Diseases of the esophagus, stomach and duodenum

Diseases of the esophagus, stomach and duodenum


Pathologies of the esophagus, stomach and duodenum play a leading role in diseases of the gastrointestinal tract. This directly affects the quality of life of patients.

Disturbances in the work of the esophagus are mainly associated with malfunctions of its motor function. The cause of pathologies of the stomach, esophagus, duodenum is most often the activity of bacteria (Helicobacter pylori), inflammatory processes, congenital features of the body, neoplasms.

Symptoms
Diseases of the esophagus are characterized by the following symptoms:

chest pain
difficulty swallowing
heartburn,
nausea,
belching.
Often the clinical picture is similar to the manifestations of pathologies of other systems – respiratory, cardiovascular (dry cough, shortness of breath, chest pain, shortness of breath).

If these symptoms appear, you should consult a gastroenterologist-hepatologist!

For chronic diseases of the stomach and duodenum, the characteristic symptoms will be pain in the epigastric region (epigastric region). As a rule, they are associated with food intake. The pathology of the stomach is characterized by the appearance of pain 15-20 minutes after eating. They last for several hours and may go away on their own. In diseases of the duodenum, pain begins 1.5-2 hours after eating.

With the development of tumors, pain syndrome is expressed in different ways: it can be associated with or not associated with food. The development of malignant tumors of the stomach is characterized by pain outside the connection with food (“hungry” pains, pain at night). Appetite is lost, pronounced weight loss occurs. Disgust for previously favorite dishes appears. Sometimes – belching of undigested food.

Classification
Diseases of the esophagus
Among the diseases of the esophagus, the most common gastroesophageal reflux disease, tumors, manifestations of pathology of other organs and systems.

Gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) is a failure of the motor and evacuation functions of the esophagus. With these violations, there is a systematic reflux of food from the stomach into the esophageal canal. This causes damage to the mucous membrane of the lower esophagus. As a result, dystrophic changes develop in it, which provokes many complications. The reasons for the development of GERD are a decrease in the tone of the lower sphincter of the esophageal tube, a decrease in the peristalsis of the esophageal canal, and a change in the composition of gastric juice.

There are non-erosive and erosive forms. A complication of the erosive form is the so-called Barrett’s esophagus.

The erosive form of GERD occurs as a result of systematic damage to the esophageal mucosa. Gastric acids gradually erode the membrane. It is clinically manifested by heartburn, which is aggravated by overeating, the intake of fatty, fried foods, and alcohol. Dysphagia is a characteristic symptom.

It is difficult to swallow food and liquids. Liquid food is difficult, solid does not cause difficulties. The occurrence of heartburn is also affected by the position of the body: bending, lying after eating.

Barrett’s esophagus
Barrett’s esophagus is a pathological process during which the cells of the mucous membrane of the esophagus are replaced by intestinal-type epithelium. It occurs as a reaction to regular exposure to acids in the contents of the stomach during reflux. As a result, the risk of developing cancer of the esophageal canal increases dramatically. Symptoms – heartburn, belching, burning sensation and pain behind the breastbone, dry cough, a feeling of disturbed heart function.

Neoplasms and tumors of the esophagus
Neoplasms are manifested symptomatically by vomiting, impaired swallowing. Benign tumors are rare, presented by leiomyoma, polyps, diverticula.

Malignant tumors are more common. The clinical picture remains unclear only at the onset of the disease. In the future, progressive pain when swallowing, belching, increased salivation is characteristic. Dysphagia manifests itself first in the difficulty in swallowing solid food, then liquid, until the complete cessation of food intake.

Diseases of the stomach
Diseases of the stomach are often mildly symptomatic. These include gastritis, peptic ulcer disease, neoplasms. The leading role in the appearance of gastritis, ulcers, and stomach cancer is the Helicobacter pylori bacterium. It contributes to the disruption of the protective properties of the gastric mucosa with the development of inflammation. As a result, it is destroyed by aggressive factors of gastric juice. The provoking factors are stress, a violation of the diet (overeating, starvation), bad habits, the use of foods with a strong effect (coffee, strong tea, drugs, alcohol, spicy and fatty foods).

Gastritis
Gastritis is an inflammatory process in the stomach lining. Often, the acute form becomes chronic. Symptoms are upper abdominal pain, heartburn, nausea, flatulence, belching, bitterness in the mouth, stool disorders.

Peptic ulcer
Stomach ulcer is often caused by Helicobacter pylori bacteria. Sometimes the appearance is associated with uncontrolled intake of anti-inflammatory drugs. Symptoms are pain associated with food. Pain syndrome can appear 30 minutes after eating, sometimes “hungry” pains appear.

The ulcer can be asymptomatic or with mild symptoms in the initial stages. The danger is that gastric ulcers without treatment with asymptomatic course can cause severe complications – stomach cancer, ulcer bleeding, ulcer perforation, penetration and perforation of the ulcer. Such conditions often require urgent surgical care due to the threat to the patient’s life.

In view of the danger of developing difficult situations that require urgent surgical intervention, patients with an established ulcer are recommended to stay close to the points of medical care.

Neoplasms and tumors of the stomach
Gastric neoplasms are common, benign tumors occupy no more than 4% in the diagnosis. They are mainly represented by polyps. As a rule, they are asymptomatic. Sometimes they are manifested by heartburn, aching pain after eating, dizziness and stool disorders.

Malignant neoplasms are diagnosed more often. The main factors are chronic H. pylori infection and chronic peptic ulcer disease without treatment. In the early stages, it is manifested by a decrease in appetite, a perversion of taste – aversion to previously loved food, weight loss. In the later stages, vomiting of yesterday’s food joins, severe pain syndrome, stool with blood.

Diseases of the duodenum
Diseases of the duodenum are most often diagnosed in the form of duodenitis, duodenal ulcers.

Duodenitis
Duodenitis is an inflammatory process in the transitional part of the duodenum. It is manifested by nausea, vomiting, weakness, spasms. The reasons are Helicobacter pylori, provoking factors – unhealthy diet, bad habits (smoking, alcoholism).

Duodenal ulcer
Peptic ulcer of the duodenum is a chronic disease that gives relapses with a pronounced seasonality. An ulcer appears as a result of the activity of Helicobacter pylori infection, uncontrolled intake of non-steroidal anti-inflammatory drugs. During the period of remission, the course of the disease is asymptomatic. Clinical manifestations become apparent during an exacerbation. These include “hunger pains” that are eliminated after eating. A symptom of an ulcer will also be severe acute pain at night, belching, heartburn. Complications of the lack of treatment for duodenal ulcers are bleeding, perforation with peritonitis, stenosis. Complications require urgent surgical intervention.

Diagnostics
The diagnostic basis for the identification and differentiation of diseases of the gastrointestinal tract allows you to make a diagnosis quite accurately.

Laboratory research methods. Establish anemia, which may indicate bleeding. Confirms the presence of Helicobacter pylori. According to the results of the study of gastric juice, the functional state of the gastric mucosa is assessed.
Fibrogastroduodenoscopy (FGDS) gives a detailed picture of the state of the stomach lining. Identifies small tumors, early stages of malignant tumors, ulcers. An informative method with which you can do a biopsy to clarify the nature of the disease.
Fluoroscopy is an additional method to FGDS that diagnoses gastric and duodenal ulcers. X-ray examination reveals a picture of stenosis, helps to see motility and evacuation through the stomach and duodenum;
Ultrasound examination of the abdominal organs is an additional method in some cases.
Treatment

Treatment is prescribed by a gastroenterologist individually for each patient!

Today’s methods allow to treat diseases of the esophagus, stomach and duodenum conservatively. Drug treatment and diet therapy in most cases give good results.

Treatment with medicines is aimed at suppressing the activity of Helicobacter pylori infection (taking antibiotics), normalizing motor function and acidity of gastric juice.

With the development of complications that occur in 25-30% of cases, surgical treatment is possible. It involves excision of ulcers, tumors, resection of a part of the stomach.

Diet therapy is an indispensable component in complex therapy, it is necessary for rest and stabilization of the gastrointestinal tract. Physiotherapy and spa treatment are also indicated for the treatment and prevention of relapse.

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