Bulbit stomach and duodenum: what is it, symptoms, treatment, diet

The tender mucous membrane of the gastrointestinal tract is daily exposed to the danger of being damaged by too sharp or hard, not enough crushed food, aggressive chemicals in food and medicine, alcohol, pathogens and other irritants. As a result of their negative impact on the mucosa, limited or diffuse foci of inflammation can form, on which erosions and ulcers subsequently form. If the inner surface of the stomach is affected, doctors diagnose gastritis, and if the mucosa of the duodenal ulcer is damaged, duodenitis is diagnosed. In the latter case, when the inflammation is localized only in the initial (bulbic, bulbar) section of the duodenum, gastroenterologists talk about the development of bulbite. Bulbit, in turn, is considered one of the most common varieties of duodenitis.

[1], [2]

Epidemiology

Among duodenal pathologies duodenitis is considered the most common disease. In turn, bulbitis is one of the most frequently diagnosed duodenitis, since in many cases it develops against a background of gastritis, the most common pathology of the gastrointestinal tract.

Ill with bulbitis can be at any age, because some pathologies that cause stagnation in the gastrointestinal tract and mucosal structure disorders, is genetically conditioned, which means that the process originates from the moment of birth of the baby is not light. Bulbit in children has the same causes and forms as in adults. Only the approach to treating the disease can differ.

With regard to sexual preferences, women in this plan are less fortunate than men. Most often, bulbits are diagnosed in women whose age is within 20-40 years.

Causes of the bulbite

The causes of the development of such an unpleasant pathology as bulbits are in many respects similar to the factors causing the appearance of one of the most frequently diagnosed diseases - gastritis. And this is not surprising, because the bulb of the duodenal ulcer is actually a continuation of the stomach turn (hence the unofficial name of the pathology - bulbot stomach).

The most popular cause of bulbitis, as in the case of gastritis, is the negative impact of bacterial infection. Helicobacter pylori, like any pathogenic microorganism, getting into the digestive tract can in a short time cause an inflammatory process in any of its departments, including bulbar.

But in order for Helicobacter pylori to take root and actively multiply in the stomach or duodenum (duodenum), it is necessary that the acidic medium is maintained there. Normally, the pancreas takes care of reducing the acidity of the contents of the stomach, going to the DPC, producing special substances - bicarbonates. If some kind of malfunction occurs in the gastrointestinal tract, food flavored with hydrochloric acid from the gastric juice, aggressive secrets of the liver and pancreas, necessary for digestion of food, get into the bulb of the DPC without correction of the acid level, and therefore, can irritate the mucosa, causing its inflammation and erosive processes on it.

Another fairly common cause of development of bulbitis are congestive events in the digestive tract. Hydrochloric acid and special enzymes, which are abundantly flavored with half-digested food coming into the PDK, begin to gradually eat away not only the food lump, but with its surrounding mucous, causing inflammatory-erosive processes in it. And to cause stagnation of food in the stomach and PDC can both weak intestinal peristalsis and congenital defects of the duodenum and intestines, which promote the formation of loops in them, where food stagnates.

There are also risk factors for the development of bulbits, which do not always cause the disease, but their presence makes the probability of the disease much higher. Here, for example, emotional lability and stressful situations leading to the exhaustion of the nervous system and provoking spasms of the vessels of various organs that disrupt the microcirculation of blood in them. This can cause vascular ruptures and hemorrhages in the bulb of the DPC, around which inflammation forms. In addition, stressful situations contribute to increased secretion of catecholamines, which are mediators of inflammatory reactions.

Bulbite can develop against a background of reduced immunity, which gives great opportunities for activating infectious and inflammatory processes. His appearance can contribute to a variety of severe diseases that reduce immunity and require the intake of medications that can have an irritant effect on the gastric mucosa. Acute bouts of bulbitis can provoke regular use of strong alcoholic beverages, antibiotic therapy, frequent intake of solid food (and even with chemical additives). The development of acute bulbitis is sometimes observed in dysentery and salmonellosis. Viral hepatitis of group A can also provoke a pathology.

Such pathologies as Crohn's disease, Zollinger-Ellison syndrome, hereditary celiac disease (atrophy of the intestinal mucosa), helminthic invasion, giardiasis, detection in the cavity of the DPC of a foreign body, abdominal surgery, overeating, disturbance of the regime and the nature of nutrition are considered not so common causes of the bulbitis. .

Pathogenesis

The above factors and pathologies can not but affect the condition of the mucosa of the bulb of the DPC. It can be damaged by external products and chemicals, as well as becoming a victim of digestive enzymes produced inside the body, or disturbance of metabolic processes in the tissues of the organ.

Bacterial infection also contributes to the development of bulbite, because not only irritates the mucosa of the duodenal by producing enzymes that cause inflammation, but also increases its sensitivity to the effects of other aggressive factors.

In principle, bulbitis can begin without the influence of Helicobacter pylori. After all, the increased acidity of the stomach, if not with it, will cause irritation and inflammation of not only the gastric mucosa, but also the bulb of the DPC, which is in the immediate vicinity of the pylorus. But whether Helicobacter pylori is included in this process depends largely on the state of immunity.

Immediate closeness of the stomach and PDC causes the inflammatory process to be thrown from the stomach into the bulb of the duodenum, and bulbits are diagnosed in most cases in parallel with gastritis. In other words, untreated gastritis can easily become a cause of development of bulbitis.

Factors such as the presence of bacterial infection and parasites in the body can not only cause the disease, but also give it a chronic course in the absence of proper therapy. But the exacerbation of bulbits, as a rule, is provoked by the use of alcohol and oral forms of drugs, the use of acute or solid foods, stressful situations.

Symptoms of the bulbite

Bulbit, as one of the diseases of the gastrointestinal tract, has a specific symptomatic characteristic of all these diseases. These are epigastric pains, a feeling of heaviness in the abdomen, nausea, sometimes with vomiting, dyspeptic phenomena (heartburn, belching, bloating), stool disorders. Patients suffer from a deterioration in appetite or, conversely, an irrepressible hunger, which causes them to eat until nausea appears.

It would seem that if the symptoms of inflammatory pathologies of the gastrointestinal tract are so similar, how can a doctor prescribe a diagnosis so that further research can lead in a particular direction? How to distinguish eye bulbits from the same gastritis with all the variety of its manifestations or ulcers of the stomach and the DPC?

In fact, the bulbite has a certain symptomatology, which helps the doctor to recognize the disease without conducting special studies. Not even the symptomatology itself, but the peculiarities of its manifestation.

So, the first signs of bulbitis are pain in the epigastric region. You can expect their appearance at any time of the day. Often patients complain that pain under the "spoon" tortures them at night. There is a pain syndrome, usually not immediately after a meal, and after 1,5-3 hours after it. Although, if not only inflammation appeared on the mucosa, but also erosion, the pain can manifest itself much earlier (15-20 minutes after eating) or appear on an empty stomach.

Characteristics of pain in the bulbite does not have certain indicators. At the very beginning of the disease, it can be minor aching pain with localization in the upper abdomen. However, later they begin to give in the right (rarely in the left) hypochondrium or concentrate in the navel area.

Patients complain of pain of a different nature. Some experience severe acute or paroxysmal pain, others have a more painful, non-expressive character. When the process is chronic, pain usually disappears altogether, it is possible to feel unpleasant sensations in the epigastrium only during palpation.

The rest of the symptoms of GIT pathologies can also manifest themselves in different ways and in different combinations. Not necessarily the presence of all the symptoms, because they largely depend on concomitant diseases. For example, with increased acidity of the gastric juice, the mandatory symptoms are heartburn and belching sour. And in other cases, heartburn may not be, but eructation will acquire a bitter taste. Some patients indicate bitterness in the mouth, which is not associated with food intake, others note, against a background of other symptoms, an unpleasant odor from the mouth, regardless of the condition of the teeth, the appearance of a plaque in a language indicating problems with digestion.

Symptomatic, characteristic of inflammatory pathologies of the digestive system, may appear after half an hour after eating. Although sometimes its appearance is noted much earlier or later.

Other symptoms may also be observed: weakness, headaches, dizziness, hyperhidrosis, trembling in the arms and throughout the body, diarrhea amid a disruption of the endocrine system and the excitation of the autonomic centers of the central nervous system, etc. Neurological symptoms are characteristic of a later period and appear a couple of hours after a meal.

[3]

Stages

Bulbit, like any inflammatory disease of the digestive tract, can occur in two forms: acute and chronic. This will also determine the symptoms of the disease.

Acute bulbitis occurs usually on the background of taking irritating food, alcohol, medicines. Sometimes it can provoke dysentery or salmonellosis.

Acute erosive bulbitis begins with a pain syndrome (pain can be acute and strong, giving back, or aching) that appears at night or on an empty stomach, and also a quarter of an hour after eating. When going to the ulcerative form or against the background of hemorrhagic bulbitis, the appearance of blood veins in the stool masses may be noted.

Chronic bulbitis is characterized mainly by the presence of neurological symptoms. Pain in chronic erosive bulbite is not expressed in nature and appears mainly at night. But in the absence of erosions, pain sensations are often absent at all (palpable only), limited to episodes of heaviness and raspiraniya in the abdomen. But there is a significant decrease in immunity, there are symptoms of chronic fatigue, against the background of hunger there is a shiver in the body and a strong weakness.

For the chronic course of the pathology, periods of exacerbation and remission are characteristic. Bulbit in the stage of remission may not manifest itself at all or be limited to attacks of heartburn and dyspepsia.

At the beginning of the disease, doctors usually diagnose bulbit 1 degree of activity. This suggests that the disease covers as yet only the upper layers of the mucosa of the DPC. There is scarring and hardening of mucosal tissues, which is not accompanied by a marked symptomatology. Sometimes there are weak pains in the epigastrium, heartburn, nausea, constipation.

While the patient does not have paroxysms of compressive or acute pains, which give in the back, like in pancreatitis, bitterness in the mouth and sour eructations, doctors suspect a moderate bulbitis. In this case, the patient shows signs of general malaise and unpleasant sensations in the abdomen.

When there are general symptoms of gastrointestinal pathologies and characteristic neurological symptoms, this indicates that the bulbit passes to the next stage. For the expressed bulbite is characterized by the appearance of symptoms of medium and high intensity, which requires more serious treatment with the use of pain medications.

[4]

Forms

Like popular gastritis, the inflammatory pathology of the onion bulb of the duodenum is called "bulbite" and there are many varieties, the most common of which is surface bulbite. This type of disease is not for nothing considered to be the easiest, because the deep layers of the mucosa of the DPC remain unaffected by inflammation and the symptomatology does not imply severe pain attacks and a marked deterioration in the general condition of the patient.

Symptoms of catarrhal bulbit are reduced to cramping pains in the abdomen, increased gas production, nausea, weakness. Sometimes on the basis of the disease, there may be attacks of headaches.

The diagnosis of "focal surface bulbitis" indicates that the inflammation does not cover the entire inner surface of the bulb of the DPC, but some of its areas. In this case, the symptomatology of the spilled and localized form of pathology has no special differences (except that the localization of pain may shift slightly).

An easy form of chronic inflammation is catarrhal bulbitis. Its symptoms are similar to manifestations of various pathologies of the duodenum, but even during an exacerbation the disease has no clearly expressed symptoms. Pain moderate spasmodic, sometimes nausea and stool disorders. If the inflammatory process has limited localization or several foci, the diagnosis will sound like a focal catarrhal bulbite.

The erythematous bulbite is said, if on the walls of the mucosa of WPC red patch spots are formed, strewn with small ulcers that tend to bleed, so that blood and vomit can be found in the feces and vomit. For focal erythematous bulbit, the appearance of limited red spots of oval shape, which can be located in different places of the bulb of DPC, is typical. It can be as one spot, and a little.

Most often, erythematous bulbitis develops as a result of the transition of the bacterial or inflammatory process from the stomach to the initial department of the PDC. The disease very often and quickly passes into a chronic form.

Erosive bulbitis - another common form of inflammation of the mucosa bulb DPC, characterized by a more severe course. At the same time on the inflamed mucosa can be seen shallow wounds (cracks, scratches), surrounded by a swollen tissue, gathering in creases.

The symptomatology of erosive bulbit is similar to its other species. But the pains appear a little earlier, after 1 or 2 hours after eating. Morning and night pains are quite intense. Nausea can be accompanied by vomiting and attacks of dizziness. There is heartburn and belching undigested food.

If ulcers are subsequently found on the wound site (deeper wounds that grab different layers of mucosa and tissues under it), causing severe painful syndrome both on an empty stomach and after eating, the bulbite is called erosive-ulcerative. In this case, there is a great danger of bleeding in the PDK, and then the stool and vomit are painted dark red or black.

Reflux-bulbit, by analogy with reflux gastritis, occurs if, due to some reasons, the contents of the duodenum (with gastritis-stomach) change the direction of movement to the opposite. In a normal state, food moves along the esophagus down to the stomach, and from there it gets into the PDK and the rest of the intestine. With reflux-bulbite, food can return to the stomach due to the weakness (reduced tone) of the sphincter located at its outlet. Symptoms of this pathology are similar to manifestations of the surface form of bulbite.

Granular bulbite is diagnosed when small red hillocks resembling grains are found on inflamed mucosa. In the diameter of the tubercle not more than 5 mm. At first, the disease may not remind itself of itself, but spreading further to other parts of the gastrointestinal tract, it acquires a pronounced symptomatology: pain occurs almost immediately after a meal, they are accompanied by nausea and vomiting.

Cicatricial bulb, or more precisely cicatrical and ulcerative deformation of the bulb of DPC, arises as a result of incorrect treatment of ulcer of duodenum. On the surface of the mucous in the place of the ulcer, rough scars form, which worsen the peristalsis and permeability of the organ.

Hyperplastic bulbit - a pathology that occurs against the background of prolonged inflammation of the mucosa, which acquires a knobby form. The tuberosity indicates hyperplasia, i.e. Proliferation of tissues. The pathology itself is not so dangerous, but one can not exclude the development of malignant tumors, because uncontrolled cell growth can be caused by oncological causes.

Atrophic bulbite is said when there is a thinning of the mucosa with disturbances in the PDK. At the same time, patients complain of a frequent acidic burp with pieces of undigested food, heaviness and rumbling in the stomach and intestines, epigastric pains, stool disorders. But atrophic form of pathology is always preceded by subatrophic bulbit, i.e. A lighter form of the disease with no symptoms of gastrointestinal diseases. Complaints in patients only for mild malaise. It is very difficult to detect a disease at this stage, especially as it progresses rather quickly, acquiring more pronounced forms.

The neglected form of atrophy of the duodenal mucosa is called hypertrophic bulbitis. If irregularities develop on the surface of atrophied mucosa and papilloma-like neoplasms speak of a warty bulbite.

Nodular (or nodular) bulbitis is the appearance on the mucosa of small nodules (granular bulbite) or vesicles (follicular bulbitis). This is not a separate type of pathology, but rather a characteristic of the clinical manifestation of certain species of bulbite.

Follicular (lymphoid) bulbitis occurs against the backdrop of an inadequate reaction of lymphoid tissue. On the surface of the mucosa of the DPC, many small vesicles are found which, bursting, turn into small ulceration.

If the disease carries a specific symptomatology of different types of bulbite, it is called mixed bulbite. So, with follicular bulbite, you can detect not only vesicles, but also sores, which indicates a mixed form of pathology.

[5]

Complications and consequences

It would seem that what harm to the body can bring inflammation of a small bowel area of 5 cm in size, if the length of the gastrointestinal tract is about 9 meters? In fact, everything is not so simple. Any inflammation leads to a disruption in the functioning of the body, which means that the entire process of digestion suffers: the body receives less of the nutrients it needs, but is saturated with toxins due to delay and decay of food, and immunity decreases. Decreased immunity entails the activation of bacterial infections in the body, enables cancer cells to develop, and so on. Such are the unsightly consequences of inflammation of an insignificant part of the digestive tract.

As for the complications of bulbits, here too everything is far from cloudless. First, in the absence of proper treatment under the influence of aggressive factors, any kind of pathology at some point threatens to turn into an erosive bulbite. And from this form of bulbit to ulcer DPK is already within reach.

Hemorrhages with erosive bulbitis and bleeding with exacerbation of its chronic form become dangerous not only for health, but also for the life of the patient. And what can we say about perforation of the ulcer, when the contents of the initial part of the intestine get into the abdominal cavity, provoking the development of inflammatory processes outside the digestive tract (peritonitis). Treatment of this condition requires immediate surgery, because it is about the patient's life, a minute of delay and a person can not be saved in time.

Proceeding from the foregoing, we can conclude: timely treatment of bulbits is the only real chance to avoid dangerous consequences that can not only worsen the quality of life, but also shorten it.

[6]

Diagnostics of the bulbite

Diagnosing bulbits can hardly be called a simple matter. All the same, the symptomatology of the disease is not specific. It is typical for any inflammatory pathology of the gastrointestinal tract. Therefore, any detail that the doctor will catch during the physical examination and examination of the patient's complaints is of value.

The chronic course of a bulbite is generally a separate conversation. Absence of characteristic symptoms and good health during remission is not an impetus for visiting a doctor. The disease can be detected by chance, when the patient is given an X-ray examination, ultrasound of the abdominal and pelvic organs, or gastroscopy for a different matter.

Pain in epigastrium with exacerbation of bulbitis is unstable and localized, which can confuse even a gastroenterologist with experience. However, at a palpation the reason of pains is found out quickly enough on a muscular strain in area DPK. Pain in a calm state can give in the back, and in the right hypochondrium, and in the navel, but when pressing on the sick body the picture immediately clears up, and the circle of "suspects" is limited to the bulb of the KDP.

To confirm the inflammatory process in the body, blood tests help. A general blood test will show an excess of leukocyte count, and a biochemical increase in the level of the reactive protein produced by the liver, as well as a change in the level of digestive enzymes produced by the pancreas.

Along with blood and urine tests, the doctor will probably also prescribe an analysis of stool. Erosive and erosive-ulcerative form of bulbita is characterized by hemorrhages into the cavity of the organ, which in turn leads to the detection of erythrocytes in fecal masses. Yes, and a blood test in this case will differ in the level of erythrocytes and hemoglobin.

Since a frequent cause of gastritis and bulbitis is a bacterial infection, and in particular Helicobacter pylori, tests for determining the causative agent of the disease will be required. True, this specific analysis is performed during the passage of instrumental examination of the stomach and duodenum (fibrogastroduodenoscopy or abbreviated to FGDS). At the same time, the acidity level of the gastric juice is determined and, if necessary, a piece of tissue (biopsy) is taken for morphological investigation (to confirm or exclude oncology).

For the detection of the causative agent of the disease, additional tests can be performed: PCR analysis, respiratory test, ELISA for antibodies against the pathogen.

In addition to the basic method of instrumental diagnostics of gastrointestinal pathologies, which is considered to be an EGF, other popular methods of internal organ research are prescribed. We are talking about X-ray and ultrasound examination of the digestive system. Radiography is carried out with the use of contrast agents. With the help of fluoroscopy you can see not only an increase in the organ, but also violations of peristalsis, stagnant and spastic phenomena. The ultrasound allows you to see the condition of the KDP and associated organs, determine the localization of inflammation, and identify the chronic course of the bulbitis.

As for the endoscopic examination (FGD), in the case of pronounced bulbite, an unusual pattern is observed, which is known as the phenomenon of semolina: on the background of the reddened swelling of the skin, small whitish nodules with a diameter less than 1 mm are clearly visible. They are easy to see because of the contrast of colors and because of the small tuberosity of the mucosa in the lesion.

Differential diagnosis

Differential diagnostics is carried out with the purpose of exclusion of gastrointestinal diseases with similar symptoms, and first of all gastritis and pancreatitis. Erosive gastritis should be differentiated from gastric and duodenal ulcers.

[7], [8], [9]

Treatment of the bulbite

The digestive system provides food for a variety of organs and systems of the human body. And in order to prevent the system from failing, it is necessary to maintain the health of all its organs.

Treatment of bulbitis, as well as any other diseases of the digestive tract, implies an integrated approach to solving the problem. From the very beginning the patient is offered to give up bad habits (first of all from smoking, drinking alcohol, overeating, eating dry), normalize the diet and the nature of nutrition (it should be full, regular and whenever possible fractional), normalize the psychoemotional state. In addition, you can begin taking anti-inflammatory herbal infusions, potato juice and rice broth that protect the gastrointestinal mucosa from the aggressive effects of adverse factors.

For mild forms of the disease, the cause of which is not a bacterial infection, sometimes even this is enough. When expressed bulbite in the complex treatment necessarily include the use of medications and physical therapy.

Physiotherapeutic treatment of bulbite includes such procedures: magnetotherapy, UHF radiation, exposure to ultraviolet waves, pain syndrome - drug electrophoresis. Sanatorium treatment and drinking of mineral waters "Borjomi", "Truskavets" and others are also shown.

Operative treatment is prescribed primarily in the case of erosive bulbitis with a tendency to bleeding. This is either a ligation of a blood vessel with bleeding from it, or vagotomy with suppression of the stalk of the vagus nerve to reduce the production of hydrochloric acid.

Drug therapy

Many forms of bulbit require not only changes in lifestyle and diet, but drug treatment. Drug therapy in this case is also multifaceted, as it pursues several important goals simultaneously.

Since bulbitis indicates inflammation in the area of PDK, it is mandatory to prescribe drugs that stop the inflammatory process by reducing the acidity of the internal environment and facilitating the work of the digestive system. For this purpose, enzyme preparations such as Wobenzym, Serox, Enzistal, etc., as well as antacid agents (Almagel, Fosfalugel, Gastal, Maalox, etc.) can be prescribed. .

Most often among antacids, doctors prefer drugs to the first two drugs. "Almagel", like "Fosfalugel", is often prescribed for any pathology of the gastrointestinal tract, including in the case of bulbite, when it is required to quickly reduce the acidity of the stomach, because the acid is one of the irritating factors that provoke inflammatory reactions.

The drug is produced in the form of tablets, solution and suspension. Take it you need half an hour before meals 3 to 6 times a day. In the interval between eating and medication, it is undesirable even to drink water. Single dose of the drug - from 1 to 3 measuring spoons of the solution (1-2 bags or tablets). The course of treatment is from 10 to 15 days.

The drug is not prescribed for intolerance to its components, Alzheimer's disease, severe liver and kidney pathology, with suspicion of acute appendicitis, ulcerative colitis, hemorrhoids, chronic diarrhea and some other pathologies. It is undesirable to apply at thoracal feeding. Children prescribe medicine only according to the doctor's indications in a limited dosage (1/3 or ½ adult norm).

Among the side effects are: stomach pain, taste disorders, constipation, nausea, vomiting, conditions associated with the excess of minerals that make up the medicine.

Antibiotics in bulbite are not compulsory medicines, since their appointment is advisable only if there is a bacterial infection, i.e. Microorganism Helicobacter pylori, which is a frequent cause of inflammatory pathologies of the digestive system.

To combat Helicobacter pylori infection, antibiotics of various groups are used: Amoxicillin, Clarithromycin, Metronidazole, Tetracycline, etc. However, antimicrobial agents are rarely used in monotherapy, most often practicing various antibiotic regimens in which two antibiotics are simultaneously used and drugs regulating the acidity of gastric juice.

The most popular in this regard is the drug "Amoxicillin", which in the case of the bulbite, associated with Helicobacter pylori, is one of the main components of the disease treatment regimen. Most often it is used in conjunction with "Clarithromycin", less often with "Metronidazole", because the joint use of drugs is fraught with the development of additional side effects.

A single dose of an antibiotic in most schemes is 250-500 mg.

It is forbidden to use the drug for infectious mononucleosis, lymphocytic leukemia, viral infections, hay fever, as well as for allergic diathesis and bronchial asthma. There is no point in taking oral antibiotics if the patient has severe vomiting and diarrhea. Do not prescribe the drug and hypersensitivity to drugs penicillin and cephalosporin series.

To reduce the resistance of amoxicillin it is sometimes combined with clavulanic acid. This combination can worsen the condition of patients with liver pathologies.

Schemes with metronidazole are not used to treat patients with pathologies of the nervous system and hematopoietic disorders.

Among the side effects can be identified: allergic reactions, including severe, disorders of the gastrointestinal tract and kidneys (in combination with metronidazole), the development of super infections.

In complex treatment regimens for bacterial and non-bacterial bulbitis, preparations that raise the pH of gastric juice are necessarily present. This antacids, histamine H ₂ receptors ( "Ranitidine" "Famotidine" "gastrosidin" et al.), Proton pump inhibitors ( "Omez" "Omeprazole" "Lansoprazole" "Pantoprazole" et al.). The reception of bismuth preparations ("Novobimol", "De-Nol", etc.) is also shown.

"Omez" - one of the most prescribed drugs for inflammatory pathologies of the gastrointestinal tract. It slows the synthesis of hydrochloric acid, as a result of which gastric juice has a lower level of acidity and does not irritate the gastric and duodenal mucosa.

"Omez" in bulbite can be prescribed in a dosage of 20-40 mg. The daily dose is taken in 1-2 doses half an hour before meals, washing the tablets with water.

Contraindications for the drug a little. It is not prescribed in childhood, during pregnancy and lactation. It is forbidden to take medicine even if it is hypersensitive to its constituents.

Side effects are rare. Basically, these are stool disorders (constipation or diarrhea) and taste perception, nausea, epigastric pain, a feeling of drying out of the mucous membranes of the mouth, headaches and dizziness, sleep disturbances. Muscular weakness and muscle pain may also be observed, occasionally increasing photosensitivity, visual acuity, allergic reactions.

Painkillers are prescribed mainly with erosive bulbite, accompanied by severe epigastric pain. To remove the pain syndrome, both analgesics (for example, the good old Baralgin) and spasmolytics (No-shpa, Spazmalgon, Drotaverin, etc.) are suitable.

[10], [11], [12], [13], [14], [15], [16],

Alternative treatment

Bulbite is one of the inflammatory diseases of the digestive tract, and since all the organs of the digestive system are interconnected, their treatment is similar in many respects. As for alternative treatment, then the same recipes will be useful for bulbites, which are used for the treatment of gastritis with high acidity.

First of all, it is freshly squeezed potato juice, which is recommended to be taken on an empty stomach 2 to 3 times a day. At one time you need to drink ½ cup of juice.

To protect against the aggressive action of gastric juice is useful intake of unsalted broths of cereals. Perfect fit rice and oatmeal (flakes), from which mucous broths are obtained.

Propolis has a very good effect on gastrointestinal diseases. Its tincture on alcohol can be bought in a pharmacy or prepared independently (a piece of propolis weighing about 60 g insist for a week in 350-400 g of alcohol). Before drinking, drop 20 drops of tincture into water or milk (just over ½ cup) and drink in between meals. Do this three times a day for a month.

Good results are also provided by herbal treatment. Instead of tea, it is recommended to take a decoction or infusion of mint and chamomile, instead of compotes - rose hips syrup (1 kg of fruit of the plant and sugar, 1.5 liters of water) three times a day for 1 tablespoon.

Good results are also obtained by infusion of Japanese Sophora fruit (1 teaspoon of crushed raw material pour a glass of boiling water and insist 15 minutes). Pitot for a glass of infusion 3 times a day.

[17], [18], [19], [20]

Homeopathy

A useful action in non-Helicobacter pylori-associated bulbits is also provided by homeopathy, the use of which is considered safer for health than traditional medicine. However, with the proviso that the remedy is prescribed correctly and its administration is carried out in accordance with the instructions of the doctor.

One of the drugs that homeopaths prescribe for the bulbite is the Kalium bichromicum in 6 dilutions. Take it recommended for 5 granules in the morning and in the evening or with pain. Do not eat while eating.

In homeopathic pharmacies, you can buy and preparations of bismuth, but you only need to take them after consulting a doctor.

For the removal of unpleasant symptoms, useful are Agaricus (neurological symptoms), Gentian (dyspeptic phenomena), Acidum acetylcum (removal of symptoms associated with high acidity of the stomach). The latter drug is prescribed and with erosive bulbite, as it helps stop bleeding.

Diet with bulbite

Dietary nutrition in diseases of the gastrointestinal tract, which includes and bulbits, is a kind of therapeutic procedures. If you ignore the requirements of the diet, treatment will not give the expected results.

Diet in bulbite can not be called tough. However, there are some limitations. The most important thing is to exclude from the diet products and dishes that can have an irritating effect on the inner surface of the stomach and duodenum or stimulate an increase in the secretion of hydrochloric acid. Prohibited products include: conservation, seasonings, coffee, strong tea, alcohol, sour fruits and berries, smoked products. Refuse should be from fried foods and spicy dishes. The consumption of salt should be minimized.

As with other pathologies of the digestive tract, fractional nutrition is recommended. Food should be taken in small portions 5-6 times a day.

Preference is given to liquid first dishes, jelly, mucous broths (decoctions of rice, oats, flax seeds). Fruits, berries and compotes of them with the bulbite help saturate the body with vitamins, but it's tedious to make sure that they are not too sour.

When the disease worsens, you can mainly eat liquid dishes, gradually adding to the menu eggs soft-boiled, steam omelet, viscous porridge, baked fruit. Among the allowed products in bulbite can be identified: low-fat cottage cheese and sour cream, yesterday's white bread and crackers from it, biscuit biscuits, dietary meat and fish, pasta. Do not add to the food and a little butter.

Milk in bulbite is not only not prohibited, but also useful, because it improves the functioning of the intestines. You can drink up to 5 glasses of milk per day. However, before use it is recommended to boil.

Example of the menu in the bulbite:

• 1st breakfast: steam omelette with vegetables, chamomile tea
• 2nd breakfast: baked apple, a little later green tea with milk
• Lunch: vegetable soup with rice, mashed potatoes with steam chop
• Afternoon snack: biscuit biscuit, compote
• 1st dinner: steamed fish, rice porridge, milk jelly
• 2nd dinner: pear mashed potatoes, mild tea with mint

Prevention

Since bulbitis - is primarily an inflammation of the mucosa of the initial intestine, then the prevention of the disease should be aimed at preventing the development of inflammatory processes in the organs of the digestive system.

Very often, pathology develops under the influence of increased acidity of the gastric juice, which means that to prevent irritation of PDC it is necessary to take drugs that promote the increase of the pH of the contents of the stomach moving towards the duodenum. If the acidic environment in the stomach provoked the development of gastritis, it should be immediately treated so that the pathology does not spread to nearby organs.

The presence of bacterial infection in the body, and Helicobacter pylori in particular, requires urgent measures to irradiate it. And, after passing the course of antibiotic therapy, it is mandatory to conduct a test showing the effectiveness of the treatment.

To block the path of Helicobacter pylori infection into the body, you need to thoroughly wash not only your hands, but also, if possible, foods used for food.

The usual measures to prevent many diseases are a healthy and active lifestyle, exercise, walking outdoors, abandoning bad habits, taking preventive medical examinations. All this helps to strengthen immunity and does not leave a chance of a bacterial infection for its development.

[21]

Forecast

The prognosis of the disease depends on how timely the patient asked for help. A great role is given to the accuracy of the prescriptions of the doctor. The most difficult to treat is the erosive form of bulbite, which requires a strict diet and all sorts of measures to protect the mucosa from irritation. Otherwise, the disease runs into the ulcer of the DPC.

As far as military service is concerned, bulbit is not considered a pathology subject to examination on points a and b of the disease schedule with the possibility of postponement and release from service in the army. Those. Conscript even with the diagnosis of "erosive bulbits" is unlikely to be released from military duty. Unless pathology has frequent exacerbations (more than 2 times a year), while the acid-forming function of the gastrointestinal tract is greatly increased and can not be treated. Postponement from the army is also subject to those who have a long-term dispensary treatment.