Duodenal Ulcer

Duodenal ulcer is a chronic, cyclical disease with the formation of ulcers during periods of exacerbation. An ulcer is a defect in the intestinal mucosa (and sometimes the underlying tissue), the healing processes of which are disrupted or significantly slowed down.

Peptic ulcer disease occurs in people of any age; it is observed in 5% of the adult population, and urban residents suffer from this disease more often than rural residents. In men of working age (25-50 years), peptic ulcer disease occurs 6-7 times more often than in women. But in old age, the disease occurs with almost equal frequency in representatives of both sexes.

Causes

The causes and mechanism of development of the disease, despite numerous clinical and experimental studies, still remain unclear.

The main manifestation of peptic ulcer disease - a defect in the wall of the duodenum - occurs as a result of the digestive effects of gastric juice. Under normal conditions, the mucous membrane of this section is resistant to its action, and only in the presence of factors that reduce the resistance of the mucosa, or when the digestive properties of the juice itself are enhanced, or when both conditions are combined, does “self-digestion” of the mucosa occur and an ulcer forms.

Based on numerous studies, the main and predisposing factors for the development of duodenal ulcer have now been identified.

The main factors are:

1. Disruption of the nervous mechanisms that regulate digestion due to negative emotions, mental and physical stress, acute or chronic mental trauma, closed head injuries, etc.

2. Disturbances of the hormonal mechanisms regulating digestion of the pituitary gland - adrenal gland system.

3. Local trophic disorders in the duodenal mucosa.

4. Chronic lesions of the mucous membrane (duodenitis).

The central place in the mechanism of development of peptic ulcer belongs to disorders of the nervous system, as well as dysfunction of the endocrine glands (including the pituitary gland and adrenal glands) - the main regulators of the digestive system. As a result, local regulatory mechanisms are also disrupted: the intensity of the production of digestive hormones changes, the mucosal barrier is disrupted, the restoration of the mucosa is inhibited and its restructuring is observed, blood circulation in the wall of the duodenum and motor function are affected.

In recent years, it has been revealed that in the mechanism of development of duodenal ulcer, an increase in the action of aggressive factors (high activity of gastric juice) is more important than a decrease in the protective properties of the mucous membrane.

Predisposing factors include:

1. complicated heredity (peptic ulcer disease in close relatives is detected in 15-40% of cases);

2. eating disorder;

3. fast, hasty food;

4. the predominance of easily digestible carbohydrates in the diet;

5. excessive consumption of spicy, rough, irritating foods;

6. consumption of strong alcoholic drinks and their surrogates;

7. smoking.

The above predisposing reasons cause increased secretion, and over time (in the presence of underlying factors) ulceration.

Symptoms

Manifestations of peptic ulcer disease are diverse; their differences are related to the age, gender and general condition of the patient’s body, the duration of the disease, the frequency of exacerbations, the presence or absence of complications.

The most characteristic of peptic ulcer disease is a triad of symptoms: pain, vomiting and bleeding, accompanied by the appearance of blood in the vomit or stool.

Pain is the leading symptom of peptic ulcer disease. It is characterized by periodicity, seasonality, increasing character, close connection with food intake, disappearance or decrease