Some medications have contraindications in their annotations, which many patients ignore, but in vain. Many medications, when taken for a long time, can irritate the mucous membrane of the stomach and intestines during absorption.

Alcohol and smoking weaken the body's protective function.

Symptoms

Ulcer of the 12 duodenum: schematically

For a long time, the disease can be asymptomatic, occasionally the patient is bothered by aching after eating and there is a slowdown in the digestive process. If you do not pay attention to these first signals from the body, the disease may progress to another stage, which may manifest itself:

• Stitching, cutting, aching pain in the abdominal area, which mainly occurs on an empty stomach or from hunger and goes away after eating
• and vomiting, especially in the morning
• Feeling of full stomach and heaviness
• heartburn,
• Constant weakness
• Weight loss

The pain does not have a pronounced localization and is of a different nature. During the disease, the amount of hydrochloric acid produced by the stomach, which is contained in gastric juice, increases. In this regard, a burning sensation often occurs. Heartburn can occur simultaneously with pain.

Many patients complain of belching. This symptom does not occur in everyone; it occurs in those people who have a weak cardiac sphincter. This fact is reflected in the movement of food through the esophagus: it changes direction to the opposite. This phenomenon is accompanied by copious salivation and...

Vomiting usually occurs due to pain. Many sick people try to induce vomiting artificially due to the fact that relief comes after it. This is explained by the fact that the vomit contains acidic gastric juice; due to the emptying of the stomach, its acidity decreases. Peptic ulcer of the duodenum is accompanied by a decrease in digestive function and absorption of nutrients, so the patient loses significant weight.

Decreased intestinal motility leads to constipation. They last up to a week and bother the patient much more than pain.

Stages of the disease and forms

A duodenal ulcer can occur in several stages:

1. Exacerbation: sharp pain and periodic vomiting
2. The appearance of a scar after healing of an ulcerative lesion
3. Remission: temporary absence of symptoms

The ulcer is classified depending on its exacerbation:

• Frequent exacerbations occur more than twice a year
• Rare exacerbations occur once or twice a year

Depending on the number of ulcers on the intestinal mucosa, a single ulcer and multiple lesions are distinguished. Also during diagnosis, the location of the lesion is important: in the expanded part of the 12 duodenum (bulb) or in the post-bulb space. When diagnosing, attention is also paid to the depth of damage to the mucous membrane: minor superficial damage or deep.

Also, when making a diagnosis, the cause of the disease is taken into account:

• Stress ulcer: after mental and emotional overload
• Shock ulcer: resulting from burn or injury
• Steroid ulcer: after taking hormonal drugs

Diagnostics

Ultrasound as a method for diagnosing ulcers

The initial examination by a doctor includes questioning and palpation of the abdomen. During palpation, muscle tone is felt, and the patient experiences pain. Then the patient is prescribed the following diagnostic methods:

1. X-ray
2. pH-metry
3. Lab tests

An X-ray of the abdominal cavity is performed with contrast. With the help of certain media, the localization of bacteria in the intestines and stomach is stained; each type of microorganism is painted in a specific color.

Allows you to identify the location of the ulcer in the intestine, the degree of damage to the mucous membrane, the depth and shape of erosive changes. The doctor can examine the bottom of the ulcer, its structure and edges, and the condition of the mucous membrane on the monitor. During the study, a piece of affected tissue is taken for histological analysis to determine the condition of the cells. Laboratory diagnostics includes:

• for occult blood: indicates the presence of intestinal bleeding.
• General blood test: changes are observed only in cases where the disease worsens; in the remission stage, the indicators do not change. Hidden bleeding is indicated by a sharp decrease in hemoglobin in the blood.
• The presence in the body is determined by the following tests:
• Blood test for antibodies to Helicobacter
• Breath test to detect ammonia and carbon dioxide that appear in the patient’s body due to the activity of bacteria
• PCR analysis determines the presence of Helicobacter fragments in stool or saliva
• Microscopic examination of mucus taken during FEGDS

Treatment

Sea buckthorn in the treatment of peptic ulcers

How to treat a duodenal ulcer is determined depending on the exacerbation of the disease, the reasons for its development and the location of the lesion. The following types of treatment are currently used:

1. Drug therapy
2. Physiotherapy
3. Diet therapy
4. Surgery
5. Traditional methods of treatment
6. Drug treatment

During the acute stage, treatment should be carried out in a hospital setting, the patient should remain in bed. The body needs strength to quickly relieve the inflammatory process and scarring of the ulcer. Usually, by the end of the second week of hospital treatment, the patient’s general condition improves.

The regimen according to which drug therapy will be carried out is prescribed by the doctor depending on the etiology of the disease: whether it is bacterial or not. Several drugs are used at once:

1. Antisecretory agents: the action of these drugs is aimed at reducing gastric secretion, reducing acidity and influencing the removal of the inflammatory process. Drugs in this group include:
2. Histamine receptor blockers: Ranitidine, Famotidine, Cimetidine
3. Proton pump inhibitors: Pariet, Ranitidine
4. Anticholinergics: Gastrin

To treat bacterial ulcers, bismuth-containing preparations are used: they prevent the proliferation of Helicobacter bacteria, create a protective film on the intestinal mucosa, which protects against harmful effects acid and bacterial damage. Such means include: , Vikalin, Vikair.

To restore intestinal motility and eliminate symptoms of the disease, such as nausea and vomiting, prokinetics are used: Cerucal, Trimedat,. A mandatory drug in the treatment of Helicobacter pylori of the duodenum 12 are antibacterial drugs (antibiotics): Amoxicillin, Metronidazole.

Antacids are used for heartburn: Maalox, . With the help of these drugs, the aggressive effect on the duodenal mucosa, adsorption, and neutralization of toxic substances are neutralized. Gastroprotectors are used to protect the intestinal mucosa: Venter. Such drugs form a protective shell on the surface of the damaged mucosa, and enable it to recover, helping to relieve the inflammatory process.

To relieve pain and spasms, analgesics and antispasmodics are used: Baralgin. To restore the mucous membrane, it needs nutrition. Medicines that will help: Actovegin, vitamin B preparations.

Dietary treatment

To restore damaged intestinal mucosa, a special gentle diet is required, excluding roughage. The temperature of the food should be close to normal body temperature. Small doses of food are needed every three hours. It is better to steam or boil dishes. Avoid fried, hot, spicy and salty foods. Allowed:

• Lean meat
• Fish, except oily
• Kiseli
• White bread

1. Fruits and fruit juices
2. Fatty dishes
3. Canned food
4. Strong or carbonated drinks
5. Physiotherapeutic procedures

In the complex treatment of duodenal ulcers, physiotherapeutic treatment is used together with diet and drug treatment. By exposing the body to microwaves, ultrasound, and heat, pain and inflammation are relieved and blood circulation is stimulated.

With the help of sinusoidal currents, pain is relieved, the inflammatory process stops and blood microcirculation improves. Exposure of the body to ultrasonic waves and electrophoresis with painkillers relieve pain and reduce secretion. The drugs used are: Novocaine, Papaverine.
An alcohol compress can be applied to the abdominal area, which has a warming effect, which helps restore the duodenal mucosa.

ethnoscience

Traditional medicine will also tell you how to treat duodenal ulcer

Folk remedies can alleviate the general condition of the patient, relieve symptoms and inflammation, but to get rid of the cause of the ulcer - Helicobacter bacteria, it is necessary to take antibacterial drugs.

Sea ​​buckthorn

A good remedy for healing wounds and mucous membranes. For duodenal ulcers, it is recommended to take a teaspoon of sea buckthorn oil several times a day. During the first days of treatment, simultaneous intake of soda may be recommended to relieve it.

Calendula

An infusion of calendula is made as follows: the flowers are poured with boiling water and kept in a water bath for 5 minutes. It is recommended to drink this remedy a quarter glass several times a day.

Clover

Clover flowers along with the stem and fireweed should be taken in equal proportions. Drink half a glass of freshly brewed tea from these ingredients twice a day.

Licorice

Dilute licorice root, orange peels, honey in a glass of water and put on fire. Evaporate until the liquid has evaporated. The resulting thick mixture must be divided into three daily doses.

• Omeprazole (syn.: zerocid, losec, omez) is prescribed 20 mg 1 or 2 times a day.
• Pariet (syn.: rabeprazole) is prescribed 20 mg 1 or 2 times a day.
• Esomeprazole (syn.: Nexium) is prescribed 20 mg 1 or 2 times a day.

Proton pump inhibitors, compared to other antisecretory drugs, most strongly reduce gastric secretion and inhibit the formation of hydrochloric acid and the production of pepsin (the main gastric digestive enzyme). Omeprazole at a dose of 20 mg can reduce the daily production of hydrochloric acid by 80%. In addition, against the background of the action of proton pump inhibitors, antibiotics more effectively suppress vital activity Helicobacter pylori. It is advisable to take proton pump inhibitors 40-60 minutes before meals.

H2-histamine receptor blockers

• Ranitidine (syn.: histaq, zantac, zoran, ranigast, ranisan, rantak) is prescribed 150 mg 2 times a day (after breakfast and at night) or 1 time - 300 mg at night.
• Famotidine (syn.: blockacid, gastrosidin, quamatel, ulfamide, ulcerone, famonit, famosan) is prescribed 20 mg 2 times a day (after breakfast and at night) or 1 time - 40 mg at night.

H2-histamine receptor blockers inhibit the production of hydrochloric acid and pepsin. Currently, ranitidine and famotidine are predominantly prescribed for the treatment of peptic ulcer from the group of H2-histamine receptor blockers. Ranitidine at a dose of 300 mg can reduce the daily production of hydrochloric acid by 60%. Famotidine is believed to have a longer-lasting effect than ranitidine. Cimitidine is currently practically not used due to side effects(with prolonged use, it can cause a decrease in sexual potency in men). H2-histamine receptor blockers (as well as proton pump inhibitors) create a more favorable environment for the action of antibiotics on Helicobacter pylori; they are taken regardless of meals (before, during and after meals), since the time of administration does not affect their effectiveness.

M1 anticholinergics

Pirenzepine (syn.: gastrocepin, pyrene) is usually prescribed 50 mg 2 times a day before meals.

This drug reduces the secretion of hydrochloric acid and pepsin, reduces the tone of the gastric muscles. The M1 anticholinergic platyphylline is currently not used as an independent treatment for peptic ulcer disease.

Preparations containing bismuth

• Vikalin (1-2 tablets) is dissolved in 1/2 glass of water and taken after meals 3 times a day.
• Vikair take 1-2 tablets 3 times a day 1-1.5 hours after meals.
• Basic bismuth nitrate is taken 1 tablet 2 times a day after meals.
• De-nol (syn.: bismuth subcitrate) is prescribed either 4 times a day - 1 hour before breakfast, lunch, dinner and at night, or 2 times a day - morning and evening.

Bismuth-containing drugs inhibit vital functions Helicobacter pylori, form a film that protects the ulcer from the action of gastric juice, increase the formation of gastric mucus that protects ulcers, improve blood supply to the mucous membrane and increase the resistance of the gastric mucosa to factors of gastric aggression. It is fundamentally important that bismuth preparations, inhibiting the activity Helicobacter pylori, do not change the properties of gastric juice. Bismuth-containing preparations turn stool black.

Ranitidine bismuth citrate is a complex product (contains ranitidine and bismuth preparation), has an astringent and antacid effect, and also suppresses vital activity Helicobacter pylori.

Sucralfate (Venter) is prescribed as an independent drug

Antibiotics and antiprotozoal drugs

• Amoxicillin is prescribed 1000 mg 2 times a day (12 hour interval) half an hour before meals or 2 hours after meals.
• Clarithromycin (syn.: Klacid) is prescribed 500 mg 2 times a day (12 hour interval) with meals.
• Metronidazole (syn.: trichopolum) is prescribed 250 mg 4 times a day (or 500 mg 2 times a day). The drug should be taken at regular (6 or 12 hours) intervals after meals.
• Tetracycline is prescribed 500 mg 4 times a day after meals.
• Tinidazole (syn.: fasigin) is taken 500 mg 2 times a day (12 hour interval) after meals.

Antibiotics and antiprotozoal drugs are prescribed to suppress vital functions Helicobacter pylori.

Prokinetics

• Coordinax (syn.: cisapride) is prescribed 5-10 mg 3-4 times a day before meals.
• Motilium (syn.: domperidone) is prescribed 10 mg 3-4 times a day 15-30 minutes before meals and at night.
• Cerucal (syn.: metoclopramide) is prescribed 10 mg 3 times a day 30 minutes before meals.

Prokinetics, improving the motor function of the stomach, eliminate nausea and vomiting, are indicated for heartburn, a feeling of heaviness and fullness in the stomach, early satiety, and eliminate discomfort. These drugs are contraindicated for stenosis (narrowing) of the pylorus, the outlet section of the stomach. Prokinetics do not have an antiulcer effect and are not prescribed as an independent remedy for the treatment of peptic ulcers.

Antacids

• Almagel is prescribed 1 teaspoon 4 times a day.
• Almagel A is prescribed 1-3 dosed spoons 3-4 times a day.
• Almagel is prescribed 1 sachet or 2 dosed spoons 4 times a day 1 hour after meals and in the evening before bedtime.
• Gastal is prescribed 4-6 times a day 1 hour after meals.
• Gelusil (gelusil varnish) is available in the form of a suspension, tablets, and powder. Gelusil is prescribed 3-6 times a day 1-2 hours after meals and 1 hour before bedtime. The suspension is not dissolved, the powder is dissolved in a small amount of water, the tablets are dissolved or chewed.
• Maalox is prescribed 1-2 sachets (or 1-2 tablets) 4 times a day 1-1.5 hours after meals.
• Phosphalugel is prescribed 1-2 sachets 4 times a day.

Antacids are prescribed symptomatically; they quickly eliminate heartburn and pain (or reduce their intensity) due to their acid-neutralizing effect, and also have an astringent and adsorbent effect. Antacids can be successfully used “on demand” as an emergency remedy for heartburn. You should not take these medications for more than 2 weeks in a row due to the possibility of side effects. Antacids do not have an antiulcer effect and are not used as an independent remedy for the treatment of peptic ulcers.

In addition to the above main groups of drugs for peptic ulcers, some painkillers (for example, baralgin, ketorol), antispasmodics (for example, no-spa, droverin), as well as drugs that help improve the nutrition of the mucous membrane of the stomach and intestines (for example, such biogenic drugs such as solcoseryl, Actovegin, B vitamins). Gastroenterologists (or therapists) prescribe these drugs according to certain regimens. Treatment regimens are developed and periodically updated by leading gastroenterologists in the form of standards. Doctors medical institutions are required to adhere to these standards in daily practice.

Drug treatment of peptic ulcer is based on what is found in the patient’s gastric mucosa Helicobacter pylori or not found. When they are identified, they speak of a peptic ulcer associated (from association - to connect) with Helicobacter pylori, in their absence - about peptic ulcer disease not associated with Helicobacter pylori.

Treatment of peptic ulcer not associated with helicobacter pylori

Before the introduction of proton pump inhibitors (omeprazole, Pariet, esomeprazole, etc.) into practice, the main means of treating peptic ulcers were H2-histamine receptor blockers (ranitidine, famotidine, etc.). Even earlier (before the invention of H2-histamine receptor blockers), the basis for the treatment of peptic ulcers were bismuth preparations (vicalin, bismuth subnitrate).

Basic, main treatment of peptic ulcer is carried out with antisecretory drugs, bismuth preparations or sucralfate. The duration of treatment with antiulcer antisecretory drugs is at least 4-6 weeks for duodenal ulcers and at least 6-8 weeks for gastric ulcers. Antacids and prokinetics are prescribed in addition to basic therapy as symptomatic remedies to eliminate heartburn and pain.

Use of H2-histamine receptor blockers

• Ranitidine is taken 300 mg per day once in the evening (at 19-20 hours) or 150 mg 2 times a day. Additionally, antacids (Maalox, phosphalugel, Gastal, etc.) or prokinetics (Motilium, etc.) can be prescribed as symptomatic agents.
• Famotidine is taken 40 mg per day once in the evening (at 19-20 hours) or 20 mg 2 times a day. Additionally - an antacid drug (Gastal, etc.) or a prokinetic drug (Motilium, etc.).

Use of proton pump inhibitors

• Omeprazole (syn.: omez) 20 mg per dose.
• Pariet (syn.: rabeprazole) 20 mg per dose.
• Esomeprazole (syn.: Nexium) 20 mg per dose.

The complex drug ranitidine bismuth citrate can also be prescribed as a basic treatment for peptic ulcers. The medicine is prescribed at 400 mg 2 times a day (for duodenal ulcers, take at least 4 weeks, for stomach ulcers - 8 weeks).

De-nol, a bismuth preparation, is taken according to two possible regimens:

• 240 mg 2 times a day 30 minutes before meals or 2 hours after meals;
• 120 mg 4 times a day - before breakfast, lunch, dinner and before bed.

Sucralfate (syn.: Venter) for the treatment of peptic ulcers is prescribed 1 g 4 times a day - 1 g 30 minutes or 1 hour before meals (before breakfast, lunch, dinner) and in the evening 2 hours after meals or before bedtime ; the course of treatment is 4 weeks, and then, if necessary, continue taking the drug 2 g per day for 8 weeks.

The daily dose, duration of treatment, and the need to include an antacid (Almagel, etc.) or prokinetic agent (Motilium, etc.) in the treatment regimen are determined by the doctor.

The combined use of basic antiulcer drugs and antacids (Almagel, Maalox, rutacid, etc.), which can quickly neutralize excess hydrochloric acid in the stomach cavity, quickly eliminates heartburn and pain. At the same time, you need to know that antacid drugs slow down the absorption of other drugs, so they should be taken separately: the interval between taking the antacid and the other drug should be at least 2 hours.

Using one or another regimen, it is quite possible to achieve good treatment results, but this is the art of the doctor to prescribe individual therapy for each patient to achieve the best results with least losses(to achieve quick and stable remission with a minimum of side effects and a minimum of financial costs).

Proton pump inhibitors (omeprazole, etc.) are today the most powerful means of suppressing gastric aggression factors. At the same time, it has been established that it is not always necessary to reduce the level of hydrochloric acid and pepsin in the stomach as much as possible. In many cases, it is sufficient to use ranitidine or famotidine (they are cheaper than omeprazole and Pariet). If necessary, the doctor can increase the dose of ranitidine or famotidine for 3-4 days, which accelerates the healing of the ulcer, but you cannot change the treatment regimen yourself due to the increased risk of side effects. The combined use of omeprazole with ranitidine or famotidine is possible, but only an experienced specialist can prescribe such a regimen.

Upon appointment drug therapy The size of the ulcer matters: if the size of the duodenal ulcer exceeds 9 mm, and the size of the stomach ulcer exceeds 7 mm, then it is better to use stronger drugs (omeprazole, etc.).

A good effect can also be obtained by using bismuth preparations or by taking sucralfate. De-nol (colloidal bismuth subcitrate) can be prescribed according to two regimens: either 240 mg 2 times a day (12-hour interval) 30 minutes before breakfast and dinner; or 4 times a day, 120 mg - before breakfast, lunch, dinner and before bed.

Sucralfate (Venter) is taken 4 times a day: 1 g before breakfast, lunch, dinner and at night. Treatment with de-nol or venter is advisable for small-sized, uncomplicated ulcers, with mild symptoms (primarily pain and heartburn). At the same time, for more severe symptoms - pain, heartburn - or larger sizes of the ulcer, de-Nol and Venter are recommended to be combined with ranitidine (or famotidine).

When treating elderly patients, age-related disorders of blood circulation in the walls of the stomach are taken into account. To improve blood circulation in the small blood vessels of the stomach, taking colloidal bismuth subcitrate (de-nol) is recommended as an antiulcer drug. Additionally, it is advisable for elderly people to take Actovegin, which improves metabolic processes in the body's tissues, and solcoseryl, which has a wound-healing effect.

Treatment of peptic ulcer associated with helicobacter pylori

For stomach ulcers Helicobacter pylori are found in 80-85% of cases, and with duodenal ulcers - in 90-95% of cases. When the patient's gastric mucosa is infected Helicobacter pylori a course of eradication therapy is carried out - this is the name of the treatment to free the mucous membrane from Helicobacter. Eradication therapy should be carried out regardless of the phase of peptic ulcer disease - exacerbation or remission, however, in practice, outside of exacerbation of peptic ulcer disease, examination of the gastric mucosa for the presence of Helicobacter pylori most often it is not carried out.

The indication for eradication therapy (in the presence of H. pylori) is gastric or duodenal ulcer in the acute or remission phase, including complicated peptic ulcer.

Currently, in accordance with the decisions of the Maastricht-3 conciliation meeting (2005), a standardized combination of three drugs is recommended as first-line therapy - the most efficient scheme eradication.

Proton pump inhibitor at a double dose (rabeprazole - 20 mg 2 times a day, or omeprazole at a dose of 20 mg 2 times a day, or esomeprazole at a dose of 40 mg 2 times a day, or lansoprazole - 30 mg 2 times a day, or pantoprazole - 40 mg 2 times a day).

• Clarithromycin - 500 mg 2 times a day.
• Amoxicillin - 1000 mg 2 times a day.

This regimen is prescribed only if the resistance indicators of the strains H. pylori to clarithromycin in this region do not exceed 20%. The effectiveness of a 14-day eradication course is 9-12% higher than a 7-day course.

In case of uncomplicated duodenal ulcer, there is no need to continue antisecretory therapy after the eradication course. In case of exacerbation of gastric ulcer, as well as in case of exacerbation of duodenal ulcer occurring against the background of concomitant diseases or with complications, it is recommended to continue antisecretory therapy using one of the antisecretory drugs (more effective proton pump inhibitors or histamine H2 receptor blockers) for 2-5 weeks for effective healing of the ulcer.

The eradication therapy protocol requires mandatory monitoring of its effectiveness, which is carried out 4-6 weeks after the end of taking antibacterial drugs and proton pump inhibitors. The optimal method for diagnosing H. pylori infection at this stage is a breath test, but in its absence, other diagnostic methods can be used.

If first-line therapy is ineffective, it is recommended to prescribe second-line therapy (quadtherapy), including:

proton pump inhibitor (omeprazole, or lansoprazole, or rabeprazole, or esomeprazole, or pantoprazole) in a standard dose 2 times a day;

• bismuth subsalicylate/subcitrate - 120 mg 4 times a day;
• tetracycline - 500 mg 4 times a day;
• Metronidazole (500 mg 3 times a day) or furazolidone (50-150 mg 4 times a day) for at least 7 days.

In addition, a combination of amoxicillin (750 mg 4 times a day) with proton pump blockers, rifabutin (300 mg/day) or levofloxacin (500 mg/day) can be prescribed as backup eradication regimens.

With absence H. pylori Patients with gastric ulcers are prescribed basic therapy with proton pump inhibitors, which are preferable to histamine H2 receptor blockers. Various representatives of the group of proton pump blockers are equally effective. The following drugs are used:

• rabeprazole at a dose of 20 mg/day;
• omeprazole at a dose of 20-40 mg/day;
• esomeprazole at a dose of 40 mg/day;
• lansoprazole at a dose of 30-60 mg/day;
• pantoprazole at a dose of 40 mg/day.

The duration of the course of treatment is usually 2-4 weeks, if necessary - 8 weeks (until the symptoms disappear and the ulcer heals).

Lansoprazole (EPICUR®)

In the world, lansoprazole is one of the most widely known and used proton pump inhibitors with a powerful anti-acid effect. Confidence in this drug is based on numerous and reliable data on pharmacodynamics and pharmacokinetics, on a well-studied antisecretory effect. In all comparative studies of omeprazole, pantoprazole, lansoprazole and rabeprazole (by intragastric pH value and time pH > 4) best performance are found for rabeprazole and lansoprazole compared to pantoprazole and omeprazole. The drug is distinguished by an early onset of antisecretory effect. Anti-Helicobacter activity has been proven. Due to good tolerability and safety, lansoprazole can be recommended for long-term use.

Indications, method of administration and doses: For gastric ulcers and erosive-ulcerative esophagitis - 30 mg/day for 4-8 weeks; if necessary - 60 mg/day. For reflux esophagitis - 30 mg/day for 4 weeks. Non-ulcer dyspepsia: 15-30 mg/day for 2-4 weeks. For HP eradication - in accordance with these clinical guidelines.

Contraindications: standard for PPIs.

Packaging: EPICUR® - 30 mg capsules No. 14 contain microspheres with an acid-resistant coating that prevents destruction in the stomach. EPICUR® belongs to the category of affordable drugs.

Histamine H2 receptor blockers are less effective than proton pump inhibitors. The following drugs are prescribed:

• ranitidine at a dose of 150 mg 2 times a day or 300 mg at night;
• famotidine at a dose of 20 mg 2 times a day or 40 mg at night.

Antacids (aluminum-magnesium antacids or aluminum-magnesium with the addition of calcium alginate 1.5-2 hours after meals or on demand, or aluminum-magnesium antacid with the addition of simethicone and biologically active substances (licorice root powder), enhancing the antacid effect and mucus formation ) are additionally used as symptomatic agents.

To prevent exacerbations (especially if the patient has a high risk of ulcer recurrence: for example, if constant use of NSAIDs is necessary), maintenance of antisecretory drugs in half daily doses is indicated for a long time (1-2 years).

And the intestines are diverse in nature and do not appear immediately or at the same time. The first characteristic signs of the manifestation of such diseases begin at an early stage and are mistakenly mistaken by many people for non-serious functional disorders of the digestive organs. At an early stage, the symptoms are vague, many signs are similar, but a quick cure is still possible if the disease is diagnosed in time. The long process of disease development initially manifests itself occasionally, episodically, approximately 1-2 times a year. The future patient of the gastroenterologist, without paying special attention to this, does not seek medical help, although the general deterioration of the condition is progressing constantly and steadily, and this is associated with the defeat of more and more new areas.

An irresponsible attitude towards one’s health leads to the fact that the signs of an ulcer or stomach become more pronounced, and a stage of the disease begins at which it is no longer possible not to react. Inflammation of the mucous membrane leads to permanent and acute pain in the epigastric region, indigestion, discomfort, and deterioration of the general condition. In order to prevent serious damage to organs, you need to see a doctor at an early stage in order to undergo a diagnosis and determine what is still possible for successful treatment. The longer the moment of making a decision is delayed, the more irreversible the consequences of delay will be.

1 Early manifestations

At an early stage, when reminded external signs gastritis, which occurs in approximately 35% of adults, the pathology manifests itself as follows:

• pain after eating in the epigastric region with radiation to the back, lower back, chest;
• pain at night;
• pain from hunger several hours after eating (“hunger” pain);
• negative sensations 1 and 2 hours after eating (“early” and “late” pain).

Continuous signaling of the receptors is also reinforced by accompanying, extremely negative sensations in the form of nausea, which occurs for no apparent reason, often not related to food intake, and spontaneous, often in the morning when the stomach is empty. Gagging and vomiting occur a short time after eating. A direct relationship with the process of eating food causes loss of appetite, lack of desire to eat previously favorite foods, concomitant loss of body weight, deterioration appearance. All this is accompanied by impaired peristalsis, increased gas production, bloating, constipation or diarrhea, and a violation of the frequency of natural bowel movements. A reasonable person with such symptoms already understands the need to see a doctor.

The presence of constant pain causes character changes: a person withdraws into himself, constantly listens to internal sensations, becomes quick-tempered and irritable. The disease becomes chronic, but its diagnosis is sometimes complicated by the absence of pain or its uncharacteristic manifestation, which is mistaken for symptoms of another lesion. They begin to treat it, often on their own, and the use of medications in such cases only aggravates the overall clinical picture.

2 Initial stage of the disease

At the early stage of a duodenal ulcer, the symptoms are superficially similar to the same stomach disease. A specialist can determine the location of the lesion based on the differences that appear in the symptoms:

• pain is observed only on an empty stomach, which leads to night meals to relieve the symptom;
• when pressing on the stomach, a person experiences pain;
• characterized by frequent sour belching, accompanied by heartburn;
• vomiting is observed with blood, and later blood clots appear in the stool.

The intensity of pain can vary depending on the degree, location, and pain threshold of the patient. Seasonal exacerbations are characteristic, which become habitual and expected, which causes personal changes. A person becomes a hypochondriac, begins to treat himself with increased attention, demands the same from others, constantly listens to his feelings, and often falls into depression. This is due to indigestion, accompanied by heartburn, belching, nausea, and vomiting.

Intestinal ulcers are characterized by constant heartburn, sometimes simply unbearable, causing burning pain and smelling like a rotten egg or recently eaten food. All this leads to high fatigue, sensitivity to the weather, sometimes hysteria and self-obsession. There is no loss of appetite, as with a stomach ulcer; on the contrary, it is increased, because the feeling of hunger causes pain, which food can soothe.

The similarity of external manifestations of stomach and intestinal ulcers at an early stage sometimes causes difficulty in localizing the lesion. In the absence of appropriate treatment, which includes diet, the symptoms change somewhat and progress, indicating an exacerbation stage.

3 Symptoms of exacerbation

Failure to provide timely assistance and an irresponsible attitude towards the health of the digestive system cause exacerbation of stomach ulcers, and symptoms usually force one to seek medical advice. During this period, the pain intensifies, becomes unbearable, and is accompanied by negative manifestations. It can hurt between the shoulder blades and in the lower back.

Atypical pain manifestations are accompanied by belching, nausea, vomiting, heaviness in the abdomen, general weakness, and increased sweating. The clinical picture may be individual, with the absence of some symptoms, but the main signs, including stool disorders, indicate a pathology of the digestive organs. When trying to survive an exacerbation, which usually occurs in the fall or spring, you can wait until life-threatening complications arise:

• destruction of the stomach wall (penetration);
• holes in the wall of the stomach (perforation);
• development of cancer (malignancy);
• bleeding;
• pyloric stenosis (narrowing of the narrow part of the stomach, up to complete refusal to eat food that causes discomfort).

Treatment of exacerbation of the disease, depending on the degree of its severity, can be inpatient, surgical, medicinal and dietary, strictly under the supervision of a doctor.

4 Duodenal ulcer

With an exacerbation of a duodenal ulcer, pain symptoms are characterized by the same intolerance and intensity as with a stomach ulcer. Coming sudden change sensations of taste buds, heartburn, nausea, vomiting, constipation, grayish coating on the tongue, quite frequent increase in temperature. A nagging pain may occur under the right rib.

A characteristic symptom is an aversion to dairy products and fruits, with increased appetite caused by the desire to get rid of pain by eating, weight loss is observed, constipation can be replaced by loose, foul-smelling stools. Lesion of the duodenum, which is not treated, can lead to:

• digestive system disorders;
• inflammation of the pancreas;
• stagnation of bile;
• gallstones;
• liver dysfunction;