Pyloric stenosis: how to cure this dangerous complication of peptic ulcer. Symptoms and treatment of pyloric stenosis

Symptoms of pyloric stenosis are quite characteristic. With them, due to scarring in the pyloric canal, but most often, in the initial part duodenum evacuation occurs.

In such patients, after a period of severe pain and the manifestation of the entire symptom complex of peptic ulcer, a painless period begins, characterized by strong belching and late vomiting. food taken lingers in the stomach, and its remains are found in the vomit, although the patient ate the day before or even a few days ago. After eating, patients complain of a feeling of nausea, fullness in the epigastric region; these complaints can be very intense at times.

After vomiting, the distension of the stomach stops and the patients get relief from this, which is why such patients often induce vomiting artificially by inserting fingers into the mouth. When researching gastric juice high acidity is not always determined, but hypersecretion is usually detected quite clearly. The remainder in the study according to Leporsky reaches 100 ml or more.

Clinical examination of patients with symptoms of pyloric stenosis allows them to detect clear gastric peristalsis, clearly visible through the abdominal integument, usually thinned from weight loss. With fluoroscopy, even without a contrast suspension, a symptom of stenosis is detected in the form of an accumulation of a large amount of fluid in the stomach even before eating. The barium suspension, taken in separate portions, falls through this liquid to the bottom of the gastric cup, forming a horizontal level, above which the liquid is visible.

Usually in such patients, the contrast mass remains in the stomach for many hours, sometimes even days. It should be borne in mind that with a sharp pylorospasm, the same delay in gastric contents is possible, but to exclude it, it is necessary to carry out atropinization. During the healing of an ulcer located in the initial part of the duodenum, a stretch is sometimes formed between the site of the narrowing of the intestine and the pylorus bottom wall intestines in the form of a diverticulum, which is always recognized by the experienced. Due to malnutrition in patients with stenosing ulcers, very often there is a sharp emaciation and loss of strength.

Another cause of stenosis of the pylorus of the stomach is the compression of the digestive tube by an infiltrate that forms around the "blooming" ulcer, near the pylorus or in the initial part of the duodenum. Clinically, this form of symptoms of pyloric stenosis is characterized by the fact that it appears during acute attack typical peptic ulcer and decreases after the subsidence of the pain symptom complex. Quite often at such patients narrowing does not come at all, and passability of the gatekeeper is restored. When observations are described complete cure therapeutic means for radiologically established pyloric stenosis, then we must think about the possibility mentioned above.

The article was prepared and edited by: surgeon

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stenosis is called a decrease in the lumen of a hollow organ. Narrowing or stricture is observed for a long time and spontaneously eliminated.

The reasons

Stricture can be congenital or acquired.
Causes of acquired stenosis:
  • Neoplasms
  • Violation of metabolic processes
  • Inflammatory diseases.

arterial stenosis

Stenosis carotid artery is a consequence of thrombosis or atherosclerotic changes in the vessels and very often causes a stroke.

Diagnostics:

  • Can be detected by listening to the carotid artery with a stethoscope
  • Ultrasound examination
  • Angiography
  • Magnetic resonance angiography.
Symptoms:
Often it is asymptomatic. Can cause ischemic attacks: unilateral deterioration of vision, memory, speech, motor function on the affected side. Violation lasts short period time ( no longer than 20 minutes) and in 60 minutes all signs of malaise disappear.

Larynx in children

Stenosis of the larynx - a decrease in the internal diameter of the larynx, expressed to a greater or lesser extent and impairs the movement of air during inspiration.
The stricture of the larynx can develop in acute or chronic form.
The acute form is characterized by a sudden onset and can cause suffocation.
The chronic form develops over a long period, the patient's health deteriorates slowly.

The reasons:

  • Children's infectious diseases
  • Neoplasms of the larynx
  • Entry into the larynx of foreign objects.
Symptoms:
  • The patient's breathing is difficult
  • Cough that resembles barking dogs
  • Voice becomes hoarse
  • The skin turns pale and takes on a blue tint
  • The patient feels unwell.
Most often acute form develops in dark time days.

Treatment:

  • Immediate call for an ambulance
  • Prior to her arrival, create high humidity in the room
  • Give warm tea
  • Get a foot and hand massage
  • Treatment is carried out only in the hospital.

Vertebrate

Chronic disease in which spinal canal gradually decreases in diameter. This is a very common disease that in most cases develops after the age of 50 and, on average, makes up about 6% of the population of this age.
Stricture spinal column may be central or lateral.

Central- the gap between the back of the vertebrae and the spinous process narrows.
Lateral- reduction of the lumen of the radicular canal, as well as the intervertebral foramen.

Causes of the disease:

  • Deforming spondylarthrosis
  • Hypertrophy of the yellow ligament
  • Spondylolisthesis
Symptoms:
  • Pain while walking
  • Pain may disappear during bending or squatting
  • Pain in the legs or only one leg
  • Weakness of the lower limbs.
Treatment:
  • Medicines: analgesics, anti-inflammatory, improving the condition of blood vessels.
  • Operational intervention.

Degenerative

The degenerative form of stenosis can develop on any hollow organ. But most often in this form the stricture of the spinal canal occurs.

There are three forms of this disease:

  • supravalvular ( only congenital)
  • valve
  • Subvalvular.
Factors causing acquired aortic stenosis:
  • Atherosclerosis of the aorta
  • Rheumatism of the valve leaflets
  • Infectious endocarditis
  • Degenerative processes of valves.
There is an idiopathic variety of the disease, the causes of which cannot be found.

Symptoms:
The first stages proceed without obvious signs. When the mouth of the valve is strongly blocked, the following appear:

  • Fainting or dizziness when bending over, standing up
  • Choking ( in especially neglected forms)
  • puffiness
  • Discomfort in the liver.
Diagnostics:
  • Cardiac catheterization.

Mitral

With mitral stenosis, the opening between the left ventricle and the left atrium decreases. In this way, arterial blood from the right atrium cannot normally pass into the left.
Causes, symptoms of the disease are similar to the aortic form.

Pulmonary

The prevalence of this disease is 10% of total number birth defects hearts. Lumen reduction pulmonary artery leads to an increase in pressure in the right ventricle, the heart muscle becomes thicker, the duration of blood evacuation increases.
At small degree narrowing of the artery, the child can develop on a par with peers without any ailments. But with a more pronounced degree, almost immediately, after the birth of the baby, a blue nasolabial triangle, nails, and lips are observed. In addition, there are phenomena of heart failure.

Treatment of severe pulmonary stenosis is surgical and should be done as soon as possible. Otherwise, the lethality of the disease is 50% in the first year of life of children.
In some cases, when medium degree disease severity surgical intervention carried out at the age of 5 - 10 years. With a weak severity of the disease, you can completely do without surgery.

Stomach and duodenum

Most often, stenosis is observed at the exit of the stomach into the duodenum in the so-called pylorus. Stenosis of the stomach occurs in an organic form or functional.


With organic form the lumen decreases due to the appearance of scars after scarring of ulcers.
With a functional form the lumen decreases due to swelling of the intestinal walls or spasm of the pylorus muscles. A common complication of an ulcer that can be eliminated with medication.

Stages of pyloric stenosis:
1 stage – compensated. The decrease in the clearance is weakly expressed, but the movement of food masses worsens. Therefore, the walls of the stomach thicken, the motor function of the stomach is activated. The patient complains about sour taste in the mouth, eructations, feeling of indigestion of food.

2 stage – subcompensated. After eating, vomiting is observed, the patient begins to feel better after vomiting. The feeling of fullness in the stomach is so strong that some patients resort to artificial vomiting. The stomach hurts even after a meager meal.

3 stage – decompensation. The motor function of the stomach weakens, the degree of narrowing of the pyloric lumen increases. Vomiting is becoming more frequent. The patient eats poorly, loses weight to the point of exhaustion.
Treatment this disease surgical.

Esophagus

Reducing the internal diameter of the esophagus. It happens "malignant", provoked by the growth of a malignant neoplasm and "benign", caused by other factors.
This is a fairly common occurrence, which is observed in most diseases of the esophagus.

Causes of benign stenosis of the esophagus:

  • Peptic ulcer of the esophagus at the stage of scarring
  • Reflux esophagitis in erosive and ulcerative form
  • Hernia esophageal opening diaphragm
  • Alcoholic gastritis
  • hysterical vomiting
  • Calculous cholecystitis
  • Complication after surgery
  • Burn by chemicals
  • Esophageal injury.
Most often, peptic strictures of the esophagus develop in people over 50 years of age.

Signs:

  • Unpleasant sensations in the chest area when eating hard food
  • Vomiting after eating hard or poorly ground food in the mouth
  • Belching
  • Slimming.
Diagnostics:
  • X-ray with contrast agents barium pills).
    • Esophagoscopy.
Treatment:
Nutrition correction, bougienage, use astringent preparations, surgical intervention.

ulcerative

Ulcerative stenosis is cicatricial ( narrowing occurs due to an increase in the volume of connective fibers) and cicatricial ulcer ( the walls of the digestive tract become inflamed and swollen).
The cicatricial form cannot be cured with the help of drugs, while the cicatricial-ulcerative form is corrected with the help of drugs. Although in most cases surgical treatment is prescribed.
The operation for this form is usually a resection of the stomach or a vagotomy with the installation of a drain. The second type of operation is used if the patient is weakened and may not withstand resection.

Diet for stomach stenosis

It is very important to choose the right diet for a patient suffering from stricture of the stomach or digestive organs. Recommended therapeutic diet №1 .
The amount of carbohydrate food is reduced to 300 - 350 grams per day, and the level of proteins and lipids in the diet is higher than usual. From carbohydrates, starchy foods should be preferred.
For a day, the weight of food should not be more than two kilograms. It is very important to endure required amount calories ( 2800 - 3000 kcal).

Preference should be given to dishes of mashed fish and meat. Reduce the level of cereals, pastries, potatoes in the diet. You should completely abandon fresh pastries, rye bread, broths from fish or meat, borscht, cabbage soup, fatty meat, canned meat, smoked meats, salted fish, hard cheeses, sour products from milk, fried eggs, corn, barley, millet, peas, beans, cabbage, radishes, cucumbers, onions, sorrel, rutabagas, vegetable pickles, marinades, mushrooms, sour fruits, chocolate, ice cream, whole raw fruits ( only available as a puree), kvass, black coffee.
Multiplicity of food intake 5 - 6 times a day.

Nasolacrimal canal

Stenosis of the nasolacrimal canal is an anomaly in the structure of the outlet canal, which in most cases is a consequence of chronic inflammation outlet channels. There is also a congenital form of stricture.

Therapy:
On the early stages conservative treatment: washing the ducts with solutions of anti-inflammatory and analgesic drugs ( hydrocortisone, dicaine, novocaine). Duration from 5 to 7 procedures.
If a conservative method is ineffective, a silicone tube is inserted into the canal, after which surgical intervention is prescribed.

renal artery

Renal artery stenosis causes a deterioration in the movement of blood through the main renal blood flow and is the cause of the development of hypertension.
Most often, this disease develops against the background of atherosclerosis. Representatives of the stronger sex over 50 years of age are more susceptible to this disease.

The reasons:

  • Fibromuscular dysplasia
  • Atherosclerosis
  • congenital form of the disease renal artery aneurysm).
Symptoms:
  • A sharp and persistent increase in pressure against the background of benign arterial hypertension
  • Heaviness and feeling of a rush of blood to the head
  • Discomfort in the eyes
  • Nervousness
  • spots before the eyes
  • Dyspnea
  • Weakness of the muscles.
Diagnostics:
  • Excretory urography
  • X-ray using radioisotopes
  • Kidney scan
  • Kidney scintigraphy
  • Angiography with radiopaque.
Treatment:
  • medication with antihypertensive drugs ( e.g. captopril)
  • surgical intervention
  • balloon dilatation.

vagina

The most common cause of vaginal stenosis is inflammatory diseases, acid burns ( vinegar, citric acid) or alkalis ( baking soda). Burns most often occur when douching to prevent unwanted conception.

In addition, stenosis can develop after a rupture of an organ or against the background of its atrophy during menopause.
In vaginismus, the stricture of the vagina is often functional. It is not uncommon for a stricture to develop after surgery to create an artificial vagina.

Symptoms:

  • The lumen of the vagina narrows
  • Copulation causes pain.
Diagnostics:
Examination by a gynecologist.

Treatment carried out with the help of antispasmodics, novocaine blockades.
If the stricture is secondary, it is necessary to eliminate the primary disease.
In some cases, surgery is prescribed.

Treatment of vascular stenosis

The most progressive technique for the treatment of vascular stenosis today is stenting . The procedure consists in the fact that an expanding mechanism is inserted into the affected area of ​​the vessel, in the open form having the shape of a tube. The stent is opened only directly in the affected vessel, returning it to its normal internal thickness. For the operation, a special catheter is inserted into the femoral vein, through which a stent is inserted into the right place.

The procedure is painless and many patients go home a day after the operation. During the recovery period, you must carefully follow all the rules prescribed by the doctor and use a number of medications.
This method treats the stricture of carotid and renal arteries.
With damage to the renal arteries, stenting is possible if the narrowing is located not far from the aorta. Otherwise, a surgical operation is prescribed to excise the site of the lesion. Sometimes it is necessary to deliver a fragment of the femoral artery instead of the affected area of ​​the artery.
If strictures renal vessels are multiple, and the function of the organ is lost, the kidney is taken away.

Prevention

Larynx
Try to avoid contact with patients with acute respiratory diseases (ORZ) and the flu. Avoid contact with food allergens. Feed your child whole foods.

spinal canal
1. Special gymnastics to strengthen the muscles that support the spine. The complex should be selected taking into account age and individual characteristics. You shouldn't be overburdened right away. Useful walking, classes in the pool, yoga.
2. It is very important to maintain the correct position of the spine both during movement and during rest. If you hold your back incorrectly, then no exercises will help and may even worsen the condition.

mitral valve
You can prevent this disease by preventing the development of streptococcal infection in the body, as well as rheumatism. Patients already suffering from rheumatism should visit the doctor regularly and carefully follow all recommendations.

To prevent the development of pyloric stenosis today, unfortunately, is not yet possible.

Before use, you should consult with a specialist.

It is a condition in which the region of the stomach and duodenum is affected, and its alternative name is pyloric stenosis. The disease is formed due to narrowing of the outlet of the gastric pylorus. As a result, all this provokes a violation of the passage of food from the stomach into the intestinal cavity. The presented disease, in its advanced form, is the cause of the formation of a variety of diseases, characterized by a change in homeostasis.

Reasons for the development of stenosis

Pyloric stenosis develops under the influence of the healing of such scars that have formed after a peptic ulcer. As you know, the scar includes, mainly, connective tissue, which makes it inactive, and therefore its formation tightens the walls of the stomach.

Another factor is the presence of cancer. inner walls in the region of the stomach and duodenum. malignant neoplasm begins to grow into the tissue, which most positively affects the reduction of the hole through which food enters the intestinal area. To aid in the evacuation of the contents, the gastric muscles grow, thereby compensating for the stenosis. However, after a while this is not enough and the food penetrating into the stomach stretches it. In the presented area, it stagnates, begins to rot, fermentation processes start.

Thus, the reasons that pylorus stenosis has formed are more than obvious and characteristic. In order to better understand exactly how the treatment should be carried out and how the symptoms will manifest, it is strongly recommended to pay attention to the stages of the development of the process.

Stages of the disease

Represented pathological condition characterized by three successive stages development. Speaking about the first stage, I would like to draw attention to the fact that in this case pyloric stenosis manifests itself very slightly.

In this case, the opening between the stomach and the intestinal area remains slightly closed.

The patient is faced with complaints of a feeling of fullness in the stomach after eating.

At the second stage, we can say that the compensation stage is accompanied by a constant feeling of fullness in the stomach. In turn, the symptoms of this are pain and belching. After eating food, the patient develops vomiting, which can alleviate problematic sensations. There is a steady weight loss, which directly indicates that treatment is necessary.

Speaking of the third stage, it is important to consider that the period of decompensation provokes the progression of the disease. The stomach of the patient in this case is stretched - this happens when accompanied by dehydration and exhaustion. In addition, symptoms may be associated with vomiting, which is characterized by bad smell . At the same time, even the remains of previously consumed food for several days can be identified. More details about what are the symptoms that characterize pyloric stenosis will be discussed later.

Symptoms of pyloric stenosis

It is necessary to pay attention to the symptoms of the condition, which differs depending on the specific type of disease. With a compensated variety of the disease, it is identified slight narrowing muscles of the stomach. The patient is faced with overcrowding of the stomach, heartburn. In addition, it is important to consider that infrequently manifested vomiting brings relief, until next use food eliminates all discomfort. It is also important to understand that the symptoms of the condition can progress slowly over several months.

In the case of a subcompensated type of illness, attention should be paid to frequent and profuse vomiting, which save the patient from discomfort in the region of the stomach.

Treatment in this case is certainly necessary, but I would like to pay attention to the following symptoms:

  1. belching rotten foods that have been consumed by a person before;
  2. occurrence pain in ;
  3. expansion of the stomach, a violation of its transport functions, which can be determined solely with the help of an x-ray.

The symptoms indicated here, with which pyloric stenosis is associated, can continue in a patient for two years. Further, I would like to draw attention to the decompensated type of the disease, which is associated with serious violations of the evacuation functions of the gastrointestinal tract. Quite often, decompensation is a symptom of peptic ulcer disease.. In addition, thirst is formed due to the steady loss of fluid after vomiting.

The patient's skin changes, which turns out to be flabby, and facial features take on a sharp appearance. When carrying out surveys, it turns out to identify the aggravation of propulsive functions, a significant amount of food. Before starting treatment, after all the symptoms have been studied and established, it is strongly recommended to take care of the diagnosis. This is what will make it possible to confirm such a diagnosis as the walls of the pylorus of the stomach.

Diagnostic measures

The disease can be identified with the help of some instrumental measures. It's about about an X-ray study, which makes it possible to determine whether there is an increase in the organ, a decrease in the activity of peristalsis, and other characteristics.

In addition, it is with the help of X-rays that possible definition the period of time that is necessary for the evacuation of food into the region of the duodenum 12.

The next diagnostic method is esophagogastroduodenoscopy. It demonstrates at what stage the narrowing algorithm is, how expanded the organ is. All this relates directly to the work of the stomach and duodenum 12. Next, I would like to draw attention to the importance of monitoring motor functions. This is provided by electrogastroenterography, which allows specialists to determine the tone, degree of activity and other characteristics of peristaltic movements when eating and on an empty stomach.

Another stage of the diagnostic examination is ultrasound, which makes it possible to demonstrate not only the current state of the organ, but also its other features. In particular, the presence or absence of inflammatory processes, the treatment of which is necessary. I would like to talk further about what it should be like if stenosis of the pylorus of the stomach has formed.

Treatment Methods

Treatment involves the implementation surgical operation at the same time certain conservative measures can be taken. In this case, we are talking about the use medicinal components, which is aimed at treating the main manifestations of the disease, preparing for surgery and correcting pathologies that are associated with water or electrolyte metabolism. Not less than milestone should be considered normalization weight class human to optimize all life processes.

If stenosis is detected at the compensated stage, it is permissible to use such drugs that are aimed at eliminating the inflammatory state, fighting the ulcer. It is also necessary to take funds that restore the motility of the stomach and intestines. In this case, we are talking about prokinetics, which, in the vast majority of cases, make it possible to exclude the main symptoms of the disease, completely eliminate them.

In some clinical cases, experts insist on such a method of treatment as endoscopy. We are talking about inflating the previously narrowed hole between the stomach and duodenum 12.

This is done with the help of a balloon, which ultimately leads to the cessation of the functioning of the pyloric valve, but restores the previous degree of patency.

In some cases similar interference is contraindicated, and may also simply not have a chance of success. If treatment and surgery are still necessary, then experts insist on intervention. open type. It is important to pay attention to the significant choice various types operations and their minimum degree of trauma. That is why they are evaluated by experts as the most effective when it is necessary to cure a disease such as pyloric stenosis.

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    1. Can cancer be prevented?
    The occurrence of a disease such as cancer depends on many factors. No one can be completely safe. But everyone can significantly reduce the chances of a malignant tumor.

    2. How does smoking affect the development of cancer?
    Absolutely, categorically ban yourself from smoking. This truth is already tired of everyone. But quitting smoking reduces the risk of developing all types of cancer. Smoking is associated with 30% of deaths from oncological diseases. In Russia, lung tumors kill more people than tumors of all other organs.
    Eliminate tobacco from your life - the best prevention. Even if you smoke not a pack a day, but only half, the risk of lung cancer is already reduced by 27%, as the American Medical Association found.

    3. Does excess weight affect the development of cancer?
    Keep your eyes on the scales! Extra pounds will affect not only the waist. The American Institute for Cancer Research has found that obesity contributes to the development of tumors in the esophagus, kidneys, and gallbladder. The fact is that adipose tissue serves not only to save energy reserves, it also has a secretory function: fat produces proteins that affect the development of a chronic inflammatory process in the body. And oncological diseases just appear against the background of inflammation. In Russia, 26% of all cancer cases are associated with obesity.

    4. Does exercise help reduce the risk of cancer?
    Set aside at least half an hour a week for exercise. Sports are on the same level as proper nutrition when it comes to cancer prevention. In the US, a third of all deaths are attributed to the fact that patients did not follow any diet and did not pay attention to physical education. The American Cancer Society recommends exercising 150 minutes a week at a moderate pace or half as much but more vigorously. However, a study published in the journal Nutrition and Cancer in 2010 proves that even 30 minutes is enough to reduce the risk of breast cancer (which affects one in eight women in the world) by 35%.

    5.How does alcohol affect cancer cells?
    Less alcohol! Alcohol is blamed for causing tumors in the mouth, larynx, liver, rectum, and mammary glands. Ethanol decomposes in the body to acetaldehyde, which then, under the action of enzymes, passes into acetic acid. Acetaldehyde is the strongest carcinogen. Alcohol is especially harmful to women, as it stimulates the production of estrogen - hormones that affect the growth of breast tissue. Excess estrogen leads to the formation of breast tumors, which means that every extra sip of alcohol increases the risk of getting sick.

    6. Which cabbage helps fight cancer?
    Love broccoli. Vegetables are not only included in healthy diet They also help fight cancer. This is also why recommendations for healthy eating contain the rule: half daily ration should be fruits and vegetables. Especially useful are cruciferous vegetables, which contain glucosinolates - substances that, when processed, acquire anti-cancer properties. These vegetables include cabbage: ordinary white cabbage, Brussels sprouts and broccoli.

    7. Which organ cancer is affected by red meat?
    The more vegetables you eat, the less red meat you put on your plate. Studies have confirmed that people who eat more than 500 grams of red meat per week have a higher risk of developing colon cancer.

    8. Which of the proposed remedies protect against skin cancer?
    Stock up on sunscreen! Women aged 18-36 are particularly susceptible to melanoma, the deadliest form of skin cancer. In Russia, in just 10 years, the incidence of melanoma has increased by 26%, world statistics show an even greater increase. Both artificial tanning equipment and the sun's rays are blamed for this. The danger can be minimized with a simple tube sunscreen. A study published in the Journal of Clinical Oncology in 2010 confirmed that people who regularly apply a special cream get melanoma half as often as those who neglect such cosmetics.
    The cream should be chosen with a protection factor SPF 15, apply it even in winter and even in cloudy weather (the procedure should turn into the same habit as brushing your teeth), and also do not expose yourself to the sun's rays from 10 to 16 hours.

    9. Do you think stress affects the development of cancer?
    By itself, stress does not cause cancer, but it weakens the entire body and creates conditions for the development of this disease. Research has shown that constant worry alters the activity of the immune cells responsible for turning on the fight-and-flight mechanism. As a result, a large amount of cortisol, monocytes and neutrophils, which are responsible for inflammatory processes, constantly circulate in the blood. And as already mentioned, chronic inflammatory processes can lead to the formation of cancer cells.

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Pyloric stenosis is an area of ​​study in gastroenterology and surgery. Stenosis results from various diseases mucous tissues of the stomach, but a common cause is precisely the ulcerative lesion of the walls of the organ. Stenosis or narrowing of the pylorus provokes severe violations in digestive processes, leads to a change in hemostasis, prevents the normal flow of water and food into the stomach. When especially severe cases patients cannot even swallow their own saliva. Pathology requires adequate timely treatment to rule out life-threatening conditions.

Anatomical location of the stomach

The nature of the pathology

The pylorus (from lat. Pylorus) is a kind of valve in gastric cavity, which is localized at the site of transition of the organ into the duodenum. Its structure consists of layers of circular muscle fibers in the form of a sphincter ring. The sphincter is responsible for closing and opening the lumen. The gatekeeper himself performs a delimiting function, which consists in separating acid environment from alkaline in departments small intestine. Such a mechanism of differentiation is necessary to exclude the backflow of gastric juice into the stomach cavity (otherwise, reflux) and its entry into the mucous structures of the duodenum.

narrowing of the lumen

Narrowing or stenosis of the pylorus is formed due to the occurrence ulcerative lesion near its lumen. Otherwise, the disease is called pyloric stenosis. Pyloric stenosis is represented by a lesion of the pyloric part of the gastric cavity in the area of ​​the inlet part of the organ with cicatricial changes in its tissues.

The disease can equally occur in adults and children, but the causes of occurrence vary significantly. normal work pylorus is provided by vegetative nervous system. With developing pyloric stenosis, the sphincter of the inlet of the stomach is not able to contract and relax normally, which is due to the absence of scarred tissue contractility. As a result of the pathology, the movement of food is disturbed, so it remains in the stomach cavity for a long time.

Important! Pyloric stenosis should be distinguished from pylorospasm. If in the first case the nature of occurrence is associated with an irreversible transformation normal tissue into a pathologically altered one, then in the second reason there is a functional decrease muscle tone.

Etiological factors

In adult patients, pyloric stenosis is an acquired pathology, when, as in children, the narrowing of the pyloric lumen is formed even in the perinatal period. The nature of the occurrence of pyloric stenosis comes down to two main reasons:

  • cicatricial changes (transformations contribute to the reduction or complete loss of stomach mobility);
  • intracellular cancer (characterized by deep germination of an oncogenic tumor in the walls of the stomach, narrowing the digestive lumen).

Scars appear on the mucous tissues of the stomach after a aggravated peptic ulcer or during its long course. Cancers formed under the influence various factors including hereditary predisposition. To indirect reasons development of gastric stenosis include:

  • lack of diet;
  • monotonous low-quality food;
  • the systematic use of alcohol, smoking;
  • long-term drug treatment;
  • long mono-diets;
  • malignant tumors.

Important! healthy eating implies compliance with the regimen and a certain number of daily servings. With a burdened gastroenterological history, observe correct image life is necessary to exclude the chronicity of certain diseases.

Classification and general features

Symptomatic manifestations of pathology depend on the degree of development of the disease and its type. The classification of pyloric stenosis fully determines the symptoms of pyloric stenosis.

Compensated stage

The compensatory stage of the disease is expressed in a slight narrowing of the muscles of the gastric cavity. Among the main features are the following:

  • feeling of a full stomach;
  • vomiting followed by relief.

X-ray diagnostics for this stage is informative method research, allows you to determine the acceleration of gastric peristalsis along with inhibition of emptying processes. With a compensated type, the disease can last for about several years.

Subcompensated stage

The patient's body partially copes with the disease, directing all resources to eliminate the defect. Stenosis becomes more pronounced and is manifested by the following symptoms:

  • constant belching with an unpleasant odor;
  • vomiting of yesterday's food.

The definition of subcompensated stenosis type allows x-ray with a contrast agent. contrast agent(barium solution) remains in the stomach from several hours to a day, which directly indicates a significant violation of the evacuation function of the stomach and intestines. The condition can last for about 2.5 years.

Decompensated stage

Represents last stage pyloric stenosis, which is characterized severe violations in work digestive system. Often the symptoms at this stage are similar to stomach ulcers. The main symptoms include:

  • persistent heaviness in the stomach;
  • nausea and vomiting;
  • dry mouth and desire to drink;
  • flabbiness and dryness of the skin;
  • sharp facial features;
  • manifestation of gastric tissues in the epigastric region.

On palpation, the absence of peristaltic waves is determined, the splash sound is clearly expressed. X-ray reveals a significant accumulation of food in the stomach, a decrease in pulsation in the stomach.

Important! With regular vomiting, dehydration and electrolyte imbalance often develop. This can lead to hypochloremic coma or death of the patient.

Features of the course in children

Pyloric stenosis in children in almost 80% of all cases refers to congenital pathologies pyloric part of the stomach. With congenital stenosis, there is a significant proliferation of the tissue component close to the excretory section of the organ. Pyloric stenosis becomes the main cause intestinal obstruction in newborns. Pathology is more typical for boys. The first symptoms of the disease occur on the 14th-30th day of life. little patient. a clear sign violations is profuse gushing vomiting some time after the next feeding. Episodes of vomiting per day can reach 10 times. The masses have an unpleasant odor, the consistency resembles curdled milk. Sometimes in the composition of vomit are determined bloody patches, brown lumps. With severe electrolyte disturbances in infants, convulsions are possible. Treatment of narrowing of the pylorus involves only surgical intervention. Forecast at timely detection pyloric stenosis in children is almost always favorable.

Important! Dehydration child's body develops much faster, therefore, with disturbing profuse regurgitation, hospitalization in specialized departments is necessary. The quick reaction of parents helps to endure this difficult period for the baby with the least loss to health.

Diagnostics

Stomach and duodenum

Differential diagnosis is aimed at excluding other pathologies of the esophagus and different parts of the stomach, life-threatening conditions and malignant tumors. Conduct the following studies:

  • x-ray with a contrast agent;
  • esophagogastroduodenoscopy to determine the exact size of the stomach, the place of narrowing and expansion;
  • electrogastroenterography to study the motility of the gastric cavity and its contractility;
  • Ultrasound of the pelvic organs (effective for late stages pyloric stenosis).

Apart from instrumental research order blood tests for enzymes and biochemical parameters, analysis of feces and urine (if necessary). The doctor conducts visual inspection patient, palpates the peritoneum, iliac region and lower abdomen. The final diagnosis is based on the patient's clinical history, complaints of anxiety, and examination findings.

Treatment tactics

Adequate treatment of pyloric stenosis is surgery. Correction of the pathology with medications is possible in the early stages of stenosis, but more like relief general well-being and preparation for the next operation. Conservative therapy aimed to:

  • elimination of metabolic disorders;
  • normalization of body weight;
  • treatment of causative diseases.

Elimination of the inflammatory process in ulcerative foci helps to improve patency in the duodenum, up to its complete recovery. The operation to eliminate advanced forms of pyloric stenosis has many options. Modern surgery virtually eliminates abdominal operations on the epigastric organs, giving preference to minimally invasive endoscopic techniques. After surgery, the risk of recurrence is extremely small, especially if all doctor's recommendations are followed and healthy lifestyle life.

Important! Treatment of pyloric stenosis folk remedies as monotherapy will be ineffective and even dangerous. ethnoscience more effective in the postoperative period or with the simultaneous use of medications for early stage ailment.

Prevention and prognosis

A protective regimen and a proper diet are the main measures to exclude pyloric stenosis in adults. Aggressive foods should be excluded from the diet (carbonated water, sour, salty, spicy, fatty), tobacco, alcoholic drinks any fortress. The diet should be rich in vitamins, fiber, minerals and enzymes. It is necessary to eat fractionally, in small portions several times a day. Sports, active lifestyle and good mood is an integral part of therapeutic treatment.

Healthy eating for pyloric stenosis

Pyloric stenosis or pyloric stenosis is a disease digestive tract which is a complication of recurrent chronic ulcers, with scarring of which there is a decrease in the patency of the canal of the pylorus of the stomach.

  • gurgling in the stomach,
  • putrid smell from the mouth,
  • nausea,
  • vomit,

As a result of the accumulation of food masses in the stomach and a decrease in the muscle tone of its walls, over time, a violation of all types of metabolism (salts, carbohydrates, proteins, fats) occurs, which leads to exhaustion.

Diagnosis of stenosis of the pylorus of the stomach

Since pyloric stenosis can be caused by tumors of the stomach, in order to find out, it is necessary to perform a gastroscopy. The final diagnosis of stenosis of the pylorus of the stomach is carried out using x-ray examination. Previously, the stomach is completely freed from food masses.

As a diagnosis, studies will be shown:

  • general blood analysis;
  • x-ray examination;
  • esophagogastroduodenoscopy;
  • electrogastroenterography;

Causes of pyloric stenosis

Pyloric stenosis is usually caused by scarring of an ulcer that occurs at the beginning of the duodenum or in the pyloric canal. Around the ulcer, due to swelling and inflammation of nearby tissues, there is a significant narrowing of the pylorus. If the peptic ulcer is not treated properly, then scarring occurs, which narrows the pyloric lumen and leads to pyloric stenosis. Pyloric stenosis can also be caused by stomach cancer.

Treatment of pyloric stenosis

Pyloric stenosis is usually treated in a hospital. The patient is prescribed drugs that stimulate the healing of the ulcer and suppress the secretion of stomach acid. Its secret and contents are regularly sucked out of the stomach. After two or three days, the patient is given water to drink and the condition of the pylorus is examined. With a sufficiently wide opening of the pylorus, the patient is allowed to eat a little. In especially severe cases, surgery is indicated.

Before surgery, antiulcer therapy, normalization general condition patient and the electrolyte composition of his blood.

With pain in the stomach, it is not recommended to self-medicate, since pain accompanied by vomiting is often a symptom of a duodenal ulcer or stomach ulcer. peptic ulcer at an early stage can be cured with drug treatment, psychosomatic therapy and diet.

Regardless of the stage, pyloric stenosis is successfully treated. However, treatment can be complicated by the exhaustion of the patient's body due to prolonged fasting. In most cases, the success of treatment depends on the patient himself. If he strictly follows the instructions of the doctor, then he has a chance for a full recovery.

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