Duodenum purpose and function. Methods for examining the stomach and duodenum

The stomach is a very important organ where all the food that comes in is digested. IN medical practice There are a lot of different diseases of the stomach and 12 duodenal ulcers.

Some of them are not dangerous, but others can cause serious complications. In this regard, people need to have an endoscopy of the stomach or choose other methods of examining the stomach. Thanks to modern ways studies will be able to timely detect the disease and even determine the development of tumors in stomach cancer.

Diagnostic methods

If a person begins to experience discomfort in the abdomen, there are different symptoms in the form of pain, diarrhea, vomiting and other changes, then you need to go to a doctor who can accurately and correctly prescribe a diagnosis. There are two modern research methods, which are shown in the table:

Research method:	Description:
Instrumental:	These clinical researches important in determining the pathologies and diseases of the gastrointestinal tract. All methods are individual and they cannot replace each other. Each method of diagnosis allows you to identify the morphological and structural characteristics of the digestive tract.
Laboratory:	In this case, the diagnosis of biological substances is used. Gastric contents may be taken to study the secretory function of the stomach, there may be a study of the acid-forming function of the stomach, a blood test, feces, urine. The laboratory method is used during a complete examination.

Now you need to deal in detail with the very methods of research that relate to laboratory and instrumental, where a study of the stomach with a probe or a probeless examination is used.

Gastroscopy or EGD

Gastroscopy of the stomach, as well as EGD, are performed using a probe that will be inserted into a person through the mouth. This is one of the most exact ways diagnostics, which shows all the pathologies, and can also conduct a study of the preparation of stomach tissues. The technique is used if the patient will have an operation the day before, and also when fast loss masses, severe abdominal pain, esophagus and other unpleasant symptoms with acute manifestation.

Not all patients may be subjected to endoscopic examination of the stomach, since there are contraindications that the doctor will talk about before diagnosing. Before FGDS and gastroscopy, preparation is carried out for the stomach. The doctor himself says what needs to be done, what diet to follow. In general, the rules are as follows:

It is necessary to stop eating approximately 12 hours before the start of the examination.
You can not smoke, take capsules and other tablets.
During the procedure, you need to remove dentures, if any.

An endoscopic examination takes 20 to 40 minutes to complete. None of the other methods provides complete information and the ability to obtain reliable results, like FGDS. In addition, it will be possible to determine the acidity of gastric secretion, as well as take materials for a biopsy. Often, the procedure can be prescribed in conjunction with other types of examinations, for example, with a colonoscopy or FGS.

Today it is possible to analyze the stomach without swallowing the probe, it has its advantages and disadvantages. The patient just needs to swallow the capsule, which has sensors, a camera and a flashlight. The capsule enters the esophagus and intestines, records everything that occurs on the way, after which the doctor can analyze the environment and make a diagnosis. The output of the capsule will be natural for 1-2 days.

The diagnostic itself with the help of a capsule is 6-8 hours. This type of research is carried out not only for adults, but also for children. But still, in order to establish a correct and accurate diagnosis, as well as to detect tumors on early dates, it is better to use FGDS, which consists in swallowing the probe.

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X-ray and ultrasound of the stomach

X-ray diagnostic methods include visualization of certain organs on the monitor screen. An x-ray method is used in order to study the mucous membrane and find pathologies in the work of organs. For the stomach, an x-ray is indicated if the patient begins to quickly lose weight, belching appears, blood in the stool. Fluoroscopy of the stomach and radiography are two different methods of diagnosing. If you need to examine a child, then it is better for children to use digital fluoroscopy, since it is more informative, passes quickly and does not need to take many pictures, the radiation dose is hundreds of times less.

Preparation of the patient for x-ray examination of the stomach and duodenum is simple. Before the allocated date, the patient needs to give up certain products in a couple of days, the list of which is called in the hospital. In general, these are ingredients that irritate the mucous membrane and take a long time to digest. On the day of diagnosis, preparing the patient for an X-ray examination of the stomach consists in taking a barium solution so that clear pictures can be obtained. When an X-ray examination of the stomach is performed, there may remain side effects for 1-2 days, in the form of nausea and white feces.

Ultrasound examination of the stomach is rarely used, the method is often used if you need to diagnose a baby, up to six years old, or even a newborn. True, the method is uninformative when compared with FGDS. The received protocol does not allow to see the pathology completely, in addition, it is impossible to take materials for histology, as well as to determine the changes. Ultrasound of the stomach is performed with constant gas, pain, as well as digestive problems. Before making a diagnosis, the doctor says how to properly prepare for the study in order to establish accurate diagnosis. In terms of time, the ultrasound lasts about 15 minutes, and the results will be known immediately.

Laboratory diagnosis

There are several options for laboratory diagnosis:

Important! As you can see, there are a lot of studies of the stomach, but only the doctor knows which diagnostic methods to choose. To establish an accurate diagnosis, the patient will need to tell his symptoms, and after conducting research and collecting tests, the doctor will be able to establish the exact disease.

The upper section has a round shape, and therefore it is also called an onion. Its length is 5-6 cm. The descending section, whose length is 7-12 cm, is located near the lumbar spine. It is in this section that the ducts of the stomach and pancreas are removed. The length of the lower horizontal section is about 6-8 cm. It crosses the spine in the transverse direction and passes into ascending division. The ascending part is 4-5 cm long. It is located on the left side of the spinal column.

The duodenum is located within 2-3 lumbar vertebra. Depending on the age and weight of the person, the location of the intestine may vary.

Duodenum performs secretory, motor and evacuation functions. The secretory function is to mix chyme with digestive juices, which enter the intestine from the gallbladder and pancreas. The motor function is responsible for the movement of the food gruel. The principle of the evacuation function is to evacuate the chyme to the subsequent sections of the intestine.

2 Causes of pathology

Inflammation of the intestine, as a rule, occurs against the background of gastrointestinal disorders. Causative factors include a viral infection, inflammation of the lining of the stomach or gallbladder, diarrhea, and low blood flow to the intestines.

Inflammation of the intestine is often caused by an infection with Helicobacter pylori. This bacterium is in the stomach and does not manifest itself in any way. Its presence in the body leads to increased production Gastric acid, which further irritates the duodenal mucosa. Left untreated, the bacterium can cause intestinal ulcers.

Diseases of the duodenum can develop against the background severe stress or surgical intervention. In some cases, the underlying cause may be the use of non-steroidal anti-inflammatory drugs, smoking, or overuse alcohol.

Inflammation of the duodenum 12 can be caused by food poisoning, eating spicy or fatty foods, as well as a foreign object. It has been proven that some pathologies of the intestine can be hereditary. Pathogenic factors such as diabetes and gallstone disease.

Symptoms of duodenal disease have their own clinical picture and may differ from each other.

3 Peptic ulcer

A characteristic symptom of peptic ulcer is indigestion. The patient has frequent and liquid stool. Often, patients have a complete intolerance to dairy products and fruits. If the patient has sudden loss weight in the presence of increased appetite, this may indicate that the duodenum is inflamed.

If ulcers have affected an organ such as the duodenum, the symptoms of the disease may manifest in a characteristic yellow coating in the language. This is due to spasms of the bile ducts, which lead to stagnation of bile. In the advanced stages of the disease, pain appears in the right side and the skin acquires a yellow tint.

With a duodenal ulcer, there are cicatricial changes part of the stomach, which results in the evacuation of food. Congestion in the stomach leads to nausea and vomiting. Often, after vomiting, the general condition of the patient improves for a while.

Pain is a characteristic symptom of peptic ulcer disease. It can be aching or sharp, prolonged or paroxysmal. As a rule, the pain subsides after eating, which is why they are also called "hungry." This symptom occurs in 70-80% of patients. Pain is most often felt in the lower back or thoracic region. In some cases, patients with duodenal ulcer may complain of pain in the collarbone.

4 Colon cancer and duodenitis

If a patient has been diagnosed with colon cancer, the symptoms of the disease may manifest as jaundice, fever, and itching. With first-degree cancer, there is pain. It occurs as a result of compression of the tumor nerve fibers or blockage of the bile duct. The pain syndrome is most often felt in the right hypochondrium, but in some cases the pain can spread to other organs.

One of the symptoms of the disease is pruritus. It appears due to the high content of bilirubin in the blood and irritation of skin receptors with bile acids. Against the background of itching, the patient develops agitation and insomnia.

No less common disease of the duodenum is duodenitis. This ailment manifests itself in the form of distension of the stomach after eating, dull and constant pain, nausea, loss of appetite, vomiting. In patients with this diagnosis, palpation epigastric region painful.

5 Proper nutrition

For any of the diseases of the duodenum, the patient is prescribed diet food. diet combined with complex treatment eliminates exacerbations and significantly improves the general condition of the patient. If the duodenum is inflamed, then, first of all, foods that can stimulate the production of gastric acid are excluded from the diet. Such foods include sour fruits, fatty broths, fresh vegetables and fruit juices, mushrooms, smoked, salted, fried and pickled foods and spices. Also banned are sweet sodas and alcoholic drinks.

The menu should contain easily digestible fats, such as vegetable oil, cream or margarine.

It is necessary to limit the intake of products that in any way irritate the mucous membrane. In order to avoid overloading the stomach and exacerbating the disease, it is not recommended to eat cold or hot dishes. Food should be at room temperature.

It is forbidden to eat foods that have mechanical irritation. These foods include raw vegetables and fruits, beans, peas, and whole grains. With inflammation of the duodenum, doctors recommend excluding mustard, vinegar, salt and other seasonings from the diet.

Meals should be frequent. You need to eat about 4-5 times a day. Between meals should be at least 3-4 hours. Preference should be given to dishes cooked in boiling water or steamed.

6 Treatment activities

Symptoms and treatment of duodenal pathologies are determined by the doctor after an appropriate examination. If the diagnosis confirmed peptic ulcer, then the patient is prescribed medication. To destroy the Helicobacter pylori bacteria, the patient is prescribed a course of antibiotics. These drugs include Erythromycin, Clarithromycin, Metronidazole and Ampiox.

To reduce the production of hydrochloric acid, doctors prescribe Omeprazole, De-Nol and Ranitidine.

These drugs provide bactericidal action. For severe pain, doctors prescribe antacids.

Surgical treatment of duodenal ulcer is quite rare. Indications for surgery are complications of the disease. In this case, during the operation, the surgeon can remove the affected area of the intestine, this helps to reduce the production of secretion and the level of hydrochloric acid.

Treatment of patients with a diagnosis of duodenal cancer is carried out with the help of surgery. The type of operation is chosen depending on where the malignant tumor is located and at what stage of development the disease is. small swelling removed laparoscopically, that is, through minimal punctures in the abdominal wall. If the tumor big size, then it is removed by extensive surgery. In this case, the doctor removes the outlet section of the stomach and the omentum adjacent to it, part of the duodenum, gallbladder and head of the pancreas.

If a malignant tumor was diagnosed at a late stage, then this greatly complicates the operation. In this case, the surgeon removes not only the tumor, but also the affected lymph nodes and adjacent tissues.

In addition to surgical treatment, the patient is prescribed radiation and chemotherapy. Such treatment helps prevent relapses and prolongs the life of the patient.

Patients diagnosed with duodenitis are prescribed medication and physiotherapy. In acute or chronic duodenitis, doctors prescribe painkillers: Drotaverine, No-shpu and Papaverine. To reduce the level of acidity of gastric juice, antacid drugs are prescribed, such as Omeprazole or Almagel.

If duodenitis has developed against the background helminthic invasion then treatment with antibiotics. To normalize the work of the intestine, drugs are prescribed that enhance its peristalsis. These drugs include Maalox and Domperidone.

As an auxiliary treatment, physiotherapy is performed. Ultrasound, heating, paraffin applications and magnetotherapy. Physiotherapeutic procedures allow you to normalize the blood supply and lymph flow of the abdominal organs, relieve pain.

HOW to determine inflammation of the duodenum 12

You will need

- referral of a gastroenterologist for examination.

Instruction

Symptoms of a disease of the duodenum can be similar to those of a disease of the stomach and colon. therefore, a complete examination of the gastrointestinal tract is prescribed. Most often, inflammatory processes of the duodenum manifest themselves in the form of pain 1.5-2 hours after eating, as well as hunger pains, indigestion, which manifests itself in the form of constipation or diarrhea. These symptoms can be attributed to all diseases associated with damage or inflammation of the mucous membranes of the gastrointestinal tract.

The doctor must prescribe an ultrasound, but this method does not always allow an accurate diagnosis, especially in obese patients, but helps to determine the location of all organs, the presence of foreign inclusions.

If you have been prescribed an irrigoscopy, then with the help of an enema they will introduce radiopaque agent and will diagnose using x-rays, which allows you to determine the patency of the duodenum.

During colonoscopy, a hardware examination of the duodenum is performed through the lumen. This allows you to make an accurate diagnosis of the mucosal lesion and determine the extent of the lesion.

During a barium fluoroscopy, you will be given 500 mg of a solution that resembles dissolved chalk to drink. If there are significant mucosal lesions, the x-ray will show the presence of niches.

Fibrogastroscopy allows you to determine the size of the lesions, allows you to get material for a biopsy. If the ulcers are deep and bleeding, then this method allows you to carry out medical manipulations and stop the bleeding.

Clinical manifestations of inflammatory diseases of the colon and small intestine are diverse. IN initial stage the course of the disease is almost asymptomatic and is manifested by intestinal discomfort, delayed or increased stools, bloating, general malaise and discomfort. In order to make an accurate diagnosis in a timely manner, it is necessary to undergo medical examination.

You will need

- Referral for examination.

Instruction

Inflammatory diseases of the colon and small intestine always affect its inner lining. If you feel the listed symptoms, address to the doctor to the proctologist and the gastroenterologist. Examination must be carried out throughout the gastrointestinal tract, since the disease of one part of the intestine leads to disruption of the entire gastrointestinal tract.

Any doctor begins the examination by listening to the subjective complaints of the patient and examining with the help of palpation. In this case, the abdomen is palpated from all sides. A hardware examination is prescribed after collecting an anamnesis of the disease and after careful preparation of the patient.

Before any kind of hardware examination, you will be prescribed a diet for 10 days, daily enemas, laxative tablets.

Eliminate from the diet all indigestible foods, meat, cheese, legumes. Completely give up bread, alcohol, carbonated drinks, sweets. Eat mashed porridge on the water or mashed vegetables. Do an enema daily with Esmarch's mug.

Take an enema the day before the test. Do not eat 24 hours before the examination, no water for 6 hours.

Based on the examination, you will be given an accurate diagnosis and prescribed outpatient, inpatient or surgical treatment. Inflammatory bowel diseases include: colitis, enteritis, proctitis, typhlitis, appendicitis, sigmoiditis. In severe cases of the disease, liquid pus or serous exudate may be discharged from the rectum. If deep ulcers are found, it threatens with perforation and peritonitis. Therefore, you must follow all the doctor's recommendations and complete the entire course of treatment prescribed.

We diagnose inflammation of the duodenum 12: symptoms

Inflammation of the duodenum is a disease that, depending on its cause, can be cured with proper diet and antibiotics. Often, however, this disease leads to consequences that are classified as peptic ulcer disease.

The most common symptoms are due to hyperacidity and the use of certain medications such as salicylates and antirheumatic agents, alcohol consumption. But the factor involved in the development of the disease may be hyperacidity or even stress. The cause may also be bacteria, in particular Helicobacter pylori, which is also responsible for the occurrence of gastritis and stomach ulcers.

Inflammation often occurs as a result of dietary errors. The disease is associated with eating contaminated food or containing toxins or harmful chemicals.

All these factors cause damage to the mucous membrane that lines the duodenum, and therefore erosion occurs. Often, the initial symptoms are ignored by the person. Due to not timely treatment erosion will increase over time. The disease then becomes chronic and soon leads to an ulcer. Therefore, it is very important to pay attention to the symptoms.

Symptoms of inflammation of the duodenum 12

With inflammation of the duodenum, the following symptoms are present:

Pain different intensity in the epigastric region, burning or dull;
Nausea and vomiting;
Fever;
Malaise;
General weakness of the body;
Diarrhea.

Pain in the abdomen, namely in the middle, can be especially severe in the morning.

How to diagnose inflammation of the duodenum 12

Currently, a doctor can make a more accurate diagnosis based on the results of endoscopy. Endoscopy of the upper gastrointestinal tract and duodenum shows an accurate picture of the disease. To perform this test, a device called an endoscope or gastroscope is used. It is in the form of a thin and flexible hose that is inserted through the mouth or nose into the throat and then passed through the esophagus and stomach into the duodenum.

Inflammation and erosion of the duodenum: diet

The first step is to reduce your consumption food products strongly stimulating the secretion of gastric acid. This is primarily coffee and foods containing caffeine, strong tea, carbonated drinks, alcohol, rich broths, mushrooms, sour fruits, undiluted fruit and vegetable juices, pickled foods, smoked meats, fried and baked foods, spicy dishes, salty, too sour.

Include dietary foods that inhibit gastric acid secretion and easily digestible fats, such as butter, cream, vegetable oils, olive oil, margarine.

It is necessary to limit products a) thermally b) mechanically and c) chemically irritating the gastric mucosa:

a) thermally irritating foods - foods that are too cold and too hot, they stimulate the peristalsis of the stomach and intestines and call for further overload and exacerbation of the disease.

b) mechanically irritating foods - foods high in fiber, whole wheat, whole grains, raw fruits and vegetables, dry legumes.

c) chemically irritating foods: too acidic fruits, undiluted juices, smoked foods, heavily salted, spicy spices (pepper, paprika, chili, mustard, ketchup, vinegar, salt).

Regular food intake is necessary, between meals there should not be an interval of more than three hours.

It is important to eat 4-5 times a day. The day should start with a good breakfast. This is the first meal after a long night break. The last meal should be consumed an hour before bedtime to prevent hunger pain at night. Meals should not be too heavy. You should eat slowly, without rushing, preferably at certain times of the day.

Use appropriate cooking techniques. Meals should be cooked in boiling water, steamed, steamed, baked in foil, sautéed.

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Signs of gastric and duodenal ulcers

According to statistics, about 5% of people annually seek help for peptic ulcer. In most patients, the clinic proceeds classically, but along with this, there are erased forms of gastric and duodenal ulcers.

Manifestation of pathology

Patients, as a rule, begin to sound the alarm when a severe pain syndrome appears. Depending on the location of the mucosal defect, pain can be early, hungry, nocturnal, late, and in some cases not at all associated with food intake. This is due to the direct action of chyme on the ulcer of the duodenum and stomach. The damaged mucosa is additionally irritated by the motility of the organs during the advancement of the food bolus.

Characteristics of the pain syndrome

Pain is described with different intensity and color. There may be cramping or constant discomfort from the epigastric zone of the abdomen. The feeling is described as something squeezing, stabbing, cutting, squeezing the epigastrium.

In the presence of an ulcer in the cardial part of the stomach, pain can radiate to the sternum, to the shoulder, to the left side of the chest, simulating angina pectoris. This localization of pathological changes is characterized by the development/intensification of symptoms no more than 30 minutes after saturation with food.

After 1-1.5 hours, signs of an ulcer of the antrum of the stomach and 12 duodenal ulcer appear, the symptoms may include vomiting at the peak of abdominal pain. The disease is accompanied by constipation. If a deep defect is located on the back wall of the stomach, pain may radiate to the back and lower back. In such a situation, women are suspected of problems in the gynecological field.

Ulcerative lesions of the duodenum in isolation are not so common. At the same time, the pain symptoms of the pathology of the bulbar and postbulbar regions differ. Signs of a duodenal ulcer in the region of the bulb are somewhat erased, pain does not depend on meals, can be permanent, localized in the right side of the epigastrium, radiating to umbilical region and chest on the right. Ulceration of the mucosa outside the bulb can be determined due to the appearance of more intense pain after a couple of hours after eating and disappearing only after 20 minutes from satisfying hunger.

Additional signs of gastric and duodenal ulcers

Together with the pain syndrome, dyspeptic phenomena are of some importance:

nausea;
vomit;
heartburn and belching;
constipation.

How to test assumptions?

Diagnosis of gastric ulcer, bulbar and extrabulbar duodenal ulcers includes the collection of information about the prescription of the condition, heredity, examination by a specialist, instrumental and laboratory research. The therapist or gastroenterologist, performing a manual examination of the abdomen, identifies areas of maximum pain, is determined with a preliminary diagnosis and further diagnostic search.

The main methods by which you can diagnose diseases of the duodenum and stomach include:

endoscopy (FGDS);
x-ray;

Fibrogastroduodenoscopy is a technique that allows you to visually examine the mucous membrane of the digestive organs of the upper part of the abdominal cavity from the inside. This study is essential for making a diagnosis. Thanks to FGDS, the doctor can determine the length of the area covered with ulcers, take material for analysis for helicobacter pylori and biopsy. In addition, in the presence of bleeding, endoscopy can really be transferred to the category of medical manipulations (drug instillation, coagulation).

Important! Endoscopic diagnostics gastric ulcer is strictly required for suspected malignant degeneration of cells. If malignancy is detected, the patient is examined and subsequently treated by an oncologist.

If it is impossible to conduct EGD, the patient is prescribed alternative methods diagnostics.

Beam methods

Fluoroscopy / radiography of the stomach and duodenum is performed using a contrast agent. Detected using X-ray the following signs this pathology:

symptom of "niche" (due to filling the bottom of the ulcer with contrast);
convergence of folds to the center of the defect;
inflammatory shaft around the ulcer (due to tissue edema);
increase in fluid volume;
radiographic symptoms of pyloric stenosis, scarring;
motor-evacuation dysfunction.

The advantage of ultrasound is the ability to make a conclusion regarding the state of the liver, the morphology of the bile ducts and pancreas, which can be initially affected or secondarily after the stomach and intestines. In such a case, along with manifestations of peptic ulcer, disorders of the glands are noted. digestive system.

Thus, the diagnosis of gastric ulcer is primarily based on the endoscopic picture of the disease and clinical symptoms. Ultrasound can differentiate some conditions and is an auxiliary method. X-ray of the stomach and duodenum confirms the diagnosis in case of contraindications to FGDS.

Laboratory methods

If a peptic ulcer is suspected or detected, the patient is prescribed blood tests (clinical, biochemical and for antibodies), urine, feces. The presence of anemia indirectly confirms the fact of bleeding. A positive Gregersen test indicates the presence of a bleeding vessel in the gastrointestinal tract.

For a complete diagnosis, it is possible to use various tests for Helicobacter pylori. The most famous is breath test. The patient is given to drink a special solution with urea. Then, using an indicator in the exhaled air, the concentration of substances metabolized by Hp is estimated.

Complicated course

The formation of the adhesive process and the malignancy of the ulcer are chronic course. In such cases, the symptoms progress gradually and for a long time. Dyspeptic manifestations are aggravated.

Diagnosis of duodenal ulcer should be carried out in as soon as possible with the development of a clinic of an acute abdomen, massive bleeding, vomiting of clotted blood of the color of "coffee grounds", black stools. The patient is urgently taken to the surgical hospital, where immediate treatment is carried out.

Diseases of the duodenum: symptoms, therapy, diagnostic methods

The human intestine consists of a thick and thin section. The duodenum belongs to the thin section - the symptoms of the disease of this organ are not always pronounced, therefore, diagnosis requires laboratory tests.

The length of the duodenum (duodenum) is only thirty centimeters. Its main functions are to transport food to the large intestine and assimilate vital important trace elements. If in the duodenum are detected pathological changes and it ceases to function normally, this negatively affects all organs of the digestive system and the human body as a whole.

Duodenum: causes of diseases of the organ

The most common pathologies of the duodenum, gastroenterologists call duodenitis, ulcers and cancer.

In the medical literature, the following causes of these diseases are distinguished:

Nowadays, diseases of the duodenum are increasingly being diagnosed in patients young age. This contributes sedentary image life, snacking on the run, drinking alcohol and smoking, going to nightclubs and other places of entertainment instead of a good rest. Let us consider in more detail the main diseases of the duodenum.

Treatment of duodenitis of the duodenum based on symptoms

Duodenitis is an acute or chronic disease of the duodenum, which is accompanied by inflammation of the mucous membrane of this organ.

Acute duodenitis occurs when food poisoning or trauma to the mucous membrane of a foreign body. Risk factors for the transition of the disease to the chronic stage are malnutrition, alcohol consumption and smoking.

There are such symptoms of duodenitis:

cramping or Blunt pain V upper section abdomen
heaviness in the stomach;
feeling of overeating;
nausea;
belching;
vomit;
heartburn;
constipation.

Treatment of duodenitis includes the appointment of a special diet. In the first ten days after acute attack you need to abandon the use of alcohol, canned food, smoked meats, as well as spicy, fried and sour dishes. The basis of the diet should be steamed food. It should be taken in small portions six times a day.

To restore the functions of the duodenum with duodenitis, use the following products:

yesterday's wheat bread;
buckwheat, rice and semolina porridge;
small pasta;
egg white omelet;
dry biscuit;
dairy products;
boiled vegetables (cauliflower, broccoli, potatoes, carrots, pumpkin, beets, zucchini).

During the period of treatment of duodenitis, the following products should be abandoned:

barley and millet porridge;
legumes;
pasta;
eggs (fried and hard boiled);
fatty dairy products;
carbonated drinks;
sweets;
fresh bread.

Such a diet must be observed throughout life, but in the acute period of the disease, it should be especially strict.

To improve the effectiveness of medications, treatment is supplemented with physiotherapy procedures.

Apply electrophoresis with novocaine, magnetotherapy and galvanization. In sanatorium-resort conditions, natural mud applications are used.

How to beat peptic ulcer?

A duodenal ulcer is a chronic disease that manifests itself in the formation of ulcerative defects on the mucous membrane. Peptic ulcer is a complication of gastritis, duodenitis and other inflammatory processes. Its exacerbations occur in autumn and spring.

For a long time, the symptoms of peptic ulcer manifest themselves in the form of mild digestive disorders, which quickly pass. Most people limit themselves to taking painkillers. However, such actions bring only temporary relief, while the duodenal ulcer progresses more and more. If treatment is not started on time, the disease can go into an acute stage.

The leading role in the appearance of duodenal ulcers is played by infection of the mucous membrane with the bacterium Helicobacter pylori. It is very important to recognize the symptoms of the disease in time.

Most often, at the appointment with a gastroenterologist, the patient makes the following complaints:

pain in the epigastric region on the right, subsiding after eating;
cramps in the abdomen, which sometimes radiate to the shoulder blade or back;
nausea;
yellow coating on the tongue;
bloating;
decrease in performance.

Ulcerative duodenal disease rarely develops on its own. As a rule, the patient is simultaneously diagnosed with cholecystitis and gastritis. The list of symptoms of an ulcer can be expanded due to the influence of certain pathological processes.

Treatment of peptic ulcer medications aimed at healing the ulcer, relieving pain and preventing complications.

The most commonly used drugs are:

Esomeprazole, Omeprazole, Lansoprazole, Rabeprazole and Pantoprazole reduce stomach acid;
Cimetidine, Nizatidine, Famotidine and Ranitidine reduce acid production;
Metronidazole in combination with omeprazole is prescribed when the bacterium Helicobacter pylori is detected.

If conservative therapy turned out to be ineffective or a complication such as severe bleeding appeared, surgical treatment is performed.

Duodenal cancer: do not miss the first symptoms

As an independent disease, duodenal cancer is rare and does not manifest itself at an early stage. As the tumor grows, the symptoms may be the same as with duodenitis and ulcers.

But it also adds other features:

pain in the right hypochondrium;
itching - this symptom is associated with skin irritation with bile acids;
rapid weight loss;
severe weakness.

Cancer treatment should focus on surgical intervention. During the operation, the part of the duodenum affected by the tumor is removed, and part lymph nodes that may contain cancer cells.

With extensive cancerous lesion during surgery, part of the stomach, pancreas and gallbladder may be affected.

After the operation, courses of chemical and radiotherapy. The use of these treatments reduces the risk of postoperative recurrence.

The duodenum: how to identify the pathology of the organ?

To diagnose diseases of the duodenum, the following examination methods are used:

Gastroscopy is a study in which the patient's organs are examined with an endoscope. This diagnostic method determines the presence of a peptic ulcer or other damage to the duodenum, and also evaluates changes in the mucous membrane;
Clinical blood test. This study allows you to identify the inflammatory process, signs of anemia and other disorders;
Biopsy - microscopic examination of a small piece of the intestinal mucosa;
A blood test for the bacterium Helicobacter pylori;
Analysis of feces for occult blood. This examination method is necessary to detect intestinal bleeding;
Magnetic resonance imaging is a modern diagnostic method, which is used when difficulties arise with the diagnosis.

In almost all diseases of the duodenum, it is necessary to follow a therapeutic diet. At the initial stage of the development of diseases of the duodenum, it is shown conservative treatment, and when serious complications surgical method is used.

How to check the intestines for diseases?

If various diseases are suspected, an examination of the intestine is required. It involves examining the mucous membrane and determining peristalsis. Distinguish between small and large intestine. Inspection of the initial sections is difficult. Instrumental diagnostic methods are supplemented laboratory tests, palpation and questioning of a sick person.

Instrumental examination of the intestine

Intestinal examination is performed according to certain indications. Patients can be both adults and children. There are endoscopic and non-endoscopic techniques. In the first case, the mucous membrane is examined from the inside using a camera. This is the most informative way to identify various diseases. It is necessary to examine a person if he has the following symptoms:

persistent or intermittent abdominal pain;
violation of the stool by the type of constipation or diarrhea;
vomiting of feces;
bloating;
the presence of blood or other pathological impurities in the feces.

The following studies are most often organized:

fibroesophagogastroduodenoscopy;
colonoscopy;
sigmoidoscopy;
anoscopy;
irrigoscopy;
computed or magnetic resonance imaging;
capsule colonoscopy;
radionuclide research;
radiography.

Sometimes a laparoscopy is performed. Therapeutic and diagnostic procedure, in which the organs of the abdominal cavity are examined from the outside. During the examination of patients, the following diseases can be detected:

benign and malignant tumors;
ulcerative colitis;
Crohn's disease;
diverticula;
polyps;
duodenal ulcer;
duodenitis;
enterocolitis;
proctitis;
haemorrhoids;
anal fissures;
condylomatosis;
paraproctitis.

Endoscopic examination of the duodenum

FEGDS allows you to check the condition of the duodenum. This endoscopic method examinations of patients. It allows you to examine only the initial section of the small intestine. FEGDS is often performed with therapeutic purpose. During the study, you can stop the bleeding or remove the foreign body. There are planned and urgent FEGDS.

The benefits of this study are:

rapidity;
information content;
good tolerance;
safety;
low invasiveness;
painlessness;
the possibility of implementation within the walls of the clinic;
availability.

The disadvantages include discomfort during the introduction of the probe and discomfort during the discharge of anesthesia. FEGDS is performed if the following pathology is suspected:

Before FEGDS preparation is required. It includes not eating immediately before the procedure and following a diet for several days. 2-3 days before the study should be excluded from the diet spicy dishes, nuts, seeds, chocolate, coffee and alcoholic beverages. Dinner on the eve should be no later than 18 pm.

In the morning you can not eat breakfast and brush your teeth. It is necessary to examine the duodenum and stomach in the supine position on the left side with the knees pressed to the body. A thin tube with a camera is inserted through the patient's mouth. Held local anesthesia. This ensures a painless procedure. During the examination, the person should not talk. Saliva should be swallowed only with the permission of a doctor. You can eat only 2 hours after the study.

Contraindications for FEGDS are:

curvature of the spinal column;
atherosclerosis;
neoplasms of the mediastinum;
a history of stroke;
hemophilia;
cirrhosis;
myocardial infarction;
narrowing of the lumen of the esophagus;
bronchial asthma in the acute phase.

Relative limitations include severe hypertension, angina pectoris, lymphadenopathy, acute inflammation of the tonsils, mental disorders, inflammation of the pharynx and larynx.

Performing an intestinal colonoscopy

The main instrumental method for diagnosing diseases of the colon in women and men is colonoscopy. It is classic and capsule. In the first case, a fibrocolonoscope is used. This is a flexible tube that is inserted into the intestine through anus.

The possibilities of colonoscopy are:

extraction of foreign objects;
restoration of intestinal patency;
stop bleeding;
biopsy;
removal of tumors.

How you can prepare for this procedure, not everyone knows. The main goal is to cleanse the intestines. For this, enemas or special laxatives are used. In case of constipation, an additional Castor oil. An enema is performed when a bowel movement is delayed. To carry it out, you will need a mug of Esmarch and 1.5 liters of water.

Within 2-3 days you need to follow a slag-free diet. It is forbidden to use fresh vegetables, fruits, greens, smoked meats, pickles, marinades, Rye bread, chocolate, peanuts, chips, seeds, milk and coffee. On the evening before the procedure, it is required to clean the intestines. Used drugs such as Lavacol, Endofalk and Fortrans.

Colonoscopy is performed under local anesthesia. The procedure is less pleasant than FEGDS. A probe with a camera at the end is inserted into the rectum. The doctor examines all parts of the large intestine, starting with the rectum. The expansion of the intestine occurs due to the injection of air. This study lasts minutes. The following complications are possible with an incorrectly performed colonoscopy:

If the general condition worsens after the procedure, you need to visit a doctor. Normally, in a healthy person, the mucosa of the large intestine pale pink. It is shiny, without ulcerative defects, protrusions and outgrowths, smooth with slight striation. The vascular pattern is uniform. Seals, pus, blood, fibrin deposits and necrotic masses are not determined. Absolute contraindications to colonoscopy are peritonitis, severe cardiac and respiratory failure, heart attack, severe ischemic stroke and pregnancy.

X-ray examination of the intestine

Methods for examining the intestines include irrigoscopy. This is a type of radiography that uses a dye. This study allows you to determine the pathological changes in the mucosa. The bowel relief is assessed in detail. Contrasting is simple and double. In the first case, barium sulfate is used. In the second, air is additionally introduced.

The advantages of irrigoscopy are:

safety;
painlessness;
availability;
information content;

The condition of the colon (ascending, transverse and descending), sigmoid and rectum is assessed. It is recommended to inject contrast not through the mouth, but through the rectum using an enema. During the examination, the patient is on his side with the upper leg. A rectal tube is installed through which a barium solution is injected.

Then done overview shot. After that, the examined person empties the intestines. Next, a second photo is taken. There are the following indications for irrigoscopy:

suspicion of a tumor;
blood in the stool;
the presence of stool with pus;
pain during bowel movements;
bloating with stool retention;
chronic constipation and diarrhea.

There are 3 main methods of preparation for the procedure:

cleansing enemas;
taking the drug Fortrans;
carrying out hydrocolonotherapy.

A conclusion is drawn from the picture. Irritable bowel syndrome can be suspected if uneven folds-gaustras, areas of narrowing of the intestine in combination with incomplete excretion of contrast during defecation are detected. If during the examination an uneven diameter is found colon, narrowing of the lumen against the background of spasm and areas of asymmetric contraction, this indicates ulcerative colitis. Barium enema should not be performed in pregnant women, with intestinal perforation, diverticulitis, ulcers, and severe heart failure.

Conducting a capsule study

Modern methods of examining the intestines include capsule colonoscopy. Its difference is that nothing is introduced into the anus of the patient. It is enough to take one capsule, equipped with two chambers. The advantages of this study are:

safety;
simplicity;
no need for anesthesia;
no radiation exposure;
minimally invasive;
the possibility of examining the intestine without a cleansing enema.

The disadvantages include the inconvenience of processing the received data and the difficulty of swallowing. A picture of the intestine with a capsule is recorded on a special device that is worn on a belt. This study is of limited use. It is costly. A capsule examination is performed when it is impossible to carry out colonoscopy and barium enema.

Complications include a delay in the removal of the capsule. Some patients develop allergic reactions. The study is being carried out in outpatient settings. The person does not need to be in the hospital. After swallowing the capsule, you can go about your daily activities. Preparation includes the use of laxatives.

Examination with a sigmoidoscope

To examine the final sections of the intestine, sigmoidoscopy is often organized. The procedure is performed using a sigmoidoscope. It is a lighting device with a metal tube. The thickness of the latter is different. Using a sigmoidoscope, you can examine the mucosa of the sigmoid and rectum at a distance of up to 35 cm from the anus.

pain in the anus during bowel movements and at rest;
persistent constipation;
unstable chair;
bleeding from the rectum;
the presence of mucus or pus in the feces;
feeling of a foreign body.

The study is carried out in chronic hemorrhoids and inflammation of the colon. Sigmoidoscopy is contraindicated in acute anal fissure, narrowing of the intestine, massive bleeding, acute paraproctitis, peritonitis, cardiac and lung failure. The preparation is similar to that for a colonoscopy.

Immediately before the introduction of the tube of the sigmoidoscope into the anus, it is lubricated with petroleum jelly. The advancement of the device is carried out during attempts. To straighten the folds of the intestine, air is pumped. In the presence of a large amount of pus or blood, an electric pump can be used. If necessary, material is collected for histological analysis.

Other research methods

Magnetic resonance imaging is a modern method for diagnosing bowel diseases. It can be done with double contrast. The dye is administered intravenously and through the mouth. This method cannot replace a colonoscopy. He is supportive. The advantages of MRI are painlessness, information content and the absence of radiation exposure.

Layered pictures of the organ are taken. The doctor receives a three-dimensional image on the screen. Tomography is based on the use of magnetic fields. The latter are reflected from the nuclei of tissue hydrogen ions. Before an MRI, you need to clean the intestines and follow a diet for several days. The procedure takes about 40 minutes. Pictures are taken while the patient is holding his breath.

The patient is placed on the platform and the body is fixed with straps. The methods of examination of patients include anoscopy. With it, you can examine the final section of the intestinal tube. An anoscope is required. This is a device that consists of an obturator, a tube and a light handle.

Anoscopy often requires a finger test before anoscopy. rectal examination. This is done in order to assess the patency of the intestine. If necessary, an anesthetic ointment is used. Thus, if you suspect intestinal pathology an instrumental study is required. It is impossible to make a diagnosis on the basis of a survey, examination and palpation.

The intestine is an organ of the digestive system that performs a very important task in the human body. important features However, today intestinal pathologies are very common. Conducting preventive examinations of the intestine in order to prevent the development of various diseases comes to the fore. In this article, we will talk about what methods of examining the intestines medicine offers, and discuss the advantages and disadvantages of each of the methods.

What is the intestine for?

The intestine is an organ that is located in the abdominal cavity and is involved in the process of digestion. It absorbs nutrients, which later enter the bloodstream. Undigested substances are excreted from the body along with intestinal gases.

It reaches four meters in a person. It lives in great amount bacteria that provide digestive processes, so it is very important that the microflora of the body is in permanent balance. Otherwise, the body will fail, which will lead to the development of various pathologies. Intestinal dysfunction can be manifested by a variety of symptoms, among which the most obvious are rumbling in the abdomen, flatulence, pain, diarrhea, stool retention, chronic constipation, etc.

The structure of the intestine

The anatomical structure of the organ is represented by two segments:

small intestine,
colon.

The small intestine is located between the stomach and the large intestine. It is where the process of digestion takes place. This section of the intestine is divided into the following components:

duodenum,
jejunum,
ileum.

The small intestine got its name due to the fact that, in comparison with the anatomical structure of the large intestine, it has less thick and durable walls. In addition, the cross-sectional diameter of its departments is much smaller.

The large intestine is the lower part of the digestive tract where water is absorbed and feces are formed. Its length is approximately 1.5-2 m.

The large intestine is represented by segments:

and appendix,
colon, which includes the ascending colon, transverse colon, descending colon, and sigmoid colon,
with a wide part and a terminal tapering part.

I must say that the methods of examining the intestines are very similar for both the small intestine and the large intestine, although there are nuances.

Relevance of bowel examination

Today, intestinal pathologies are very common. Unfortunately, there are often serious illnesses- oncological neoplasms. About 1 million new cases of colorectal cancer are diagnosed every year worldwide. Half of the patients diagnosed with this disease die. Oncology of the intestine occupies a leading position among all malignant tumors. Therefore, it becomes relevant to conduct preventive examinations of the intestine in order to prevent the development of diseases.

Modern ones make it possible to detect various pathologies intestines on early stages and begin immediate treatment, which increases the patient's chances of a speedy recovery or at least maintaining a good quality of life. More popular is the diagnosis of diseases of the colon, because serious violations occur in these parts of the intestine. Medicine offers patients a whole range of methods for diagnosing this organ, including:

capsule examination,
colonoscopy,
endoscopy,
MRI diagnostics,
irrigoscopy.

Intestinal examination with video capsule

Among all the available diagnostic methods, this method is considered the most painless and at the same time quite informative. The essence of the study is that the patient swallows a capsule equipped with a video camera. Once in the human body, the “device” travels through all parts of the gastrointestinal tract, taking a photo every two seconds. The data from the chip is processed by a special program, and based on the results, medical conclusions are drawn.

It is necessary to prepare for the procedure in advance. On the eve of the manipulation, food intake is prohibited, the study is performed on an empty stomach. A device is attached to the human body, which will record the results of the study. Diagnostic procedure takes about eight hours, during which the patient leads a normal life - goes about his business, without disturbing the daily rhythm. After the examination, the capsule dissolves and is excreted from the body in a natural way.

The most modern methods of examining the intestines today are represented precisely by the use of video capsules, although this method has its drawbacks. Such manipulation is very expensive. The fact is that "smart" capsules cost about 1 thousand USD. That is, and only two countries offer them today - Japan and Israel, leaders in the market for such services. The CIS countries do not yet have their own production of diagnostic chips.

Intestinal endoscopy

An endoscope is an optical instrument that is used in medicine for research hollow organs human, for example, the esophagus, stomach, intestines. In most cases, it is injected through the natural opening of the body, less often through surgical incisions.

Endoscopic methods for examining the intestine are prescribed for suspected presence of polyps or tumor formations in the intestine. Before the procedure, the patient should carefully prepare the body - cleanse the intestines. Today, this measure is easily implemented through special medications. The doctor introduces an ultrasonic sensor into the intestine, which allows you to examine in detail the mucous membrane and the condition of the walls of the organ under study. In order to clarify the results during the procedure, biological material may be taken for additional laboratory tests.

Endoscopic ultrasound of the large intestine is performed in most cases, with the exception of moments when the patient has diseases of the heart and blood vessels or lungs. This is directly related to the need to take special drugs. However, the expediency of conducting such a study is decided individually in each case.

Colonoscopy

Colonoscopy is a research method based on the use of a special device - a fibrocolonoscope - a plastic tourniquet with an optical system. Such a study is recommended for preventive purposes to be performed every five years for people over forty years old and for those who have a burdened heredity. oncological pathologies intestines.

Before the procedure, it is necessary to cleanse the intestines with the help of medications. Usually a colonoscopy lasts no more than 30-40 minutes, but it is a rather unpleasant procedure. The patient may experience discomfort due to the fact that the intestines are filled with air, and the person has a feeling of bloating. Methods for examining the intestine with a fibrocolonoscope also allow the sampling of biomaterial for histological analysis. In addition to diagnostic functions, colonoscopy allows you to remove polyps or benign formations small sizes. Using this technique, adhesions in the intestine can also be detected. The results of the study are ready, as a rule, immediately after the manipulation.

Irrigoscopy

The method of irrigoscopy is a method of examining the intestines using x-rays. Before the procedure, the patient must carefully prepare the body - cleanse the intestines, while eating is not allowed. Immediately before the study, a liquid is introduced into the body, which contains a radiopaque preparation - barium sulfate. The essence of the study is as follows. Once in the gastrointestinal tract, the solution fills all areas of the intestine and allows you to evaluate the contours and degree of intestinal lumen in the pictures. The procedure can be supplemented by another manipulation. After the contrast agent is removed from the body, air is injected into the intestines - this provides an additional opportunity to examine in detail the contours of the organ sections.

This technique makes it possible to diagnose fistulas, birth defects, ulcers, scars, but is considered insufficiently informative. The procedure is considered conditionally safe, since during the study the body is exposed to radiation exposure.

MRI bowel examination

Another way to diagnose bowel diseases is magnetic resonance imaging, which is based on the use of a magnetic field in the study. This procedure is painless and is considered safe, as it does not carry a radiation load on the body. On the eve it is necessary to clean the intestines, and immediately before the manipulation - to introduce a contrast agent into the body. The study itself takes no more than ten minutes and allows you to identify serious disorders in the intestines, up to malignant tumors.

I must say that the diagnosis should be carried out in a complex manner, therefore, methods of clinical examination of the intestine are added to the above manipulations. To detect dysbacteriosis, a stool sample is taken, in addition, rectal and bacteriological studies can be carried out. Blood is taken from the patient - as a rule, both biochemical and clinical analysis material. Modern diagnostic methods, however, will not replace digital

Examination of the small intestine: methods

As noted earlier, most often serious pathologies affect the sections of the colon, however, diseases of the sections small intestine also take place. Diagnosis, as a rule, begins with a study of the duodenum, located between the stomach and large intestine. For these purposes, fibroscopy or endoscopy is prescribed, in addition they can resort to irrigoscopy or radiography. A few days before the manipulation, the patient is advised to adhere to a certain diet.

With the help of endoscopy, you can not only diagnose the intestines, but also remove polyps, stop bleeding, and install a probe for food intake. The most modern method for diagnosing diseases of the small intestine is double-balloon enteroscopy, which is performed under general anesthesia. This procedure is considered quite severe and is performed only in a hospital setting. Enteroscopy is prescribed for bleeding in the small intestine, with its obstruction.

Thus, capsule examination, endoscopy, colonoscopy, barium enema and MRI are base methods through which the diagnosis and examination of the intestine is carried out. I must say that in general, pathological conditions of the organ are diagnosed more often in women, but this is only due to the fact that the beautiful half of humanity carefully monitors their health and consciously undergoes a medical examination for preventive purposes. There is also an opinion that similar diseases inherent in wealthy people, because they are more able to afford refined food.

The duodenum (duodenum) is part of the human intestine. It is located in the retroperitoneal space (retroperitoneally). What is a DPC? The duodenum looks like a tube that connects the stomach to the small intestine. It has a hole in the middle through which pancreatic enzymes enter. This is the initial and shortest segment of the intestine.

The duodenum got its name because of its length, which is approximately 30 cm, which corresponds to 12 fingers. The anatomy of the duodenum, like the stomach, includes a division into sections that differ in external coverage and length.

Where is the duodenum located? It is usually located at the level of the segment of the spine L2-L3. Depending on height, weight, type of human figure, it can move lower. It ends near the third lumbar vertebra. WPC has single system blood supply, and the outflow of lymph occurs through the walls of the head of the pancreas. Diseases of the duodenum is a common phenomenon in the modern world.

Structure and functions

The duodenum can be C-shaped, V-shaped, U-shaped. Each of them is a variant of the norm. Despite the small size, anatomical structure The duodenum includes 4 sections:

upper horizontal (bulb) - 5-6 cm long, covered thin layer muscles, located on the border of the last thoracic and I lumbar vertebrae;
descending - 7-12 cm long with pronounced circular folds, is detected to the right of the first 3 lumbar vertebrae;
lower horizontal - 6-8 cm long, covered with a shell in front, located on level III lumbar vertebra;
ascending - 4-5 cm long, located near the II lumbar vertebra. Sometimes it can be vaguely expressed, creating the effect of absence.

The first section is located near the liver, from below it touches the kidney. Posteriorly, it contacts with retroperitoneal tissue. Diseases of the duodenum can affect any of its departments.

The wall of the duodenum has a complex structure, it consists, like the anatomy of the stomach, of several membranes:

mucous - with circular folds, microscopic villi;
submucosal - from loose connective tissue with collagen fibers and many blood vessels;
muscle tissue - has smooth fibers, regulates muscle tone, helps to move chyme into the intestines;
serous membrane - formed from squamous epithelium, prevents friction of the duodenum against other organs.

The duodenum is located at the junction of the stomach, gallbladder with bile ducts, pancreas, liver, and right kidney.

Functions of the duodenum:

secretory - helps mixing food with digestive juices;
reflex - with its help, a connection is maintained with the stomach, allowing you to open and close the gastric pylorus;
motor secretion helps to move the food mass;
regulatory - controls the production of food enzymes;
the protective function allows you to maintain a normal alkaline level for the body in the chyme;
the principle of the evacuation possibility is to move the chyme to other departments.

normal operation stomach and 12 duodenal process is needed for the smooth functioning of the whole organism.

Diseases and their prevention

Due to the influence of various external factors, heredity, infection Helicobacter pylori, background pathologies, as well as age, changes appear that affect the work of the duodenum.

How does the affected area hurt? Discomfort is usually localized in the upper abdomen. Duodenal ailments are also manifested by other symptoms: heartburn, nausea, upset stool. The most common diseases of the stomach and duodenum:

duodenitis - inflammation of the duodenal mucosa, disrupting its normal functioning;
ulcer - the formation of a defect in the wall of the organ;
gastritis - an inflammatory process of the gastric mucosa;
cancer - the appearance of a malignant tumor.

To reduce the risk of developing duodenal disease, it is recommended to adhere to correct mode nutrition. It should consist of 5-6 daily meals. At the same time, food is consumed in small portions and chewed thoroughly. Prevention of peptic ulcer of the stomach and duodenum also provides for the rejection of bad habits, since smoking and alcohol abuse are serious provoking factors.

It is better to cook dishes by steaming, stewing or baking methods. Carbonated drinks, strong tea and coffee should also not be consumed. Marinades, pickles, smoked meats, fatty, spicy dishes should be excluded.

The main prevention of duodenal ulcers is to minimize stress factors. Moderate physical activity will also benefit, and an annual medical checkup will help to identify pathologies in the early stages, which will greatly facilitate the treatment process and further predictions.

The duodenum is an important organ of the gastrointestinal tract, which has a complex structure and performs functions that contribute to normal digestion. Violations of its work affect the entire body, worsening the quality of human life. Regular physical examination, proper nutrition, sufficient physical activity help control the health of the duodenum and prevent duodenal disease.

And the duodenum is performed under the control of transillumination on an x-ray television monitor. To increase the information content, gastroscopy is supplemented by sighting radiographs in direct, lateral and oblique projections. A minimum of 6 images are taken during the examination.

The appointment of radiography for the diagnosis of diseases of the gastrointestinal tract is an individual choice of a doctor, because there is a probe gastrography, which is not accompanied by radiation exposure.

Due to the big radiation background x-ray of the duodenum and stomach is prescribed according to strict indications. Nevertheless, the technique makes it possible to detect bowel cancer in 75% of cases in the elderly, and more effective alternative it doesn't exist.

When is an x-ray of the duodenum and stomach prescribed?

Photo of the targeted radiograph: a large adenomatous polyp (indicated by an arrow)

An x-ray of the stomach, as well as the duodenum, is prescribed if there are the following indications:

gastrointestinal discomfort;
dysphagia;
vomiting and nausea;
unexplained weight loss;
stomach ache;
ascites;
liver enlargement;
hidden blood in feces;
anemia of unexplained etiology.

Some European doctors perform an X-ray examination of the intestine in a category of patients for whom there is a high probability of developing stomach and duodenal cancer.

In practice, our radiologists are convinced that the value of the study for each patient is different. Sometimes a contrast x-ray does not provide valuable information, and the examination can only reveal violations of the motor function of the intestine.

Photo. Fibroplastic gastric cancer (SFRC): concentric narrowing with uneven contour(indicated by arrows)

We also note that when choosing the tactics great importance plays not so much the experience of the radiologist as his professional qualifications. A rational plan for the sequence of x-ray procedures allows you to create maximum efficiency with minimal exposure to the patient.

Modern types of radiographic studies of the gastrointestinal tract

There are several types x-ray examination small intestine:

Checking.
Urgent.
Classic.
Double contrast.
Two-phase.

Checking X-rays are carried out in medical institutions on gastrographic units under the control of an X-ray television monitor. In the absence of special equipment, the examination is carried out on the RUM-20 apparatus, which was produced in Soviet times and has a television path sufficient for a full diagnosis.

Using the technique of double contrasting, radiologists are able to study the structure of the relief of the mucous membrane. At the same time, it is possible to detect not only ulcers and duodenal cancer, but also superficial gastritis.

What is double gastric contrast:

2 days the gastrointestinal tract is cleansed (fortrans, enema, activated charcoal);
30 minutes before the procedure, the patient takes 2-3 Aeron tablets under the tongue;
for contrasting, a solution of barium sulfate with an antifoam agent (for example, 1 gram of dimethylpolysiloxane) is used;
to inflate the stomach, a person takes a gas-forming substance (urodan);
after translucence of the duodenum, a series of sighting radiographs is performed in the prone and standing position;
on average, the duration of the study takes 5-7 minutes.

What does a biphasic study of the stomach show?

Biphasic examination of the stomach involves a combination of the classical examination of the stomach and double contrasting. In the first phase, the radiologist performs double contrasting according to the above scheme.

In the second stage, tight filling with barium is carried out.

For the correct conduct of a two-phase examination, it is necessary to produce a barium suspension of high (for the 1st phase) and low (for the 2nd phase) density. If you suspect perforated ulcer or perforation of the wall of the small intestine, contrasting is carried out with water-soluble substances - gastrografin or verografin. When using them, the cocktail is prepared as follows: 200 grams of contrast with 350 grams of Borjomi and half a bag of vanillin.

Biphasic contrast shows:

ulcer of the stomach and duodenum;
violations of the motor function of the body;
esophageal-gastric reflux;
cancerous filling defects.

How is a classic X-ray of the small intestine performed?

Photo: saucer-shaped cancer: defect in the filling of the antrum with an accumulation of contrast

Radiologists of medical clinics most often perform a classic study. With it, the stomach is first translucent in the vertical position of the patient. After the patient takes a sip of contrast under the control of an X-ray television monitor, the condition of the folds is studied and the doctor takes pictures of important anatomical structures. Uniform distribution contrast is carried out using dosed compression. For this, the equipment is equipped with special tubes.

At the next stage, the patient drinks a whole glass of contrast (about 200 ml), which leads to tight filling. The study allows to identify the pathology of the outer contour of the small intestine in cancerous and ulcerative defects.

The following anatomical formations should be reflected on sighting images in a classical study:

front and back wall body;
pyloric and cardiac department;
condition of the duodenum (anterior and posterior bulbs).

To improve the peristalsis of the gastrointestinal tract, the patient can be injected with 1 ml of aceclidine solution (0.2%) or 0.5 ml of hydrochloric morphine (1%).

In hospital settings, it is preferable to conduct double contrasting, which allows a more thorough examination of the small intestine.

An urgent x-ray of the duodenum of the small intestine is performed if peritonitis is suspected or air is present in the abdominal cavity. Overview allows you to identify pathology and make a decision regarding the method and tactics surgical treatment.

Sometimes the study will have to be supplemented with angiography of the gastric vessels in order to identify changes in the duodenal part of the small intestine. For example, in Menetrier's disease, it is possible to detect the formation of an anatomical border of the gastrointestinal tract.

Summing up: an x-ray of the duodenum and stomach requires a highly qualified doctor. If the procedure is performed by an untrained specialist, the examination time increases, which increases the radiation load on the patient.