Peptic ulcer 12 duodenum - disease duodenum chronic recurrent nature, accompanied by the formation of a defect in its mucous membrane and the tissues located under it. It appears severe pain in the left epigastric region, occurring 3-4 hours after eating, attacks of "hungry" and "night" pains, heartburn, acid belching, often vomiting. The most formidable complications are bleeding, perforation of the ulcer and its malignant transformation.
General information
Duodenal ulcer Is a chronic disease characterized by the occurrence ulcerative defects mucous membrane of the duodenum. It runs for a long time, alternating periods of remission with exacerbations. Unlike erosive mucosal lesions, ulcers are deeper defects that penetrate into the submucosa of the intestinal wall. Duodenal ulcer disease occurs in 5-15 percent of citizens (statistics fluctuate depending on the region of residence), more often in men. Duodenal ulcers are 4 times more common than stomach ulcers.
Reasons for development
The modern theory of the development of peptic ulcer disease considers an infectious lesion of the stomach and duodenum with Helicobacter Pylori bacteria to be a key factor in its occurrence. This bacterial culture is sown during bacteriological examination of gastric contents in 95% of patients with duodenal ulcer and in 87% of patients with gastric ulcer.
However, infection with Helicobacteria does not always lead to the development of the disease, in most cases there is an asymptomatic carriage.
Factors contributing to the development of duodenal ulcer:
- alimentary disorders - improper, irregular nutrition;
- frequent stress;
- increased secretion gastric juice and decreased activity of gastroprotective factors (gastric mucoproteins and bicarbonates);
- smoking, especially on an empty stomach;
- long-term intake drugs having an ulcerogenic (ulcer-generating) effect (most often these are drugs of the group of non-steroidal anti-inflammatory drugs - analgin, aspirin, diclofenac, etc.);
- gastrin-producing tumor (gastrinoma).
Duodenal ulcers resulting from ingestion medicines or concomitant gastrinoma, are symptomatic and are not included in the concept of peptic ulcer disease.
Peptic ulcer classification
Peptic ulcer disease differs in localization:
- Stomach ulcer (cardia, subcardial region, stomach body);
- peptic post-resection ulcer of the pyloric canal (anterior, back wall, small or large curvature);
- duodenal ulcer (bulbous and postbulbar);
- ulcer of unspecified localization.
According to the clinical form, they distinguish between acute (newly diagnosed) and chronic peptic ulcer disease. In phase, periods of remission, exacerbation (relapse) and incomplete remission or fading exacerbation are distinguished. Peptic ulcer disease can be latent (without a pronounced clinic), mild (with rare relapses), moderate (1-2 exacerbations during the year) and severe (with regular exacerbations up to 3 or more times a year).
Directly a duodenal ulcer differs in morphological picture: acute or chronic ulcer, small (up to half a centimeter), medium (up to a centimeter), large (one to three centimeters) and giant (more than three centimeters) in size. Stages of ulcer development: active, scarring, “red” scar and “white” scar. With accompanying functional disorders the gastroduodenal system also note their nature: violations of the motor, evacuation or secretory function.
Duodenal ulcer symptoms
In children and the elderly, the course of peptic ulcer disease is sometimes almost asymptomatic or with minor manifestations. Such a course is fraught with development severe complications, such as perforation of the duodenum wall followed by peritonitis, latent bleeding and anemia. Typical clinical picture duodenal ulcer is a characteristic pain syndrome.
The pain is most often moderate, dull. The severity of pain depends on the severity of the disease. Localization, usually in the epigastrium, under the sternum. Sometimes the pain can be diffuse in the upper abdomen. It often occurs at night (1-2 hours) and after prolonged periods without food when the stomach is empty. After eating, milk, antacids, relief comes. But most often the pain resumes after the evacuation of the contents of the stomach.
The pain can occur several times a day for several days (weeks), and then go away on its own. However, over time, without proper therapy, relapses become more frequent, and the intensity of the pain syndrome increases. Seasonality of relapses is characteristic: exacerbations often occur in spring and autumn.
Complications of duodenal ulcer
The main complications of duodenal ulcers are penetration, perforation, bleeding and narrowing of the intestinal lumen. Ulcerative bleeding occurs when the pathological process affects the vessels of the gastric wall. Bleeding can be latent and manifest only as growing anemia, or it can be pronounced, blood can be found in vomit and appear during bowel movements (black or bloody streaked feces). In some cases, it is possible to stop bleeding during endoscopic examination, when the source of bleeding is sometimes possible to cauterize. If the ulcer is deep and the bleeding is profuse, surgical treatment is prescribed, in other cases it is treated conservatively, correcting iron deficiency. At ulcerative bleeding patients are prescribed strict hunger, parenteral nutrition.
Perforation of the duodenal ulcer (usually the anterior wall) leads to the penetration of its contents into the abdominal cavity and inflammation of the peritoneum - peritonitis. When the intestinal wall is perforated, a sharp cutting-stabbing pain in the epigastrium usually occurs, which quickly becomes diffuse, increases with a change in body position, deep breathing... Symptoms of irritation of the peritoneum (Shchetkin-Blumberg) are determined - when pressing on abdominal wall, and then with a sharp release, the pain intensifies. Peritonitis is accompanied by hyperthermia.
It - emergency condition, which, without proper medical care, leads to the development of shock and death. Ulcer perforation is an indication for urgent surgical intervention.
Prevention and prognosis of duodenal ulcer
Measures to prevent the development of duodenal ulcer:
- timely detection and treatment of Helicobacter pylori infection;
- normalization of the regime and nature of nutrition;
- quitting smoking and alcohol abuse;
- control over the drugs taken;
- harmonious psychological environment, avoidance of stressful situations.
Uncomplicated peptic ulcer disease, with proper treatment and adherence to dietary and lifestyle recommendations, has a favorable prognosis, with high-quality eradication - ulcer healing and cure. The development of complications in peptic ulcer disease aggravates the course and can lead to life-threatening conditions.
Where is the duodenum located and how it hurts? We can say that the small intestine originates from it. It begins just after the stomach and is the smallest segment of the intestine, only 25-30 cm long.
The KDP got its name from the old designation of lengths - 12 closed fingers or fingers. The duodenal jejunum continues.
Duodenal anatomy
The duodenal ulcer is located in the region of the 2-3rd lumbar vertebra. Its location can change during a person's life, depending on his age and weight.
The duodenum consists of 4 parts:
- The upper bulb of the duodenum is located at the level of the 1st vertebra lumbar and is essentially a gatekeeper. Above it is the right lobe of the liver.
- The descending one bends downward and reaches the 3rd vertebra of the lumbar spine. This segment is bordered by the right kidney.
- The lower one bends to the left, crosses the spine.
- The ascending one is located at the level of the 2nd lumbar vertebra to the left of the spine and bends upward.
The duodenum is shaped like a horseshoe, bending around the head of the pancreas. On its mucous membrane is a large papilla of Vaters, with which the liver and pancreas are connected by ducts.
The duodenum in the body performs the following functions:
- Hummus enters it and the digestive processes begin in it. Here hummus, processed with gastric juice, is also processed with bile and enzymes.
- In the duodenum, the secretion of bile and pancreatic enzymes is regulated, depending on the composition of the chyme.
- The connection with the stomach is maintained, expressed in the opening / closing of the pylorus.
- Implemented motor function responsible for the transportation of hummus.
Causes of the pathology of the duodenum
The causes of duodenal pathologies can be:
- gastric and intestinal diseases and pathological processes - inflammation of the gastric mucosa, viral infections, diarrhea, etc. Due to the increased secretory activity of the stomach, a lot of hydrochloric acid gets into the duodenum, due to the reduced - rough unprocessed food;
- Helicobacter pylori, which leads to increased production of gastric secretions, irritating the intestinal mucosa;
- and cholecystitis;
- liver disease - hepatitis, cirrhosis;
- prolonged stress;
- transferred operations;
- smoking and alcohol abuse, fast food;
- taking non-steroidal anti-inflammatory drugs;
- food poisoning;
- abuse of fatty and spicy foods;
- helminthic invasions;
- hereditary predisposition.
Diseases of the duodenum
Each disease has its own specific disease symptoms. However, there is also common manifestations typical for most diseases of the duodenum:
- Pain is the main syndrome of diseases of this organ. With erosions and ulcers, these are hunger or night pains. They appear in the epigastrium, in the right hypochondrium, radiate to the arm and back.
- Bleeding occurs in 20% of patients. They can be seen by chalk, vomit - brown or obviously bloody. UAC can show low level hemoglobin.
- Dyspeptic disorders - heartburn, constipation, or diarrhea.
- In addition, any intestinal pathology is accompanied by irritability, malaise, and loss of performance.
Peptic ulcer
Ulcer - inflammatory disease duodenal mucosa with the formation of an ulcer in it. The emergence of pathology is associated with the carriage of Helicobacter Pilari and the presence of chronic duodenitis. The disease affects about 10% of the world's population. The disease is more often exacerbated in the spring.
The disease begins with indigestion, expressed as upset stool. Spasms of the ducts lead to stagnation of bile and to the appearance yellow bloom in the language. At further development pathology, pain appears in the right side and yellowness of the skin occurs. If the pathology has caused cicatricial changes in the stomach, the patient may begin to worry about nausea and vomiting.
Pain is the main symptom of peptic ulcer disease. The pain is different in its manifestations: it can be aching, prolonged, sharp, but always subsides after eating. Are felt pain in the lumbar or in thoracic region spine.
Cancer
The tumor grows slowly, therefore, the onset of the tumor process is manifested by subtle symptoms characteristic of most gastrointestinal diseases: malaise, weakness, weight loss, belching, heartburn, pain in the upper abdomen.
The pain is dull and aching in nature and is not associated with food. When the formation begins to grow into the pancreas and when it manifests itself, the pain intensifies and becomes longer. There is heaviness in the epigastrium. The pain can radiate to the back. The first place among duodenal cancer is sarcoma.
Duodenitis
Duodenitis - inflammation of the duodenal mucosa is considered the most commonly diagnosed disease of this part of the intestine.The disease is manifested by a feeling of fullness after eating, dull constant pain, vomiting and nausea. Soreness is also felt on palpation of the epigastric region.
Young women develop headache accompanied by increased fatigue, insomnia, irritability, tachycardia as a result of asthenovegetative disorders. In the elderly, the disease is often discovered by chance, during duodenoscopy.
Erosion
Erosion is the second most common. They often come complete with diseases of the liver, kidneys, benign and neoplastic processes of the intestine and diseases of the respiratory and cardiovascular systems.
Bulbit
Bulbit is an inflammation of the duodenal bulb. Pathologies are considered a type of duodenitis. usually accompanied by gastritis or ulcers.
With absence timely diagnosis and therapy at the site of inflammation of the duodenum, erosion is formed, gradually turning into an ulcer. Therefore, the symptomatology is similar to an ulcer.
The pain with bulbitis develops under the spoon, sometimes it is given to the right hypochondrium. They are often a reaction to poor nutrition. Bulbit at chronic course can last for years.
Polyps
Polyps - benign formations, which are very rarely found during life.
Polyps grow very slowly and symptoms occur only if they exceed a length of 5 cm.The formations are prone to malignancy, therefore their presence is precancerous condition.
Diagnostics
There are some signs that allow you to determine the cause of pain before a diagnostic examination of the duodenum:
- Hunger and night pains, accompanied by heartburn, sour belching and constipation indicate the presence of Helicobacter.
- It hurts in the hypochondrium, pain intensifies after fatty, bitterness in the mouth, diarrhea alternates - the cause of secondary duodenitis may be pathologies of the pancreas and gallbladder.
- Pain, heaviness in the stomach: the cause of inflammation is atrophic gastritis.
- Visceral pain is most often indicative of an ulcer.
The main method for diagnosing diseases of the duodenum is fibrogastroduodenoscopy. The patient swallows a tube with a video camera attached to the end, and the doctor on the monitor examines the state of the mucous membrane of the esophagus, stomach and duodenum, identifies the presence of polyps, ulcers, tumors, and determines their location. Endoscopy allows you to take a biopsy at the same time. Fibroesophagogastroduodenoscopy allows you to immediately remove the polyp using a metal loop.
X-ray with contrast agent less informative, but it is used if there are contraindications to the endoscopic research method.
An informative test is CT. Endoscopic method research allows you to examine only the outer layer of the duodenal mucosa, while CT allows you to carefully assess the state of all layers of the intestinal wall. CT scan in the presence of an oncological process, it allows to determine the stage of cancer, to reveal the presence of metastases in nearby tissues and organs.
To diagnose the tumor process, X-ray with barium, endoscopy with biopsy are performed... On initial stages you can see the tumor on. For the diagnosis of duodenum, MRI is rarely used due to the multi-layered organ and the difficulty of viewing all of its bends.
Sounding allows you to determine the degree of activity of the secret by analyzing the contents of the duodenum. The selection of liquid material is carried out in several ways: blind, fractional sounding (material is taken every 5 minutes), chromatic sounding.
Duodenal treatment
Treatment of duodenal ulcer is specific for each disease.
An important role in identifying diseases of the duodenum is played by changing the usual diet to a sparing dietary one.
If EGDS detects the presence of Helicobacter, antibiotic therapy... Complicated ulcers require surgical treatment... Also, the patient must be operated on when duodenal cancer is detected. After the operation, radiation therapy and chemotherapy.
With duodenitis, pain relievers are prescribed. To reduce the acidity of gastric secretions, antacids... To normalize the duodenum, medications that enhance peristalsis are shown. Physiotherapy is considered an effective method in the treatment of duodenitis: ultrasound, heating, magnetotherapy are prescribed. Physiotherapy allows you to normalize blood supply in abdominal cavity, reduce pain.
Video - where is the duodenum and how does it hurt?
Conclusion
Diseases of the duodenum have an excellent prognosis. In the presence of chronic diseases, you should still change the place of work, especially if it is associated with strong stress, heavy physical activity and violation of the diet.
Also, the patient will have to change his diet, switch to fractional meals, quit smoking. Patients with pathologies of the duodenum are constantly monitored by a therapist or gastroenterologist, in the spring and in the fall they undergo an anti-relapse course of therapy.
12 duodenum (lat.duodnum)- This is the original section, which is located after the stomach. In relation to the human skeleton, the intestine is located at the level of 1,2,3 of the lumbar vertebrae. The average length of the intestine is from 25 to 30 cm, which corresponds to 12 fingers folded transversely - hence the specificity of the name. The duodenum is unique in its structure, both externally and at the cellular level, plays an essential role in the digestive system. The next after the duodenal ulcer is.
This organ, located directly in the abdominal cavity, along its length often grasps the pancreas, namely its head. The duodenum may not be constant in its location and it depends on gender, age, constitution, fatness, position of the body in space, and so on.
Skeletotopically, taking into account the four sections of the intestine, its top part starts from the 12th thoracic vertebra, makes the first (upper) bend at the level of the 1st lumbar, then goes down and reaches the 3rd vertebra of the lumbar spine, produces the lower (second) bend, follows from right to left in a horizontal position, and finally , reaches the 2nd lumbar vertebra.
Divisions of the duodenum
This organ lies retroperitoneally and has no mesentery. The body is conventionally divided into four main sections:
- Upper horizontal section. The upper horizontal section may border on the liver, namely its right lobe and is located in the region of the first vertebra of the lower back.
- Descending part (department). The descending section borders on the right kidney, bends and can reach the second third lumbar vertebra.
- Lower horizontal section. The lower horizontal section carries out the second bend and begins with it, is located near the abdominal aorta and the inferior vena cava, which are located posterior to the duodenum.
- Upstream department. The ascending section ends with the second bend, rises up and smoothly passes into the jejunum.
The organ is supplied with blood by the celiac trunk and superior artery the mesentery, which, in addition to the intestine, also supplies the base of the pancreatic head.
The structure of the duodenal wall
The wall is represented by the following layers:
- serous is the serous membrane that covers the intestine from the outside;
- muscular - presented muscle fibers(located circularly and along the organ), as well as nerve nodes;
- submucosal - represented by lymphatic and blood vessels, as well as a folded submucosa with crescent moon;
- mucous - represented by villi (they are wider and shorter than in other parts of the intestine).
Inside the intestine there is a large and small nipples. located approximately 7 to 7.5 cm directly from the pylorus. The main pancreatic duct and common bile duct (or common bile duct) enter it. A small papilla emerges approximately 8-45 mm from the nipple of Vater, and an additional pancreatic duct exits into it.
Functions
- Motor-recovery. It is the process of pushing food through the alimentary canal. The organ also serves as a reservoir, it releases bile acids and various pancreatic enzymes.
- Digestive. In the intestine, the initial stage of digestion occurs, due to the action of bile acids and pancreatic enzymes.
- Regulatory. It is caused by the regulation of bile acids and pancreatic enzymes.
- Acid-base. In the duodenum, the pH of the lump of food is brought to optimal values for its further transformation in other parts of the digestive tract.
Diseases 
- (infectious duodenitis, parasitic duodenitis; duodenitis caused by giardiasis; duodenal candidiasis);
- bulbit;
The human intestine begins with the duodenum- it is located just behind the stomach and is relatively small compared to other parts of this organ (see photo above). Also called KDP for short.
Why was it called that: Medieval scientists - anatomists did not have modern means measurements, and they, having measured the length of this organ with their fingers, received an indicator of 12 fingers in diameter - 25 - 30 cm.
Duodenal functions
The duodenum plays an important role in the entire digestive process. Since it is the initial link in the intestine, the processes of absorption of nutrients from the incoming food and liquid are actively proceeding here. It brings the acid-base index of food to a level that will be optimal for the subsequent stages of digestion in the intestine. It is in this organ that the stage of intestinal digestion begins.
Another integral phase of the work of this part of the intestine is the regulation of pancreatic enzymes secreted by the pancreas, as well as bile, depending on the acidity of the food lump and its chemical composition.
The duodenum affects the proper functioning of the secretory function of the stomach, since there is a reverse interaction. It consists in opening and closing the pylorus of the stomach and in humoral secretion.
Evacuation and motor functions.
12 the duodenum carries the functions of further advancement of food gruel, processed with enzymes, to the next section small intestine... This is due to the massive muscle layer of the duodenal wall.
Features of the structure of the organ (shape, location, attachment)
The shape of most people is diverse, and for one total person, both the shape and the location of the duodenum can change during life. It can be V-shaped, and resemble a horseshoe, loop and other shapes. In old age, or after weight loss, it is lowered compared to where the duodenum is located in young and middle-aged people and with overweight... But most often it originates at the level of the seventh thoracic or first lumbar vertebra, located from left to right. Then there is a bend with a descent to the third lumbar vertebra, another bend with an ascent parallel to the upper part, and the intestine ends in the region of the second lumbar vertebra.
It is attached by connective fibers located on the walls to the organs of the abdominal cavity. The least of these attachments is in the upper part of the duodenum, so it is mobile - it can move from side to side.
Duodenal wall structure:
- serous outer layer performs mechanical protective functions.
- the muscle layer is responsible for the organ's peristalsis during the digestion of food.
- the submucosal layer contains nerve and vascular nodes.
- the inner layer is a mucous membrane, strewn with a large number of villi, folds and depressions.
Bodies adjacent to the KDP
This section of the intestine is in contact with other organs of the abdominal cavity from all sides:
- and the main duct;
- right kidney and ureter;
- the ascending part of the colon.
This anatomical arrangement of the organ has a huge impact on the characteristics and course of diseases that arise in it.
The most common diseases of the duodenum.
- - the most common ailment of the duodenum of acute or chronic type, manifested in the form of inflammation of the mucous membrane.
- Ulcer- develops as a result of chronic duodenitis. Chronic damage to the duodenum, in which ulcers form in the mucous layer.
- Cancer tumor – malignant neoplasm, localized in different layers of the duodenal wall.
Duodenitis
More than 90% of patients develop chronic duodenitis. It can develop due to many factors, including:
- consumption of low-quality products;
- alcohol abuse;
- smoking;
- hit foreign bodies and toxic substances;
- other chronic bowel ailments.
This disease manifests itself in the form of epigastric pain of moderate intensity, weakness, belching, heartburn, nausea, turning into vomiting. Fever is often associated with symptoms.
A variation of this inflammatory phenomenon is in which the pathological process takes place only in the bulb of the duodenum. This form of duodenitis does not arise just like that - it is a consequence of other pathologies of the intestine or stomach. Bulbit can be caused by:
- or KDP.
If the disease is on acute stage then the person feels pain and nausea and suffers from repeated vomiting. Acute bulbit develops on the background long-term intake large group drugs, or poisoning. In the chronic form, there is also a aching pain syndrome, sometimes it can be accompanied by nausea.
Patients also have chronic duodenal obstruction, which occurs against the background of tumor processes, developmental anomalies and other disorders in the duodenum. It is expressed in a violation of the motor and evacuation function in this part of the intestine and is characterized by the following symptoms:
- decreased appetite;
- feeling of heaviness and discomfort in the epigastric region;
- constipation;
- gurgling and gurgling.
The manifestation of this ailment is influenced by the reasons that caused duodenal obstruction, the stage of the course and how long ago the disease arose.
Peptic ulcer
The main reason for this dangerous disease is the reflux of acid from the gastric contents and its destructive effect on the mucous membrane of this part of the intestine. But this pathological process develops only when the surface layers of the intestine cannot cope with their protective functions. The ulcer is localized in the initial section of the duodenum and in the bulb, that is, in the zone of the intestine that is at a minimum distance from the stomach.
Many gastroenterologists unanimously repeat about the negative effect of frequent intake of anti-inflammatory drugs, which lower the protective barrier of the mucous layer of the duodenum. These drugs are aspirin and dosage forms based on it, ibuprofen, diclofenac, etc.... Therefore, if there is such an opportunity, you should limit the intake of drugs in this group as much as possible.
Poorly treated or neglected duodenitis, alcohol abuse and consumption of products harmful to the body can also become duodenal ulcer.
It also tends to affect not only the stomach, but also the mucous membrane of the 12 duodenal ulcer. She is pretty common reason the occurrence of ulcerative pathology, opening the way for acid in the mucous layers of the intestine. In 19 out of 20 cases of the development of an ulcer of this organ, it is the bacterium Helicobacter that is to blame.
Symptoms:
Since this ailment is very common in gastroenterological practice, you should know what kind of symptomatic picture it manifests itself in. This is a paroxysmal pain syndrome in the upper abdomen slightly below the sternum. during a feeling of hunger or, conversely, immediately after a meal. After eating, symptoms such as:
- nausea;
- urge to use the toilet.
The main dangerous complications this disease of the duodenum is bleeding or perforation, which require emergency operational assistance... Bleeding is fraught with dangerous blood loss and filling of the abdominal cavity with it. Perforation is when food with all the enzymes and acids enters the abdominal cavity through the ulcer formed in the intestine.
If health care is not provided on time, then such complications can lead to the death of the patient. Are in medical practice cases when a peptic ulcer also passes into a cancerous state.
An ulcer, like other duodenal lesions, is diagnosed by an endoscopy procedure. Using this procedure, a gastroenterologist can visually assess the condition of all organs digestive system... A blood test may also be needed, especially when it comes to duodenal ulcer caused by the bacterium Helicobacter. Comprehensive diagnostics may include biopsy of the affected area of the intestine - it is carried out directly during the endoscopic examination (a procedure for taking a small volume of the affected tissue for laboratory examination).
Duodenal cancer
, bladder;
According to research by scientists, the components of coffee in combination with nicotine can also affect the development of duodenal cancer. Therefore, doctors do not recommend getting carried away with coffee: you should limit yourself by making a maximum of 2 - 3 cups per day. Continuous ingestion of carcinogens and chemical substances, which have a detrimental effect on the entire gastrointestinal tract, can also cause duodenal cancer. The unfavorable ecological situation in the region of residence undoubtedly affects the development of many groups of diseases, including oncological ones. Both men and women over 50 are at risk.
This disease is considered insidious, because it is difficult to diagnose at the initial stages of development. The first signs of the disease can be easily confused with common gastrointestinal disorders. Later, pains are added to these sensations with the development of oncology, especially when a person feels hunger, heaviness. The patient feels weak, his appetite disappears and depressive syndrome... This symptomatology is associated with the intoxication process.
A person with duodenal cancer is much more likely to have a normal outcome if the tumor is found in the early stages of development. For staging accurate diagnosis EGDS and biopsy of the affected area of the intestine are performed, the complex is also connected to them laboratory research(UAC, etc.). After that, an operation to remove the tumor and the lymph nodes closest to it should be urgently performed.
From all of the above, a simple and logical conclusion can be drawn. The duodenum is, like all organs, a very important part of our body. She performs complex and important functions in the digestive system, therefore, each person should be attentive to their food addictions - if possible, exclude from their diet harmful products nutrition and give up bad habits. After all, it is much easier to prevent diseases than to go to doctors and stay in the hospital, hoping to overcome them.
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Interesting
The duodenum is the initial section of the large intestine. It is located immediately after the pylorus of the stomach. The gut got its name due to the fact that its length is twelve transverse fingers of the hand.
The special structure of the mucous membrane of the organ allows its epithelium to maintain resistance to the aggressive effects of digestive juice, bile secretion, as well as pancreatic enzymes. The bulb, the rest of the intestines and the head of the pancreas have a common circulation. In this article, we will take a closer look at the features of the structure and location of the intestine, and also find out how it can hurt.
Anatomy
Most people have a variety of forms. Even in the same person, the shape and location of the organ can change over time. First, let's talk about the structure of the duodenum.
Structure
The organ has several layers:
- outer shell;
- muscle layer with longitudinal and circular layers;
- submucosa, due to which the mucous membrane can collect in layers;
- a mucous layer covered with villi.
Location
The body has four main parts:
- Top, or initial. It is located approximately at the level of the first lumbar vertebra or even the last thoracic vertebra.
- Descending. It is located to the right of the lumbar region and touches the kidney.
- Bottom, or horizontal. Goes from right to left and then passes next to the spine and bends upward.
- Ascending. Forms a bend and is at the level of the second lumbar vertebra.
Where is the duodenum located? Most often it is located at the level of the second or third lumbar vertebrae. Each person's location may differ and this is affected a large number of factors such as age and weight. For example, in elderly and thin people, the organ is located slightly lower than in young and well-fed subjects.
The photo clearly shows where the duodenum is in humans
The intestine is in contact from all sides with other organs of the abdominal cavity:
- liver;
- bile ducts;
- pancreas;
- right kidney;
- ureter;
- the ascending colon.
The length of the duodenum is 25-30 cm.
Functions
Let's highlight the main functions of the duodenum:
- production of enzymes and duodenal juice necessary for normal digestion;
- motor and evacuation function, that is, it is responsible for the movement of food gruel;
- secretory;
- regulation of bile enzymes of the pancreas;
- support of communication with the stomach. She is responsible for opening and closing the gatekeeper.
- adjustment acid-base balance food. It makes the food lump alkaline.
Since the duodenum is the initial section of the entire intestine, it is here that the processes of absorption of nutrients that come with food and drink are actively taking place. This is where the intestinal digestion phase begins.
Digestion
After the food bolus enters the initial section of the large intestine, it mixes with bile, secretions of the intestinal walls, as well as fluid from the pancreatic ducts. Then acidic environment food is neutralized by bile, thereby protecting the mucous membrane. In addition, bile breaks down fat and breaks it down into small emulsions, which speeds up the digestion process.
Under the influence of bile secretion, fat breakdown products are dissolved and absorbed into the intestinal walls, and also there is a complete absorption of vitamins and amino acids. It should also be noted that bile regulates intestinal motility, stimulating the contraction of its muscles. Thanks to this, the food lump moves faster along the intestinal lumen and is evacuated from the body in a timely manner.
An important role is played by pancreatic juice, with the help of which starch, as well as proteins and fats are digested. The duodenal glands produce intestinal fluid, which is mostly mucus. This secret promotes better protein breakdown.
Considering all of the above, we can say that the duodenum plays a huge role in the digestion processes. It saturates the food bolus with the necessary enzymes and ensures further digestion.
KDP provides normal flow digestive processes
How does the duodenum hurt?
Given the fact that the duodenum starts from the stomach, and the ducts of the gallbladder and pancreas open into it, many of its diseases are associated with the malfunctioning of these organs:
- increased acidity stomach leads to the fact that hydrochloric acid begins to corrode the mucous membrane of the duodenum;
- low acidity stomach is fraught with coarse food that is poorly processed into the intestine. It renders mechanical damage;
- with pancreatitis and cholecystitis, a violation of the production of digestive enzymes occurs, because of this, food is poorly crushed in the duodenum;
- with hepatitis and cirrhosis, blood circulation is impaired and, as a result, nutritional deficiencies occur.
But sometimes the occurrence of diseases of the duodenum is influenced not by the existing pathologies of other organs, but by the person's lifestyle. Snacks on the go and in a hurry, insufficient chewing, overeating, too much big breaks between meals - all of this negatively affects the functioning gastrointestinal tract(Gastrointestinal tract).
You can identify the reason why the organ is suffering by how it hurts:
- duodenitis caused by Helicobacter pylori. The pain occurs at night and on an empty stomach. It disappears after taking antisecretory and antacids as well as after meals. Unpleasant sensations may be accompanied by heartburn, belching and constipation;
- duodenitis caused by diseases of the gallbladder and pancreas. Painful sensations arise in the right or left hypochondrium and intensify after taking fatty foods... Patients complain of bitterness in the mouth, nausea, and constipation, which is replaced by diarrhea;
- inflammation associated with stomach cancer or atrophic gastritis. Pain and heaviness in the stomach;
- peptic ulcer. Pain in the form of colic, which is a consequence of spasm of the smooth muscles of the muscles.
By the way the duodenum hurts, one can understand the reason from which the organ suffers
Duodenitis
Duodenitis is an inflammation of the duodenal mucosa. The disease is acute and chronic, which proceeds with relapses. In almost all recorded cases of duodenitis, the process is chronized.
Improper nutrition bad habits, chronic diseases Gastrointestinal tract - all this can serve as an impetus to activate the inflammatory response. Patients are worried about pain in the upper abdomen, nausea, belching, heartburn, weakness. Inflammation of the duodenum can lead to peptic ulcer and even cancer.
Ulcer
Peptic ulcer disease is also accompanied by inflammation of the organ, only the appearance of ulcers on the surface of the mucous membrane is added to everything else. This is a chronic pathology with frequent relapses. If you let the disease take its course, it can lead to atrophic changes, as well as fistulas and bleeding.
A duodenal ulcer can even be fatal. Improper nutrition, intake potent drugs, chronic duodenitis- all this can lead to an ulcer. But the most common cause is the bacterium Helicobacter pylori.
The infectious agent seriously damages the mucous membrane of the organ with the products of its vital activity. A characteristic symptom are hungry or night pains that disappear half an hour after eating. The danger of peptic ulcer disease is that it can degenerate into cancer.
Duodenostasis
These diseases affect motor function organ, leading to the development of stagnation. As a result, a mass accumulates in the lumen of the duodenum, consisting of undigested food, gastric juice and digestive enzymes. This leads to the appearance painful sensations, nausea and vomiting.
it chronic pathologies, which are characterized by a change in periods of remission and relapse. With an exacerbation, pain appears in the right hypochondrium, which intensifies after eating. The patient loses his appetite, he may also be disturbed by constipation.
Tumor
A tumor in the duodenum can be both benign and malignant in nature. Long time the pathological process may absolutely not manifest itself in any way. Cancer usually appears when a tumor grows from other organs, most often the stomach.
According to statistics, most often the disease occurs in elderly people. The first symptoms of the disease go away with gastrointestinal disorders or digestive disorders. Further, there are abdominal pains, weakness, lack of appetite, depressive state.
Untreated organ inflammation can lead to cancer
Helminths ultimately cause atrophic changes in the duodenal mucosa. As it progresses pathological process patients have skin rash, itching, abdominal pain, heartburn, diarrhea.
Erosion
Pathology causes an inflammatory reaction on the surface of the mucous membrane, while not affecting the muscular layer of the organ. Erosive areas at ultrasound examination look like thickened walls. Serve as the cause of the appearance of erosion can stressful situations, smoking, Helicobacter pylori, nutritional inaccuracies and much more.
TO pain syndrome problems with stools, belching, as well as a burning sensation in the esophagus join.
Obstruction
Chronic obstruction of an organ can develop for a number of reasons: malformations, incorrect rotation of the organ, vascular anomalies. Pathology manifests itself in the form of a painful outbreak in the right hypochondrium. Gallstone obstruction is most often diagnosed in older women. The stone migrates along alimentary canal and gets stuck in thin section intestines.
Summing up, we can say with confidence that the duodenum is essential organ digestive tract, contributing to the normal digestion of food. You can maintain the health of this organ by using proper nutrition that should become your way of life.
When there is unpleasant sensations in the area of the duodenum, immediately contact a specialist for an examination. Early diagnosis help to avoid serious problems with the intestines.
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