Technique for X-ray examination of the stomach and duodenum. Structure and functions of the organ

Diseases of the gastrointestinal tract are a very common problem even in progressive developed countries. This is due to the accelerated pace of life, poor nutrition, poor quality products. One of the indirect causes of serious illnesses is considered to be untimely application behind medical care. Most pathologies in the area digestive tract accompanied by unpleasant symptoms, pain, weight loss or obesity. To establish accurate diagnosis and treatment, doctors use many examination methods. The main one remains radiography duodenum and stomach.

What does a gastrointestinal x-ray show?

An examination of the digestive organs is necessary in order to assess their condition, functioning, detect problems and eliminate them. Today there are several technologies for this: MRI, CT scan, angiography.

The very first research technique was x-ray (x-ray) - radiology diagnostics internal structure bodies. With its help, one-time images of the stomach and duodenum are obtained.

The result obtained is recorded on film, from which the doctor will evaluate the condition of the internal organs. This procedure is also called gastrography.

Often, images alone are not enough to fully study the anatomy of the digestive tract. In such cases, radiography is combined with fluoroscopy.

The latter is carried out using a special amplifier - a contrast agent. IN laboratory conditions prepare a special barium-based solution that does not transmit x-rays.

The patient drinks this cocktail during the procedure, as a result the doctor can observe in real time the patency of the esophagus, the peristalsis of the stomach, and have a good look at it internal walls and folds.

As a rule, these two procedures are carried out in combination. Radiography gives pictures, and fluoroscopy allows you to see the movement of internal organs and records the data on an electronic medium. This makes it possible to study in detail the structure of the walls of the esophagus, duodenum, and stomach without invasive intervention.

Radiation diagnostics remains the most accessible method examination of the patient can be carried out in every hospital. The success of this process depends on the experience and skill of the radiologist.

But this technique also has a significant drawback: during the examination, the patient receives an increased dose of radiation, especially during fluoroscopy. Therefore, doctors resort to it only in extreme cases. The doctor must first carry out all non-radiation examination methods and only if they do not give the desired result, prescribe an x-ray.

X-ray of the gastrointestinal tract shows:

diseases of the esophagus: diverticulum (protrusion of the mucous membrane), tumors, narrowings, varicose veins veins;
foreign bodies in the digestive tract;
pathologies of the duodenum: ulcers, cancer, spastic narrowing;
stomach diseases: gastritis, cancer, ulcers, impaired absorption and weak peristalsis, etc.;
other organs abdominal cavity are not the main purpose of diagnosis, but their outlines are still visible on the image. From the image, the doctor may notice problems in other organs.

In some cases, the patient has to undergo several procedures at once, since each type of diagnosis shows different areas. For example, endoscopy reflects the condition of the internal mucous membrane and allows you to take material for a biopsy. And on the x-ray you can see the outer part of the organs, a little internal, tumors and neoplasms, narrowing of the esophagus are visible.

Indications for examination

A therapist, a gastroenterologist, directs to gastrography. Other doctors may also suspect digestive problems. The procedure itself is carried out by a radiologist, he also deciphers the results. According to the decoded data, the attending physician determines the tactics of treatment. Also, sometimes you need to go through the procedure again to find out how the therapy is going.

Radiography is assigned to determine various pathologies. Among them:

irritable stomach syndrome;
hernia of the diaphragm and esophagus;
inflammation of the digestive tract;
foreign bodies in the digestive tract;
malignant and benign tumors;
ulcers and gastritis;
deformation of the duodenum and its departments.

At the same time, during the examination, problems with the liver, spleen, and kidneys may be identified. Gastrointestinal pathologies make themselves felt by deteriorating well-being; often such diagnostics are prescribed based on the patient’s complaints.

But, as already noted, the doctor first conducts other types of examinations to reduce the radiation dose to the patient.

Suspicious symptoms include:

constant nausea and vomiting after eating;
frequent attacks of heartburn, hiccups, belching;
abdominal pain;
cutting pain in the stomach area, reminiscent of hunger. The unpleasant sensation goes away after eating;
frequent bowel movements;
unexplained weight loss;
obesity with normal nutrition.

If one or more symptoms are detected, it is recommended to consult a gastroenterologist. Problems with the digestive system can progress to more serious pathologies, and timely seeking help will be the key successful treatment. Also, people who may have a genetic predisposition to tumors of the stomach and intestines are also recommended to undergo preventive examinations.

Contraindications to the procedure

Due to the increased radiation dose, x-rays are not prescribed during pregnancy, since radiation rays can unpredictably affect the development of the fetus. For the same reason, this procedure is prescribed to children only in severe cases.

A categorical contraindication is a through formation in the stomach or intestines - perforation. The contrast agent may enter the abdominal cavity, causing further complications.

Gastrography is performed with caution in cases of acute obstruction and inflammatory processes. Such research is prohibited for people with allergies to barium.

How to prepare for an x-ray

The procedure takes place on an empty stomach. The abundance of gases or the presence of food in the gastrointestinal tract makes diagnosis difficult and can distort the data. Therefore, doctors' reviews recommend preparing 2 days before the scheduled session; for this you need to follow a diet or artificially cleanse the intestines.

At the time of issuing a referral for examination, you should consult with your doctor about detoxification methods. The easiest way is a cleansing enema; it is done the day before and in the morning before the procedure. The enema can be replaced with special drugs, which cleanse the gastrointestinal tract. In this case, patient reviews recommend Fortrans; the soluble powder removes gases and food debris well without enemas.

Preparatory measures also include an allergy test for iodine and barium. You can take medications only with the permission of your doctor. Before the x-ray, you need to warn the specialist if you have taken any medications.

A couple of days before the session, you need to remove gas-forming products from the menu. These include:

and grains (except);
dairy products;
cabbage, ;
carbonated drinks.

On the day of diagnosis, it is important to stop smoking; alcohol is excluded 2-3 days before the session. You are prohibited from eating 8 hours before the examination.

How does this happen

The study is carried out only on an empty stomach, after pre-training sick. In the X-ray room, the patient takes off his clothes and puts on a special gown. Be sure to remove all jewelry and notify your doctor if there are metal inserts in your body. After this, the laboratory assistant does overview shot in a standing position, further process is possible only after the first pictures. This is necessary to eliminate the possibility internal bleeding, organ ruptures, acute obstruction. The resulting photos are examined by the doctor; if there are no contraindications, contrast is performed.

In the laboratory, a mixture is prepared: solution and barium sulfate. The subject takes a few sips of the drink. It tastes and smells like chalk, discomfort doesn't call. After entering the esophagus, the barium mixture covers the mucous membrane of the gastrointestinal tract, and the esophageal tube becomes clearly visible on the screen. For subsequent examination of the stomach and duodenum, the patient drinks the remainder of the solution - 200-250 ml. The fluid fills the organs and they are better visible in the image; ulcers, neoplasms, deformations, and narrowings are easily visible.

For getting full picture The patient is placed on a table and a series of photographs are taken. Diagnosis is carried out in direct, lateral and oblique projections. To do this, the patient is asked to change his position several times.

After receiving the data, the radiography procedure is considered complete. In some cases, an x-ray is needed lower sections intestines, then the process is repeated several hours later, when barium enters colon.

Once the radiologist has enough information, he will write a report and describe the images. Sometimes this takes several days, sometimes the patient can receive results after 30-60 minutes. With this data, he goes to the doctor who referred him for examination. The attending physician will be able to establish a diagnosis and determine treatment, in best case scenario– decide that there is no disease or complications.

Where to get an X-ray of the gastrointestinal tract

Every clinic provides a similar service. She doesn't need it special technique, although private clinics have digital devices that give quick results on electronic media. An X-ray of the stomach and duodenum can be taken at state clinic, hospital, clinic.

Private medical institutions also conduct X-ray examinations of the gastrointestinal tract. The price for an x-ray will be 40-50 dollars, fluoroscopy is priced separately - from 45 to 65 dollars. Included in the price contrast agent, diagnostics and data. In some private diagnostic centers you will have to pay separately to decipher the results.

Possible complications

It is recommended to drink a lot immediately after the x-ray clean water, this will help remove the barium mixture from the body faster. It does not dissolve in liquid, so it is not absorbed into the walls of the digestive tract and does not cause damage to the body. Among mild complications, patient reviews note attacks of nausea and vomiting, but this is only possible with hypersensitivity. There may be constipation for 2-3 days after the session, this common reaction which goes away over time. The stool also turns whitish or gray. If bowel problems do not go away after three days, you should contact your doctor.

Significant discomfort such side effects do not bring, so they are not called complications. Among the rare and serious consequences – allergic reaction. This is possible if the preparation rules were missed. The patient must undergo a barium test.

Sometimes the barium suspension is replaced with an iodine solution, so the reaction to it must also be checked. In case of allergies, the patient may experience swelling of internal organs, difficulty breathing, and Quincke's edema. If the patient is well prepared for the procedure, gastrography will take place without negative consequences.

Alternative methods of examination

Before ordering an X-ray, the attending physician should try alternative ways. If a patient is prescribed an x-ray, then there is a good reasons. But it’s still worth asking your doctor about a possible alternative.

The main competition for gastrography is MRI. Magnetic resonance imaging does not involve radiation exposure and gives excellent results.

However, it is more expensive and in some cases less informative than radiography. For example, ulcers are better distinguished by conventional X-rays, and cancer is detected faster by MRI.

Endoscopy is also a common examination technique. It is carried out in a completely different way: through oral cavity An endoscope is inserted down the esophagus. This device has a light source and a camera that transmits the image in color to the monitor.

This is an indispensable method for diagnosing pathologies of the internal mucous membrane; it shows the esophageal tube and stomach. But this is an inconvenient method for checking the duodenum, and it does not reflect the outer walls of the organs.

There is another progressive option - computed tomography. A CT scan is performed in the same way as an MRI, but the former is based on the same radiation. The difference between conventional x-rays and CT scans is cost and performance. Computer methods better reflect soft tissue, gives a three-dimensional image and is in many ways superior to x-rays. But such an examination costs much more. In addition, the radiation intensity with CT is higher than with a conventional examination.

In any case, the patient cannot independently choose the diagnostic method; this requires a doctor’s referral. In Russia, according to the Law on Radiation Safety, every citizen can refuse x-rays, except in cases where his illness is of an epidemiological nature. But in case of serious illness, we should not forget that time works against us.

Gastrography is prescribed in limited quantities, so the radiation dose will not cause significant harm. But progressive cancer or ulcers shorten life much faster than radiation. Therefore, it is better to seek help and get diagnosed on time.

The duodenum is easily accessible to X-ray examination, and recognition of its diseases occupies a prominent place in X-ray diagnostics.

The shape of the duodenum most often approaches a horseshoe (Fig. 94), but fluctuates depending on the constitution and position of the body, varying widely, sometimes acquiring the shape of a ring, sometimes bending, sometimes forming a loop-like figure of a run. The position and shape of the duodenal bulb also vary depending on constitutional features (Fig. 95).

Rice. 94. Normal length of the duodenum (x-ray).

Rice. 95. Normal duodenal bulb (x-ray).

The shape of the bulb may change depending on different phases research depending on contractile activity muscles. According to the course of the curvature of the stomach in the bulb, a greater and lesser curvature is distinguished. The size of the bulb varies depending on the tone. It can be small with normal tone and expanded with decreased tone, sometimes acquiring large sizes.

When examining the duodenum in a state of artificial hypotension, it is possible to see the nipple of Vater, which forms a double depression on the internal contour, reminiscent in its shape of the Latin letter W (Fig. 96). Under pathological conditions of Vater, the nipple becomes deformed, enlarges, and in case of tumors it creates a filling defect along the internal contour of the duodenum.

Rice. 96. Normal duodenum in a state of artificial hypotension (x-ray).

The arrow indicates the papilla of Vater.

The tone of the bulb can be judged by the nature of its emptying. If the bulb empties quickly, even before its tight filling is achieved, then this indicates an increase in tone. Slow emptying, accompanied by a significant remainder, may indicate a decrease in tone.

The so-called duodenoptosis often occurs. At the same time, except low position, the duodenum can be lengthened and expanded. In such cases, expansion of the bulbs is noted. Duodenoptosis occurs together with general splanchnoptosis or in the presence of duodenal mesentery.

The relief of the mucous membrane of the bulb and the rest of the duodenum has different kind. In the area of the bulb, longitudinal folds predominate, repeating the relief of the mucous membrane of the gastric outlet. The folds of the bulb are clearly visible either at the time of its contraction or during compression. Starting from the upper knee of the duodenum, there are already typical Kerckring folds, which have a transverse arrangement and form a feathery relief pattern, similar to what is found in the small intestine.

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 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 vital role in the digestive system. Next after the duodenum is.

This organ, located directly in the abdominal cavity, often envelops the pancreas along its length, namely its head. The duodenum may not be constant in its location and this depends on gender, age, constitution, fatness, position of the body in space, etc.

Skeletotopically, taking into account the four sections of the intestine, its top part starts from the 12th thoracic vertebra, produces the first (upper) bend at the level of the 1st lumbar, then descends down and reaches the 3rd vertebra lumbar region spine, makes the lower (second) bend, follows from right to left in horizontal position and finally reaches the 2nd lumbar vertebra.

Sections of the duodenum

This organ lies retroperitoneally and does not have a mesentery. The organ 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 area of the first lumbar vertebra.
Descending part (department). The descending department borders 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, located near abdominal region aorta and inferior vena cava, which are located posterior to the duodenum.
Rising department. The ascending section ends with a second bend, rises upward and smoothly passes into the jejunum.

The organ is supplied with blood by the celiac trunk and superior artery mesentery, which, in addition to the intestine, also supplies the base of the head of the pancreas.

The structure of the wall of the duodenum

The wall is represented by the following layers:

serous is serosa, covering the intestine from the outside;
muscular – represented by muscle fibers (located circularly and along the organ), as well as nerve ganglia;
submucosal – represented by lymphatic and blood vessels, as well as the submucosal membrane, which has a folded shape with crescents;
mucous - represented by villi (they are wider and shorter than in other parts of the intestine).

Inside the intestine there are the major and minor nipples. located approximately 7-7.5 cm directly from the pylorus of the stomach. The main pancreatic duct and common bile duct (or common bile duct) exit into it. The minor papilla emerges approximately 8-45 mm from the papilla of Vater, into which the accessory duct of the pancreas emerges.

Functions

Motor-evacuation. 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. The initial stage of digestion occurs in the intestine, due to the action of bile acids and pancreatic enzymes.
Regulatory. Caused by the regulation of bile acids and pancreatic enzymes.
Acid-base. In the duodenum, the pH of the bolus of food is brought to optimal performance for its further transformation in other parts of the digestive tract.

Diseases

(infectious duodenitis, parasitic duodenitis; duodenitis caused by giardiasis; duodenal candidiasis);
gurgle;

And the duodenum is performed under the control of transillumination on an X-ray television monitor. To increase the information content, gastroscopy is supplemented with targeted radiographs in direct, lateral and oblique projections. During the examination, a minimum of 6 photographs are taken.

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

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

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

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

X-rays of the stomach and duodenum are prescribed if the following indications exist:

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 conduct X-ray examinations of the intestines in patients who are at high risk of developing stomach and duodenal cancer.

In practice, our radiologists are convinced that the value of the study is different for each patient. Sometimes contrast X-rays do not provide valuable information, and examination can only reveal disturbances in intestinal motor function.

Photo. Fibroplastic gastric cancer (SFGC): concentric narrowing with uneven outline(indicated by arrows)

Note also that when choosing tactics great importance It is not so much the experience of the radiologist that plays a role, but rather his professional qualifications. Rational Sequence Plan x-ray procedures allows for maximum efficiency with minimal patient exposure.

Modern types of radiographic studies of the gastrointestinal tract

There are several types x-ray examination small intestine:

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

Test 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 using a RUM-20 apparatus, which was produced in Soviet times and has a television path sufficient for full diagnostics.

Using the double contrast technique, radiologists are able to study the structure of the relief of the mucous membrane. In this case, it is possible to detect not only ulcers and duodenal cancer, but also superficial gastritis.

What is double contrast gastric contrast:

The gastrointestinal tract is cleansed for 2 days (fortrans, enema, Activated carbon);
30 minutes before the procedure, the patient takes 2-3 Aeron tablets under the tongue;
for contrast, a solution of barium sulfate with an antifoam is used (for example, 1 gram of dimethylpolysiloxane);
to swell the stomach, a person takes a gas-forming substance (urodan);
after transillumination of the duodenum, a series of targeted radiographs are performed in the supine and standing positions;
On average, the duration of the study takes 5-7 minutes.

What does a two-phase study of the stomach show?

A two-phase examination of the stomach involves a combination of a classic examination of the stomach and double contrast. In the first phase, the radiologist performs double contrast according to the scheme described above.

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

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

Biphasic contrast shows:

stomach and duodenal ulcers;
violations of the motor function of the organ;
esophagogastric reflux;
cancerous filling defects.

How is classical radiography of the small intestine performed?

Photo: saucer-shaped cancer: antral filling defect with contrast accumulation

Radiologists medical clinics Most often, classical research is carried out. In this case, the stomach is first x-rayed vertical position patient. After the patient takes a sip of contrast, the condition of the folds is studied under the control of an X-ray television monitor and the doctor takes pictures of important anatomical formations. Uniform distribution contrast is carried out using dosed compression. For this purpose, the equipment is equipped with special tubes.

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

Aiming images in a classic study should reflect the following: anatomical formations:

front and back wall organ;
pyloric and cardiac sections;
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.

Indications for surgery

In what cases can surgery not be performed?

Diet after surgery

What are gallbladder polyps and much more.

The information is presented in an accessible manner, in the form short articles, without excess “water”.

Source: http://medforyour. info/html/reflux3.html ( Tatyana Timchishena's website)

Below is one of her articles.

Reflux of contents from the duodenum into the stomach or duodeno-gastric reflux.

What does “duodeno-gastric reflux” mean? If you remember, in the previous article we found out what reflux is and that each reflux has its own “name”. And we also discussed what components this “name” consists of in the article “What is reflux?” So, if I tell you that “duodenum” is the duodenum, and “gaster” is the stomach, you can easily understand that duodeno-gastric reflux is nothing more than the reflux of contents from the duodenum into the stomach . Moreover, it is precisely the “cast”. Because normally the contents of the stomach enter the duodenum, and not vice versa.

But here interest Ask: Why does this reverse, unnatural movement of content occur?

In order for us to answer this question, we need to understand a little about how the stomach and duodenum work.

Both the stomach and duodenum are hollow organs, through which food masses move. But they don’t just move forward, but are gradually processed, broken down and absorbed. What we “load” into the oral cavity goes further into the esophagus, then into the stomach, small and large intestines. The duodenum is the very first section of the small intestine and it follows immediately after the stomach.

Food masses move in one direction. And this movement is ensured by the coordinated and interconnected work of the muscles of the esophagus, stomach and intestines. Yes, in the walls of these organs there are special muscles that constantly contract and relax, thereby ensuring the “pushing” of food masses in the desired direction. But this is not enough. To ensure that food masses move only in the right direction and cannot “go back” between different departments The gastrointestinal tract has so-called sphincters. Sphincters are valves, or more precisely, they are groups of muscles that, by contracting, close the entrance or exit, and by relaxing, open it.

For clarity, I will give an example. There are sphincters at the entrance and exit of the stomach. Groups of muscles that ring around the entrance and exit of the stomach. When they are compressed, the entrance or exit from the stomach is closed, just like any bag that is pulled together and tied with a rope is closed. When these muscles relax, the entrance or exit is open.

So, when food passes through the esophagus and approaches the stomach, the inlet valve opens and lets it into the stomach.

Then the valve closes tightly. And the food is securely closed in the stomach. Here it is processed and slowly moves to the exit from the stomach.

When food bolus turns out to be well processed and advanced to the exit, the valve at the exit from the stomach opens and allows it to pass into the duodenum.

And when it passes, it closes tightly. And the next stage of food processing begins - in the duodenum.

This, of course, is a schematic, simplified description of the process, but for our purposes it will be quite sufficient. The most important thing in this process is the coherence of the muscles and sphincters. Think about it: in order for a bolus of food to pass from the stomach into the duodenum, the muscles of the stomach must contract, creating increased pressure in the stomach, due to which the bolus of food will be “pushed out” of the stomach. But at the same time, the sphincter muscles at the outlet of the stomach should relax, thereby opening the outlet from the stomach. And the muscles of the duodenum, at this moment, must also be relaxed in order to “accept” the food masses. But that’s not all: at the same time, the sphincter at the entrance to the stomach must be tightly closed to prevent food from moving in the opposite direction - from the stomach to the esophagus.

What happens next? Then the food masses enter the duodenum and the “door” behind them closes tightly. That is, the sphincter at the outlet of the stomach closes. And then food processing begins in the intestine. The next stage is the transition of food masses from the duodenum further to the next section of the small intestine - the jejunum. In order to push food masses further, the muscles of the duodenum contract, creating increased pressure in the intestine, which “pushes” the contents further. And what is important is that at this moment the sphincter at the outlet of the stomach must be tightly closed to prevent the reverse movement of food masses. Not only that, he must be strong enough to withstand high blood pressure in the duodenum.

It's a complicated process, isn't it? Even in a schematic version of the presentation. But having understood this, it will not be difficult for you to answer the question “Why does the reverse, unnatural movement of contents from the duodenum into the stomach occur?”

This happens when:

1. The sphincter at the outlet of the stomach becomes weak, unable to tightly and reliably close the outlet of the stomach.

2. Coordination and “coherence” of the muscles of the stomach, duodenum and sphincter are disrupted.

3. When the pressure in the duodenum is so high that the movement of food from the stomach into the duodenum becomes difficult and a reverse, unnatural movement (reflux) may even occur.

What does duodeno-gastric reflux lead to and how to deal with it.

Today, my dear readers, we will continue the conversation started in the two previous articles. And now we’ll talk about what duodenogastric reflux leads to? Although, if we consider this issue correctly, then it should be said that the duodeno-gastric reflux itself is a consequence. This is a consequence of some disease. It never arises just like that, in the midst of complete well-being and health. What diseases lead to its occurrence?

These are all diseases that lead to weakness of the muscles of the sphincters, to a violation of the coordination of movements of the muscles of the sphincters, stomach, intestines and esophagus, to an increase in pressure in the duodenum.

1. Chronic gastritis and duodenitis (inflammation of the mucous membrane of the stomach and duodenum).

2. Ulcers of the stomach and duodenum.

3. Stomach surgeries and upper section intestines.

These are the main causes of duodeno-gastric reflux.

And what are its consequences?

With duodeno-gastric reflux, as we already know, the contents of the duodenum enter the stomach. This means that bile and pancreatic juice enter the stomach. Because it is in the duodenum that the ducts of the liver and pancreas open.

(You can see the pictures in the articles “Cholelithiasis and pancreatitis, gallbladder and the pancreas or the "common canal" theory and "The Tale of Vater's nipple and the sphincter of Oddi or why pain may be disturbing after gallbladder removal surgery").

And the thing is that the gastric mucosa, unlike the mucous membrane of the duodenum, is not adapted to resist bile acids, which are part of bile and enzymes, which are part of pancreatic juice. And these substances are very active and aggressive. So sooner or later they cause chemical burn gastric mucosa and its inflammation. The so-called chemical gastritis, gastritis C or reflux gastritis.

Moreover, cases of so-called “high duodeno-gastric reflux” are common. What does it mean? This means that it happens that the contents from the duodenum enter the stomach and the process stops there. This is a common, duodeno-gastric reflux. And it happens that this content is pushed even further in an unnatural direction - into the esophagus ("esophagus") and even into the oral cavity ("oris"). And this is already “high reflux” or duodeno-gastro-esophageal and duodeno-gastro-esophago-oral reflux. In this case, not only the gastric mucosa is damaged, but also the esophageal mucosa.

How does chemical gastritis, also known as gastritis C and also known as reflux gastritis, manifest itself?

Very often, this disease is asymptomatic and only during gastroscopy is an open, “gaping” outlet from the stomach and bile in the lumen of the stomach detected. And characteristic changes in the gastric mucosa - inflammation. But it also happens that a person feels burning pain"in the pit of the stomach", especially after eating. I am concerned about nausea and vomiting mixed with bile. Feeling of “fullness” and “stagnation” in the stomach.

How to deal with this unpleasant phenomenon How is duodeno-gastric reflux?

First of all, you need to cure the diseases that led to its occurrence. Cure gastritis, duodenitis, ulcers, if any. Most often, after successful treatment of these diseases, duodeno-gastric reflux goes away on its own. When the cause disappears, the effect also disappears.

But it happens, of course, and so that it is not possible to eliminate the cause. This may be the case after surgery on the stomach and upper intestine. Whatever you say, the anatomy is already damaged and restoring the functioning of these organs in full is not so easy. What to do then?

Then you have to deal with the consequences. For this purpose, drugs are used that strengthen and coordinate the work of the muscles of the stomach, esophagus and intestines. Drugs that protect the gastric mucosa from the harmful effects of duodenal contents. And drugs that treat existing inflammation of the mucous membrane caused by reflux. In each specific case, the set of these drugs may be different and they are prescribed by the doctor who is treating the patient.

I can advise you to eat more often than usual, but in small portions. Under no circumstances should you overeat. Food during the treatment period should not be coarse, easily digestible. After eating for about an hour, it is not advisable to lie down or, conversely, exercise strenuously physical exercise. Especially those that are associated with bending and stress on the abdominal muscles.

But this does not mean that you cannot move at all. Even immediately after eating, calm hiking will only benefit your digestion. Don't forget about this, walk more often. Remember that moving image life always contributes not only good mood, positive attitude, but also tones your internal organs. Makes them work faster, stronger and better.