Dyskinesia duodenum - porushennyaskorochuvalnoyi and/or evacuation function duodenal lengthening or shortening the stay in it to digest food.
Most often duodenum dyskinesia occurs in the pathology of the duodenum and related bodies:
- Duodenal ulcer - in 53.8-100% of cases;
- Stomach ulcer - in 66,7-76,5% of cases;
- Diseases of the biliary tract - in 65-96,2% of cases;
- Pancreatitis - in 46-75.6% of cases.
Also, dyskinesia of the duodenum may occur:
- In patients who have undergone operations on the stomach, with adhesive disease;
- In parasitic diseases (giardiasis, opisthorchiasis, helminthiasis);
- With lesions of the central and autonomic nervous system;
- At endocrine disorders;
- With systemic diseases.
Under the influence of these factors is disturbed regulation of motor function duodenum, secretion of digestive juices in it, which are indirectly affecting the quality of digestion (gastrin, cholecystokinin, pancreatin, secretin, etc..). At the same time possible as accelerated passage of food in the duodenum, and an increase in the terms of stay in it - duodenostasis. This type of dyskinesia of the duodenum is most common and occurs with periodic exacerbations and remissions.
The main manifestations of dyskinesia of the duodenum
The remission period usually occurs asymptomatic or accompanied by poor symptomatology, while the exacerbation occurs with pronounced and characteristic symptoms. Usually this is a permanent pain in the peritoneum and right hypochondrium, feeling of severity, nausea, vomiting with bile admixture due to reflux (retrograde throwing of the contents of the duodenum into the stomach and esophagus).
In the period of exacerbation, patients often have low appetite, they may lose weight, often they are bothered by bloating, unstable fecundity. Patients are asthenic, irritable, noted fatigue, weakness. Often, these symptoms fall into the background, and more clearly show the symptoms of the underlying disease, which caused the appearance of dyskinesia. Sometimes the patient appears spastic contractions in the right hypochondrium, associated with an increase in the duodenal motility to irritate her for a long time in her food.
The leading method of diagnosis of dyskinesia of the duodenum is X-ray.
- Relaxation duodenografiya - the study of the duodenum with the use of medication relaxation, which allows you to carefully study the structure of the gut and detect pathological changes in it.
- Ballocomografic method (now it is used rarely) - registration of contractions of the wall of the duodenum, which allows to detect disturbances of its motility.
- The combination of cylinders with intravenous pH-graph provides an opportunity to estimate the time of passage of duodenal contents.
- The uncontrolled method using a radiotelemetric capsule is a study of pressure in the lumen of the duodenum, depending on the tone of its walls and the speed of movement on it of the contents.
- Electromyographic method using in vivo-duodenal electrodes.
Basic principles of treatment of dyskinesia of the duodenum
- Diet therapy, which takes into account the nature of the main disease, with fractional nutrition, which includes vitamin and easily digestible products.
- Medicinal therapy (antispasmodic, sedatives, tranquilizers, cholinolytics, drugs that improve nerve conduction).
- Physiotherapeutic treatment, massage, therapeutic exercises (exercise therapy).
- Reflexotherapy, phytotherapy.
- Balneotherapy (use of mineral water, mud therapy, ozokeritotherapy) and spa treatment during remission.
- Surgical treatment - used only in extreme cases, with ineffective conservative therapy.