Superficial bulbitis: erosive, antral, acute, chronic, focal, catarrhal

Superficial bulbitis is the mildest form of the inflammatory process. It is considered the initial or preceding stage of other pathologies affecting the duodenum and stomach.

Causes superficial bulbitis

One of the reasons for the appearance of bulbitis is the special location of the bulb of the duodenum - this area is located on the border of the transition of the gastric part to the intestinal. In this place, the acidified lump of food undergoes the process of alkalization and is prepared for subsequent digestion. In addition, it is inside the bulb of the duodenum that the bile ducts open. Since the bulb is the most vulnerable part of the duodenal mucosa, all of the above factors, combined with poor nutrition, constant stress, and smoking, provoke pathological changes in this area, leading to the development of bulbitis.

The so-called short bowel syndrome, which occurs as a result of an operation to cut off part of the intestine, can also cause the development of the disease. As a result, the amount of substances produced in the duodenum, which are necessary for regulating the production of gastrin, decreases. This leads to increased gastric acidity and the development of inflammation. The accelerated movement of a lump of food through the intestines during this disease can also have an effect.

The acute form of superficial bulbitis usually develops as a result of food poisoning, poor nutrition, and, in addition, unsystematic abuse of alcoholic beverages. Along with this, the provoking factor may be damage to the mucous membrane by some foreign object.

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Risk factors

To transform gastritis into superficial bulbitis with a transition to the initial sections of the duodenum, the following factors must be present:

• failure to follow a diet, regular consumption of spicy, fried, and fatty foods;
• abuse of bad habits;
• deterioration of the body's immunity;
• genetic predisposition.

Symptoms superficial bulbitis

In its symptoms, superficial bulbitis is similar to a duodenal ulcer or stomach ulcer. Its main symptom is pain in the epigastric region. The pain can be different, but is mostly aching, with moderate severity (but sometimes it can be spasmodic). Attacks occur on an empty stomach or 1 hour after eating. They can be stopped by eating or taking antacids.

In addition to pain, patients also complain of increased bloating, dyspeptic symptoms, and nausea. During examination of patients, a white coating is found on their tongue, and palpation in the epigastric region causes pain. During periods of exacerbation of the disease, the muscles in the projection of the duodenal bulb may be slightly tense.

Superficial reflux bulbitis

The hollow organs inside the intestines are ducts with tubes of different width, length, and diameter. They have elastic thick membranes (walls), as well as an internal cavity through which the contents of the digestive system move (always remaining in a strictly defined position). The occurrence of a failure in this process (unnatural movement of contents begins) leads to the development of reflux bulbitis.

Its symptoms are similar to superficial bulbitis. The disease can be diagnosed using gastroscopy and X-rays.

Focal superficial bulbitis

In focal superficial bulbitis, inflammation affects different areas of the mucous bulb in the duodenum.

Among the signs of the development of this pathology are digestive disorders (the appearance of belching, vomiting with nausea, a feeling of heaviness in the stomach, the development of heartburn, etc.), as well as pain. The pain occurs at different times of the day, mainly localized under the pit of the stomach. It often radiates to the right hypochondrium, as well as near the navel.

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Chronic superficial bulbitis

The chronic form of superficial bulbitis can develop either independently or as a secondary disease that occurs against the background of other gastrointestinal pathologies.

The first type develops as a result of stress, poor nutrition, and regular consumption of spicy foods that irritate the intestines.

The secondary form appears as a result of the development of an ulcer, chronic gastritis or pancreatitis, as well as various generalized infections, etc.

The main factor that provokes the development of chronic superficial bulbitis is infection with the Helicobacter bacterium. In the case of the development of the antral form of gastritis, this microorganism provokes increased production of pepsin with hydrochloric acid. As a result, the mucous membrane of the duodenal bulb is damaged, and H.pylori penetrates into the initial intestinal sections.

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Complications and consequences

In the absence of therapy, the chronic form of the pathology will progress, which will further lead to the appearance of bleeding in the gastrointestinal tract (about 10% of all such bleeding occurs due to bulbitis), and in addition to this, to the development of cancer of the major duodenal papilla.

Diagnostics superficial bulbitis

Patients with symptoms of superficial bulbitis should consult a gastroenterologist who will determine the cause of the disease and prescribe the necessary tests to clarify the diagnosis.

The patient may have blood drawn for analysis, and an endoscopic biopsy may also be performed.

A final diagnosis can be made after an esophagogastroduodenoscopy. In addition to this, an X-ray of the duodenum and stomach is also performed (contrast may be used additionally).

Thanks to such instrumental diagnostic methods as gastrointestinal impedance analysis, as well as measurement of the pH level in the stomach and antroduodenal manometry, it is possible to clarify the diagnosis, which is necessary for selecting the optimal treatment regimen.

Differential diagnosis

The disease must be differentiated from such pathologies as ulcers, chronic forms of pancreatitis or gastritis, hernia in the area of the esophageal opening in the diaphragm, and in addition, cholecystitis, spasm and cancer of the large duodenal papilla.

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Treatment superficial bulbitis

The disease requires complex and long-term treatment, which includes adherence to special diets. But the first priority for the patient is to make changes to their lifestyle. You should get rid of bad habits, change your diet, avoid excessive stress on the psyche and nervous system, and also adjust your food intake.

Medicines

In cases where the inflammatory process occurs as a result of infection or parasites entering the body, the following medications should be used.

To eliminate giardiasis, Macmiror is used, and to treat opisthorchiasis, Praziquantel is used. Campylobacteriosis and Helicobacter infection are treated with antibiotics. In the second case, it is necessary to combine several antibiotics (2-3), as well as combine them with drugs that suppress acid secretion (such drugs as omeprazole or nolpaza). In addition, you can use De-Nol, which contains bismuth - it is suitable for monotherapy.

In the case of a chronic form of the pathology, it is necessary to take medications that help to improve the motility of the duodenum, as well as the function of the gastroduodenal sphincter.

To increase the tone of the gastroduodenal sphincter, prokinetics should be used: such as trimedate or domperidone (Motilium or Passazhiks). The disorder of the bile excretion process is eliminated with the help of antispasmodics and choleretic drugs. Among them are Gepabene and Odeston, and in addition, Ursosan and Karsil. Spasms are effectively eliminated by drugs such as Dicetel, Buscospan, as well as Duspatalin and No-Shpa.

Folk remedies

To eliminate the symptoms of the disease and improve the patient's well-being, you can use folk remedies. But before starting therapy with folk remedies, it is still recommended to consult with your doctor.

A mixture of honey and plantain juice. You need 1 teaspoon of honey (it is recommended to take liquid fresh honey), as well as 3 tablespoons of plantain juice (freshly squeezed). This mixture should be drunk before meals.

Tincture based on propolis. Add propolis (60 g) to 1 glass of alcohol, and then leave it in a dark place for about 7 days. Drink the tincture as follows: dissolve 5 ml of the medicine in 150 ml of water (boiled warm), and then drink in small sips. Do this on an empty stomach in the morning.

St. John's wort tea - pour 2 tablespoons with boiling water (1 glass), then leave for 1 hour. Drink the tincture 3 times - before each meal.

Potato juice is also effective. It should be drunk on an empty stomach. The intake begins with 1 tablespoon, and then gradually increases the amount of medicine to 0.5 glass.

Diet for superficial bulbitis

First of all, when developing superficial bulbitis, the patient should remove from his diet foods that irritate the inflamed gastric mucosa. Among these are:

• strong coffee with tea;
• spices and seasonings;
• smoked, fried, and fatty foods;
• alcoholic beverages.

You should eat often, but in small portions - 5-6 times a day in small portions. Meals should also be prepared in such a way that the sick stomach can digest them quickly and efficiently - you need to grind the food, boil it well and stew it. These dishes should only be eaten warm. You are allowed to consume no more than 50 g of sugar and 5 g of salt per day.

At the beginning of the diet, it is better to eat only liquid food. These can be boiled porridges, light broths, soups. Then you can add egg dishes (soft-boiled eggs, omelette), dairy products, soufflé from lean meat and fish. You should drink compotes, kissels, milk. It is not recommended to eat bread and pastries at the first stages of treatment.

When the condition improves, you can add crackers or toasted bread, as well as steamed pasta and cutlets to your diet. It is also useful to drink olive oil (1 tablespoon) before meals. It has enveloping properties and helps protect the mucous membrane from irritation.

Prevention

Prevention of the disease consists of eating right, maintaining a healthy lifestyle, and promptly treating other gastrointestinal pathologies that can provoke the appearance of superficial bulbitis.

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Forecast

Superficial bulbitis responds well to treatment and therefore has a favorable prognosis.