Symptoms of bulbitis of the 12 duodenum. Follicular form of the disease

- this is catarrhal or erosive inflammation of the bulbar region of the twelve duodenum. In most cases etiological factor bulbitis is an infection with Helicobacter. Clinical signs pathologies include pain syndrome varying degrees intensity, dyspeptic syndrome, with severe course and the presence of ulcers, bleeding is possible. Diagnosis of bulbitis is based on the results of endoscopic examination and biopsy, pH-metry, tests for the presence of H. pylori, and contrast radiography. Therapy consists of the use of anti-Helicobacter antibiotics, drugs to reduce production hydrochloric acid and regeneration of the mucous membrane.

Pathogenesis

Normally, a person has a balance between the factors of aggression and protection of the gastroduodenal zone. Bicarbonates produced by the pancreas reduce the acidity of stomach contents entering the duodenum. When this balance is disturbed, hydrochloric acid, liver and pancreatic enzymes damage the mucous membrane. Increased acidity creates favorable conditions for the colonization of Helicobacter. They are adapted to exist in an aggressive acidic environment and create a protective alkaline barrier around themselves. Helicobacter pylori causes the production of pro-inflammatory substances, resulting in damage to the mucous membrane. In this case, an erosive form of the disease develops, and in the absence of proper treatment, ulcers form.

Symptoms of bulbitis

The symptoms of this pathology depend on clinical form. The main symptom is pain, which can have varying intensity. Catarrhal bulbitis is characterized by minor pain in the upper abdomen. With erosive bulbitis, pronounced pain occurs on an empty stomach and 10-15 minutes after eating. Patients note a decrease in appetite, nausea, sometimes vomiting occurs, which brings relief, bitter belching and heartburn.

If, as the erosive process progresses, ulcers form and become damaged blood vessels, bleeding may develop with characteristic features: high intensity pain syndrome, vomiting mixed with blood, severe general weakness; With heavy blood loss, hemorrhagic shock is possible.

Acute bulbitis, which occurs against the background of food poisoning, is accompanied by an increase in body temperature, severe nausea, frequent vomiting, stool disorder. The patient's general condition suffers significantly. Due to insufficient enzymatic processing of food, symptoms of digestive disorders occur. There may be a feeling of discomfort in the abdomen, upset stool, signs of dysbacteriosis.

Diagnostics

When examining a patient with bulbitis, pallor is detected skin(in case of blood loss), upon palpation upper sections Abdominal pain occurs. The tongue is covered with a white coating, and teeth marks are visible on it. Clinical and biochemical tests changes in the blood are non-specific for bulbitis: a decrease in red blood cells, hemoglobin (in the erosive version with bleeding), changes in the level of liver and pancreatic enzymes. If bleeding is suspected, a stool test for occult blood is performed.

If bulbitis has developed against the background of hyperacid gastritis, pH-metry determines the increase in acidity gastric juice, and specific tests detect Helicobacter. A urease breath test is performed to confirm the presence of H. pylori. enzyme immunoassay, PCR diagnostics of Helicobacter, examination of a biopsy specimen taken during endoscopy.

A mandatory method for diagnosing bulbitis is esophagogastroduodenoscopy - an endoscopic examination that allows you to visually assess the condition of the mucous membrane of the stomach, duodenum and in particular the bulbar region, identify erosions, determine the degree of damage and conduct an endoscopic biopsy for the purpose of histological evaluation of duodenal tissue. Often, superficial bulbitis is a finding and is detected in the form of diffuse hyperemia of the mucous membrane and edema.

In the diagnostic program for bulbitis, ultrasound of the abdominal organs can be used. This method does not directly determine the condition of the duodenum, but makes it possible to examine the liver and pancreas.

Treatment of bulbitis

Complex treatment is carried out by a gastroenterologist, and in case of complications - by a surgeon. A diet is required. Acute period assumes complete failure from mechanically, thermally and chemically rough food. Liquid and pureed dishes are recommended. Meals should be fractional - at least 6 times a day. Outside the period of exacerbation of bulbitis, the diet is gradually expanded. However general recommendations the patient must adhere to it at all times. You should exclude products with preservatives and chemical additives that irritate the mucous membranes and provoke an exacerbation.

basis drug therapy is the eradication of the pathogen. For this purpose, anti-Helicobacter antibiotics and inhibitors are prescribed proton pump, bismuth preparations. To reduce the acidity of gastric juice, antacids, M-anticholinergics, and H2-histamine blockers are used. To heal erosive defects of the mucous membrane, drugs are used that accelerate the repair processes (rose hip oil, sea buckthorn, dalargin) and drugs that increase mucus formation (licorice root, carbenoxolone).

Physiotherapy for bulbitis includes the appointment of magnetic therapy, electrophoresis with analgesics and antispasmodics (Novocaine, papaverine). Outside the period of exacerbation, patients should undergo twice a year spa treatment using mineral waters. Herbal medicine for bulbitis includes the use of herbs, which include celandine, chamomile, yarrow, St. John's wort, fennel, and linden. At home, it is recommended to use Esentuki mineral waters No. 17 and No. 4, “Borjomi”.

Surgical treatment of bulbitis, accompanied by the formation of ulcers, consists of performing vagotomy - a surgical intervention, the purpose of which is parasympathetic denervation of the gastroduodenal zone and reducing the production of hydrochloric acid. Trunk vagotomy (the entire stomach is denervated) or selective proximal vagotomy (the acid-producing zone is denervated) can be used. Emergency surgical intervention consists of stopping gastroduodenal bleeding by clipping or ligating bleeding vessels during gastroduodenoscopy. If endoscopy does not reveal the source of bleeding, duodenotomy and suturing of the duodenal ulcer are performed.

Prognosis and prevention

At timely application for specialized assistance, prescribing adequate therapy for bulbitis and eradication of Helicobacter, the prognosis is favorable. Patients must follow dietary therapy recommendations and, if necessary, adjust their lifestyle. You should stop smoking and drinking alcohol.

Prevention of bulbitis involves timely treatment gastritis with mandatory after therapy, tests confirming eradication of the pathogen. Even without exacerbations, it is necessary to regularly attend medical examinations. Many drugs are aggressive to the mucous membrane of the stomach and duodenum, therefore, for bulbitis, all drugs should be used only after consultation with a doctor. To prevent infection with Helicobacter, you should maintain food hygiene and wash your hands thoroughly before eating.

ICD-10 code

Bulbit is a type of duodenitis. With duodenitis, the inflammation process involves the directly adjacent part of the duodenum to the stomach. Bulbit is an inflammation of the duodenal bulb itself. The bulb opens into the excretory duct of the gallbladder and pancreas. The contents of the stomach enter it. It is immediately neutralized. It also begins to produce digestive enzymes.

Very often the disease is accompanied by gastritis. is an inflammation of the gastric mucosa and has similar symptoms. That is why in gastroenterology the term “stomach bulbitis” is used.

There are several types of bulbitis: erosive bulbitis, catarrhal bulbitis, superficial bulbitis, acute bulbitis and chronic bulbitis.

Causes gurgle

There may be several reasons for the development of bulbitis. The duodenum does not have a mesentery, but there are cases when the embryonic mesentery is preserved. Then the intestine is too mobile, thereby forming additional loops. This leads to part of the food mass flowing through the duodenum getting stuck in them. As a result, favorable conditions are created for the proliferation of bacteria that inhabit the intestine. And as soon as some unfavorable factor (spicy and fatty foods, alcoholic drinks) provokes the rapid growth of these bacteria, the duodenum begins to bubble.

In addition to the incorrect location of the intestine in relation to the axis of the body and its excessive mobility, there is also a relationship between gastritis and gastric bulbitis.

Gastritis is also a provocateur of bulbitis. With gastritis, it is usually produced large number hydrochloric acid, which can be thrown into the duodenum. A superficial bulbite is formed. As a rule, this causes erosive gastritis.

It should be noted that helminthic diseases, giardiasis, also play a role in the formation of inflammation of the duodenum. But it more often takes on a chronic form of the disease.

Gastrointestinal injuries, ingestion of irritating foods, alcoholic drinks and some medicines can provoke acute bulbitis, since the duodenal mucosa is very sensitive to this kind of influence on it.

It has also been proven that Helicobacter pylory promotes inflammation of the mucous membrane of the stomach and duodenum, which leads to a significant change in the pH acidity of the contents of the bulb. This causes a crash digestive process, which causes irritation and then inflammation. Bottom line - catarrhal bulbitis.

According to scientists, genetic predisposition also has a certain role in the occurrence of duodenal bulbitis.

Bulb symptoms

This disease can occur with different symptoms and course. It can occur with subtle symptoms, or even in acute form.

With acute bulbitis of the stomach and duodenum, the pain can be quite severe and may be accompanied by nausea and repeated vomiting, sometimes with bile. There may be a bitter taste in the mouth. Provocation of such a bulbitis often occurs after drug abuse or after severe poisoning. This can be explained by the fact that the tablets always contain such chemical composition, which is a powerful irritant for the mucous membrane.

Acute bulbitis can also be confused with an attack of gastroenteritis or with, which is characterized by cramping pain in the epigastrium, or of a girdling nature.

Catarrhal and chronic bulbitis duodenum is characterized by aching, bursting pain “in the pit of the stomach.” Sometimes they can radiate to the right hypochondrium or to the navel area. As a rule, the pain is not severe and is usually triggered by poor nutrition, for example, after a heavy dinner, usually two hours after eating. Sometimes these symptoms may be accompanied by mild nausea, but without the urge to vomit. These types of bulbitis are characterized by a long-term course, in the form of seasonal exacerbations.

Erosive bulbit manifests itself in pain varying intensity. They can occur at different times of the day. So-called “hunger pains” can also arise from hunger. Moreover, they are practically permanent. With erosive bulbitis, there may be complications in the form of bleeding, which is accompanied by severe pain, persistent vomiting mixed with blood, general malaise, fever, etc. A patient with such an attack may experience a state of shock.

Due to a violation of the motor and secretory function of the duodenum, its contents are periodically thrown into the stomach. As a result, heartburn appears, with symptoms of bitter belching.

Diagnosis of any type of bulbitis is not difficult. It includes fibrogastroduodenoscopy, x-ray of the stomach, and examination of gastric juice. In some cases, they resort to probing.

Bulbit treatment

When an attack of bulbitis occurs, it is advisable to immediately take antacid medications (Gastal, Reni, Maalox, etc.). But this is temporary relief. An important factor in successful recovery is, of course, the correct treatment tactics. a certain type bulbita.

For acute bulbitis, it is prescribed in addition to antacids, painkillers (No-shpu, Baralgin, Papaverine). These drugs will help relieve pain attacks by relaxing the tone smooth muscle. It is also advisable to prescribe fasting in the first days of the disease, and subsequently strict diet. It is best to treat acute gastric bulbitis in a hospital setting, where gastric lavage may be required to prevent poisoning. They may also prescribe drips with saline solution to relieve symptoms of intoxication of the body. There, additional examination methods will be carried out, the results of which will determine the most advantageous treatment tactics for acute duodenal bulbitis.

For chronic and catarrhal bulbitis, it is prescribed antibacterial therapy, since this type of bulbitis usually develops due to Helicobacter pylori infection. Antibiotics are prescribed taking into account the sensitivity of the pathogen to them. These can be certain groups of antibiotics that act on the cell of the pathogen itself - Amoxicycline, Vilprafen, Summed, De-nol and others. Sometimes Metronidazole may be prescribed. But in our time, its effectiveness among potential “killers” of Helicobacter is disputed. Also, with this type of bulbitis, a long-term diet is prescribed. In addition, you must stop smoking. If possible, avoid stressful situations. It is necessary to stop taking all kinds of food additives; they can also be a provoking factor for the exacerbation of catarrhal and chronic bulbitis. Also when stressful situations during the treatment of this type of bulbitis, sedatives and sedatives. You should understand and be psychologically prepared for the fact that you will have to reconsider your usual way of life, since the treatment will be complex and lengthy.

For superficial and erosive bulbitis, wound healing drugs (methylarucil) are prescribed. enveloping drugs in the form of a suspension, which better envelops the gastric mucosa (antacid Maalox, Almagel, Reni and Atropine, Hofitol). Hydrochloric acid prescription blockers (Omeprazole, Methiclopramide, Ranitidine) are prescribed without fail. This is one of the successful cures for this kind of bulbitis, since it is the throwing of hydrochloric acid onto the damaged area that provokes the development of ulcers and erosions. The above drugs do not allow acid to be produced in excess and also to be thrown onto damaged areas. Methiclopramide is especially effective in this regard. It also relieves attacks of nausea, which is caused by increased activity of the duodenum. Also, for a complex effect on the digestive system, Wobenzym (a drug wide range action, consisting of a complex of enzymes and acids that are actively involved in the metabolism of many processes in our body), Essentiale (a drug to improve liver function, which will be very stressed during the treatment of bulbitis). Physiotherapeutic treatment and sanatorium-resort holidays will also be useful.

Bulbit diet

We should also talk about diet during the treatment of bulbitis. This is very important factor on the road to recovery.

Proper nutrition is necessary for every person. This is good. But, as a rule, it is not possible to monitor your diet, and most people do not even know what it is. proper nutrition. It is especially important for people suffering from inflammatory diseases gastrointestinal tract. Diet is not precisely the identity of the products that are approved for use, since all diseases are individual, like each organism.

A nutritionist, together with a gastroenterologist, will help you choose the right diet, which will need to be followed for a fairly long period of time - about six months. And even if the symptoms of the disease have passed, you still need to continue to adhere to the diet.

When bulbitis worsens, it is important to immediately give up foods that irritate the mucous membrane - coffee, strong tea, alcoholic drinks, spicy, smoked, salty and fatty foods. After all, they became the provoking link in the occurrence of the attack.

In the first days after an attack, you should eat only liquid food. Since food for such a patient should be easily digestible and even a kind of “unloading”. Subsequently, prerequisite treatment should be separate and fractional meals. Food intake should be increased to 6 times a day. Food must be kept warm. Table salt limited to 5 grams per day, sugar - up to 50 grams.

In the first weeks, the foods allowed for consumption include soft-boiled eggs, scrambled eggs, steamed slimy porridges, baked apples, chicken broth and fillet, compotes and jelly, up to four glasses of milk, milk and cereal soups, meat and fish in the form of a soufflé. Bakery products are prohibited.

After two weeks of treatment, you can slightly expand your food intake by including day-old white bread, crackers, biscuits, low-fat sour cream, butter, low-fat cottage cheese, steamed pork cutlets, boiled veal, pasta. The only drinks you can include for now are tea, and even a weak one. And freshly squeezed juices from non-acidic fruits and vegetables. Nutritionists may also recommend consumption half an hour before meals. olive oil in the amount of one tablespoon. And so twice a day - morning and evening. This suppresses the secretion of gastric contents well and helps in treating the disease.

Sample diet menu for one day for bulbitis:

Breakfast. 8 hours

1. Steamed omelette stuffed with carrots.

2. A glass of weak, slightly sweetened tea with milk.

Lunch. 10 o'clock

1. Apple puree.

Snack. 11 hours 30 minutes

1. Rose hip decoction

Dinner. 12 hours 30 minutes

1. Soup with chicken fillet meatballs.

2. Boiled rice with steamed veal cutlet.

3. Kissel.

Afternoon snack. 15 hours

1. A glass of compote

Dinner. 5:30 p.m.

1. Carrot salad

2. Fish soufflé.

3. Buckwheat porridge.

Second dinner. 19 hours

1. Rusk pudding with pear puree.

2. A glass of tea.

Before bed. 21 o'clock

1. A glass of milk.

It is important to remember that if you suddenly stop following this diet, you can go back to square one and then have to start treatment all over again. It is also important to listen to the recommendations of specialists.

Bulbit is inflammatory disease mucous membrane of the duodenal bulb, which occurs due to a violation of its mobility and the formation of an additional loop in which part of the food is retained, which creates favorable conditions for the proliferation of bacteria. Often this pathology due to the similarity of symptoms, it is associated with gastritis, which is why it is called “stomach bulbitis”. Stomach bulbitis is a type of duodenitis.

Most often, bulbitis occurs in women and develops over a long period of time. It often occurs in early childhood.

Reasons

The cause of gastric bulbitis in most cases is pathogenic bacterium Helicobacter pilori, the rapid development of which, if it enters the human body, occurs against the background of gastritis. Also, the reasons that provoke gastric bulbitis include increased acidity gastric juice that enters the duodenum.

Stomach bulbitis can occur in both acute and chronic forms. The acute form of the disease is most often provoked by taking certain medications, drinking alcoholic beverages, or poisoning the body toxic substances. The course of the pathological process in a chronic form can be caused by giardiasis or Crohn's disease. In addition, the cause of bulbitis can be mechanical injury stomach, caused by the entry of a foreign object into it.

Symptoms

Depending on the nature and causes of the disease, there are several types of gastric bulbitis:

• superficial bulbitis - affected upper part mucous membrane;
• erosive bulbitis - small ulcers appear on the mucous membrane;
• focal bulbitis - accumulation of ulcers;
• atrophic bulbitis - thinning and pallor of the walls of the duodenum.

Spicy

Symptoms of acute bulbitis are usually characterized by general malaise, headache, dizziness, chills, severe weakness, increased heart rate, nausea and vomiting. When palpating the abdomen, pain is felt in the navel area. When pressed, its intensity increases significantly. Often the symptoms of acute bulbitis are mistaken for symptoms of a duodenal ulcer.

Chronic

Chronic bulbitis is accompanied significant reduction immunity, which manifests itself in the form of malaise, increased sweating, fatigue, and headaches. Long periods between meals lead to tremors in the body and severe muscle weakness. The symptoms of chronic gastric bulbitis are similar to the symptoms of all types of this disease.

Catarrhal and follicular

The symptoms of catarrhal bulbitis are difficult to distinguish from the symptoms of diseases of the stomach and duodenum. These include aching and cramping pain in the epigastric region, belching of eaten food, heartburn, unpleasant odor and bitter taste in the mouth, nausea and vomiting after eating, a tendency to constipation, weakness and tremors in the muscles, irritability, dizziness, sleep disturbances.

Surface

Superficial bulbite is the most mild form a disease that precedes other diseases of the gastrointestinal tract. At this stage, there is slight swelling and redness of the folds of the mucous membrane, and dilated capillaries are visually noticeable. Sometimes there are phenomena of reflux of bile from the bulb into the stomach and esophagus.

Superficial bulbitis is manifested by constant rumbling in the stomach, general malaise, irritability, a feeling of extreme hunger, nausea, and constipation. Pain syndrome does not always accompany pathological changes of this period. Aching, intermittent pain may occur in the epigastric region on an empty stomach or after eating.

Erosive

The dominant symptom of erosive bulbitis is hunger pain, which is localized in the stomach and intestines and is permanent or spasmodic in nature. Immediately after eating, hunger pains are replaced by heartburn.

Characteristic symptoms of erosive bulbitis also include general malaise body, weakness, severe fatigue, frequent bloating, bitter taste in the mouth, belching.

Focal

The main symptoms of focal bulbitis are pain and digestive disorders, which manifest themselves as a feeling of heaviness in the stomach, nausea and vomiting, heartburn, belching, etc. Pain can occur at any time of the day. It is often localized in the epigastric region, and in some cases extends to the right hypochondrium and around umbilical region. Almost always, exacerbations of focal bulbitis are accompanied by general weakness of the body and headaches.

Atrophic

Symptoms of atrophic bulbitis are manifested by belching (often with a sour taste) that occurs after each meal and persistent heartburn. The frequency of these factors increases as the pathological process develops. The patient is worried constant feeling heaviness in the stomach, as well as rumbling and gurgling in the abdomen, bowel dysfunction in the form of constipation or diarrhea. Due to incomplete absorption of microelements, vitamins and especially important nutrients the general condition of the body worsens, as evidenced by the appearance of weakness, increased fatigue, frequent dizziness. Against the background of deterioration or total loss loss of appetite and loss of body weight.

Deficiency of iron and vitamin B12 leads to the development of anemia, which is accompanied by pallor and dry skin.

Treatment of bulbitis

Treatment of gastric bulbitis, as well as all diseases of the gastrointestinal tract, should begin with a particularly gentle diet (table No. 1a):

Diet

• fermented milk products (kefir, cottage cheese, milk, yogurt, mild cheese, fermented baked milk);
• jelly;
• slimy porridge;
• bread crackers;
• chicken broth;
• boiled or steamed meat.

Treatment for bulbitis should include:

• Rational small meals at least 4 times a day. The food should be well ground, warm and have a semi-liquid consistency. Dishes must be stewed, baked or boiled. When choosing a menu for every day, the emphasis is on porridge, a variety of soups and broths.
• Quitting alcohol and smoking.
• Exclusion from the diet of foods that have irritant effect on the mucous membrane - sour, pickled, fatty, salty, fried, hot, spicy, strong tea and coffee, garlic, onions, legumes, various sweets.
• During periods of exacerbation of gastric bulbitis, fasting for two days is recommended. After this, the stomach is washed with a weak solution of potassium permanganate and the intestines are cleansed with a solution of magnesium sulfate. For pain, antispasmodics are used.
• Reducing emotional and mental stress.
• Dental treatment because oral cavity is entrance gate for any infection.
• Treatment with medications should be symptomatic. Mandatory drug treatment for all types of disease should include the use of drugs that normalize gastrointestinal motility, reduce the secretion of hydrochloric acid, as well as bismuth preparations, antacids and reparants.
• Gives a good healing effect regular use warm mineral water"Truskavets" or "Essentuki", from which gas was released in advance.

Treatment with folk remedies

Traditional medicine offers many folk remedies and recipes with which you can cure stomach bulbitis at home.

During the period of remission, patients with gastric bulbitis are indicated for physiotherapeutic procedures and sanatorium-resort treatment.

Duodenal bulbitis is a disease characterized by inflammation of the mucous membrane of the bulbar region. The main cause of the pathology is considered to be infection of the bulb by the bacterium Helicobacter pylori, which occurs as a result of reflux of stomach contents.

The physiological feature of the bulbar region lies in its structure. Two ducts open into the duodenal bulb: the bile duct and the pancreatic duct. In this part of the digestive tract, a chemical process occurs to neutralize the acid of the stomach contents, and digestion processes are launched under the influence of pancreatic and liver enzymes.

The main causes of inflammation

Today, gastroenterologists are increasingly reporting a decrease in the frequency of bulbitis caused by Helicobacter pylori. This is explained by timely drug therapy. In this case, the frequency idiopathic forms diseases that have nothing to do with bacterial infection remains quite high. One way or another, an unfavorable background for the development of duodenal bulbitis is stomach problems, which are characterized by increased secretion gastric juice. With the constant entry of excessive concentrations of hydrochloric acid into the bulb, an inflammatory process begins. The impetus for the direct development of bulbite most often becomes the following factors:

• frequent overeating;
• smoking;
• unbalanced diet;
• alcohol abuse.

Symptoms and treatment of duodenal bulbitis depend on the severity of inflammation and the form of the disease. The disease may be diffuse or focal character, be chronic or acute. In addition, bulbit comes in several types:

• catarrhal;
• erosive-ulcerative;
• follicular;
• atrophic.

Catarrhal bulbitis

The disease of this form, as a rule, is not perceived by specialists as an independent pathology. Most often, this term is used to emphasize the severity of the inflammatory process. Catarrhal bulbitis appears the following symptoms:

• aching “hungry” pains (mostly occurring at night);
• heartburn;
• nausea after eating;
• belching with a sour and putrid taste;
• persistent bad breath that does not go away even after brushing your teeth;
• muscle weakness, fatigue;
• dizziness;
• dyspeptic disorders;
• increased sweating;
• sleep disorders;
• irritability.

Damage to the mucous membrane of the duodenum, which is a fairly delicate and vulnerable organ, can be done without much difficulty by frequent abuse of too hot dishes. The consequence of a microscopic burn is the formation of wounds characteristic of erosive bulbitis. Without proper treatment, erosions affect the entire intestine. This type of pathology affects the entire bulbar region, on the mucous membrane of which superficial lesions form. The main symptom of the erosive form of the disease is severe pain in the epigastric zone. In severe cases, patients experience bleeding, vomiting, and stool disorders.

Manifestations of the disease

As a rule, the signs of erosive bulbitis of the duodenum are similar to the symptoms of the catarrhal form of the disease. In addition to those mentioned, the disease is characterized by additional manifestations:

• uncomfortable feeling of fullness and pressure in the abdominal cavity;
• nausea and frequent vomiting;
• belching with bile;
• bloating.

Pain is most often felt in the umbilical region or in the left hypochondrium. The attacks usually disappear after eating or drinking dairy products. Acute bulbitis of the duodenum in most cases is accompanied by discomfort, burning, and bleeding of erosive foci. Characteristic feature the stool of a patient with bulbitis has: feces have dark color.

Due to high blood loss, vomit resembles coffee grounds. Without treatment, the patient's condition will worsen every day, and dizziness will become more frequent. Bleeding is not typical for the chronic form of bulbitis, but in this case the above-described manifestations are often supplemented by constipation.

Follicular form of the disease

• weakened immune system;
• poor quality nutrition;
• functional disorders at work digestive system.

Symptoms of duodenal bulbitis of the follicular type do not have fundamental differences from manifestations of other forms of this disease. And yet, patients report cramping, alternating aching pain in the epigastric region. Unpleasant sensations radiates to the back and navel. The discomfort, which usually appears at night, persists until the person has breakfast. You should pay attention to a number of other symptoms of follicular bulbitis:

• belching and heartburn after each meal;
• diarrhea and diarrhea;
• weakness and headaches.

Atrophic type of disease

This pathology of the duodenum is extremely rare. This variation of bulbitis is characterized by sour belching and intractable heartburn after eating any food. As the disease progresses clinical picture becomes more pronounced and gains stability.

With atrophic bulbitis, the patient is bothered by constant heaviness inside the stomach. Rumbling and gurgling inside the peritoneum becomes a common “companion,” and diarrhea often occurs, followed by constipation. Dyspeptic disorders interfere with the complete absorption of nutrients. Microelements and vitamins are not completely absorbed, which affects general condition and the patient's well-being. Decreased appetite leads to weight loss, and a lack of iron entering the body causes the development of anemia. Externally, patients with bulbitis look sickly, their skin is pale and suffers from moisture deficiency.

Patient examination

To confirm the diagnosis, as a rule, resort to instrumental methods research. Only one visual inspection not enough for an accurate diagnosis. Without fail, the specialist detects painful areas by palpating individual areas of the abdomen, carefully reads the patient’s complaints, and checks whether there is a coating on his tongue characteristic of the disease. To the complex diagnostic procedures includes:

• fibrogastroduodenoscopy;
• radiography;
• bacteriological analysis duodenal juice.

The results of an X-ray examination help doctors assess the degree of changes that have occurred in the structures of the organ bulb. Thanks to FGDS, it is possible to determine the presence of damage and inflammation of the duodenal mucosa, as well as motor activity bulbs, its ability to contract.

Dietary restrictions

With duodenal bulbitis, diet plays a major role. It is the correction of the diet that is fundamental in the treatment of such a disease, and not the use of medications, as many patients mistakenly believe. Taking medications, but at the same time continuing to eat “harmful” foods, you should not expect any significant results.

It is worth noting that diets for duodenal bulbitis and gastritis of the stomach are practically no different. Patients with such pathologies of the digestive system are recommended to include in their diet following products:

• fermented milk (low-fat cottage cheese, kefir, yogurt, fermented baked milk);
• jelly, compotes;
• oatmeal, buckwheat, rice porridge;
• “yesterday’s” bread, crackers;
• boiled or steamed chicken;
• lean fish;
• baked or boiled vegetables, fruits (except cabbage, mushrooms, grapes).

During the treatment of erosive bulbitis of the duodenum, gastroenterologists advise limiting, and if possible completely eliminating:

• whole cow's milk;
• sour, pickled, fried, spicy and spicy dishes;
• canned food;
• coffee and strong teas;
• garlic and onion;
• all legumes;
• white bread and a variety of baked goods;
• sweets.

Diet features

In case of inflammation of the bulbar region, warm mineral non-carbonated water “Truskavets”, “Essentuki” will have a beneficial effect on the functioning of the organ. Before treating duodenal bulbitis, it is important to realize that only a properly selected diet can ensure success. In the chronic form of the disease, the amount of food consumed also decreases. You also need to pay attention to the temperature of the food you consume - both too hot and too cold food is unacceptable. Under no circumstances should you eat foods irritating mucous membrane. Preference should be given only to easily digestible foods.

Ideally, dishes should be prepared without oil or spices, in an oven or steamer. The most suitable consistency of food for a patient with bulbitis is puree. The semi-liquid form will avoid the traumatic effects of the coarse fibrous texture of consumed products on the mucous membrane. Doctors also strongly recommend eating fractionally - every two hours in small portions.

Treatment with medications

Cope with duodenal bulbitis without using medicines hard enough. Drugs are prescribed to the patient individually by the attending physician. The specialist builds a treatment regimen based on the results of laboratory and instrumental studies.

The course of treatment for bulbitis usually consists of several directions:

In addition to the main drug course, the doctor may also recommend treatment folk remedies. With duodenal bulbitis alternative medicine can really be an effective addition to the prescribed medication course. However, success in therapy can only be achieved if you strictly follow the recipes for preparing medicinal formulations. Duodenal bulbitis is treated:

• Honey and plantain juice - take one teaspoon of the mixture with meals.
• A decoction of St. John's wort and tansy. Preparing the medicine is very simple: for 2 cups of boiling water you will need a tablespoon of plant material. Cook over low heat for 10-15 minutes.
• Propolis tincture. The main component is infused in alcohol for 3 weeks, and before use, the resulting liquid is diluted with water in a ratio of 1:30.
• Freshly squeezed carrot juice. Drink half an hour before meals.
• Water infusion from oak bark, chamomile, marshmallow, licorice, flax seeds.

Indications for surgery

As a rule, treatment of duodenal bulbitis occurs without surgical intervention. However, in cases where the patient has ulcers on the mucous membrane and erosive bleeding occurs, surgery becomes the only rational way to combat the disease. Surgeons stitch together ulcers on the surface of the duodenum - this technique minimizes the impact of gastric juice on the mucous membrane of the organ. At chronic bulbitis During the period of stable remission, patients are advised to follow a diet and for preventive purposes undergo sanatorium-resort treatment, physiotherapeutic procedures.

Bulbit refers to diseases of the gastrointestinal tract and is a type of duodenitis. In case of duodenitis, damage to the mucosa concerns the entire section of the duodenum adjacent to the stomach and intestines; in case of bulbitis pathological process limited distribution - in the duodenal bulb. This part of the digestive system is designed to communicate with bile duct and pancreas. The bulb is filled with gastric contents, neutralizes it, and production occurs in it. digestive enzymes. The duodenum itself is intermediate between the stomach and intestines.

That is, the duodenal bulb is constantly at work, comes into direct contact with food entering the stomach and is exposed to all the beneficial and harmful components found in food. Bulbitis of the duodenum is an inflammation of the mucous bulb, which can be accompanied by erosion, turning into an ulcer, and other pathological phenomena. A common cause of the disease is gastritis. Untimely treatment can lead to a chronic form, which is characterized by a lot of unpleasant complications in the gastrointestinal tract and other organs.

The symptomatic picture of the disease is a complex set of signs by which the disease is diagnosed using various methods. Great value is given to the sensations of the patient himself, usually patients complain of pain of varying degrees and discomfort in various parts of the gastrointestinal tract.

Typology of the disease

The symptoms of duodenal pathology are closely related to the type of bulbitis. The type is determined depending on the extent and depth of damage to the mucous membrane. In addition, different localization of the inflammatory process is characterized by different signs and a different visual picture.

1. Catarrhal bulbitis of the duodenum, called simple in medicine, is a consequence of the introduction of Helicobacter into the human body. In this case, the functionality of the duodenum is disrupted, acidity changes, which negatively affects the digestion process. The mucous membrane becomes inflamed, pockets of irritation appear on it, swelling in the folds, capillaries become filled, which gives the membrane a bright color.
2. Erosive bulbitis of the duodenum is manifested by a violation of the bulbous mucosa. Ulcers appear on pathological areas, which, merging, can form complete lesions. The larger the lesion, the greater the pain experienced by the patient. Heartburn and bleeding are added to the pain syndrome; if treatment is not started urgently, then erosive bulbitis turns into an ulcerative form.
3. Ulcerative bulbitis is distinguished by the presence on the inner bulbous surface of areas of lesions with hyperemia (discoloration and swelling), edged with inflamed edges.
4. The hyperplastic type is characterized inflammatory process on the inner bulbous walls of the duodenum with the formation of rough folds, cell proliferation and their degeneration. These changes are called epithelial metaplasia and can cause the formation of polyps and granular growths.
5. Hemorrhagic - characterized by the occurrence of local foci of hemorrhage on the membrane due to rupture of small vessels.
6. Lymphoid hyperplasia means the formation of tubercles from lymph vessels on the bulb.
7. Superficial, focal and diffuse.

With erosive bulbitis, ulcers appear

According to the characteristics of the course of the disease, the doctor develops a treatment regimen. Therefore, increased attention is paid to determining the type of disease. For diagnostics, hardware technologies (FGDS) and analysis are used.

The patient's feelings

Consider the symptoms of the disease and the patient’s feelings. Character pain syndrome depends on the type of disease and degree. In the acute form, in addition to malaise, headaches, chills, increased heart rate, pain in the umbilical area, and general weakness are observed. Chronic stage characterized by smoothed symptoms, patients complain of headache, muscle weakness, seasonal exacerbation of dysfunctions in the gastrointestinal tract.

Pain can occur at different times. For example, a couple of hours after eating in the chronic form, before eating in the erosive form, on an empty stomach and during sleep in catarrhal form. Painful sensations are also not the same. Most often, this is a “spreading” pain that manifests itself in the epigastric region, moving to the right hypochondrium and to the umbilical region. In the abdomen from this disease there may be colic, bloating, cutting, aching, cramping pain.

If treatment is delayed, then the symptoms become more and more severe and noticeable. A whole bunch of unpleasant signs are added:

• Belching and heartburn.
• Nausea and vomiting.
• Maximum release of bile into the duodenum.
• Abnormal stool – constipation becomes frequent, diarrhea occurs.

It must be borne in mind that the symptoms of this disease are similar to the manifestations of many other diseases, therefore, if there is discomfort in digestive tract you need to see a doctor. Only on time measures taken and adequate treatment can lead to recovery.

Treatment algorithm for the disease

Treatment of duodenal bulbitis is a long and complex process. The most important requirement of doctors for a patient is patience and strict adherence to the doctor’s recommendations. Self-medication for this disease is inappropriate; it can only lead to aggravation of the disease.

Treatment of the disease is carried out with the help of medications and dietary adjustments.

The treatment regimen for bulbitis includes:

1. Use of medications.
2. Diet food.
3. Application of phytotherapeutic treatment.

In severe cases of the disease complicated by Crohn's disease, bulb ulcer, duodenal stenosis, it is indicated surgery. Medication method treatment is used when Helicobacter pylori is detected and is aimed at eliminating the causative agent of the disease. A complex of antibiotics is usually prescribed.

Stomach acidity and pathological effects on the mucous membrane are helped to reduce by antacid drugs, proton pump inhibitors, and gastric H2-histamine receptor blockers. Depending on the type of bulbitis, immunoregulators may be prescribed, anthelmintics, hormonal drugs. The disease can be treated with medications only after a doctor’s prescription, this will minimize side effects that occur with drug therapy.

To the recipes traditional medicine You also need to be careful; the use of any decoctions and tinctures should be discussed with your doctor. When treating bulbitis, medicinal herbs are used that have an anti-inflammatory, disinfecting and healing effect. These include:

• St. John's wort.
• Plantain.
• Chamomile.
• Calendula.
• Yarrow.

The combination and concentration of medicinal raw materials in decoctions, the composition of the preparations, and methods of preparation must necessarily comply with the recipe. Dietary nutrition for patients with bulbitis becomes the norm for life. It helps avoid relapse of the disease and is part of complex treatment. The doctor prescribes a diet number that contains a list of all acceptable and prohibited foods. The main requirement is to avoid fatty, fried, spicy, salty, smoked and other unhealthy foods.