Duodenal reflux. Provoking factors for the development of the disease. Plants for peristalsis

Not always getting the contents of the duodenum into the lumen of the stomach can be considered a disease: many experts are convinced that healthy people physiological duodeno gastric reflux occurs without negative impact on the body (this condition is present mainly at night).

Clinical manifestations develop with regular, long-term duodenogastric reflux. This causes a change in acidity in the stomach, leading to damage to its mucous membrane and indigestion. All of these disorders contribute to the onset of symptoms.

- companion of many diseases gastrointestinal tract, however, in a third of patients is independent disease and occurs with equal frequency in men and women.

Normal digestion in the upper gastrointestinal tract

Normally, food that has entered the stomach from the esophagus undergoes mechanical mixing and the stage of digestion under the influence of gastric juice, then enters the duodenum, where it is further processed by enzymes and acids that are produced by the liver and pancreas. Between the stomach and the duodenum of a person there is a border - the pyloric sphincter, the pylorus. Food saturated with gastric juice enters the pyloric section of the stomach, where hydrochloric acid irritates the receptors, which provokes the opening of the sphincter and the evacuation of the food bolus. Along with this, there is a contraction of the muscles of the stomach, as a result of which the contents in portions pass into the lumen of the duodenum. The acidic food bolus changes the acidity in the duodenum, and the pylorus closes, preventing food from being thrown back into the stomach.

The etiology of the development of duodenogastric reflux

Throwing the contents of the duodenum into the lumen of the stomach occurs due to the presence of the following conditions:

• insufficiency of the pyloric part of the stomach;
• increased pressure in the duodenum;
• chronic inflammatory processes in the duodenum (duodenitis);
• slowing down the evacuation of food from the stomach and / or duodenum.

The main conditions that can provoke the occurrence of these pathological changes:

• smoking:
• pregnancy;
• malnutrition:
• alcohol abuse;
• obesity;
• wearing belts and tight clothing;
• surgical interventions on the stomach, biliary tract, gallbladder, pancreas or duodenum;
• sharp and chronic pathologies digestive tract;
• uncontrolled intake of some medicines(blockers calcium channels, non-steroidal anti-inflammatory drugs).

What happens in the digestive tract during duodenogastric reflux?

Under the influence of various pathological factors the harmonious digestive process in the stomach and duodenum is disturbed.

When the contents of the duodenum enter the cavity of the stomach, the mucous membrane of the latter is damaged under the influence of aggressive substances. Enzymes and acids synthesized by the liver and pancreas are able to dissolve the protective slime layer lining the stomach from the inside, and the gastric epithelium becomes vulnerable to the effects of hydrochloric acid. Inflammation occurs, which, with regular duodenogastric reflux, becomes chronic. In some cases, duodenogastric reflux may provoke the development of gastroesophageal reflux disease or be combined with it.

Clinical manifestations

The main symptoms most common in duodenogastric reflux:

• bitter taste in the mouth;
• belching air or food;
• pain in the stomach;
• nausea, vomiting of bile;
• heaviness, feeling of fullness in the epigastrium;
• yellowish coating on the tongue;
• heartburn;
• dry cough;
• hoarseness of voice (in rare cases- its loss);
• bloating (flatulence);
• pain when food passes through the esophagus.

Duodenogastric reflux can long time not be accompanied by the development of symptoms.

Complications

Prolonged and / or intense negative impact of the duodeno gastric reflux on the digestive system can cause the development of the following pathological conditions:

• gastroesophageal reflux disease - the reflux of gastric contents into the final section of the esophagus (in turn, leading to the occurrence of other serious complications- peptic ulcers of the esophagus, Barrett's syndrome, strictures of the esophagus, bleeding from ulcers of the esophagus, adenocarcinoma of the esophagus);
• chronic gastritis (toxic-chemical gastritis type C).

1. Fibrogastroduodenoscopy. Using this method, you can detect the presence of bile in the stomach, signs, esophagitis, erosion, ulcers and any pathological changes caused by duodenogastric reflux.
2. Plain radiography of the stomach and duodenum after contrasting. Defines esophageal opening diaphragms, tumor formations, strictures of the esophagus and so on.
3. pH meter(including daily). Used to detect changes in acidity in the esophagus, stomach, helps to assess the duration and number of duodenogastric refluxes.
4. Manometry. Used to assess motility and peristalsis upper divisions digestive tract.
5. Ultrasound examination of the liver, biliary system, pancreas and so on.

Medical treatment

Drugs prescribed for the treatment of DRG:

1. Inhibitors proton pump (Pariet, Losek, Nolpaza, Lancid, Nexium) and H2-histamine receptor blockers (Ranitidine, Famotidine). They are prescribed to reduce the production of hydrochloric acid.
2. Prokinetics(Motilium, Cerucal). Accelerate the transition of the food bolus from the stomach to the duodenum and improve digestion, stop nausea, vomiting, discomfort and heaviness in the stomach.
3. Ursodeoxycholic acid preparations(Choludexan, Livodex, Ursofalk, Urdoksa, Ursosan). They bind and neutralize bile acids, preventing their negative impact on the inner lining of the stomach and esophagus.
4. Sorbents(Enterosgel, Polysorb, Smekta). Contribute to the neutralization and removal of enzymes and acids from the digestive tract.
5. Antispasmodics(Trimedat, No-shpa). Normalize motility and peristalsis of the gastrointestinal tract, relieve discomfort and pain.
6. Antacids(Gaviscon, Gastal, Maalox, Rennie). The preparations protect the stomach and esophagus from the damaging effects of hydrochloric and bile acids and enzymes.

Influencing the factor that caused the development of duodenogastric reflux (lifestyle change) is one of key points treatment.

Lifestyle Modification

Lifestyle interventions:

• weight control, maintenance normal weight body;
• strict adherence to diet and diet;
• quitting smoking and drinking alcohol;
• wearing loose clothing, avoiding tight belts, belts;
• the use of medicines only as prescribed by the doctor;
• timely treatment for any disease of the digestive tract.

Diet for duodenogastric reflux

• eat small meals, preferably 5-6 times a day, avoiding overeating and long time intervals between meals;
• do not eat at night (a light meal is allowed three hours before bedtime);
• all food should be warm;
• do not lie down after eating;
• exclude physical activity, inclinations of the torso after eating (optimally - sit quietly, keeping the torso in an upright position).

Special attention should be paid to food preparation and food selection:

Conclusion

With conscientious observance by the patient of all the recommendations of the doctor, the prognosis of the course of the disease is predominantly favorable. Sometimes there are "neglected" cases, the presence of which is explained by the late application for medical care or / and ignoring the doctor's advice about lifestyle changes and adherence to drug therapy. The development of complications is also more often a consequence untimely treatment and the patient's inattention to their own health.

What is this disease? Duodeno gastric reflux appears against the background of gastritis, pancreatitis, ulcers, duodenitis. Also, this disease can appear if a person has undergone surgery on the stomach.

Symptoms

This is a disease in which the contents of the duodenum are thrown into the stomach cavity. Symptoms of the disease are expressed as follows:

plaque on the tongue (yellow);

pain in the abdomen. Causes of pain: activity of the biliary tract and intestines, which leads to spasm;

heartburn (discomfort, burning behind the sternum). In some people, this can be expressed by a feeling of warmth, pressure, fullness in the abdomen. Heartburn occurs with any acidity, but most often with hyperacidity;

belching (ingestion of food from the stomach into the mouth). There is an arbitrary eructation and involuntary. Belching is accompanied by the release of sound and the release of air (from the mouth).

What complications does duodeno gastric reflux cause?

A person suffering from duodeno gastric reflux for a long time may develop a very severe complication. It:

chemical-toxic gastritis (type C),

reflux gastritis,

gastroesophageal reflux disease,

Symptoms and treatment of duodeno gastric reflux of a complicated form. The disease leads to the formation of an ulcer. A mixture of bile with pancreatic juice is an aggressive environment that destroys the mucous barrier of the stomach. At the same time, over time, duodeno gastric reflux causes metaplasia of the gastric epithelium. In addition, lysolecithin is formed, which has a toxic effect on the mucous membrane, gradually damaging it.

Diagnostics

This disease can be detected only by examination (comprehensive):

ultrasound examination abdominal cavity;

determination of the degree of acidity. This is very important, as it will allow a specialist to install accurate diagnosis, and to what extent the disease is expressed;

conduct electrogastroenterography;

treatment of the disease can only be prescribed by a specialist, based on the result confirmed by the examination.

Treatment

Treatment of duodeno gastric reflux should be prescribed by a specialist - a gastroenterologist. Treatment this disease will be aimed at normalizing the proper functioning of the organs - the stomach and duodenum. The specialist also prescribes a certain diet, in which everything fried, spicy and fatty is excluded.

To treat reflux, you need to neutralize the effect of bile acid on the mucous membranes of the stomach, oral cavity, because bile has a very irritant effect. In addition, it is necessary to achieve accelerated emptying using medications, and you also need to increase the tone of the esophageal sphincter.

Symptoms and treatment of duodeno gastric reflux chronic form. Usually prescribe drugs from the group of prokinetics. Perhaps doctors will prescribe Metoclopramide, Domperidone, but for a short continuous period, that is, a maximum of three weeks. negative moment Such therapy may be called the fact that after cessation of therapy, the symptoms of reflux may resume.

Complex treatment should consist of inhibitor drugs, if the disease is accompanied by increased level acidity. This group of drugs is able to neutralize the aggressive effect of acid on the mucous membrane. In this case, it is recommended to give preference to representatives of the latest generation, for example, the drug Pantoprazole. It has a minimal side effect, is approved for use by pregnant women, as it is safe for health.

Home Care Tips

So that you are not tormented by the symptoms of the disease, perform a few useful tips:

eat more often, but little by little;

mouth treatment of duodeno gastric reflux rest more and sleep on your right side;

follow the regime;

spend more time in the air - this will ensure excellent digestion;

make a decoction of herbs (St. John's wort). Pour boiling water over one tablespoon (tablespoon) of St. John's wort. Let it brew for half an hour. Drink half a glass before meals (30 minutes). Drink this decoction for two weeks.

It is recommended to increase, as much as possible, walks and stays on fresh air(calm step), try not to get nervous over trifles. But, everyone knows that all diseases come from nerves. Better smile, and then everything will be fine!

Using these tips, you will feel much better, the symptoms of the disease will appear much less.

healthy diet

Almost every 5th person has a disease such as gastritis. For some, it manifests itself in a more pronounced form (pain, spasms, nausea, etc.), for someone to a lesser extent. If left untreated, gastritis can lead to a disease such as duodeno-gastric reflux. The main component of the treatment of this disease is diet. It is also important in disease prevention.

Apart from drug treatment It is important to maintain a certain diet. And this means that it is necessary to exclude from the diet: fried, spicy, fatty, citrus fruits, chocolate, cocoa, tomato, garlic. The following is recommended for the treatment of duodeno gastric reflux by specialists:

vegetarian soups, low fat meat broths;

vegetable and fruit salads;

include in your menu - bran;

low-fat cottage cheese;

juice, mineral water, yogurt.

The diet for duodeno-gastric reflux is generally accepted for the gastrointestinal tract, that is, it has not yet been fully developed, but there are a number of useful advice, the implementation of which facilitates the course of the disease and prevents the development of complications. Here are some of these recommendations:

frequent fractional meals in compliance with the diet: 3 main meals with duodeno-gastric reflux and 2-3 "light" between them;

food with duodeno-gastric reflux should be easily digestible;

avoid overeating;

food with symptoms of duodeno gastric reflux should be thoroughly chewed;

during "snacks" in the diet with duodeno-gastric reflux, it is better to use crackers, crackers, cookies, bran, which contribute to the excretion of bile.

Nutrition rules

Contributes to the effectiveness of the diet for duodeno-gastric reflux following the rules

do not take after meals horizontal position not less than 1 hour;

do not allow for symptoms of duodeno gastric reflux physical activity for at least 1 hour after eating (especially those associated with bending, muscle tension abdominals);

do not wear tight clothing and belts, so as not to increase intra-abdominal pressure;

frequent outdoor walks active image life;

smoking cessation as common cause duodeno-gastric reflux.

Sample menu for the diagnosis of duodeno gastric reflux

The diet provides:

avoid eating salty, spicy, fatty, smoked and fried foods;

exclude from the diet: citrus fruits, tomatoes, fresh bread, coffee, chocolate, garlic, onions and other foods that reduce the tone of the pyloric sphincter;

avoid in the diet with duodeno gastric reflux products that increase the acidity of gastric juice - for example, cabbage, apples;

use bran, contributing to the symptoms of duodeno-gastric reflux, the normalization of the composition of bile;

mineral water courses rich in magnesium(for example, donation).

Diet for a complicated form of the disease

Since the occurrence of reflux is often due to pathological conditions such as gastritis or peptic ulcer, with duodeno-gastric reflux, the diet should be combined with the diets provided for this pathology. In this case, the above recommendations are added:

“gentle” cooking: food should not be hot or cold, mashed soups, pureed cereals are recommended;

lean meats and fish;

avoid acidic foods (including fermented milk products), acidic juices;

from dairy products in the diet with symptoms of duodeno-gastric reflux, it is recommended: milk, non-acidic sour cream and yogurt, fresh cottage cheese;

avoid sour fruits, berries.

Full list products allowed or not allowed in the diet for duodeno gastric reflux (table No. 2) and peptic ulcer(table number 1) can be checked with your doctor.

Do not forget that the treatment of duodeno gastric reflux should be comprehensive. First of all, you need to buy pathological condition, which led to its occurrence, otherwise, even with proper nutrition, duodeno-gastric reflux will occur again. Therefore, along with a diet for duodeno-gastric reflux and performing general recommendations various drugs are shown, the doses and course of which are selected by a qualified specialist individually for each patient, depending on the etiology of the disease that led to the occurrence of reflux.

Causes of the disease

Why does duodeno gastric reflux occur? As you know, duodeno gastric reflux is a consequence of many common diseases of the stomach and esophagus. Duodeno gastric reflux can be observed in chronic gastritis, ulcers and duodenal ulcers. In addition, this type of reflux is considered the main cause of the development of chemical gastritis, or as it is popularly called type "C" gastritis.

The bottom line is that with duodeno-gastric reflux, the normal, normal movement of bile is disrupted. The bile accumulated in the duodenum is thrown back into the stomach, which should not happen. At the same time, once in the stomach, bile and enzymes (digestive) cause irritation of the mucous membrane. The cause of the disease is a dysfunction of the pylorus.

Provoking factors

Pyloric dysfunction is caused by the following factors:

chronic duodenitis;

more high pressure(higher than normal) in the duodenum.

It also happens that bile, from the duodenum getting into the stomach, remains there. There is a so-called burn of the stomach (mucous membrane). After all, the mucous membrane is not able to resist such active and aggressive enzymes. Therefore, there is a duodeno-gastric reflux. There are cases of "high" duodeno-gastric reflux. In this variant, bile goes not only to the stomach, but also to oral cavity. This is "high" reflux. In these cases, both the mucous membrane (shell) of the stomach and esophagus are damaged.

Video: Symptoms and treatment of duodeno gastric reflux

Duodenogastric reflux (DGR) is a syndrome associated with such diseases digestive system like gastritis, gastric ulcer, duodenitis. It manifests itself by throwing bile located in the duodenum into the stomach cavity.

As such, DGR has been found in about 50% of people. And only in 30% of cases is it an independent disease, and 15% of healthy people are not aware of its presence at all, since it is asymptomatic. In this case, duodenogastric reflux is not considered a disease.

Causes of DGR

Duodenogastric reflux occurs when duodenal patency is disturbed, as a result of which an increase in pressure occurs in the duodenum, and a weakening of the closing function of the pylorus occurs. The causes of this disease can be:

• smoking;
• dysbacteriosis and inflammation localized in the pancreas or gallbladder;
• loss of tone of the esophageal muscles that separate the stomach from the duodenum;
• hernia of the diaphragm;
• pregnancy;
• use to reduce muscle tone smooth muscle esophageal drugs.

With a long course of GHD, the gastric mucosa is damaged by pancreatic enzymes, bile acids, lysolecithin, and bile salts. This leads to the appearance of gastric ulcer, reflux gastritis, gastroesophageal reflux disease.

Symptoms of the disease

The symptoms of GHD are similar to other diseases of the digestive system, due to their interdependence. But this similarity is only superficial. The main symptoms of this disease are few:

• heartburn that occurs after eating;
• belching with ordinary air or with a taste of sourness;
• bloating after eating, a feeling of fullness;
• appearing after eating pain and spasmodic pain in the epigastric region;
• a bitter taste is felt in the mouth;
• feeling of nausea followed by possible vomiting bile;
• coating of the tongue with a yellow coating.

Often, when performing fibrogastroduodenoscopy (FGDS) to diagnose a third-party disease, the doctor can detect duodenogastric reflux in a patient. At the same time, the disease does not manifest itself in everyday life. In such cases, it is periodically activated during sleep or during certain physical activities. Wherein negative impact does not affect the patient's digestive system.

Diagnosis of the disease

For qualified specialist the diagnosis of this disease is not difficult, since the symptoms of the disease are very specific. If duodenogastric reflux is suspected, the patient is referred for such studies:

• fibrogastroduodenoscopy (FGDS);
• study of the acidity of the cardia of the stomach, the lower third of the esophagus, as well as the body of the stomach - daily pH-metry;
• Ultrasound of the abdominal organs;
• electrogastroenterography;
• radiography of the stomach, as well as the duodenum using a contrast agent.

A comprehensive study of acidity for a doctor is the most informative, as it allows you to accurately recognize the symptoms of GHD in a patient and the severity of the syndrome. For greater reliability, monitoring is carried out at night. This eliminates the effect on the acidity index of the medications and food taken. If the pH of the stomach rises to 3 units or more, then we can talk about the presence of GHD in a patient.

Conducting electrogastroenterography allows you to obtain information about the contractile function of the duodenum and stomach. But fibrogastroduodenoscopy is currently being used less frequently, since such a study can provoke duodenogastric reflux.

Treatment of the disease

The direction of the treatment of the disease is the organization of the proper functioning of the motility of the stomach, duodenum and the normalization of the binding of bile acids. To improve motor skills, the patient is usually prescribed "Trimedat". The action of the contents of the duodenum on the gastric mucosa is neutralized with Nexium and Omez preparations. For better assimilation food and activating its promotion along small intestine the doctor prescribes Domperidone or Cerucal. And to eliminate heartburn - "Almagel", "Phosphalugel" or "Gaviscon".

For successful treatment important proper diet. It is also necessary to change the diet: eat often, but in small portions; limit the consumption of "rough" food; exclude alcohol and smoking. Long leisurely walks in the open air are useful.

The diet for GHD is based on:

• exclusion from the diet of spicy, fried, salty and fatty foods;
• deletion from the diet of foods that reduce the tone of the pyloric sphincter: garlic, tomatoes, onions, chocolate, fresh bread, coffee, citrus, etc.;
• avoiding the use of cabbage and apples, as they contribute to an increase in the acidity of gastric juice;
• drinking magnesium-rich mineral water;
• the use of bran.

The diet for complication of GHD is somewhat different:

• it is allowed to eat low-fat fish and meat;
• you can use cottage cheese, yogurt, milk and non-sour sour cream;
• reception is contraindicated sour berries with fruits;
• do not eat acidic foods and juices;
• porridge should be well rubbed, and the soup should be crushed to a puree state.

Traditional medicine for DGR

Treatment of DGR with folk remedies often gives the same positive effect as well as medication. In addition, the frequency of manifestations side effects when it is carried out - much lower. The most famous folk remedies for the treatment of this disease are the following:

• brew St. John's wort, chamomile and yarrow, taken in any proportion, with boiling water and add to tea. You need to drink a decoction 2 times a day. It will relieve heartburn, relieve the symptoms of gastritis, minimize duodenogastric reflux, eliminate dysbacteriosis;
• 1 st. l. flaxseed is poured 100 ml cool water, infused until the seeds secrete mucus. Consume - on an empty stomach;
• 2 tbsp. l. dymyanka herbs in 500 ml of boiling water. Set aside for an hour, take 50 ml every 2 hours. Infusion of 2 tbsp. l. marshmallow roots per 500 ml of water, infused for 5-6 hours, taken in small portions throughout the day. Using these folk remedies, you can prevent bilious vomiting;
• effective folk remedies for the establishment of intestinal motility are rue leaves. They need to be chewed after eating 1-2 sheets;
• mix 50 g of sage and calamus root with 25 g of angelica root; 1 tsp mix pour 1 tbsp. boiling water, stand for 20 minutes. Drink 1 hour after eating 3 times a day.

Treatment of duodenogastric reflux is important to start on early stages. The benefits of folk remedies therapy are undeniable, but it would be better to consult a doctor. This will determine the successful and speedy outcome of the disease. Folk remedies disease can be successfully prevented. And the right diet will ease the course of the disease.

Life modern man filled frequent stress, bad habits and disordered eating. All this leads to disruption of the normal functioning of internal organs. One of the consequences of an inattentive attitude to health is duodenogastric bile reflux. This disease brings a lot of inconvenience, accompanied by unpleasant symptoms that reduce the quality of human life. Having mastered necessary information about the causes and signs of reflux, you can determine its presence or, conversely, refute it.

Causes

The gastrointestinal tract is a conveyor belt from the oral cavity to the rectum. The traffic here is one-way. In some departments of this system, a reverse current is observed - reflux. Aggressive, opposite environments of the gastrointestinal tract mix, causing a number of other diseases, pain. Reasons for violation physiological process:

1. Taking medications, especially analgesics, antispasmodics that paralyze the muscles of the sphincters (valves). This begins the free flow of gastrointestinal fluid in all directions, which causes the disease.
2. Unhealthy diet: fried, fatty foods, animal products, coffee can provoke diseases of the stomach and esophagus.
3. Smoking, drinking alcohol adversely affects the stomach and the walls of the esophagus.
4. meal large portions stretches the stomach and causes reflux.

First signs and symptoms

Many people, feeling discomfort in the abdomen, are not aware of the development of such a dangerous disease as gastric dysrhythmias, what it is they learn at a doctor's appointment. Patients have the following symptoms:

• with reflux, persistent heartburn appears;
• with the disease, an increase in body temperature is noted, due to inflammatory processes in the stomach and esophagus;
• stomach pain accompanying reflux disease;
• with reflux, there is a decrease in appetite and a loss of pleasure from eating;
• with diseases of the stomach, blanching of the skin is noted;
• reflux stains the tongue yellow;
• reflux causes a sour or bitter taste in the mouth.

Diagnostics

If you have the above symptoms, you should definitely visit a doctor for timely diagnosis dgr stomach. It is impossible to ignore such a phenomenon as heartburn. If you let the disease take its course, then exacerbations can occur:

• reflux provokes ulcers in the walls of the stomach and esophagus;
• with a strong weakening of the valve in the esophagus, gastric fluid can penetrate into the lungs and bronchi, irritating them;
• Barrett's esophagus (precancerous condition), cancer of this organ.

At the appointment, the doctor will prescribe the following examinations:

1. Analyzes to determine the state of the stomach: blood, urine, feces.
2. Gastroscopy (swallowing a probe) is the most effective diagnostics, which allows you to see the presence of gastrointestinal reflux.
3. Fibrogastroscopy - histological analysis esophagus to determine the degree of complexity of the disease.

Treatment methods for duodenogastric reflux

When diagnosing DGR of the stomach on early stage, it is easily correctable. However, no treatment can change the sphincter. With such a condition, the patient must learn to live and adhere to the clear recommendations of doctors. The main measure that should be taken in the treatment of the disease is the adoption of measures to radically change lifestyle and nutrition.

Therapeutic diet

With reflux disease, a health-improving diet is prescribed, which is used for disorders of the duodenum, gastrointestinal tract, called table number 1. Rules for this diet:

1. With DGR of the stomach, thermally sparing food is needed: not hot and not cold.
2. In diseases of the stomach, you can not use spicy, sour and fatty foods.
3. If you are sick, you should not eat foods that relax the lower esophageal sphincter: sweet carbonated drinks, strong coffee, tea, sour citrus juices.
4. To eliminate the disease, it is necessary to abandon the products, bloating intestines: legumes, grapes, dairy products.
5. Reception mineral waters alleviates the situation initial stage disease or during its remission. In acute inflammatory processes in the stomach, they should not be consumed.
6. During the treatment of the disease, tea lovers should drink this drink with caution. It is allowed to use it chilled and not to combine with honey.
7. People prone to stomach diseases are recommended to eat at least four times a day in fractional portions.

Medical therapy

For the treatment of gastroduodenitis, many doctors prescribe drug therapy for the disease. Its duration is prescribed by the attending physician, but any treatment with drugs should not exceed one month. Reflux therapy consists of:

1. Antacids. The most famous: baking soda, "Almagel", tablets "Renny", "Gastal", "Maalox". These medicines neutralize the acid in the stomach, thereby relieving heartburn.
2. Prokinetics that stimulate the peristalsis of the gastrointestinal tract and prevent the disease: Motilak, Ganaton, Metoclopramide.
3. H2 blockers that minimize the amount of acid in the stomach: Cimetidine, Ranitidine, Famotidine.

Surgery

AT advanced cases when the patient's condition is accompanied not only by burning heartburn, but also by constant hiccups, patients cannot do without surgical intervention for treatment of dgr stomach. In modern conditions, the operation passes through punctures, due to which the following actions are performed:

1. The formation of a new valve from the tissues of the stomach, which prevents the reflux of gastric contents into the esophagus.
2. Restoration of the normal physiology of the stomach, which was before the disease.

Physiotherapy

To fix the result to the main treatment, doctors prescribe physical procedures. They are carried out with the help of high-frequency devices "Azor-IK" and "DiaDENS". The procedure is carried out in the morning, on an empty stomach. The course of treatment is from 10 to 20 sessions. When exposed through the skin, physiotherapy:

1. Affects pathological changes in the esophagus and stomach: it has a healing, anti-inflammatory effect.
2. It tones the muscles of the esophagus and stomach, thereby improving its work.
3. Increases blood circulation in the walls of the stomach, which triggers metabolic processes in the body.

Folk remedies

To alleviate the condition with reflux disease, many resort to folk ways. Herbalists successfully treat heartburn with the help of fees and tinctures:

1. Freshly squeezed yarrow juice (aloe) is taken in the amount of 1 tsp. before meals in diseases of the esophagus, stomach. This plant has antiseptic and antimicrobial action. Juice, falling on the walls of the esophagus, has an enveloping and analgesic effect.
2. To reduce the acidity of the stomach, it is recommended to take a decoction of flax seeds. For cooking, you need 2 tbsp. l. grains and 500 ml of water. It is necessary to weld over low heat until a sticky state appears. It is recommended to take chilled, before breakfast. The solution has a beneficial effect on the entire digestive tract, healing ulcers and erosion. In addition, flax is rich in vitamins and vegetable proteins necessary to maintain strength during therapeutic diet.
3. Herbal collection: chamomile (1 tablespoon), St. John's wort (1 tablespoon) pour boiling water (300 ml) and leave in a water bath. Take cooled 3 times a day half a cup before meals.

Disease prevention

Even after complete healing from duodenogastric reflux, you must constantly take care of your health, listen to the signals sent from inside and carry out prevention in order to avoid the recurrence of the disease. The preventive measures are:

1. Maintaining a stable weight. People who are prone to reflux disease are not allowed to dial overweight, because their presence increases intragastric pressure, predisposing to the release of acid into the esophagus.
2. Refuse fast food.
3. To prevent the disease, it is necessary to increase physical activity: accelerated walking, elementary daily exercise, morning running will make the metabolism work better, have a beneficial effect on the condition of the stomach, esophagus.

Find out what kind of disease, its symptoms and treatment.

Video about the disease gastroduodenal reflux

This video will be useful for those who periodically experience abdominal pain. After watching the video, you will find out what are the dangers of seemingly minor symptoms: heartburn, stomach pain. Experienced Doctors gastroenterologists will talk about such a disease as duodenogastric reflux, what it is. Learn about the errors in the treatment of gastritis. If you experience discomfort in digestive tract, then let this video be the impetus for visiting the doctor.

Duodeno-gastric reflux is a condition characterized by dysfunction of the upper parts of the digestive system. Has unpleasant symptoms and can lead to the development dangerous complications, so when pathological form reflux treatment should begin immediately. To detect the disease, laboratory and hardware methods are used.

Answering the question, gastroduodenal reflux, what it is, it should be understood that this condition is not always a pathology. Approximately 15% of the inhabitants of our planet face this problem. Pathological GHD is considered when there is a pronounced increase in the acidity of gastric contents, not associated with food intake. Reflux is observed in many diseases of the stomach and duodenum, but in 30% of cases the pathology is primary.

Causes and mechanism of development of pathology

The mechanism of development of duodeno-gastric reflux of bile includes the following disorders:

• narrowing of the lumen of the duodenum;
• increased pressure in the upper intestines;
• decrease in the tone of the pylorus of the stomach;
• throwing the contents of the duodenum into the stomach;
• the development of inflammatory processes in the mucous membranes of the upper parts of the digestive system.

Duodeno-gastric reflux occurs under the influence of such causes as:

• impaired motility of the stomach or intestines;
• endoscopic examination of the upper gastrointestinal tract;
• uncontrolled use of drugs (non-steroidal anti-inflammatory and choleretic drugs);
• organic lesions of the lower parts of the stomach, accompanied by a constant partial or complete opening of the sphincter;
• congenital malformations of the digestive system (DGR may occur due to improper formation of the digestive tube in the embryonic period);
• sharp and chronic diseases stomach, for the most part affecting lower divisions body;
• complications arising after surgical interventions in the lower sections of the stomach and duodenum.

Symptoms and diagnosis of the disease

The clinical picture of the disease includes:

1. Pain syndrome. Unpleasant sensations cover all upper part belly. They do not have a clear localization. The pains are spastic, paroxysmal in nature and of moderate severity. They appear some time after eating.
2. Signs of indigestion. Patients complain of bloating and increased gas formation. After eating, heartburn occurs, independent of the acidity of the gastric contents. Less commonly observed is belching with air and regurgitation (throwing food from the stomach into the esophagus and oral cavity).
3. Attacks of vomiting. The vomit contains a large number of bile.
4. Change in the nature of the stool. Against the background of impaired bowel function, constipation occurs, which is quickly replaced by diarrhea.
5. Bitter taste in the mouth. Associated with the appearance of thick yellow plaque in the language. The same reason explains the appearance bad smell from mouth.
6. Ulceration of the mucous membranes of the esophagus. Constant occurrence DGR of the stomach leads to the development of metaplasia (replacement of the healthy epithelium of the esophagus with intestinal), which is a precancerous condition.
7. Signs of liver damage. The organ increases in size, appear drawing pains in the right hypochondrium, skin the patient acquire a yellowish tint.

Diagnosis of the disease involves the use of the following methods:

1. Examination and questioning of the patient. Make a diagnosis for this stage impossible, however, during the consultation, the gastroenterologist identifies possible causes of the pathology, evaluates general state patient.
2. Esophagogastroduodenoscopy. By using special equipment the mucous membranes of the upper and middle sections of the gastrointestinal tract are examined. This makes it possible to distinguish reflux from erosive gastritis and peptic ulcer of the stomach.
3. Intragastric pH-metry. The method is aimed at identifying changes in the acidity of gastric contents that occur during the day.
4. Antroduodenal manometry. During the procedure, a violation of the motility of the stomach and duodenum, a decrease in the tone of the esophageal sphincter, is detected.
5. Analysis of the enzymatic composition of gastric juice. Used to determine the amount of pancreatic enzymes and bile acids.
6. Ultrasound of the abdominal organs. It is used to exclude other diseases of the digestive system ( acute inflammation pancreas, bile duct obstruction, cholelithiasis).

Treatment of GHD

With duodeno-gastric reflux, treatment involves the use of:

1. Means that normalize the motility of the stomach (Motilium). They prevent the stagnation of food masses in the stomach and their reflux into the esophagus.
2. Selective prokinetics (Itomed). Contribute normal course digestive processes, relieve nausea, reduce the frequency of vomiting attacks.
3. Bile acid inhibitors (Ursosana). Neutralize the irritating effect of bile, prevent ulceration of the mucous membranes of the stomach and esophagus.
4. Proton pump blockers (omeprazole). Reduce the production of hydrochloric acid, normalizing the acidity of gastric contents.
5. Antacids (Almagel, Rennie). Neutralize hydrochloric acid, relieve heartburn and sour belching.

If the occurrence of DGR is associated with a violation of the functions of the gatekeeper, conservative methods may turn out to be ineffective. In this case, doctors decide on the need for surgical intervention - pyloroplasty. With mild forms of reflux, folk remedies help to alleviate the condition:

1. Herbal collection of St. John's wort, chamomile and yarrow. Herbs are taken in equal parts, 1 tbsp. l. collection pour 200 ml of boiling water. The decoction is taken 100 ml 2 times a day. It helps to get rid of stomach pain, heartburn and nausea.
2. Flax-seed. 1 st. l. raw materials are poured into 100 ml of chilled water. The drug is infused until mucus is released. The medicine is taken on an empty stomach for 1 tbsp. l.
3. Infusion of fumes. 2 tbsp. l. herbs pour 0.5 liters of boiling water, insist 60 minutes. Take 50 ml before each meal.
4. Infusion of marshmallow. 2 tbsp. l. raw materials pour 0.5 liters of boiling water, insist 6-8 hours. Take in small sips throughout the day. The drug helps to prevent attacks of vomiting and normalize intestinal motility.
5. Rue leaves. 1-2 leaves are chewed before each meal. The herb helps to increase intestinal motility and improve digestion.
6. Infusion of sage, calamus root and angelica. Herbs are taken in a ratio of 2:2:1. 1 st. l. mixture pour 0.5 liters of boiling water, insist 20 minutes. Ready infusion is taken an hour after meals 3 times a day.

Forecast and prevention

Prevention of DGR includes:

• exclusion of overeating, which contributes to impaired intestinal motility;
• correct performance of endoscopic diagnostic procedures;
• reception medicines only on doctor's orders;
• performing exercises aimed at strengthening the abdominal muscles (help keep the stomach and intestines in the correct position).

At proper treatment the disease has a favorable prognosis. The chances of recovery decrease with the development of complications that cause severe violations functions of the gastrointestinal tract. Duodenum is switched off from digestion, because of which the patient is transferred to intravenous nutrition.