What to take for duodenal ulcer. Treatment regimen for stomach and duodenal ulcers. Treatment of peptic ulcer not associated with helicobacter pylori

Peptic ulcer and twelve duodenum is a lesion of the mucous membrane of the digestive organs, which can affect both the upper and deeper layers of the walls of the organs. Without treatment, the damaged area expands and deepens, and the wound begins to bleed.

A serious consequence is perforation of the walls internal organs- the appearance of holes through which the contents digestive tract rushes into abdominal cavity. In the absence of immediate surgical intervention This situation ends in death.

Much more often than the stomach, the disease affects the duodenum.

The disease is usually associated with a violation of the acidity level of the digestive tract. The aggressive gastric environment affects the walls of organs, damaging them. At the same time, the protective mucous layer, which is designed to neutralize the effect of hydrochloric acid, is weakened.

These processes can occur for several reasons:

• infection with Helicobacter pylori microorganisms, the activity of which first contributes to the development of gastritis, and then more serious diseases;
• taking non-steroidal anti-inflammatory drugs (aspirin, ibuprofen), corticosteroids or cytostatics;
• entry of a large amount of acid into the duodenum due to weakness of the muscles of the outlet of the stomach;
• smoking and alcohol abuse;
• non-compliance with rules healthy eating: overeating, forced fasting (long periods between meals), passion for spicy or salty foods;
• mechanical damage to the abdominal organs;
• genetic predisposition (if among your relatives there are those who suffer from gastrointestinal diseases, your risk of getting sick increases);
• stress, depression and similar mental problems.

It has also been found that men are more susceptible to pathology.

Symptoms of stomach and duodenal ulcers

The main symptom of the disease is pain syndrome. Pain, pulling or burning, radiating to the back or heart, occurs in the epigastric region. Painful sensations can disappear and reappear, usually worsening in the spring and autumn.

There is also a connection with food intake: if the stomach is damaged, pain is noted after eating (20 minutes to half an hour), damage to the duodenum is accompanied by “hungry” pain, including at night, as well as one and a half to two hours after eating.

Peptic ulcer disease is characterized by:

• sour belching and heartburn (when stomach contents enter the esophagus);
• nausea and vomiting, which brings slight relief;
• difficulties with bowel movements (constipation);
• loss of appetite and weight loss (a person, fearing pain, begins to refuse food);
• deterioration of general health, weakness.

About serious complications - bleeding, ulcers, intestinal obstruction- testify:

• dark shade of stool (in the case when, as a result of internal bleeding in feces blood gets in);
• vomit, the consistency and color of which resembles coffee grounds;
• sharp “dagger” pain.

Education is also a serious consequence of pathology. malignant tumor at the site of scarring lesions. In all these cases, urgent hospitalization and surgical intervention are necessary.

Preventing the progression of the disease is only possible with timely consultation with a therapist or gastroenterologist.

Diagnosis of pathology

At your initial appointment with the doctor, it is important to talk in as much detail as possible about:

• previous or existing gastrointestinal diseases;
• drug therapy prescribed or used independently;
• family situations: does anyone suffer from digestive disorders;
• disturbing symptoms - how long they have been observed, the nature of the pain, time of occurrence, dependence on food intake; describe vomit and feces.

The following tests are prescribed:

• FGDS - examination of the stomach and thin section intestines using a probe. The procedure allows you to detect bleeding, inflamed areas, determine their location and the extent of damage. A biopsy determines the presence of Helicobacter bacteria. The acidity of gastric juice is also measured;
• To identify complications (in particular, organ obstruction), radiography with a contrast agent is used;
• clinical blood and stool tests to detect bacteria and hidden bleeding.

Treatment of stomach and duodenal ulcers

It is prescribed only after clinical studies have been carried out and the cause of the pathology has been determined:

• affects Helicobacter pylori antibacterial medications(Biaxin, metronidazole, amoxicillin), in parallel, drugs are prescribed that lower the acidity level of the gastric environment (omeprazole, rabeprazole), as well as stimulate the restoration of intestinal microflora (Linex, Bifidumbacterin, Hilak Forte);
• in the absence of infection, proton pump inhibitors are prescribed to normalize the pH balance, which reduce the secretory function of the stomach;
• the action of some drugs is aimed at healing damaged mucous membranes: sucralfate, de-nol, biogastron;
• motility of the duodenum is restored with dopamine receptor antagonists (for example, cerucal);
• psychoneurological causes are eliminated with antidepressants and sedatives.

Surgical intervention is indicated in emergency cases:

• resection - removal of the ulcerated part of the stomach and connecting it to the intestines. The digestive process is not disrupted after surgery;
• vagotomy - the nerve that stimulates the production of hydrochloric acid is cut;
• pyloroplasty - widening the outlet connecting the stomach with the intestines to facilitate the passage of food.

During an exacerbation peptic ulcer It is better not to refuse to carry out a therapeutic course in a hospital. Not only will you be under 24-hour monitoring, which is important for providing medical care and performing operations in the event of complications, but you will also get used to the regime.

Nutrition rules

How effective treatment regimens will be directly depends on the behavior of the patient himself, his psychological state and his compliance with the necessary recommendations:

• a gentle diet is chosen, with small portions in order to avoid overeating: excessive stretching of the internal organs leads to pain;
• The temperature of the food should be approximately equal to the temperature human body: excessively hot or cold is prohibited;
• rough foods, including those containing plant fiber (cabbage, carrots, cucumbers, legumes, mushrooms, wholemeal bread), are excluded; at first, preference should be given to liquid foods - slimy soups (oatmeal, rice), low-fat broths;
• After about two weeks, porridge (semolina, buckwheat, rice) and mashed potatoes (for example, potato) are introduced into the diet. Next they move on to boiled and pureed dishes: lean meat and fish, steamed cutlets, soft-boiled eggs, vegetable and fruit purees, dried White bread;
• also, in the absence of contraindications, dairy and fermented milk products are allowed;
• you will have to give up fatty, spicy, smoked, salty and spicy dishes, canned and pickled foods, carbonated drinks, yeast baked goods, strong tea and coffee - it is better to replace them with jelly;
• It is not recommended to chew gum, which promotes the production of gastric juice;
• alcohol and cigarettes are your worst enemies on the road to recovery.

You need to stick with it for about six months. All dietary changes must be agreed with your doctor. He also appoints therapeutic exercises or refers you to sanatorium-resort treatment, which usually includes a large number of physical procedures.

Traditional medicine

Before treating a peptic ulcer, consult your doctor. It will help take into account the individual characteristics of your body.

Most effective means counts potato juice. Take it fresh daily for a month, 3 times a day, half an hour before meals, starting with one tablespoon, then two, after a week the serving is already half a glass.

Cabbage juice 50-70 ml also before meals, 3 times a day. It is also well suited for the prevention of diseases of the gastrointestinal tract.

The unique composition of vegetable oils (especially olive or sea ​​buckthorn) helps protect the mucous membrane even from bacteria. Take one teaspoon on an empty stomach for three months.

Saturates the body with vitamins rosehip infusion, herbal decoctions based plantain, chamomile, St. John's wort, calendula have a healing effect.

Oatmeal jelly Sprouted grains are consumed exclusively in freshly brewed form. Dilute flour from ground sprouted oats with cold water, then add boiling water and cook for no more than two minutes. After 15-20 minutes you need to strain the drink.

Honey cleanses the body well: 1 tsp. dissolve in a glass warm water and take on an empty stomach.

Prevention of gastric and duodenal ulcers

Measures will differ depending on the goals: to prevent the development of the disease itself (primary) or to reduce the risk of exacerbations (secondary).

Primary prevention methods:

• compliance with personal hygiene rules (mandatory hand washing, timely change of toothbrushes and regular visits to the dentist);
• infectious patients must be in quarantine: eat from separate dishes, have a separate towel. Contact with bacteria carriers is limited; avoidance of alcoholic beverages and nicotine-containing substances, which irritate the mucous membranes and reduce the body’s protective functions;
• screening for diseases gastrointestinal tract and their eradication; compliance with the rules of a healthy diet: regular meals, exclusion from the diet harmful products(canned food, smoked meats, spicy and fatty foods);
• normalization of the daily routine: it is necessary to allocate enough time for rest and for feasible physical activity;
• do not self-medicate: almost all drugs have side effects, and effective folk remedies can be selected only after the cause of the ailment has been established;
• resolving conflict issues at the stage of their occurrence; try to keep the situation in your family under control, otherwise you risk turning your life into a series of incessant stress.

Secondary prevention includes:

• annual examinations by a gastroenterologist in autumn and spring; compliance with treatment recommendations;
• visiting sanatoriums and other specialized institutions;
• it is important not to deviate from the prescribed nutrition plan;
• periodic examinations when the first symptoms of the disease return appear;
• Adopt a comprehensive approach that includes primary preventive measures.

Stomach ulcer and duodenum belongs to the category of chronic diseases associated with the state of immunity. In the absence of symptoms during periods of remission, the protection of the gastric mucosa leaves much to be desired, so patients are advised to avoid stressful situations, adhere to a diet, use nutritional supplements in the form of herbs, seeds, do not drink alcohol.

Doctors are well aware of how to treat duodenal ulcers; therapy should be aimed at eliminating the causes and symptoms of the disease. The internal structure of the stomach is protected from the effects of dangerous substances (hydrochloric acid and the enzyme pepsin) by mucus, which becomes thinner in a certain place during an ulcer.

A focus is formed through which digestive juices penetrate into the muscle layer and destroy it. This causes severe pain in the upper abdomen, which can radiate to the heart. Men are more prone to the disease than women. According to statistics, the age of patients is from 20 to 50 years. 70% of those who consult a doctor are mostly healthy men.

After 50 years, the incidence rate drops sharply and accounts for only 20% of the number of patients. The disease also occurs in women, but much less frequently. Generally 5–7% of the population suffers from ulcers departments digestive system. There is a seasonality in the disease - it worsens in spring and autumn.

The disease is treated faster if it is diagnosed in initial stage. Most often, the patient comes to the doctor with obvious signs and the presence of damaged mucosa. In this case, treatment requires more time and attention.

In contact with

Causes of ulcers

Among the causes of this disease the main ones are:

• poor and irregular nutrition, abuse of fast food;
• frequent consumption of alcoholic beverages;
• taking medications that negatively affect the gastric mucosa;
• stressful situations at work or in the family;
• entering the body specific bacteria, which, with low immunity, forms colonies and destroys the mucous membrane.

Causes of peptic ulcer

Poor nutrition consists of:

• eating dry rough food;
• lack of vegetables and fiber in the diet;
• lack of fermented milk products;
• abuse of sweet carbonated drinks;
• lack of water.

This principle of nutrition first causes gastritis - inflammation of the mucous membrane, which over time turns into an ulcer.

The body needs water to produce digestive juices. By replacing water with other liquids - tea, coffee, soda - a person provokes the release of especially concentrated pancreatic enzymes and gallbladder, which damage the inner lining of the stomach and make it thinner.

Sour dairy products are completely absorbed, while the body receives valuable nutrients, which has a positive effect on the immune system.

Sweet carbonated drinks cause great harm to health. A large number of sugar causes the pancreas to work hard, which depletes its defenses and takes away many useful substances, for example.

Vegetables and fruits are the main sources of vitamins and minerals. Without eating plant foods, you should not expect good and coordinated functioning of the body's systems, especially the digestive one. Complications of gastric and duodenal ulcers are most often associated with non-compliance with diet and low immune status due to poor digestion.

Important! Most of the immune cells are located in the intestines, so their condition depends on general health person.

Peptic ulcers are often caused by the bacterium Helicobacter pylori. This type of microorganism resists the destructive effects of gastric juice and causes various diseases, including cancer. Infection occurs through household contact - through saliva, mucus, dishes, and hygiene items.

Ulcer symptoms

How does an ulcer appear? Mainly by the following symptoms:

• severe cutting pain in the abdomen in the solar plexus area;
• nausea or vomiting;
• diarrhea or constipation;
• weight loss;
• feeling of heaviness after eating, frequent belching;
• coating on the tongue (not only with ulcers);
• seizures;
• poor bowel function and increased gas formation.

Symptoms of stomach and duodenal ulcers manifest themselves differently. It depends on the location of the damaged area, the age of the patient, general condition body. Nausea with duodenal ulcer is the first symptom to pay attention to.

Based on the symptoms, you can determine the location of the ulcer:

• pain immediately after eating indicates the presence of pathology in the cardinal and subcardinal parts of the stomach;
• bloating and excessive salivation, hunger pain at night indicate damage to the pyloric region;
• in older men, the greater curvature is most often affected, and the process can be advanced and malignant;
• emergence painful sensations an hour after eating, it indicates damage to the lesser curvature;
• in young people, the antrum is vulnerable, as evidenced by pain with right side, night pain, vomiting.

Important! Malignant processes most often affect the antrum, so it is necessary to undergo examination and begin treatment as quickly as possible.

Complications of the disease

Peptic ulcer

Serious complications are possible with stomach and duodenal ulcers:

1. Perforation (formation of a through wound) and loss of food into abdominal space– threatens the development of peritonitis, digestive juices destroy body tissues, which can cause damage to large vessels, bleeding and death. Symptoms – increased body temperature, secretion of sticky sweat, vomiting, decreases arterial pressure, limbs become cold.
2. Penetration. The integrity of the wall is also compromised, but the contents enter small intestine, pancreas, liver. The pain becomes unbearable and constant, radiating to the right shoulder or back. Threatens organ damage and death. Painkillers do not help and urgent surgery is required.
3. Pyloric stenosis is an anatomical change in the sphincter (narrowing) connecting the stomach and duodenum. When a scar forms, food cannot travel further down the digestive canal. When food stagnates metabolic processes are disrupted, an unpleasant odor appears when breathing, vomiting and fullness of the stomach often occur.
4. Bleeding. Duodenal ulcers are characterized by bloody stools, while gastric ulcers are characterized by bloody vomiting. This is very dangerous condition, because with massive hemorrhage it can lead to death within 20 - 40 minutes. Requires urgent hospitalization.
5. Cancerous degeneration of an ulcer – malignancy. Most common for stomach ulcers. Cancers of the duodenum are rare. Stomach cancer is more common in older people. Characteristic changes in taste, constant pain, the person loses weight.

It is better to constantly monitor nutrition and immunity than to treat stomach and duodenal ulcers in advanced stage, because digestive disorders interfere with recovery and the process drags on for many months. Prevention of gastric and duodenal ulcers involves observing basic nutritional rules, balance of proteins, fats and carbohydrates. Great importance has a positive psychological attitude, which makes it easier to tune in and believe in recovery.

What does an ulcer look like?

Important! Complications of gastric and duodenal ulcers in some cases occur suddenly, without obvious symptoms, so if you have stomach problems, you need to monitor your well-being and call doctors in time to provide assistance.

Ulcer treatment regimen

To know how to treat stomach and duodenal ulcers, you need to do tests. If Helicobacter pylori is detected, a course of treatment for the ulcer is prescribed. antimicrobials, which is designed for 14 days. In most cases, symptoms go away. If you carry out antibacterial therapy at the stage of gastritis, complications will be avoided. The treatment regimen for stomach and duodenal ulcers includes the simultaneous use of several drugs:

• clarithromycin;
• amoxicillin or metronidazole;
• omeprazole to regulate acidity.

During the treatment period, you must follow a strict diet and balance your diet as much as possible. Adjuvant therapy includes immunomodulators, antiemetics, vitamins.

How to treat stomach and duodenal ulcers if a person is against medications?

There are folk remedies that require taking longer, but the effect is positive:

• potato juice - always fresh 3 times a day before meals, the amount is increased to 100 g for a month, the course of administration is a month, then a break;
• plantain decoction before meals;
• propolis with butter;
• turmeric – antiseptic, eliminating infection in the stomach, but use with caution, gradually increasing the dose;
• St. John's wort is a herbal antibiotic - taken in the form of a decoction or tincture.

Peptic ulcer of the stomach and duodenum is a dangerous chronic illness digestive organs, which is characterized by the formation of ulcers (wounds) on the mucous membrane of the stomach or duodenum.

The disease occurs with periods of relapses and remissions. When the disease relapses, an open wound appears on the inner walls of the stomach or the initial part of the small intestine, and with a temporary improvement in the condition, the wound heals, but does not completely disappear. As a rule, relapses occur in spring and autumn.

According to statistics, about 10% of the total population suffers from ulcers. At the same time, men suffer more often from this disease, and women – less often.

Many factors can provoke the development of the disease, the main ones of which are: :


In addition, all men, as well as older people, are at risk.

Symptoms of the disease

The disease is characterized by the following symptoms:

1. Stomach ache- the most basic symptom. The pain can be of a different nature (cutting, stabbing, aching, a burning sensation may be felt), localized in one place (upper abdomen) or spread throughout the entire abdomen. More often painful sensations decrease or disappear completely after eating and intensify after a few hours.
2. Progressive weight loss with normal nutrition and appetite.
3. Dyspeptic disorders: nausea, vomiting , bowel dysfunction (diarrhea or constipation), heartburn, belching, increased gas formation.

Video - Symptoms of duodenal ulcer

The danger of peptic ulcer disease: possible complications

Peptic ulcer disease can lead to dangerous complications.

1. Perforation– one of the most terrible complications, characterized by a breakthrough of the ulcer. As a result, a through hole is formed in the wall of the affected organ, and the entire contents of the organ enter the abdominal cavity. When perforation occurs, the patient feels severe cutting pain and peritonitis develops. The condition requires immediate surgical assistance.
2. Penetration– spread of ulcers beyond the affected organs. When penetrating, the ulcer can affect the pancreas, gallbladder, liver and cause the development of concomitant diseases.
3. Bleeding which occurs due to rupture of blood vessels in the area of ​​the ulcer. With ulcer bleeding, abdominal pain intensifies, vomiting of blood begins, stools become black, and blood pressure decreases. It is very important to immediately provide medical care patient, since bleeding from an ulcer can be fatal.

Attention! In the absence of proper and timely treatment, an ulcer can develop into a malignant tumor.

Diagnosis of ulcers

A gastroenterologist can diagnose the presence of a stomach ulcer or the initial part of the small intestine.

To diagnose the disease, the following procedures are prescribed:

1. Esophagogastroduodenoscopy (gastroscopy)– examination of the gastrointestinal tract using a special device – an endoscope. This method allows you to examine the condition of the mucous membrane of organs, identify the presence, location and depth of the ulcer. If the presence of malignant cells is suspected, a biopsy is performed during gastroscopy.
2. X-ray examination using a contrast agent allows you to evaluate the shape and size of the stomach and the initial part of the small intestine and assess the condition of their walls. This method is also used to identify complications of ulcers.
3. General blood analysis. With its help, you can determine the presence of anemia (typical of a severe ulcer), a reduced number of red blood cells, an increased erythrocyte sedimentation rate - all these signs indicate the presence of inflammatory process
4. Fecal occult blood test. This analysis allows you to identify hidden bleeding characteristic of an ulcer.

Treatment of the disease with medications

Treatment of stomach ulcers and the initial part of the small intestine must be comprehensive. Typically, the treatment regimen includes drugs to destroy Helicobacter pylori (if they are detected), reduce the acidity of gastric juice, eliminate dyspeptic disorders (diarrhea, nausea, heartburn, belching) and prevent the development of complications.

Drug treatment


Group of medicines	Name of drugs	Action
Antibacterial drugs	Preparations based on bismuth: De-nol, Tribimol, Vikalin. Antibacterial drugs: Furazolidone. Antibiotics: Amoxicillin, Tetracycline, Clarithromycin, Metronidazole	Removing pathogenic bacteria Helicobacter pylori from the body
Antisecretory drugs:
H2-histamine receptor blockers	Famotidine, Ranitidine, Roxatidine, Pilorid, Nizatidine, Erinit	Reducing the acidity of gastric juice by blocking histamine H2 receptors
Proton pump inhibitors	Omeprazole, Rabeloc, Pariet, Nexium	Reducing the acidity of gastric juice by blocking the proton pump in the cells of the gastric mucosa
Antacids	Maalox, Keal, Almagel, Phosphalugel, Sucralfate	Coating of the stomach and reduction negative action hydrochloric acid on the mucous membrane
Antispasmodics	Papaverine, Drotaverine, No-shpa, Spasmomen, Mebeverine, Buscopan	Relieving spasms from the walls of the stomach, eliminating pain
Probiotics	Bifiform, Lactiale, Linex	Assigned upon use antibacterial drugs. Normalize intestinal microflora

Treatment regimens

If a peptic ulcer was caused by the bacteria Helicobacter pylori, then eradication therapy is used to treat it. Eradication therapy is aimed at the complete destruction of harmful microorganisms, relief from the symptoms of the disease and healing of ulcers. 7-day and 10-day treatment regimens are used.

First-line therapy includes 2 treatment regimens (course from 10 to 14 days):


Scheme No. 1 (three-component):


1. Omeprazole (or its analogues) - 2 times a day, 20 mg. Take in the morning on an empty stomach, in the evening - 2 or more hours after the last meal.
2. Clarithromycin (Clarbact, Fromilid) - this drug must be taken twice a day, 500 mg. Take after meals.
3. Amoxicillin (Amoxil, Amosin) - you need to take the antibiotic twice a day, 1 g, 2 times a day. Take after meals.

Scheme No. 2 (four-component):


1. Omeprazole (or its analogues) - drink 20 mg twice a day. Take in the morning before breakfast, on an empty stomach, in the evening - 2 or more hours after the last meal.
2. De-Nol - 120 mg four times a day. Take three times half an hour before meals, once before bed, 2 or more hours after meals.
3. Metronidazole is an antimicrobial drug prescribed to be taken three times a day, 0.5 g. The medicine should be taken strictly after meals.
4. Tetracycline - 0.5 g four times a day, 4 times a day. Take after meals.

After completing the chosen therapy, Ranitidine, Famotidine or Roxatidine are prescribed to prevent exacerbations of the disease. You need to take one of the drugs 2 times a day for 5-7 weeks.

If the peptic ulcer was caused not by Helicobacter pylori bacteria, but by other reasons, then its treatment occurs without the use of antibiotics: Ranitidine or Famotidine is prescribed once a day (before bedtime), 2 tablets. In addition, some kind of antacid drug is prescribed - Maalox, Almagel, etc. - to relieve unpleasant symptoms diseases.

Video - How to treat stomach and duodenal ulcers with folk remedies

Surgery

Surgery to treat ulcers is used only as a last resort. Surgery may be prescribed when drug treatment does not produce results. Another indication for immediate surgical treatment are perforation and ulcerative bleeding.

During the operation, the area of ​​the stomach or the initial part of the small intestine affected by the ulcer is removed.

It is important to remember that this operation is quite complex. It can lead to a number of negative consequences, which can appear immediately or after some time. Thus, there are frequent cases of inflammation and bleeding after surgery.

In this case, it is very important to correctly identify the cause of the disease - this can be done by an experienced and qualified gastroenterologist.

Proper nutrition is the key to successfully fighting the disease

Diet is an important component in the fight against ulcers.

All foods on the diet should be boiled or steamed. Blanching and stewing are allowed.

It is important to exclude from the diet all foods that irritate the walls of the stomach - spicy, too salty, smoked.

On a note! If you have an ulcer, you must exclude cold and hot foods from your diet - all food should be warm (30-35 degrees).

Meals for ulcers should be divided - you need to eat little by little 5-6 times a day. You should not take too long breaks between meals. You can't overeat.

It is important to drink plenty of clean water - up to 2 liters per day.

What can you eat if you have an ulcer:

1. Jelly-like soups with the addition of vegetables, boiled cereals, and meat.
2. Porridge – buckwheat, rice, oatmeal. Can be cooked with water or milk.
3. Puréed vegetable purees.
4. Lean meat and river fish, steamed or boiled.
5. Eggs – can be cooked soft-boiled or steamed as an omelet. Hard-boiled and fried eggs should not be consumed.
6. Dairy products - milk, sour cream, fermented baked milk, cottage cheese, mild cheese, cheesecakes, curd soufflés and casseroles.
7. Stale white bread and dry biscuits.

What you can and cannot eat if you have an ulcer

• fatty meat (pork, goose, duck) and fish (mackerel saury, halibut, eel, salmon);
• mushrooms;
• smoked sausages;
• canned food (stewed meat, pates, sprats);
• vegetables - beans, peas, corn, cabbage;
• fruits with high acidity - tangerines, oranges, lemons, pineapples, etc.;
• sauces: ketchup: mustard, mayonnaise, vinegar;
• any alcoholic drinks;
• soft carbonated drinks;
• chocolate.

Disease prevention

To prevent the development of the disease, it is important to adhere to the following rules:

1. Follow the rules of hygiene - wash your hands before eating, eat from clean dishes to prevent Helicobacter pylori bacteria from entering the body.
3

A peptic ulcer is an open wound or moist area that tends to develop in one of two places:

In the lining of the stomach (stomach ulcer);
- in the upper part of the small intestine - the duodenum (duodenal ulcer).

Duodenal ulcers are three times more common than gastric ulcers.

Ulcers develop when digestive juices appear in the stomach, intestines, and digestive glands and the lining of the stomach or duodenum is damaged.

Ulcers can average from 0.62 cm to 1.25 cm in diameter. Helicobacter Pylori bacteria are the main cause of peptic ulcers. Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) is the second most common cause.

Peptic ulcer disease affects everything age groups, but rarely occurs in children. Men are twice as likely to get ulcers as women. The risk of duodenal disease tends to increase starting at age 25 and continuing until age 75. The risk of its greatest peak is from 55 to 65 years.

Mechanism of ulcer formation

Two important components of digestive juices are hydrochloric acid and the enzyme pepsin. Both substances are critical in breaking down and digesting starches, fats and proteins in food. They play different roles in ulcers.

- Hydrochloric acid. It is a common misconception that excess hydrochloric acid, which is secreted in the stomach, is solely responsible for the production of ulcers. Patients with duodenal ulcers tend to have higher than normal levels of hydrochloric acid, but most patients with peptic ulcers have normal or lower than normal acid levels. Having stomach acid is actually important for protecting against H. Pylori, the bacterium that causes peptic ulcers in most cases. The exception is ulcers that occur from Zollinger-Ellison syndrome, a rare genetic condition in which a tumor in the pancreas or duodenum secretes very high level gastrin is a hormone that stimulates the secretion of hydrochloric acid.

- Pepsin. This enzyme breaks down proteins in food. He is also important factor in the formation of ulcers. Since the stomach and duodenum are composed of proteins, they are sensitive to the action of pepsin. However, the body has a defense system to protect the stomach and intestines against these two potent substances:

A layer of mucus that covers the stomach and duodenum (the first line of defense);
- bicarbonate, which secretes a layer of mucus that neutralizes digestive acids;
- hormone-like substances prostaglandins that help expand blood vessels in the stomach to ensure good blood flow and to protect against injury. Prostaglandins can also stimulate the action of bicarbonate and mucus.

The destruction of these protective mechanisms makes the mucous membrane of the stomach and intestines susceptible to the effects of acid and pepsin, increasing the risk of ulcers.

> Reasons ulcers of the stomach and duodenum

In 1982, two Australian scientists identified Helicobacter Pylori (or H. Pylori) as the main cause of stomach ulcers. They showed that stomach inflammation and the result of stomach ulcers from a stomach infection are caused by H. Pylori bacteria.

The bacteria appear to cause ulcers in this way: the corkscrew shape of Helicobacter Pylori allows them to penetrate the mucous layer of the stomach or duodenum so that they can attach to the lining. The surfaces of the cells lining the stomach contain protein. The protein breakdown accelerating factor acts as a receptor for bacteria.

H. pylori survives in highly acidic environments. H. Pylori stimulates the increase and release of gastrin. Higher gastrin levels promote increased acid secretion. The increase in acid damages the intestinal lining, leading to ulcers in certain individuals. H. Pylori also modifies certain immune factors that allow this bacteria to evade detection by others. immune system and lead to frequent inflammation, even without invasion of the mucous membrane. Even if ulcers do not develop as is believed, the bacteria Helicobacter pylori is the main cause of active chronic inflammation in the stomach - gastritis, and in the upper part of the small intestine - duodenitis. H. Pylori is also strongly associated with stomach cancer and possibly other extraintestinal problems. H. Pylori bacteria are most likely transmitted directly from person to person. However, little is known about exactly how these bacteria are transmitted.

About 50% of the world's population is infected with H. Pylori. The bacteria are almost always acquired in childhood and persist throughout life if the person is not treated. The prevalence of this bacterium in children is about 0.5% in industrialized countries. However, even there, in regions with critically unsanitary conditions, the conditions for infection are equal to those in developing countries.

It is not yet entirely clear how these bacteria are transmitted. Possible transmission methods include:

Intimate contact, including contact with liquid by mouth;
- diseases of the gastrointestinal tract (especially with vomiting);
- contact with feces (feces);
- contaminated wastewater.

Although Helicobacter pylori are quite common, ulcers in children are very rare - only 5-10% of H. Pylori-infected adults. Several factors may explain why some infected patients get ulcers:

Smoking;
- drinking alcohol;
- presence of relatives with peptic ulcer disease;
- male gender;
- infection with a bacterial strain that contains a cytotoxin-related gene.

When the bacteria Helicobacter Pylori was first identified as the main cause of peptic ulcers, it was found in 90% of people with duodenal ulcers and about 80% of people with stomach ulcers. Because everything more people Now tested and treated for the bacteria, the rate of H. Pylori-induced ulcers has decreased. Currently, H. Pylori is found in about 50% of people with peptic ulcers;

Factors that cause ulcers in H. Pylori carriers

Certain factors may increase the risk for ulcers in NSAIDs:

Age 65 or older;
- history of peptic ulcer or gastrointestinal bleeding;
- other serious illnesses– such as congestive heart failure;
- use of medications such as: anticoagulant Warfarin (Coumadin), corticosteroids, osteoporosis drug Alendronate (Fosamax), etc.;
- alcohol abuse;
- Helicobacter Pylori infection;
- other risk factors for ulcers from H. Pylori or NSAIDs;
- stress and psychological factors;
- bacterial or viral infections;
- bodily injury;
- radiation therapy;
- smoking. Smoking increases acid secretion, decreases prostaglandins and bicarbonate, and decreases blood flow. However, research results on the actual effect of smoking on ulcers vary.

Only 10-15% of people infected with Helicobacter Pylori develop peptic ulcers. H. Pylori infections, especially in older people, may not always lead to peptic ulcers. Other factors must also be present to actually cause ulcers:

- genetic factors. Some people have strains of H. Pylori with genes that make them more dangerous bacteria and increase the risk of ulcers;

- immune disorders. Some people have a disorder of the intestinal immune response that allows bacteria to injure the intestinal lining;

- lifestyle factors. Although lifestyle factors such as chronic stress, coffee and smoking have long been considered the main causes of ulcers, they are now thought to only increase susceptibility to ulcers in some H. Pylori carriers - and nothing more;

- stress. Although stress is no longer thought to be a cause of ulcers, some research suggests that stress may predispose a person to ulcers or prevent existing ulcers from healing;

- shift work and interrupted sleep. People who work in night shift, have significantly more high frequency ulcers than day workers. Researchers suspect that frequent sleep interruptions may weaken the immune system's ability to defend against harmful bacteria.

- non-steroidal anti-inflammatory drugs (NSAIDs). Long-term use of NSAIDs such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) is the second most common cause of ulcers. NSAIDs also increase the risk gastrointestinal bleeding. The risk of bleeding continues as long as the patient takes these drugs, and it may continue for about 1 year after the break. Short courses of NSAIDs for temporary pain relief should not cause serious problems because the stomach has time to recover and repair any damage that has occurred.

Patients with ulcers from NSAIDs should stop taking these medications immediately. However, patients who require these medications on a long-term basis can reduce the risk of developing ulcers by taking proton pump inhibitor PPI drugs such as Omeprazole (Prilosec), Famotidine (H2 blocker Pepcid), and others.

15-25% of patients taking NSAIDs regularly will have evidence of one or more ulcers, but in most cases these ulcers are very small. Long-term use of NSAIDs can possibly damage the small intestine. Even low doses of aspirin (81 mg) may pose some risk, although the risk is lower than with higher doses. Greatest risk in people who use very high doses NSAIDs for long periods of time, especially in patients with rheumatoid arthritis.


- Medications. Some medications other than NSAIDs can also make ulcers worse. These include: Warfarin (Coumadin) - an anticoagulant that increases the risk of bleeding, oral corticosteroids, some chemotherapy drugs - Spironolactone and Niacin. Bevacizumab, a drug used to treat colorectal cancer, may increase the risk of gastrointestinal perforation (a perforation or perforation of an ulcer is when an ulcer breaks outside the stomach or duodenum and releases its contents). Although the benefits of Bevacizumab outweigh the risks, gastrointestinal perforations are very serious. If they occur, patients should stop taking the drug.

Zollinger-Ellison syndrome (ZES).. Another cause of peptic ulcers, although much less common than H. Pylori or NSAIDs, is Zollinger-Ellison syndrome. Large amounts of acid are produced in response to overproduction of the hormone gastrin, which in turn causes tumors of the pancreas or duodenum. These tumors are usually cancerous and must be removed. Acid production must also be suppressed to prevent new ulcers.

ZES should be suspected in patients with ulcers who are not infected with H. Pylori and who have no history of NSAID use. Diarrhea may occur before ulcer symptoms. Ulcers occurring in the second, third or fourth parts of the duodenum or in the jejunum (the middle part of the small intestine) are signs of ZES. Gastroesophageal reflux disease (GERD) is more common and often more severe in patients with ZES. Complications of GERD include ulcers and narrowings (strictures) of the esophagus.
Ulcers associated with ZES are usually persistent and difficult to treat. Treatment consists of removing the tumor and suppressing the acid with special medicines. In the past, gastric removal was the only treatment option.
Experts don't know what factors actually increase the risk of developing ulcers.

Symptoms stomach and duodenal ulcersAnd

- Dyspepsia. The most common symptoms of peptic ulcer disease are collectively known as dyspepsia. However, peptic ulcers can occur without dyspepsia or any other GI symptoms, especially if they are caused by NSAIDs.

Main symptoms of dyspepsia:

Complications stomach ulcers

Most people with severe ulcers experience significant pain and insomnia, which can have a dramatic and negative impact on their quality of life. In addition, treating ulcers is extremely expensive.


- Bleeding and hemorrhage. Ulcers caused by H. Pylori or NSAIDs can be very serious if they cause bleeding or perforation of the stomach or duodenum. Up to 15% of people with ulcers have some bleeding, which can be life-threatening. There are ulcers in which small intestine attaches to the abdomen and, as a result of narrowing or closing of the intestinal opening, can swell and produce scars. In such cases, the patient vomits the entire contents of the stomach, and urgent emergency treatment is prescribed.

Because ulcers often do not open from gastrointestinal symptoms NSAIDs Until bleeding begins, doctors cannot predict which patients taking these drugs will develop bleeding. The risk of an adverse outcome is highest in people who have had long-term bleeding from NSAIDs, bleeding disorders, low systolic blood pressure, mental instability, or other serious and adverse health conditions. Among the population at higher risk are older people and those with other serious illnesses, such as heart problems.

- Stomach cancer. Stomach cancer is the second leading cause of cancer death worldwide. In developing countries, where levels of Helicobacter Pylori are very high, the risk of developing stomach cancer is now six times higher than in developed countries. H. Pylori can be carcinogenic (producing cancer in the stomach), like cigarette smoke in the lungs. Infection with Helicobacter pylori promotes a precancerous condition called atrophic gastritis. This process most likely begins in childhood.

When Helicobacter pylori infection begins in adulthood, it presents more low risk cancer development, because atrophic gastritis may develop. Other factors, such as specific strains of Helicobacter Pylori and diet, may also influence the risk of developing stomach cancer. For example, a diet high in salt and low in fresh fruits and vegetables is associated with great risk. Some evidence suggests that a strain of H. pylori that carries the cytotoxin gene may be a specific risk factor for the development of precancerous lesions.

Although there is conflicting evidence, some studies suggest that early elimination of H. Pylori may reduce the risk of developing stomach cancer in the general population. It is important to monitor patients over a long period of time after treatment. People with duodenal ulcers caused by Helicobacter pylori appear to have a lower risk of developing stomach cancer, although scientists don't know why. It is possible that the duodenum and stomach are affected by different strains of H. Pylori. And perhaps the high levels of acid found in the duodenum may help prevent bacteria from spreading to important areas of the stomach.

- Other diseases. H. pylori is also weakly associated with other extraintestinal disorders, including migraine, Raynaud's disease, and others. skin diseases like chronic urticaria. Men with stomach ulcers may experience more high risk developing pancreatic cancer, although duodenal cancer does not seem to pose the same risk.

A duodenal ulcer can be discovered accidentally during an examination of the digestive system, or it can torment its owner for many years severe pain– the disease manifests itself in different ways. To treat it and minimize symptomatic manifestations, a variety of folk remedies are used, the effectiveness of which has been proven by the experience of generations.

Duodenal ulcer: briefly about the disease

Duodenal ulcer is a chronic disease with a cyclical course (constant alternation of periods of subsidence of symptoms and exacerbations). This diagnosis means that there are mucosal defects on the intestinal walls with a slow or impaired healing process.

An ulcer develops under the influence various reasons– this could be the activity of the Helicobacter pylori bacterium, long-term use of non-steroidal anti-inflammatory drugs, and so on.

The main symptoms include

• pain below the sternum;
• pain during night sleep, which may force you to wake up;
• nausea;
• As the disease progresses, vomiting with blood appears.

It is worth noting that quite often the disease occurs in a latent form, without revealing itself as obvious symptoms.

Video about the disease

Traditional medicine for treating illness

Peptic ulcer disease brings a lot discomfort therefore, to treat it and prevent exacerbations, active therapy is often used, which combines both traditional and traditional medicine. Natural remedies have different purposes: some are used to minimize symptoms, others act on the problem itself, helping to relieve the inflammatory process and stimulating tissue regeneration. This approach is considered to be most effective as part of prevention, during a period of decreasing intensity of disease manifestations.

When choosing a particular product, you must pay attention to contraindications, since they will differ depending on the ingredients included in it. The main thing to consider is the effect of the composition on acidity.

Specialist Note: Before starting alternative therapy, it is very important to consult a doctor. He will be able to assess the condition, the appropriateness of using the selected recipes and their ability to positively influence the situation.

Decoctions and infusions

Herbal medicine has proven itself well in the treatment of many diseases. On to the pros this method include its availability, effectiveness, the possibility of combining with drug therapy and simplicity. If you have ulcerative lesions of the duodenum, you should resort to the following recipes:

• Yarrow decoction. To prepare it, pour 2 tablespoons of dried raw materials with a glass of boiling water and leave under a closed lid for half an hour, after cooling, filter. The daily norm is 300 ml, divided into 3 doses. This drug is contraindicated during pregnancy.
• Calendula decoction. Has an active anti-inflammatory effect. Prepare the infusion in the same way, take half a glass 2 times a day.
• Oil infusion of St. John's wort. The preparation of the product is very simple: pour 20 grams of herbs with a glass of oil (preferably olive) and leave in a dark place for a month. Only a specialist can suggest a specific dose, based on the parameters of the patient’s condition. St. John's wort should not be taken if you have epilepsy, along with sedatives, or if you have HIV.
• Chamomile tea. Several flowers are simply poured with boiling water and infused, or added to regular tea.
• Decoction of golden mustache. The proportions are standard - a spoonful of raw materials per glass of water. Take half a glass orally three times a day for a month.
• Burdock root drink. The decoction is prepared in a water bath (boil for 30 minutes) by mixing the crushed root with water in a ratio of one to twenty. It is recommended to drink this composition 100 ml 2 times a day;
• Viburnum infusion. 20 grams of mashed fruits are poured into 200 ml of boiling water and left to infuse in a closed container for 4 hours. The strained composition is drunk before meals 2-3 times during the day, half a glass.

Herbal infusions have a good effect in treating the disease - this way it is possible to achieve a more active and versatile effect.

Let's look at the most popular recipes:

• dandelion root, chicory and elecampane root. Preparation process: a tablespoon of the described composition is placed in a jar and poured into two glasses cold water for a couple of hours, and then boil in a water bath for 10 minutes. The strained broth is drunk 2 tablespoons before meals;
• calendula flowers and Birch juice– 50 grams of dried flowers are boiled in three liters of juice and left for a day;
• monastery tea (calendula, plantain, fennel, rose hips, St. John's wort, mint, wormwood, horsetail, chamomile, yarrow) - 2 tablespoons of the mixture are brewed with two glasses of water;
• a mix of wormwood, mint, St. John's wort, sage, plantain, calamus root, chamomile and calendula flowers. The product is prepared in the same way as monastery tea.

Means for preparing infusions and decoctions in the photo




Honey and propolis


Honey can reduce pain

Treatment using honey is only relevant in situations with increased acidity Well, this remedy can reduce pain.

1. For cooking medicinal composition you need to mix liquid honey and olive oil in equal proportions, then place the mixture in the refrigerator.
2. You can take it the next day, a tablespoon half an hour before meals, only three times a day.

Propolis is useful for duodenal ulcers, but you need to carefully select the basis of the recipe. It is better not to use alcohol compounds, as they can severely irritate the mucous membranes..

An oil base is perfect:

1. 100 grams of propolis are diluted in melted butter in a ratio of 1:8.
2. Take it daily – a teaspoon before meals and so on for a month.

Flax seed is taken for two months

Most effective way The use of flax seeds for duodenal ulcers is to take a decoction.

1. Add a tablespoon of seed to a liter of clean water.
2. Boil the mixed ingredients over low heat for about 5 minutes.
3. Leave the product to cool completely under a closed lid.

The minimum course of treatment is two months of daily use of 50 ml before meals. This decoction is also suitable for preventive purposes: it is drunk in two-month courses during periods of expected exacerbations (spring and autumn).

The only contraindication for taking such a product is allergic reaction on linen.

You can simply chew aloe half an hour before meals.

Aloe can be used for peptic ulcers in several ways. The simplest one is to chew clean leaves of the plant half an hour before meals. The piece should be about 4 centimeters long. The event must be carried out in a course lasting one month, followed by a month-long break.

The second method is to prepare an infusion with honey.

1. It is necessary to pass aloe leaves through a meat grinder.
2. Mix half a glass of the resulting mass thoroughly with 150 ml of honey.
3. The finished mixture is infused in a dark place for 3 days, after which it is taken several times a day in a tablespoon, always some time before meals.

Badger lard

Badger fat is very effective for peptic ulcers - it helps to heal affected areas and normalize organ functions. It is used in melted warm form (to do this, just leave it at room temperature for some time).

The course of treatment is two weeks; every day during this period it is recommended to eat a tablespoon of lard three times a day. To improve taste, you can add fat to milk and honey.

Juices


Potato juice is a popular remedy for duodenal ulcers.

Natural vegetable juices can provide positive effect for a patient with an ulcer. In addition to the local effect, due to the properties of the products used, this method helps to saturate the body as a whole. useful substances and strengthen it.

If you have a duodenal ulcer, you should pay attention to the following drinks:

• For cooking you will need only young potatoes, which need to be washed, peeled and minced. The resulting pulp is placed in gauze and squeezed thoroughly. The product should be consumed some time before meals, 100 ml. The recommended duration of such therapy is 3 courses of 10 days at intervals of a similar duration.
• Cabbage juice. The cooking method is the same as with potatoes. If you have a juicer, this issue fades into the background. The daily norm is from 100 to 200 ml, the course is 3 weeks. If repetition is necessary, take a ten-day break. If the acidity is high, you can add a little honey to the juice.
• Beetroot juice. Before use, it must be diluted with water in equal proportions. It is recommended to take 100 ml of diluted juice per day half an hour before meals.
• Celery juice. The product should not be used by people with high acidity, varicose veins veins and problems with blood clotting. The product is taken half a glass before meals.

Mumiyo can be diluted in water or milk

Mumiyo for ulcers can be used in several variations. First - water solution. To make it, 2 grams of the product are mixed with a glass of water. Take a tablespoon of the mixture every morning on an empty stomach for 10 days, after which you take a break of the same duration.

The second recipe is a milk solution. In this case, mumiyo is diluted not in water, but in 100 ml of milk. You need to take a dessert spoon of the product per day, the course is 25 days.

There are no direct contraindications to the use of this product, but experts recommend avoiding it if you have cancer-type diseases.

Flaxseed and sea buckthorn oil


Sea buckthorn oil prevents the proliferation of bacteria

To the main properties sea ​​buckthorn oil refers to the ability to suppress the proliferation of bacteria, promote wound healing and reduce the intensity of the inflammatory process, which is why it is often used for duodenal ulcers.

You need to take sea buckthorn oil three times a day, a teaspoon, only half an hour after that you can eat. During periods of improvement, you can reduce the number of doses to one in the morning. The course of treatment is a month.

Flaxseed oil can be taken in pure form the same as sea buckthorn, or you can simply add it to food.


Walnuts promote tissue repair

Nuts have a beneficial effect on tissue regeneration processes, therefore, in case of ulcers, they are used to activate the healing of ulcerative formations on the intestinal mucosa.

Can be cooked effective infusion based on this product:

1. Pour boiling water (100 ml) over 30 grams of chopped nuts.
2. Leave the mixture for half an hour and strain.
3. Mix in a couple of tablespoons of honey.

I take the resulting product one tablespoon 3-4 times during the day.

Duodenal ulcer is a complex disease, the treatment of which requires an integrated approach. Folk recipes There are a lot of medications to combat this problem; the patient’s main task is not to abuse them and consult with specialists.