Dimensions 12 duodenum. Duodenum: location, structure and functions

The human body is susceptible to various diseases. Diseases can affect any internal organ. The duodenum is no exception. The most well-known ailment of this part of the digestive system is peptic ulcer disease. Many people associate it with the stomach, but in fact it is associated with more than just that. The duodenum is quite often involved in the pathological process. What is this disease? What other diseases can affect the duodenum? Before looking for answers to these questions, it is worth considering the structure of the named section of the digestive system.

Structure of the duodenum

The human digestive system is complex. One of its components is the duodenum. It is considered the initial section in the small intestine. The duodenum originates from and ends with the duodenojejunal flexure, which passes into the next section of the small intestine (the jejunum).

The duodenum contains several components:

• the upper part, the length of which is from 5 to 6 cm;
• the descending part, which is 7-12 cm in length;
• horizontal part, which is 6-8 cm in length;
• the ascending part, equal in length to 4-5 cm.

Functions of the duodenum

The duodenum performs several important functions:

1. The process begins here. Food coming from the stomach is brought here to an alkaline pH, which does not irritate other parts of the intestine.
2. The duodenum regulates the production of bile and pancreatic enzymes depending on the chemical composition and acidity of food coming from the stomach.
3. The initial one also performs a towing function. From it, food gruel coming from the stomach is sent to other parts of the intestine.

Some diseases that may be associated with the duodenum

One of the diseases that occurs in the duodenum is duodenitis. This term refers to inflammatory-dystrophic changes in the mucous membrane. They arise due to exposure to harmful factors on the body: food poisoning, toxic substances that cause poisoning when they enter the digestive system, spicy foods, alcoholic beverages, foreign bodies. With duodenitis, pain is felt in the epigastric region, nausea, vomiting, weakness, and body temperature rises.

Diseases of the duodenum also include chronic duodenal obstruction. This is a process that leads to disruption of passage through the duodenum, that is, motor and evacuation activity in this part of the digestive system is disrupted. The disease occurs for many different reasons (for example, the presence of tumors, congenital anomalies, etc.). Signs depend on the reasons that caused chronic duodenal obstruction, on the stage of the disease and on how long the duodenum has been affected. Sick people experience symptoms such as discomfort and heaviness in the epigastric region, heartburn, loss of appetite, constipation, gurgling and transfusion in the intestines.

Treatment of duodenitis and chronic duodenal obstruction

Treatment of diseases must be prescribed by a doctor. In order for the duodenum to restore its functions during duodenitis, the following measures may be required:

• fast for 1 or 2 days;
• gastric lavage;
• prescription of a special diet (No. 1, 1a, 1b);
• prescription of astringents, enveloping, antacid, antispasmodic, anticholinergic, ganglion-blocking agents, vitamins;
• in some cases, surgery and antibiotic therapy are required.

In case of chronic duodenal obstruction, treatment of the duodenum requires an individual approach. If the disease is caused by a mechanical obstacle, then surgical intervention is performed. In other cases, prokinetics may be prescribed. These drugs have a stimulating effect on the muscles of the gastrointestinal tract, increase contractile activity, tone of the stomach and duodenum, and make the evacuation of gastric contents faster.

What is meant by peptic ulcer?

When considering diseases of the duodenum, special attention should be paid to peptic ulcers. This term refers to a serious disease that occurs in a chronic form with alternating periods of remission and exacerbation. The etiology of this disease is not well understood. Previously, it was believed that peptic ulcers were caused by substances such as pepsin and hydrochloric acid, which were produced in the digestive system. However, studies have shown that the microorganisms Helicobacter pylori play an important role.

Statistics indicate that the prevalence ranges from 6 to 15%. It cannot be said that a representative of a particular gender gets sick less often or more often. Men and women are equally susceptible to this disease.

Features of duodenal ulcers

Ulcers are lesions of the duodenum. They can be compared to erosions. However, there are significant differences between these two types of damage. Erosion affects only the mucous membrane that lines the duodenum. The ulcer penetrates into the submucosal and muscular layers.

Research shows that ulcers are found in the upper part in most cases. They are localized near the pylorus of the stomach. The diameter of the damage varies. Most often there are ulcers in which this parameter does not exceed 1 cm. In some cases, large ulcers are found. Doctors in their practice encountered injuries to the duodenum that reached 3-6 cm in diameter.

Clinical manifestations of peptic ulcer

In some people, the disease proceeds unnoticed, while in others, duodenal ulcer manifests itself with suspicious signs. The most commonly observed symptoms are:

• recurrent pain localized in the upper abdomen;
• digestive disorders;
• deterioration in a sick person’s appetite and weight loss;
• tarry stools;
• bleeding that occurs due to gastric juice corroding the walls of the blood vessel;
• pain in the back (they occur due to the growth of an ulcer into the pancreas);
• intense abdominal pain (they are observed when an ulcer perforates or peritonitis develops).

Of these symptoms, the most common is pain. It can be different in nature - sharp, burning, aching, vague, dull. Pain usually occurs on an empty stomach (in the morning after waking up). They can also appear after eating in about 1.5-3 hours. Unpleasant sensations can be relieved with antacid medications, food, and even a glass of milk or warm water. The fact is that when foods and drinks enter the body, they partially neutralize the effects of hydrochloric acid. However, after a short period of time the pain returns again.

Diagnostic procedures for peptic ulcer disease

The diagnosis of “duodenal ulcer” cannot be made based only on symptoms and an external examination of a sick person, because the above signs are characteristic of a wide range of diseases. The listed symptoms may hide not only a duodenal ulcer, but also cholelithiasis, pancreatitis, benign tumors, etc.

A suitable and reliable method for diagnosing peptic ulcer disease is fibrogastroduodenoscopy. During this test, a special instrument with a light source and camera is inserted through the mouth into the stomach to examine the lining of the digestive system. The image is formed on the monitor. The doctor evaluates the stomach and duodenum. Diseases are diagnosed by noticeable pathological changes. If necessary, the specialist takes a sample of the mucous membrane to examine for the presence of microorganisms that provoke the occurrence of peptic ulcers.

Drug treatment of duodenal ulcers

Peptic ulcers can be treated with medication or surgery. In the first method, doctors prescribe drugs to sick people that neutralize hydrochloric acid. They are called antacids. Medicines that help suppress the production of hydrochloric acid in the human body also help with illness. For example, Omeprazole may be prescribed.

If the diagnosis reveals Helicobacter pylori microorganisms, then three-component therapy can be prescribed. Omeprazole or Ranitidine are prescribed in combination with antibiotics (Amoxicillin and Clarithromycin).

Surgery for peptic ulcer disease

When the diagnosis of duodenal ulcer is made too late, surgical treatment is prescribed. It is carried out for certain indications:

• with perforation of the ulcer or heavy bleeding;
• frequent exacerbations of the disease that occur despite drug treatment;
• narrowing of the outlet of the stomach, which arose due to scar deformation of the duodenum;
• chronic inflammation that does not respond to drug therapy.

The essence of surgical treatment is removal. During the operation, that part of the internal organ that is responsible for the secretion of gastrin in the body is excised. This substance stimulates the production of hydrochloric acid.

In conclusion, it is worth noting that if suspicious symptoms characteristic of diseases of the duodenum occur, you should seek help from specialists at the clinic. Self-medication for ailments is inappropriate, because incorrect drug therapy, its absence or unnecessary folk remedies can cause serious harm to your body and worsen your well-being.

The duodenum gets its name due to its length, which is approximately 12 transverse dimensions of a finger. The section of the large intestine begins with the duodenum. Where is it located and what are its main functions?

1 Structure and functions of the organ

The duodenum has 4 sections:

• top horizontal;
• descending;
• lower horizontal;
• ascending.

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

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

The duodenum performs secretory, motor and evacuation functions. The secretory function consists of mixing chyme with digestive juices, which enter the intestine from the gallbladder and pancreas. The motor function is responsible for the movement of food gruel. The principle of the evacuation function is the evacuation of chyme into subsequent sections of the intestine.

2 Causes of pathology

Inflammation of the intestine usually occurs against the background of gastrointestinal disorders. Causal factors include viral infection, inflammation of the stomach or gallbladder mucosa, diarrhea, and low blood flow to the intestines.

Often, intestinal inflammation is caused by Helicobacter pylori infection. This bacterium is located in the stomach and does not manifest itself in any way. Its presence in the body leads to increased production of stomach acid, which subsequently irritates the duodenal mucosa. Without treatment, the bacterium can cause intestinal ulcers.

Diseases of the duodenum can develop due to severe stress or surgical intervention. In some cases, the underlying cause may be taking nonsteroidal anti-inflammatory drugs, smoking tobacco, or drinking too much alcohol.

Inflammation of the duodenum can be caused by food poisoning, eating spicy or fatty foods, or a foreign object. It has been proven that some intestinal pathologies can be hereditary. Pathogenic factors such as diabetes mellitus and cholelithiasis can cause the development of duodenal 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 disease is indigestion. The patient develops frequent and loose stools. Often patients experience complete intolerance to dairy products and fruits. If a patient experiences sudden weight loss and increased appetite, this may indicate that the duodenum is inflamed.

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

With a duodenal ulcer, cicatricial changes occur in the stomach, which results in the evacuation of food. Stagnation in the stomach leads to nausea and vomiting. Often, after vomiting, the patient’s general condition improves temporarily.

A characteristic symptom of peptic ulcer disease is pain. It can be aching or sharp, long-lasting or paroxysmal. As a rule, the pain subsides after eating, which is why it is also called “hungry pain.” This symptom occurs in 70-80% of patients. The pain is felt most often in the lumbar or thoracic region. In some cases, patients with duodenal ulcers may complain of pain in the collarbone area.

4 Colon cancer and duodenitis

If a patient has been diagnosed with colon cancer, the symptoms of the disease may manifest themselves in the form of jaundice, fever and itchy skin. Stage 1 cancer causes pain. It occurs as a result of tumor compression of 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 itchy skin. It appears due to the high content of bilirubin in the blood and irritation of skin receptors by bile acids. Against the background of itching, the patient develops agitation and insomnia.

An equally common disease of the duodenum is duodenitis. This disease manifests itself in the form of distension of the stomach after eating, dull and constant pain, nausea, loss of appetite, and vomiting. In patients with this diagnosis, palpation of the epigastric region is painful.

5 Proper nutrition

For any disease of the duodenum, the patient is prescribed dietary nutrition. A diet in combination 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 stomach acid are excluded from the diet. Such products include sour fruits, fatty broths, fresh vegetable and fruit juices, mushrooms, smoked, salted, fried and pickled foods and spices. Sweet carbonated and alcoholic drinks are also prohibited.

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

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

It is forbidden to eat foods that cause mechanical irritation. These products include raw vegetables and fruits, beans, peas, and coarse grains. For 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. There should be at least 3-4 hours between meals. Preference should be given to dishes cooked in boiling water or steamed.

6 Treatments

Symptoms and treatment of pathologies of the duodenum are determined by the doctor after conducting an appropriate examination. If the diagnosis confirms a peptic ulcer, the patient is prescribed medication. To destroy 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 also have a bactericidal effect. For severe pain, doctors prescribe antacids.

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

Treatment of patients diagnosed with duodenal cancer is carried out using surgery. The type of operation is selected depending on where the malignant tumor is located and at what stage of development the disease is. A small tumor is removed laparoscopically, that is, through minimal punctures in the abdominal wall. If the tumor is large, it is removed through extensive surgery. In this case, the doctor removes the outlet of the stomach and the adjacent omentum, part of the duodenum, gallbladder and head of the pancreas.

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

Inflammation of the duodenum: symptoms and treatment of the stomach

Live healthy! Symptoms of duodenal ulcer

In addition to surgical treatment, the patient is prescribed radiation and chemotherapy. This treatment helps prevent relapses and helps prolong the patient's life.

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

All about the drug Almagel and in what cases to take it -.

If duodenitis has developed against the background of helminthic infestation, then treatment is carried out with antibiotics. To normalize intestinal function, drugs are prescribed that enhance intestinal peristalsis. These drugs include Maalox and Domperidone.

Physiotherapy is used as an auxiliary treatment. Ultrasound, heating, paraffin baths and magnetic therapy are considered effective. Physiotherapeutic procedures can normalize blood supply and lymph flow to the abdominal organs and relieve pain.

The human intestine begins with the duodenum– it is located immediately behind the stomach and is relatively small in size compared to other parts of this organ (see photo above). Also called DPC for short.

Why was she called that: Medieval scientists - anatomists did not have modern means of measurement, and they, having measured the length of this organ with their fingers, received an indicator of 12 fingers in diameter - 25 - 30 cm.

Functions of the duodenum

The duodenum plays an important role in the entire digestive process. Since it is the initial link of the intestine, the processes of absorption of nutrients from incoming food and liquid actively occur here. It brings the acid-alkaline indicator of food to a level that will be optimal for subsequent stages of digestion in the intestines. It is in this organ that the stage of intestinal digestion begins.

Another integral phase of the work of this part of the intestine is the regulation of pancreatic enzymes secreted by the pancreas, as well as bile, depending on the acidity of the food bolus and its chemical composition.

The duodenum affects the proper functioning of the secretory function of the stomach, since the opposite interaction occurs. It involves the opening and closing of the pylorus of the stomach and humoral secretion.

Evacuation and motor functions.

The 12 duodenum carries the function of further promoting food gruel, treated with enzymes, into the next section of the small intestine. This occurs due to the massive muscle layer of the duodenal wall.

Features of the structure of the organ (shape, location, fastening)

The shape of most people is varied, and even in one person, both the shape and the location of the duodenum can change over the course of a person’s life. It can be V-shaped, and resemble a horseshoe, loop and other shapes. In old age, or after weight loss, it is lowered compared to where the duodenum is located in young and middle-aged people and overweight people. But most often it originates at the level of the seventh thoracic or first lumbar vertebra, located from left to right. Then there is a bend with a descent to the third lumbar vertebra, another bend with an ascent parallel to the upper part and the intestine ends in the area of ​​​​the second lumbar vertebra.

It is attached by connective fibers located on the walls to the abdominal organs. The upper part of the duodenum has the least number of such attachments, so it is mobile - it can move from side to side.

The structure of the wall of the duodenum:

• The serous outer layer performs mechanical protective functions.
• The muscle layer is responsible for the peristalsis of the organ during the digestion of food.
• The submucosal layer contains nerve and vascular nodes.
• the inner layer is the mucous membrane, strewn with a large number of villi, folds and depressions.

Organs adjacent to the duodenum

This section of the intestine is in contact with other abdominal organs on all sides:

• and the main duct;
• right kidney and ureter;
• ascending colon.

This anatomical location of the organ has a huge impact on the characteristics and course of diseases that occur in it.

The most common diseases of the duodenum.

• - the most common ailment of the duodenum of acute or chronic type, manifested in the form of inflammation of the mucous membrane.
• Ulcer– develops as a result of chronic duodenitis. Chronic damage to the duodenum, in which ulcers form in the mucous layer.
• Cancer tumor– a malignant neoplasm localized in different layers of the duodenal wall.

Duodenitis

More than 90% of patients develop chronic duodenitis. It can develop due to many factors, including:

• consumption of low-quality products;
• alcohol abuse;
• smoking;
• ingress of foreign bodies and toxic substances;
• other chronic intestinal diseases.

This disease manifests itself in the form of pain in the epigastrium of moderate intensity, weakness, belching, heartburn, nausea, turning into vomiting. Symptoms are often accompanied by fever.

A variation of this inflammatory phenomenon is in which the pathological process occurs only in the duodenal bulb. This form of duodenitis does not occur just like that - it is a consequence of other pathologies of the intestines or stomach. The cause of bulbitis can be:

• or KDP.

If the disease is at an acute stage, the person feels pain and nausea and suffers from repeated vomiting. Acute bulbitis develops against the background of long-term use of a large group of drugs, or poisoning. In the chronic form, there is also an aching pain syndrome, sometimes it can be accompanied by nausea.

Patients also experience chronic duodenal obstruction, which occurs against the background of tumor processes, developmental anomalies and other disorders in the duodenum. It is expressed in a violation of motor and evacuation functions in this part of the intestine and is characterized by the following symptoms:

• decreased appetite;
• feeling of heaviness and discomfort in the epigastric region;
• constipation;
• gurgling and gurgling.

The manifestation of this disease is influenced by the causes that caused duodenal obstruction, the stage of progression and how long ago the disease arose.

Peptic ulcer

The main cause of this dangerous disease is the reflux of acid from the gastric contents and its destructive effect on the mucous membrane of this part of the intestine. But this pathological process develops only when the surface layers of the intestine fail to cope with their protective functions. The ulcer is localized in the initial part of the duodenum and in the bulb, that is, in that zone of the intestine that is at the minimum distance from the stomach.

Many gastroenterologists unanimously speak about the negative impact of frequent use of anti-inflammatory drugs, which lower the protective barrier of the mucous layer of the duodenum. These drugs are aspirin and dosage forms based on it, ibuprofen, diclofenac, etc.. Therefore, if possible, you should limit your intake of medications from this group as much as possible.

Poorly treated or neglected duodenitis, abuse of alcoholic beverages and consumption of foods harmful to the body can also cause the duodenum.

It also tends to affect not only the stomach, but also the mucous membrane of the duodenum. It is a fairly common cause of ulcerative pathology, opening the way for acid into the mucous layers of the intestine. In 19 out of 20 cases of the development of ulcers of this organ, it is the Helicobacter bacterium that is to blame.

Symptoms:

Since this disease is very common in gastroenterological practice, you should know what kind of symptomatic picture it manifests. This is a paroxysmal pain syndrome in the upper abdomen slightly below the sternum. during a feeling of hunger or, conversely, immediately after eating. After eating, symptoms worsen such as:

• nausea;
• urge to go to the toilet.

The main dangerous complications of this disease of the duodenum are bleeding or perforation, which require emergency surgical assistance. Bleeding is fraught with dangerous loss of blood and filling of the abdominal cavity with it. Perforation is when food with all the enzymes and acids enters the abdominal cavity through an ulcerative hole formed in the intestine.

If medical care is not provided on time, such complications can lead to the death of the patient. There are cases in medical practice when a peptic ulcer turns into a cancerous state.

An ulcer, like other lesions of the duodenum, is diagnosed by an endoscopy procedure. Using this procedure, a gastroenterologist can visually assess the condition of all organs of the digestive system. A blood test may also be needed, especially if we are talking about duodenal ulcer caused by the Helicobacter bacterium. Complex diagnostics may also include a biopsy of the affected area of ​​the intestine - this is carried out directly during an endoscopic examination (a procedure for taking a small volume of affected tissue for laboratory examination).

Duodenal cancer

, bladder;

According to scientists, components of coffee in combination with nicotine can also affect the development of duodenal cancer. Therefore, doctors do not recommend getting carried away with coffee: you should limit yourself to 2–3 cups per day as a maximum. Constant ingestion of carcinogens and chemicals that have a detrimental effect on the entire gastrointestinal tract can also cause duodenal cancer. The unfavorable environmental conditions of the region of residence undoubtedly influence the development of many groups of diseases, including cancer. Both men and women over 50 years of age are at risk.

This disease is considered insidious because it is difficult to diagnose in the initial stages of development. The first signs of the disease can be easily confused with ordinary gastrointestinal disorders. Later, pain is added to these sensations during the development of oncology, especially when a person feels a feeling of hunger and heaviness. The patient feels weak, loses his appetite and experiences depression. These symptoms are associated with the process of intoxication.

A person with duodenal cancer has a much greater chance of a normal outcome if the tumor is detected in the primary stages of development. To make an accurate diagnosis, an endoscopy and a biopsy of the affected area of ​​the intestine are performed, and a complex of laboratory tests (CBC, etc.) is also connected to them. After this, an urgent operation must be performed to remove the tumor and the lymph nodes closest to it.

From all of the above, a simple and logical conclusion can be drawn. The duodenum is, like all organs, a very important part of our body. It performs complex and important functions in the digestive system, so every person should be attentive to their food preferences - if possible, exclude unhealthy foods from their diet and give up bad habits. After all, it is much easier to prevent diseases than to then go to the doctors and stay in the hospital in the hope of overcoming them.

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Contents of the article:

The duodenum is the very first section of the small intestine, it goes immediately after the stomach, and is small in size. This part of the gastrointestinal tract received such an interesting name because its length is about 25-30 cm, that is, approximately the same as 12 fingers folded across. The duodenum is followed by the jejunum. This is one of the shortest, but at the same time thickest segments.

Structure

Where is the duodenum located? Let's consider the location of each of its parts, as well as the structure of the 12 duodenum and its sections. It consists of 4 parts:

1. Top part. This is the initial part of the duodenum. You can find it between the last thoracic and 1st lumbar vertebrae, above it you can see part of the liver. The length of this part is about 5-6 cm. First it goes obliquely, from left to right, and then makes an upper bend.
2. Descending part. Its length is about 7-12 cm, it can be found to the right of the lumbar region, it gradually forms a lower curve. Reaches the 3rd lumbar vertebra and touches the kidney located on the right.
3. Horizontal or bottom part. The length of this part is about 6-8 cm. It is directed from right to left, then passes next to the spine and bends upward. Behind the lower part is the aorta, as well as the inferior vena cava.
4. The ascending part. The length of this part is no more than 4 or 5 cm. It can be found on the left side of the lumbar region, where the 2nd lumbar vertebra is located, where it forms a bend.

In one section of the intestine, located near the stomach, there is an expansion called the duodenal bulb or ampulla. It is different from the rest of the intestine. The mucous membrane of the bulb is the same as that of the pylorus of the stomach, with longitudinal folding, whereas in other parts the folding is circular.

Shape, fixation and more

We talked about where the duodenum is located, but its position can constantly change, depending on various factors. In an elderly person or in those who have lost a lot of weight, this part of the intestine is located lower than in young people of normal obesity. But most often, the beginning of the duodenum is the level of the 7th thoracic or 1st lumbar vertebra, then it is directed from left to right, then it bends, descends to the 3rd lumbar vertebra, makes a lower bend and runs parallel to the upper part, but from right to left and ends at level of the 2nd lumbar vertebra.

The shape of the duodenum can also be different and change over time. Sometimes it resembles a horseshoe, sometimes it resembles a loop, it can be V-shaped and so on. This part of the intestine is fixed by special connective fibers that go from its walls to the organs located in the abdominal cavity. Less fixed, that is, more mobile, is the upper part of the duodenum, which can move from one side to the other. The upper part of the intestine is not covered by the peritoneum.

The structure of the wall and vater of the papilla

The structure of its wall is the same as that of the entire small intestine; it has several layers:

1. Outer shell.
2. The muscular layer contains longitudinal as well as circular layers.
3. Submucosa. It is thanks to the submucosa that the mucous membrane gathers into folds, which are called spiral and semilunar. They are 1 cm high and cannot stretch or disappear if the intestines fill with food.
4. Mucous membrane. It is covered with villi; in this part of the intestine the mucous membrane is wider and shorter.

In the descending part there is the major papilla of Vater. This is a bulge that protrudes slightly above the mucous membrane. Behind it are 2 large glands, namely the pancreas and liver. These glands and the papilla of Vater are connected. Sometimes there may be another, minor papilla.

Functions

Let's look at the functions of the duodenum, there are not many of them:

1. Changing the pH of food gruel. It must change the pH of the food, make it alkaline, and prepare the food for intestinal digestion.
2. Regulation of bile secretion and pancreatic enzymes. The duodenum in humans is responsible for the secretion of bile and enzymes secreted by the pancreas. Their quantity depends on the chyme that enters the duodenum.
3. Maintains connection with the stomach. The duodenum goes immediately behind the stomach, so it is responsible for how the pylorus of the stomach opens and closes. These reflex actions depend on the food gruel. This part of the intestine also affects the regulation of gastric acidity.
4. Responsible for moving food gruel, that is, it performs an evacuation or motor function.

Diseases of the duodenum

There are many diseases of the duodenum. Let us list those that occur most often and talk briefly about each pathology.

Duodenitis

Duodenitis is a disease in which the mucous membrane of the duodenum becomes inflamed. There are both acute duodenitis and chronic, often recurrent; in 94% of cases, patients experience the chronic form. Causes of duodenitis: poor diet, bad habits, chronic intestinal diseases, and so on. The patient is worried about weakness, mild pain in the stomach, nausea, sometimes vomiting, as well as belching, heartburn and other symptoms.

One of the varieties of duodenitis is bulbitis, in which only the duodenal bulb, that is, the section adjacent to the stomach, becomes inflamed. Rarely, this disease occurs on its own; most often it appears against the background of gastritis or an ulcer of the duodenum or stomach. The symptoms of this disease can vary. In acute bulbitis, which occurs after poisoning or drug abuse, people complain of pain, nausea, and suffer from repeated vomiting. If this is a chronic form, pain also appears, but it is aching, not severe, and sometimes there is nausea.

Peptic ulcer

If duodenitis is not treated or due to other reasons, namely stressful situations, poor diet, alcohol abuse, frequent use of medications that irritate the mucous membrane, a duodenal ulcer may appear. The duodenum first becomes inflamed, then a defect forms on its mucous membrane. It has been proven that one of the causes of the disease is the bacterium Helicobacter pylori.

The main symptom of an ulcer is aching pain in the epigastric area. It appears on an empty stomach or at night and goes away about half an hour after the patient has eaten. He may also have belching with a sour taste or heartburn, his stomach will swell, and he may suffer from constipation.

An ulcer is dangerous because over time it can develop into cancer. Sometimes patients experience bleeding or perforation. These are very dangerous complications that can lead to the death of the patient.

Tumor

In addition to the diseases listed above, neoplasms may also appear in the duodenum. They can be benign, that is, polyps, fibroids, lipoma, etc., and malignant, this is intestinal cancer. Often the patient does not know that he has polyps in his intestines, since they may not bother a person for a long time; this disease is discovered by chance, during the next examination. In this case, the patient is advised to remove the polyps, as they can transform into a malignant tumor.

Duodenal cancer is considered a rare disease; most often it appears due to the fact that the tumor grows from another organ, for example, the stomach. It occurs in older people over 50 years of age. It is difficult to diagnose in the early stages; the first symptoms of the disease are similar to a gastrointestinal disorder. Later, abdominal pain appears, especially if the patient is hungry, and a feeling of heaviness. A person complains of weakness, loses appetite, and becomes depressed. All these symptoms are the result of intoxication of the body. A person with a diseased intestine, if a tumor is discovered, must be urgently operated on to remove the tumor and the lymph nodes closest to it. When the tumor is small (less than 1 cm), then partial excision of the duodenum is performed. About half of the patients survive after surgery.

Diagnostics

To make a correct diagnosis, the doctor refers the patient to an endoscopy. This is the best way to make or clarify a diagnosis, since the doctor will be able to examine the intestinal mucosa himself, see ulcers, if present, their size and location, and so on. In addition, polyps and other neoplasms that appear on the mucous membrane are visible. The doctor will definitely take a section of the mucous membrane for examination to make sure that the patient does not have a malignant tumor, and may immediately remove a small polyp.

To clarify the diagnosis, radiography may be prescribed. But this examination does not provide as much information as can be obtained through endoscopy, but is sometimes used by doctors to examine the outline of the intestine. Even less often, an ultrasound is performed, which helps to examine the location and size of organs.

Of course, these are not the only examinations prescribed by a doctor. To clarify the diagnosis, the doctor may ask for many other, additional tests, but these are the main procedures prescribed most often. Only after an accurate diagnosis has been made can the doctor prescribe treatment. The duodenum, as we see, plays a huge role in the human body, has a complex structure and performs many functions. There are many diseases of this part of the intestine that it is advisable to diagnose at an early stage and treat immediately before complications begin that threaten a person’s life.

The duodenum, as we see, plays a huge role in the human body, has a complex structure and performs many functions. There are many diseases of this part of the intestine that it is advisable to diagnose at an early stage and treat immediately before complications begin that threaten a person’s life.

Stomach disease is a very unpleasant and common ailment that a large number of people face. Most often, the occurring disorders are associated with gastric dysfunction, gastroduodenitis and ulcers, as well as duodenal cancer.

As for the last organ, it is located at the beginning of the intestine and is responsible for the absorption of nutrients entering the human body. And if the disease is associated specifically with this organ, then the negative consequences affect the entire health as a whole. Therefore, it is important to know all the causes and inflammation of duodenal ulcers, the signs of such a disease, as well as methods of its treatment.

Where is the duodenum located?

The very first part of the small intestine, starting from the stomach, passing into the small intestine and flowing into the jejunum, is precisely the duodenum.

If problems begin with this organ in the form of diseases such as an ulcer or an inflammatory process, then the person begins to experience severe discomfort, noticeable pain and disorder of the entire digestive tract.

The topography of the duodenum is quite complex. Its length is 30 centimeters, which is equal to 12 transverse dimensions of the fingers, which is why the intestine is called that. Moreover, it is located behind the peritoneum and is adjacent precisely to those tissues that are also located in the retroperitoneal cavity.

Structure

This organ consists of several parts:

1. Upper and descending section.

The uppermost part of the duodenum reaches up to six centimeters in length. It is located along an oblique line, bending and forming a kind of arc, the mucous membrane of which forms longitudinal folds.

Then comes the descending section. It is located on the right side of the spine at the same level as the lower back. It is in this area that the large papilla is located, from where the ducts open.

After which the intestine bends upward and forms the ascending part. Its length is up to five centimeters, and it is located to the left of the spine in the lumbar region.

The structural features of the duodenum are that it does not have a permanent shape. The situation changes and depends on many factors, including the age and weight of the person.

Another feature of such an organ is its syntopy. Simultaneously in contact with the liver and pancreas, the ducts of the glands flow into the duodenum, as well as the ureter and right kidney. This anatomy provokes the risk of developing serious diseases in this area.

Functions

This organ plays one of the most important roles in the entire digestion process. It is in the cavity of the duodenum that enzymes mix with digestive juices (pancreatic and gastric, bile). Due to this, the food entering the body is broken down into nutrients, which are then easily absorbed in the intestinal walls.

At the base of the villi of the duodenum, intestinal glands open, producing duodenal juice and necessary hormones. The functions of this body also include regulation:

• activity of the liver and pancreas;
• reflex closing and opening of the pylorus;
• acidity of gastric juice.

Symptoms of duodenal ulcer

Peptic ulcer disease (ICD code 10) is chronic, so it is constantly accompanied by stages of exacerbation and remission. During the passive period of the disease, ulcer patients usually do not worry about anything special and they do not feel any discomfort. But in the acute stage, the main symptoms of this disease begin to appear.

There is a mirror ulcer, characterized by the presence of neoplasms, both at the beginning of the intestine and at its end. Quite often there are several ulcers, and this complicates the course of the disease and takes longer to cure.

The main symptom of the disease is pain, which has its own specific characteristic. Usually the painful spasm is localized on the right side. The pain begins in the right hypochondrium, gradually localizing in the lumbovertebral region. Another distinctive feature is that such an unpleasant sensation appears on an empty stomach and at night. But when a person eats food, the spasm decreases. This happens because the ulcer gradually destroys the mucosa and submucosa.

Additional symptoms of peptic ulcer disease may include:

1. present heartburn;
2. emerging nausea;
3. belching after eating;
4. vomiting with a sour taste;
5. sudden weight loss.

Another characteristic sign of an ulcer is indigestion. It manifests itself as frequent diarrhea. In this case, a person may not tolerate fruits and dairy products well. Also, if with increased appetite, body weight decreases, then we are definitely talking about inflammation of the duodenum, which is extremely dangerous.

If the ulcers completely affect this organ, then a yellow coating may appear on the tongue. This happens due to the fact that a spasm of the bile ducts occurs and bile stagnation occurs. As a result, at an early stage of the disease, a person suffers from pain on the right side, and the skin surface becomes yellowish.

During an ulcer, the stomach area is covered with scar tissue, which can cause the evacuation of food that gets inside. All this leads to vomiting, after which the patient’s condition may improve for a while.

More often, the period of exacerbation occurs in the spring and autumn seasons, and lasts for eight weeks. But the remission stage can last from four weeks to several years. The danger of such a disease lies in the complications that the course of the disease can lead to.

How to check the duodenum

To avoid serious complications and consequences for the entire body, treatment of duodenal ulcers should begin as early as possible. And in order to detect this disease, it is necessary to carry out a number of activities. It is diagnosis and subsequent therapy that help prevent destruction of the mucous membrane.

All these methods make it possible to identify the presence of erosion, diverticulum or parafateral ulcer, thanks to which an accurate diagnosis is made, since the symptoms of various gastric diseases are very similar to each other. They help check whether the histology of the duodenum, as well as its anatomy and physiology, is normal.

Therefore, as soon as signs of a duodenal ulcer have been discovered in women or men, you should immediately consult a doctor, who will prescribe a series of diagnostic measures, and then draw up a treatment regimen.

Diseases of the duodenum

Diseases associated with damage to the duodenum have similar symptoms at the initial stage, but the clinical picture is different. Moreover, they all provoke an inflammatory process that negatively affects the condition of the entire body.

One of these diseases is duodenal lymphangiectasia. With this pathology, the lymph nodes become enlarged, which causes swelling of the duodenal tissue, which is called microlymphostasis.

Proteins entering the body cease to be absorbed and swelling only increases. The cause of this disease can be pancreatitis, pericarditis, oncology, intestinal endometriosis, Crohn's disease.

More often, lymphectasia is diagnosed in childhood and young age.

Inflammatory

Inflammatory processes include dyskenesia and duodenostasis. Such ailments lead to disruption of the motor function of the diseased organ. Stagnation forms in the cavity of the duodenum. As a result, a mushy mass (chyme), which is the remnants of incompletely digested food and gastric juice, is retained in the intestine. Pain in the epigastric area begins to appear.

The spasm often occurs after a meal, thereby provoking a feeling of nausea and vomiting. There is a feeling of heaviness in the pit of the stomach, the person stops eating normally, he may experience constipation and weight begins to decrease.

Treatment in this case is most often based on following a special diet. Meals become fractional up to six times a day. The menu should contain dishes containing large amounts of vitamins and fiber. In some cases, if necessary, parenteral nutrition and intestinal lavage are prescribed (once every four days).

Additionally, therapy may include the use of sedatives and tranquilizers. Abdominal massage and therapeutic exercises can speed up the treatment process.

Another inflammatory disease is duodenal erosion. In this case, the inflammatory process occurs on the surface of the mucosa, without penetrating into the muscle layers and forming erosive areas.

An ultrasound may show thickening of the wall of the duodenum itself. Quickly identified symptoms and treatment of duodenal erosion, started in a timely manner, produce results. But this disease can be provoked by long-term use of medications, stress, poor diet, Helichobacter bacteria and smoking.

Ulcer

This disease occurs as a result of exposure of the mucous membrane of the duodenum to acid and pepsin. The bacterium Helicobacter pylori is of great importance in the pathogenesis of this disease. The disease occurs with relapses and even after healing the ulcer leaves a scar.

The main manifestation of this disease is pain of varying intensity, manifested in the upper abdomen. During physical activity, the unpleasant spasm intensifies. The same thing happens when you feel hungry, when you eat spicy food and alcohol. The pain usually decreases after the person takes antacid or antisecretory medications.

The ulcer is dangerous due to its manifestations. And if the disease is severe and has complications, the person may face disability.

Complications of duodenal ulcer

Quite often it worsens and can lead to unpleasant consequences. Sometimes internal bleeding occurs, which can be detected by blood clots present in the vomit and stool.

The ulcer also tends to spread to adjacent healthy organs. Sometimes the wall of the duodenum acquires a through hole. And if penetration occurs, then the person experiences regular vomiting and nausea, after which relief does not come.

Against the background of the underlying disease, a hernia may form. And these are not all the complications that can be encountered with duodenal ulcers:

1. Perforation of the ulcer. It develops quite suddenly and is characterized by acute pain in the pit of the stomach. Palpation of the abdomen is painful, and the muscles of the anterior abdominal wall are very tense. In this case, the ulcer increases in size and becomes 1 cm in size, which is considered large. For suturing of a perforated ulcer, preliminary mobilization of the intestine according to Kocher is necessary.

2. Pyloric stenosis. It manifests itself as vomit of the food that a person ate the day before. In this case, a belch with a rotten smell appears. And upon superficial examination, peristalsis in the epigastric region is noticeable.

3. Penetration of the ulcer. This is the transfer of the disease to other organs. The pain intensifies and does not depend on food intake. The temperature may rise and the person may experience a feverish state. A parapapillary ulcer breaks into a confined space. These are nearby organs and ligaments.

4. Malignancy. This is the degeneration of an ulcer into a malignant tumor. At first, there are no obvious symptoms. And the disease itself is revealed through a detailed examination. At the same time, the clinical picture changes, the frequency of exacerbations becomes more frequent, and the disease ceases to be associated with a specific seasonality.

5. Arteriomesenteric obstruction of the duodenum. It develops due to improper rotation of the intestine or due to a congenital deformity called atresia. This condition is aggravated if cholelithiasis begins to develop additionally. This usually happens to older women.

Treatment of duodenal diseases

Treatment of all diseases of the duodenum should be comprehensive and complete. First, the doctor studies the history of the disease, makes a diagnosis and chooses therapy. A person will have to follow all basic recommendations. They may relate to nutrition, exercise and basic lifestyle.

All this will help reduce symptoms and treatment of duodenal inflammation will proceed at an accelerated pace. Bed rest becomes mandatory, as it has a beneficial effect on blood supply in the gastrointestinal tract.

Therapeutic therapy is based on the following principles:

• taking pills that relieve symptoms of the disease;
• taking a course of antibiotics;
• use of painkillers;
• diet;
• rejection of bad habits;
• use of traditional medicine recipes;
• physiotherapy.

Medication

Drug treatment is based on drugs belonging to the group of proton pump inhibitors. They promote scarring of ulcerative formations, and thereby the scarred tissue alleviates the painful spasms that arise.

When the bacterium Helicobacter pylori is detected in the body during an ulcer, then eradication drugs are added to therapy. Typically, the treatment regimen consists of the following medications:

1. Drugs Rabeprazole or Omez (PPI);
2. Clarithromycin;
3. Metronidazole or Amoxicillin.

The dosage is prescribed by the attending physician. If the completed course of drug therapy does not give the desired result, then the drug De-Nol is added to the treatment. Finally, fibrogastroscopy is performed and if serious complications are detected, then surgical intervention is performed.

So, if we are talking about arteriomesenteric compression, gastric resection is performed. Polyps in the duodenum are also removed. In some cases, a suturing device for the duodenal stump is used.

Treatment with folk remedies

Treatment with folk remedies can also give positive results. The basis of this therapy is the use of natural ingredients that enhance the functions of the immune system, improve the digestion process, and also have antibacterial and healing properties. What helps relieve pain from ulcerative lesions.

Good results are obtained from decoctions prepared from calendula and yarrow, golden mustache and burdock root. A tincture of St. John's wort and olive oil gives a quick positive effect. Viburnum, dandelion root, chamomile and honey, and propolis are also used.

One of the effective ways to cope at home is flax seeds. A special decoction is prepared from them, which is taken daily for two months, 50 ml before the main meal.

Flax decoction improves the condition of ulcers and can be used as a prophylaxis, especially during exacerbations.

Causes of duodenal diseases

Factors that provoke diseases associated with duodenal tract include:

Men are more often susceptible to such diseases, since they do not monitor their diet at all. In most cases, they eat on the run or simply replace meals with a cup of coffee. They smoke a lot and drink more alcohol than women.

As for children, their stomach diseases are associated with a hereditary predisposition, with increased acid formation, with toxin poisoning and with a lack of eating habits.

Bulbitis of the duodenum

Duodenal bulbitis is also a digestive disorder in which beneficial substances are no longer absorbed in the gastrointestinal tract. And such a disease manifests itself immediately.

Its manifestation causes significant discomfort and prevents a person from leading a full and normal lifestyle. But if the diagnosis is made in a timely manner and treatment is started, then this disease can be completely eliminated.

Bulbit is an acute or chronic inflammation of the duodenal bulb, which is one of the types of duodenitis. Very often this pathology is accompanied by gastritis or postbulbar ulcers.

According to its localization, this disease can be focal or total. In adults, this disease occurs for the following reasons:

1. infections caused by the bacterium Helicobacter pylori;
2. weakened immunity;
3. lack of adrenal hormones;
4. prolonged exposure to stress and psychosomatics;
5. failure of eating habits;
6. heredity and the presence of bad habits.

Bulbit is accompanied by noticeable painful spasms and indigestion. In the early stages, nausea without vomiting, constipation and heartburn occur. Then, as the disease progresses, vomiting with bile appears, which the liver secretes, and belching with a bitter taste. In the final stages, a person faces decreased performance and a deterioration of the immune system, which is accompanied by regular headaches and muscle weakness.

Treatment is based on taking medications, maintaining proper nutrition and herbal medicine.

Duodenal cancer

Cancer is considered a rare disease that is very difficult to diagnose at an early stage. This disease is a carcinoma, which is a malignant neoplasm (polyp or adenoma). It develops from epithelial cells of the intestine, which spread to all neighboring organs. This diagnosis is mainly faced by older men and women (after 50 years).
The first symptoms of duodenal cancer do not manifest themselves. But over time, signs indicating stomach diseases begin to appear:

• belching and heartburn;
• loss of appetite;
• weakness and weight loss;
• pale skin;
• sleep disturbance and migraine.

The most obvious symptom indicating cancer is a dull and constant aching pain that is in no way related to eating. And as the tumor grows, all the symptoms only get worse.

Duodenitis

The inflammatory process that affects the mucous membrane of the duodenum is duodenitis. If inflammation occurs in the upper part of this organ, then the symptom
Atika resembles a disease such as an ulcer. But if it affects the lower parts of the intestine, then the symptoms are similar to pancreatitis. And men experience duodenitis more often than women. And on endoscopy, during inflammation, semolina syndrome can be observed.

The main symptoms of this disease include:

1. poor appetite and indigestion;
2. feeling of severe heaviness after eating;
3. vomiting and nausea with a certain frequency;
4. painful cramps in the center and upper abdomen;
5. feces mixed with blood;
6. flatulence and diarrhea;
7. general weakness of the body.

When duodenitis is combined with a duodenal ulcer, then the main and obvious symptom is severe pain, which manifests itself on an empty stomach. More details about Duodenitis in the video:

Nutrition during and after illness

Nutrition and treatment for duodenal ulcers are inextricably linked. Only then does therapy give tangible results and speed up the healing process.

The basic principles of nutrition during the treatment period include:

• fractional meals up to six times a day;
• food is steamed or boiled;
• frying of food is excluded;
• You need to chew food slowly and thoroughly;
• salt intake should be limited;
• spices, garlic and seasonings are completely removed from the diet;
• Dishes should be warm, not cold or hot.

You need to exclude from the main menu products that irritate the mucous membrane of the duodenum. These are spicy and salty foods, carbonated drinks, fast food, sour fruits, which create an alkaline reaction in the environment. Prohibited products also include:

1. smoked and fatty meats;
2. store-bought semi-finished products, including dumplings;
3. rich broths and lard;
4. yeast-based baked goods;
5. raw vegetables, especially tomatoes and cabbage;
6. coffee and strong tea;
7. mushrooms and seeds;
8. sweets and confectionery;
9. citrus fruits and pomegranate;
10. alcohol, including beer.

During treatment of duodenal ulcers, the diet should consist of such approved foods as:

• dairy, chicken and vegetable soups;
• porridge with water and milk;
• white bread and lean meat;
• mineral water;
• low fat cheese;
• skim milk and cottage cheese;
• eggs only boiled;
• vegetables and fruits that have undergone heat treatment and do not cause gas formation;
• honey and fiber.

Bananas can be eaten during remission, but during an exacerbation they are removed from the diet. You need to be careful with pearl barley, millet and corn porridge. You can add cinnamon and vanillin to dishes. When the disease becomes moderate and all signs disappear, dried fruits such as prunes, dried apricots and dates are allowed. But during the period of acute illness they are prohibited.

For duodenal bulb ulcers, treatment table 1, 5 is prescribed. Subsequently, when the symptoms of the disease are eliminated, it is necessary to continue to adhere to the recommended diet. You can consume dairy products, but fermented milk products, such as kefir, are better with minimal fat content. And it’s better if it’s one-day. Yogurt is allowed, but only low-fat.

Fruits and berries should be sweet and are best consumed in the form of jam or puree. It is better to stew vegetables and take those that do not irritate the mucous membrane. But you should give up sauerkraut. It is better to replace this vegetable with cauliflower; it is also useful to include pumpkin in the menu: read.

You should drink a lot of water, jelly and fruit drinks, compotes and decoctions of medicinal herbs that have anti-ulcer properties. Instead of coffee, it is recommended to drink chicory, but not in its pure form, but as part of other healthy preparations. You can have green and clarified tea.

Prevention

In order not to again provoke an exacerbation of the duodenal ulcer, which becomes healed within 21 days, you need to give up such bad habits as smoking and drinking alcoholic beverages. Then questions about how many people live with this disease will not arise.

You also need to follow the basics of proper nutrition and avoid foods that irritate the mucous membrane. Persimmon is very useful during this period, as it reduces the likelihood of bleeding.

You need to regularly visit the dentist and try to reduce the negative effects of stress on your own body. You should play sports without excessive stress. Such prevention will reduce the risk of repeated relapses and relieve unpleasant symptoms.

Expert opinion Tsigalov M.M. Doctor - gastroenterologist, Barnaul. The most important and valuable thing is your health. In order to prevent such unpleasant and sometimes scary diagnoses, you should lead a healthy lifestyle and adhere to simple rules, namely: eat evenly throughout the day: 3 main meals and 2 snacks, drink clean water, lead an active lifestyle and not yourself with nervous breakdowns. These simple rules will allow you to live without disease. Well, if you have already felt unpleasant symptoms, then you need to conduct an examination without delay. Stay healthy.