A peptic ulcer is an open sore or moist area that tends to develop in one of two places:

In the lining of the stomach (gastric ulcer);
- in the upper part of the small intestine - duodenum (ulcer duodenum).

Duodenal ulcers are three times more common than gastric ulcers.

Ulcers develop when digestive juices appear in the stomach, intestines, digestive glands, and the lining of the stomach or duodenum is damaged.

Ulcers can be on average from 0.62 cm to 1.25 cm in diameter. Helicobacter pylori bacteria - the main cause peptic ulcer. Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) is the second most common cause.

Peptic ulcers affect all age groups but are rare in children. Men are twice as likely to have ulcers as women. The risk of duodenal disease tends to increase from the age of 25 and continues until the age of 75. The risk of its greatest peak is from 55 to 65 years.

Mechanism of ulcer formation

Two important components digestive juices - hydrochloric acid and the enzyme pepsin. Both substances are critical in the breakdown and digestion of starches, fats and proteins in food. They play different roles in ulcers.

- Hydrochloric acid. It is a common misconception that excess hydrochloric acid, which is secreted in the stomach, is solely responsible for the production of ulcers. Patients with duodenal ulcers tend to have higher than normal hydrochloric acid levels, but most patients with gastric ulcers have normal or below normal acid levels. The presence of stomach acid is, in fact, important in protecting against H. pylori, the bacterium that most often causes peptic ulcers. The exception is ulcers, which come from Zollinger-Ellison syndrome, a rare genetic condition in which a tumor in the pancreas or duodenum secretes very high level gastrin - a hormone that stimulates the release of hydrochloric acid.

- Pepsin. This enzyme breaks down proteins in food. It is also an important factor in the formation of ulcers. Since the stomach and duodenum are composed of proteins, they are sensitive to the action of pepsin. However, the body has a defense system to protect the stomach and intestines against these two potent substances:

The layer of mucus that covers the stomach and duodenum (the first line of defense);
- bicarbonate, which secretes a layer of mucus that neutralizes digestive acids;
- hormone-like substances prostaglandins, which help to expand blood vessels in the stomach to ensure good blood flow and to protect against injury. Prostaglandins can also stimulate the action of bicarbonate and mucus.

The breakdown of these defense mechanisms makes the lining of the stomach and intestines susceptible to the action of acid and pepsin, increasing the risk of ulcers.

> Reasons stomach and duodenal ulcers

In 1982, two Australian scientists identified Helicobacter Pylori (or H. Pylori) as the main cause of stomach ulcers. They showed that inflammation of the stomach and the result of stomach ulcers from stomach infection are caused by the bacteria H. pylori.

The bacteria seem to cause ulcers in this way: the corkscrew shape of Helicobacter pylori allows them to penetrate the lining of the stomach or duodenum so that they can attach to the lining. The surfaces of the cells lining the stomach contain protein. The factor accelerating the breakdown of proteins acts as a receptor for bacteria.

H. pylori survives in a highly acidic environment. H. pylori stimulates the increase and release of gastrin. Higher levels of gastrin promote increased acid secretion. The increase in acid damages the intestinal mucosa, leading to ulcers in certain individuals. H. pylori also alters certain immune factors that allow these bacteria to evade outside detection. immune system and lead to frequent inflammation, even without mucosal invasion. Even if ulcers do not develop, Helicobacter pylori is believed to be the main cause of active chronic inflammation in the stomach - gastritis, and in the upper part of the small intestine - duodenitis. H. pylori is also strongly associated with gastric cancer and possibly other extraintestinal problems. H. pylori bacteria are most likely transmitted directly from person to person. However, little is known exactly how these bacteria are transmitted.

About 50% of the world's population is infected with H. Pylori. The bacteria are almost always acquired during childhood and persist throughout life if the person is left untreated. The prevalence of this bacterium in children is about 0.5% in industrialized countries. However, even there, in regions with critically unsanitary conditions, the conditions for infection are equal to those in developing countries.

It is not yet entirely clear how these bacteria are transmitted. Possibly transmission methods include:

Intimate contact, including contact with liquid through the mouth;
- diseases gastrointestinal tract(especially with vomiting);
- contact with feces (faeces);
- polluted sewage.

Although Helicobacter pylori are fairly common, ulcers in children are very rare - only 5-10% of H. Pylori-infected adults. Several factors may explain why some infected patients get ulcers:

Smoking;
- alcohol intake;
- the presence in communication of relatives with peptic ulcer;
- male gender;
- infection with a bacterial strain that contains a cytotoxin of the associated gene.

When Helicobacter pylori was first identified as the main cause of peptic ulcers, it was found in 90% of people with duodenal ulcers and about 80% of people with stomach ulcers. Since everything more people now tested and treated for bacteria, the rate of H. pylori-induced ulcers has decreased. Currently, H. pylori is found in about 50% of people with peptic ulcers;

Factors that cause ulcers in H. pylori carriers

Certain factors may increase the risk for ulcers in NSAIDs:

Age 65 years and older;
- history of peptic ulcer or gastrointestinal bleeding;
- other serious illnesses such as congestive heart failure;
- the use of drugs such as: the anticoagulant Warfarin (Coumadin), corticosteroids, the osteoporosis drug Alendronate (Fosamax), etc.;
- alcohol abuse;
- infection with Helicobacter pylori;
- other risk factors for ulcers from H. Pylori or NSAIDs;
- stress and psychological factors;
- bacterial or viral infections;
- bodily injury;
- radiation therapy;
- smoking. Smoking increases acid secretion, reduces prostaglandins and bicarbonate, and reduces blood flow. However, studies on the actual effects of smoking on ulcers vary.

Only 10-15% of people infected with Helicobacter pylori develop peptic ulcers. H. pylori infections, especially in the elderly, may not always lead to peptic ulcers. Other factors must also be present in order to actually cause ulcers:

- genetic factors. Some people have strains of H. pylori with genes that make the bacteria more dangerous and increase the risk of ulcers;

- immune disorders. Some people have an impaired gut immune response that allows bacteria to injure the intestinal mucosa;

- lifestyle factors. While lifestyle factors such as chronic stress, coffee, and smoking have long been considered major causes of ulcers, they are now thought to only increase susceptibility to ulcers in some H. pylori carriers—nothing more;

- stress. While stress is no longer thought to cause ulcers, some research suggests that stress may predispose a person to ulcers or prevent existing ulcers from healing;

- shift work and interrupted sleep. People who work night shifts have a significantly higher incidence of ulcers than day workers. Researchers suspect that frequent sleep interruptions may weaken the immune system's ability to defend against harmful bacteria.

- non-steroidal anti-inflammatory drugs (NSAIDs). Long-term use of NSAIDs such as aspirin, ibuprofen (Advil, Motrin) and Naproxen (Aleve, Naprosyn) is the second most common cause of ulcers. NSAIDs also increase the risk of gastrointestinal bleeding. The risk of bleeding continues as long as the patient is taking these drugs, and it may continue for about 1 year after the break. Short courses of NSAIDs for temporary pain relief should not cause serious problems because the stomach has time to repair and repair any damage that has occurred.

Patients with ulcers from NSAIDs should immediately stop taking these drugs. However, patients who require these drugs on a long-term basis may reduce their risk of developing ulcers by taking PPI inhibitor drugs. proton pump- such as Omeprazole (Prilosec), Famotidine (Pepsid - H2 blocker), etc.

15-25% of patients taking NSAIDs regularly will have evidence of one or more ulcers, but in most cases these ulcers are very small. Long-term use of NSAIDs may harm, possibly small intestine. Even low doses of aspirin (81 mg) may present some risk, although the risk is lower than at higher doses. The greatest risk is in people using very high doses of NSAIDs for a long period of time, especially in patients with rheumatoid arthritis.

- Medications. Some drugs other than NSAIDs can make ulcers worse. These include: Warfarin (Coumadin) - an anticoagulant that increases the risk of bleeding, oral corticosteroids, some chemotherapy drugs - Spironolactone and Niacin. Bevacizumab is a drug for the treatment colorectal cancer, may increase the risk of gastrointestinal perforations (perforation or perforation of an ulcer is a breakthrough of an ulcer outside the stomach or duodenum with the release of their contents). Although the benefits of bevacizumab outweigh the risks, gastrointestinal perforations are very serious. If they occur, patients should stop taking the drug.

Zollinger-Ellison Syndrome (ZES).. Another cause of peptic ulcer disease, although much less than H. Pylori or NSAIDs, is Zollinger-Ellison syndrome. A large amount of acid is produced in response to an overproduction of the hormone gastrin, which in turn causes tumors in the pancreas or duodenum. These tumors are usually cancerous and must be removed. Acid production must also be suppressed to prevent new ulcers.

ZES should be suspected in patients with ulcer who are not infected with H. pylori and who do not have a history of NSAIDs. Diarrhea may occur before ulcer symptoms. Ulcers that occur in the second, third, or fourth part of the duodenum or in the jejunum (middle part of the small intestine) are signs of ZES. Gastroesophageal reflux disease (GERD) is more common and often more severe in patients with ZES. Complications of GERD include ulcers and narrowing (strictures) of the esophagus.
Ulcers associated with ZES are usually persistent and difficult to treat. Treatment consists of removing the tumor and suppressing the acid with special drugs. In the past, removal of the stomach was the only treatment option.
Experts don't know what factors actually increase the risk of developing an ulcer.

Symptoms stomach and duodenal ulcersand

- Dyspepsia. The most common symptoms of peptic ulcer disease are collectively known as dyspepsia. However, peptic ulcers can occur without dyspepsia or any other GI symptoms, especially if caused by NSAIDs.

The main symptoms of dyspepsia:

Complications stomach ulcers

Most people with severe ulcers experience severe pain and insomnia, which can have a dramatic and negative impact on their quality of life. In addition, the treatment of ulcers is extremely expensive.

- Bleeding and hemorrhage. Ulcers caused by H. pylori or NSAIDs can be very serious if they cause bleeding or perforation of the stomach or duodenum. Up to 15% of people with ulcers have some bleeding that can be life-threatening. There are ulcers in which small intestine attaches to the abdomen and, as a result of narrowing or closing of the intestinal opening, may swell and scar. In such cases, the patient vomits the entire contents of the stomach, and urgent emergency (emergency) treatment is prescribed.

Because often ulcers do not open from gastrointestinal symptoms NSAIDs until bleeding starts, doctors cannot predict which patients taking these drugs will bleed. The risk of a poor outcome is highest in people who have had long-term bleeding due to NSAIDs, bleeding disorders, low systolic blood pressure, mental instability or other serious and adverse health conditions. The highest risk group in the general population are the elderly and those who have other serious conditions, such as heart problems.

- Stomach cancer. Gastric cancer is the second leading cause of cancer death worldwide. In developing countries, where levels of Helicobacter pylori are very high, the risk of developing stomach cancer is now six times higher than in developed countries. H. pylori can be carcinogenic (producing cancer in the stomach) like cigarette smoke in the lungs. Helicobacter pylori infection contributes to a precancerous condition called atrophic gastritis. This process most likely begins in childhood.

When Helicobacter pylori infection begins in adulthood, it poses a lower risk of developing cancer because atrophic gastritis can develop. Other factors, such as specific strains of Helicobacter pylori and diet, may also affect the risk of developing stomach cancer. For example, a diet high in salt and low in fresh fruits and vegetables is associated with greater risk. Some evidence suggests that a strain of H. pylori that carries a cytotoxin gene may be a specific risk factor for the development of precancerous changes.

Although there is conflicting evidence, some studies suggest that early elimination of H. pylori may reduce the risk of stomach cancer in the general population. It is important to monitor patients after treatment for a long period of time. People with duodenal ulcers caused by Helicobacter pylori appear to have a lower risk of developing stomach cancer, although scientists don't know why. It is possible that the duodenum and stomach are affected by different strains of H. pylori. And perhaps the high levels of acid found in the duodenum may help prevent bacteria from spreading to important areas of the stomach.

- Other diseases. H. pylori is also weakly associated with other extraintestinal disorders, including migraine, Raynaud's disease, and others. skin diseases like chronic urticaria. Men with stomach ulcers may face a higher risk of developing pancreatic cancer, although duodenal cancer does not seem to pose the same risk..

When the pain in the abdomen overtakes, acute, but still tolerable, you hope that it will pass by itself, as it has happened more than once. Every day more and more tormented by heartburn, which now appears not only after eating, but also in the morning, and from hunger. The next stage is night pains in the abdomen, just above the navel, exhausting and interfering with sleep. Very little time passes, and you are forced to go to the doctor, because painkillers no longer help, and the pain becomes so severe that it is no longer possible to endure. The therapist gives a referral for blood and urine tests and refers to a gastroenterologist. After examining by pressing the hands on various parts of the abdomen and performing FGDS, the doctor announces the diagnosis: "duodenal ulcer in the acute stage", along the way naming a few more newly diagnosed concomitant diseases.

Types of duodenal ulcer and its complications

Modern medicine divides the disease into acute and chronic. The ulcer itself is an open wound (or several) on the mucous membrane of the internal organ. It can increase in size not only in diameter, but also in depth, which is fraught with the main danger.

With the diagnosis of "acute ulcer" we are talking about the fact that the symptoms of the disease appeared for the first time. The depth of the wound on the mucosa in this case reaches the muscle layer, maybe deeper. A chronic ulcer differs from an acute one only in that it is already a recurrent manifestation, regularly aggravated and turning into a remission stage after the course of treatment.

How a stomach ulcer forms and progresses - video

An ulcer usually forms on the lower or upper wall of the duodenal bulb, but a small percentage of patients have a postbulbar ulcer (located behind the bulb). A mirror ulcer may also develop (the so-called 2 formations located opposite each other, they can touch the edges). Associated diseases such as different kind gastritis, duodenitis, bulbitis, esophagitis are detected during the diagnosis of the ulcer itself using FGDS (or EGDS), in addition, free pyloric patency is noted, which causes the contents of the duodenum to be thrown into the stomach and vice versa.

The disease causes a lot of discomfort, but its complications and their consequences, which are treated only inpatients, are much more terrible:

• Internal bleeding. In the stomach and duodenum, the blood supply is very intense. When the hydrochloric acid released in the composition of the gastric juice enters the ulcer, it corrodes it even more and the wound can deepen to the vessels and damage them. Blood enters the stomach and intestines, as a result of which hematemesis may begin and / or the stool will turn black. External signs of the opened bleeding - severe dizziness, feeling of weakness, frequent pulse. With profuse bleeding (if large vessels are affected), blood loss can amount to several liters in 15-20 minutes!
• Perforation (perforation) - an ulcer so deep that it breaks through the wall of the organ. This complication develops suddenly and may be accompanied by bleeding. The contents of the organ fall into abdominal cavity, and the likelihood of developing peritonitis (inflammation of the peritoneum) becomes very high.
• Penetration - an ulcer penetrates into nearby organs (stomach, pancreas, etc.). This is not as dangerous as perforation, since the wound itself remains closed and infection of the abdominal cavity with microbes does not occur.

Comprehensive treatment of peptic ulcer - the path to recovery

To be honest, reading this is scary. And the question immediately arises: is it possible to recover from an ulcer? Alas, it is believed that it will not be possible to completely get rid of the disease, but it is possible and necessary to maintain a state of stable remission - the pain will become a thing of the past and there will be no need to take medication. After a course of treatment, the ulcer heals and a scar forms on the mucous membrane in this place. However, any push - be it not proper nutrition, drinking alcohol, smoking, nervous overload - can cause an exacerbation and everything repeats. These reasons affect the decrease in general immunity (it also takes place in the spring-autumn period), as a result, Helicobacter pylori is activated - a bacterium located in the gastrointestinal tract and which is one of the causes of the disease.

How can medicine help today? Treatment includes several methods at once, prescribed in combination, excluding radical methods (if you can do without them).

Pharmaceutical preparations for duodenal ulcer

If the operation is not yet necessary, the gastroenterologist, based on the results of the examination, may prescribe the following medications:

1. Antacids - Almagel, Phosphalugel - have an astringent, enveloping effect, softening the effect of hydrochloric acid on the mucous membrane.
2. Cytoprotectors - Sucralfate, De-nol, Misoprostol - help protect the duodenal mucosa from aggressive factors acting on it. Take 2 times a day.
3. Reparants - Actovegin, Solcoseryl (prescribed as injections) - stimulate the regeneration of the damaged area of ​​the mucous membrane.
4. Antisecretory drugs - Famotidine, Nexium, Omeprazole, Pariet, Omez - neutralize the effect of hydrochloric acid - 1 time per day in the morning.
5. Prokinetics - Trimedat, Metoclopramide (intramuscularly) - have an antiemetic effect, activate the digestion of food and its further movement along the gastrointestinal tract.
6. Antibiotics - Amoxicillin, Ciprofloxacin, Clarithromycin, Flemoclav, Metronidazole, Trichopolum, Tetracycline - 4 times a day. Needed to destroy Helicobacter pylori, which was mentioned above.
7. Antispasmodics - Drotaverine, No-shpa, Atropine - to relieve spasms of the muscles of internal organs.
8. Sedatives - Fenzitat, Phenazepam - since the ulcer develops faster against the background of nervous strain, it is necessary to take sedatives.
9. Vitamins of group B intramuscularly, Omega-3 in capsules - for general maintenance of the body and increased immunity.

All these funds (one from each group) are included in the mandatory course of treatment for exacerbation of the ulcer. Their combination makes it possible to reduce the dose of each individual drug, but makes the whole course more effective.

Sometimes there are questions about the combination of drugs with each other, if there are any other diseases. Undesirable means include Cardiomagnyl - prevents the occurrence of blood clots, thins the blood - due to the content of acetylsalicylic acid in it, Barboval (sedative), which irritate the duodenal mucosa. Ketorol (painkiller) is also better not to use, but if necessary, it can be taken only after meals.

But Smektu, as an anesthetic and antidiarrheal medicine, can even be used by children. If the temperature rises against the background of the ulcer, then it is better to knock it down with Paracetamol, which is relatively safe for an irritated stomach and intestines.

Physiotherapy and exercise therapy

In addition to medicines, complex treatment ulcers, physiotherapy plays an important role. Its task is an anti-inflammatory effect and activation of recovery processes by intensifying blood and lymph circulation.

This direction includes:

• SMT-therapy (exposure to electrodes). With its use, a decrease in pain syndrome, normalization of the general condition, blood flow is achieved.
• Medicinal electrophoresis (the agents used are novocaine, papaverine, atropine, etc.), which gives an analgesic and antispasmodic effect;
• Magnetotherapy helps to restore the integrity of the mucous membrane and improves overall well-being. The impact of a magnetic field has a beneficial effect on almost all organs and systems of the body - in addition to the gastrointestinal tract, it is also used in gynecology, for diseases of the respiratory system, musculoskeletal system, joints and muscles, cardiovascular and nervous systems, skin integuments. On the basis of magnetic radiation, the action of the Almag apparatus is based, using which it is possible to conduct magnetotherapy sessions at home, which is especially important for the disabled and the elderly.
• EHF (extremely high frequency therapy), laser therapy - they are indicated for intolerance to pharmaceuticals, frequent relapses and during periods of remission;
• electrosleep (or central analgesia) is prescribed to relieve stressful effects.

This includes hydrotherapy (sea, coniferous, iodine-bromine, warm fresh baths), and drinking treatment. mineral waters(they are used without gases, because gases irritate the mucous membrane and stimulate the secretion of gastric juice), and psychotherapy (including autogenic training), which helps stabilize the mental state of the patient, and massage.

Physiotherapy exercises (LFK) are used together with the main methods of therapy. It helps to improve blood circulation in the abdominal cavity, due to which the recovery processes in the duodenal mucosa are accelerated. Exercise therapy is also the prevention of adhesions and congestion, toning the muscles of the abdomen, back, small pelvis and general strengthening of the body.

Exercise therapy is not prescribed for the development of complications of peptic ulcer, during periods of exacerbations or severe pain in the epigastric region. The exercise therapy course consists of 2 parts, each of which takes into account the patient's condition. In the first half of the course, classes are held in the supine position and on the side, in the second half, movements performed on all fours, knees, sitting and standing are added to the familiar exercises. These complexes are mainly aimed at relaxing the muscles, because with an exacerbation of the ulcer, there is an increased excitability of the entire muscles of the body.

In conclusion - Spa treatment helping to consolidate the success of other measures and implying, among other things, the prevention of relapses. It is contraindicated only during periods of exacerbations, in the first months after surgery, or if an ulcer is suspected of degenerating into a tumor.

Mode and diet

Nutrition plays a huge role both in the appearance and further progression of an ulcer, and in its cure and maintaining a state of stable remission. When you suffer from pain in your stomach, you begin to feverishly think about what to eat so that it does not get worse, and at best, the pain has completely subsided.

With an exacerbation of a duodenal ulcer, a strict anti-ulcer diet is prescribed (table 1a), which must be followed for 5–7 days, since it does not fully satisfy physiological needs organism. Meals are taken 7 times a day (every 2–2.5 hours) in small portions. All dishes are liquid or mushy, with a sharp restriction of salt. Products recommended for use during this period:

• milk,
• butter,
• eggs,
• sugar,
• cereals,
• raw fruit juices.

An indicator of the action of such a diet is the reduction of pain and the elimination of dyspeptic disorders. A week later, you can add to the menu:

• liquid milk porridge (rice, oatmeal, etc.),
• steam dishes from minced meat and fish (meatballs, meatballs).

The frequency of meals is reduced to 6 times (every 2.5-3 hours). This diet is followed for another 2 weeks (table 1b). Before going to bed, you can drink a glass of milk or one-day yogurt.

From the 3rd week of inpatient treatment, the following products are added to the above products (table 1):

• White bread,
• fresh fruits,
• potatoes and other vegetables,
• cream, tea.

Now meals occur every 3-4 hours 5 times a day, and this diet is observed throughout the year.

Products that can be consumed with duodenal ulcer - photo gallery

Soft-boiled egg - one of the main products for ulcers
Shabby vegetable soup provides mechanical sparing of the gastrointestinal tract Vegetables - a source of vitamins and minerals Fruit juices help the body recover Dairy products, along with eggs, are the basis of the ulcer menu Meatballs with mashed potatoes are possible when the exacerbation phase has passed Milk porridge is useful for ulcers

Sample menu when using tables of group 1

Time reception food	Name of dishes
	Table 1a	Table 1b	Table 1
7.00–8.00	1 glass of milk soft-boiled egg	steam omelet, crackers, butter, a glass of milk	Rice porridge pureed milk, cheese sandwich, butter, tea with milk
10.00–11.00	fruit jelly, a glass of milk	Kissel or jelly, milk	apple, cookie, rosehip decoction
13.00–14.00	Mucus soup (rice, oatmeal), soufflé meat steam. Cup jelly or fruit puree	Mucus soup (rice, oat, wheat bran). Steam quenelles with mashed potatoes. Fruit puree, grated apple, crackers	Soup from pureed vegetables. White bread. steam cutlet (boiled fish) with mashed potatoes from vegetables or with porridge. Milk cream.
16.00	Glass of milk, butter creamy, soft-boiled egg	Soft-boiled egg, creamy butter with breadcrumbs, glass milk	Rusks with tea or broth wild rose
19.00	Soup slimy semolina, milk jelly, butter	Steam meat cutlets, mashed porridge with milk, kissel, crackers	Boiled fish with vegetables puree, steam noodles. White bread, a glass of tea.
20.00	Omelet, fruit juice	Soft-boiled egg, semolina, fruit puree	Kefir or fermented baked milk, scrambled eggs or grated cottage cheese sugar
21.00–21.30 (before bedtime)	a glass of milk or kissel	a glass of milk or kissel	A glass of milk

With an ulcer, the following foods should be excluded from the diet:

• pickles,
• smoking,
• canned food,
• fried food,
• meat and fish strong broths,
• condiments,
• cabbage,
• gooseberry,
• currant,
• stringy meat.

Products prohibited for use during exacerbation of duodenal ulcer

Cause an ulcer Spices irritate ulcers Barbecue can cause stomach pain Fast food disrupts metabolism Soda irritates the mucous membrane Smoked meats are prohibited Alcohol provokes internal hemorrhages

When following a diet, it is imperative to adhere to the principle of mechanical and chemical sparing, so the meat is rubbed, the cereals are very soft, the eggs are soft-boiled, soups and jelly are mucous. Before eating, it is good to take antispasmodics (Atropine, No-shpa), along with food - enzyme preparations (Hilak forte, Panzinorm forte, Mezim, Festal and others).

Therapeutic fasting can also be used to treat ulcers, but only if the disease is in initial stage. Fasting involves the refusal of food, but water or other liquids must be drunk up to 1.5 liters per day.

In any case, it is worth consulting a doctor, because this type of treatment can have rather unpleasant consequences. If the “good” is received, then during fasting it is necessary, firstly, not to overcool, and secondly, to avoid heavy physical activity, thirdly, just before you start starving, you need to sit on a special diet for 3-5 days in order to smoothly move on to fasting. Also, get out of fasting - without overeating, gradually.

With an ulcer, water can be diversified only with freshly squeezed carrot juice.

Grandma's folk remedies

There are also time-tested recipes of traditional medicine, inherited from our great-grandmothers. These drugs can be used as an adjunct to the treatment prescribed by your doctor.

1. Freshly squeezed potato juice. To prepare it, you need to peel fresh potatoes and either grate it and squeeze the juice through cheesecloth, or use a juicer. Drink juice 2 times a day - in the morning on an empty stomach and at bedtime, 50-100 ml. within 7 days.
2. Honey drink. For 1 glass of water, take 1 tablespoon of linden honey, stir and drink half an hour before meals 3 times a day.
3. Propolis tincture is made on the basis of: 2 cups of medical alcohol for 20 g of propolis, infused in a dark place for 2 weeks at a temperature of 20–22 degrees

   Moreover, the tincture must be shaken every day. Strained through gauze and consumed 1 teaspoon per 1/4 cup of warm milk for a week.

4. Well helps with an ulcer collection: chamomile, calendula and yarrow - in equal parts. Two tablespoons of the collection pour 0.5 liters of boiling water, leave for 1 night. Drink 3/4 cup 3 times a day for 40 days. Take a break of 14 days and, if necessary, start a new course.

In addition, I would like to note one more thing: some sufferers prefer to eliminate heartburn, which often appears with an ulcer, with the help of soda. It is categorically impossible to do this, because when soda is used for heartburn, a neutralization reaction of hydrochloric acid occurs, the discomfort disappears, but the reaction of alkali, which soda is, with acid corrodes the ulcer even more, and after a short time, when gastric juice begins to stand out again , the pain will resume with greater force.

The same applies to those who want to "cauterize" the ulcer by drinking alcohol and drinks containing it. More F.G. Uglov, our famous surgeon, who operated on many patients, warned against the use of alcohol not only ulcers, but also healthy people. Due to the use of alcohol-containing drinks in the organs of the digestive tract, bleeding can be so intense (alcohol itself dilates blood vessels and blood flow increases) that they don’t even have time to take a person to the hospital - the case ends in death.

When the pain literally does not let you sleep peacefully, many seek advice from relatives and friends, looking for information in the public domain. Nobody likes going to the doctor.

On the Internet, there are often descriptions of various miracle drugs that are a panacea (or so their authors position them). One of these drugs is ASD (fraction 2). It was created by the doctor of veterinary medicine A. Dorogov and was used to treat tuberculosis, the gastrointestinal tract, in gynecology and the treatment of ENT diseases. Opinions about this drug are divided. Negative reviews are extremely rare and only from those who have shown allergic reaction to drug components.

A negative opinion exists mainly among doctors, since this drug was not officially registered, contraindications were not identified, and it is not possible to include it in official treatment regimens. However, some doctors still recommend it as an addition to the main scheme. The use of this drug by the patient will be at "your own risk". In this case, no doctor can vouch for the positive outcome of the treatment of the disease - after all, if during self-treatment (and this is what the uncontrolled use of the drug is called) an exacerbation nevertheless occurs, then in any case you will have to turn to official medicine.

If there are complications...

If the ulcer is no longer amenable to treatment using the above methods, then the radical method of treatment is an operation to resect the ulcer. Surgery is necessary if:

1. There is bleeding or perforation of the ulcer;
2. There is no effect of treatment with pharmaceutical preparations;
3. The ulcer has evolved into malignant tumor(malignancy).

The operative way of treatment is chosen depending on the degree of complication and the size of the ulcer on the duodenal mucosa. Here, too, there are several methods for carrying out the operation:

• Suturing - a way surgical treatment perforated ulcer, is usually carried out using video laparoscopy or laparotomy. Indications may be diffuse peritonitis, a fresh ulcer in a young patient, a high risk of surgery, etc.). The difference between the first and the second lies in the size of the incision - with video laparoscopy, it is only 0.5–1.5 cm.
• Excision is used both for bleeding and perforation of the ulcer. It all depends on the severity of the case. The operation involves a wide incision abdominal wall, excision of the ulcer and subsequent suturing of the walls of the organ. After this, pyloroplasty is done to prevent the occurrence of duodenal deformity (for example, narrowing of the lumen).
• Thermal methods - the most sparing, are prescribed for open bleeding. These include electrocoagulation, thermocauterization, laser photocoagulation and argon plasma coagulation. In short, the essence of all these methods is to cauterize bleeding vessels with different tools and using different materials. Due to cauterization of the bleeding site, relatively stable hemostasis is achieved (i.e., stopping blood loss). It should be noted that laser photocoagulation in recent times losing ground to other methods due to its relatively high cost. In particular, argon-plasma coagulation, the advantage of which is that it is non-contact and devoid of many side effects observed with contact methods.

All types of surgical intervention are carried out only in a hospital. After the operation, physical activity is very important for the speedy healing of the sutures and the prevention of complications after the operation. Patients begin to perform passive exercises already on the first day after surgery (in the absence of complications). On the third day, you can slowly get up. The sutures are removed after about a week, after 2 weeks - discharge home. At the same time, in the postoperative period, some of the methods described above are prescribed, and obligatory adherence to the diet and regimen.

It is recommended to have examinations by a gastroenterologist once every six months for 5 years in the absence of signs of the disease, by a general practitioner - once a year, during examinations - blood and urine sampling for tests; EGDS control; a complete ban on smoking and alcoholic beverages; in the spring-autumn periods - conducting courses of anti-relapse treatment (antacids and antispasmodics for 4-8 weeks); exemption from night shifts and long business trips for the period of anti-relapse treatment.

Having considered the main methods of treatment of duodenal ulcer, its possible complications, and comparing the efforts used for treatment with efforts in the field of prevention of this disease, the conclusion involuntarily suggests itself that the optimal solution is to use willpower to overcome various kinds of temptations and prevent the development of such a pathology in oneself.

But we are all strong in hindsight and are generally sure that this will not happen to us. Where this confidence comes from remains a mystery. But whoever is warned is armed, and after reading the above information, there is a glimmer of hope that someone will think about their health and lifestyle.

Gastric ulcer. This is serious. No less, or rather, complications of a stomach ulcer sound more menacing: a cancerous tumor or perforation (or perforation). What to do to recognize the ulcer in time and prevent complications? The therapist will tell Evgenia Anatolyevna Kuznetsova.

stomach ulcer- it is first of all chronic illness, which has periods of exacerbation and remission, the main symptom of which is the formation of a defect (ulcer) in the wall of the stomach. Not always the formation of a defect can be only in the stomach, it happens that a stomach ulcer is combined with an ulcer in the duodenum. AT pathological process often other organs and systems of the digestive system are also involved, which can lead to dangerous complications and sometimes death of the patient.

In Russia, it is customary to combine peptic ulcer of the stomach and duodenum, this is due to the similarity of the mechanisms of occurrence.

The main mechanism of this disease is an imbalance between the protective and aggressive factors of the gastric and duodenal mucosa. Next, we will analyze these factors.

In this image, we see an endoscopic picture of an ulcer of the antrum of the stomach, the photo was taken during an endoscopic examination.

Protective factors guarding the health of the stomach, this is, firstly, slime which is produced by the cells of the gastric mucosa. It also maintains the necessary balance normal circulation. The cells of the mucous membrane of the stomach and duodenum are normally regenerated very quickly. It is this active regeneration and protects the mucous membrane from damage.

What factors are aggressive for the gastric mucosa? In the first place, of course, hydrochloric acid. It is produced by the cells of the stomach to digest incoming food. Bile acids are also "aggressors". they are produced by the liver, then enter the duodenum. It may also occur casting the contents of the duodenum with these same bile acids into the stomach.

bacterium infection Helicobacter pylori (Hp) It can also cause gastric and duodenal ulcers.

But infection does not always lead to stomach and duodenal ulcers (as well as gastritis), asymptomatic carriage is often HP. Reason why not all carriers get sick HP may be: the state of general and local immunity, as well as non-specific protective factors of the gastric mucosa, such as the secretion of bicarbonates, protective mucus.

There are so-called risk factors that can contribute to the onset of the disease. Risk factors can be:

1. The presence of a patient with high acidity of gastric juice or gastroduodenitis
2. Prolonged stress
3. Reception of some medicines, for example, non-steroidal anti-inflammatory drugs ("popularly" the so-called painkillers)
4. Smoking, drinking alcohol
5. Drinking strong tea, coffee, spicy food
6. genetic predisposition

But there is also rare causes , which can lead to peptic ulcer of the stomach and duodenum, these include: tumors of the stomach and duodenum, diabetes mellitus, Crohn's disease, foreign body in the stomach, tuberculosis, syphilis, HIV infection.

Symptoms of gastric and duodenal ulcers

What symptoms disturb the patient with peptic ulcer? let's consider clinical picture diseases.

It should be noted that the symptoms appear during an exacerbation of gastric and duodenal ulcers, outside of an exacerbation, most often, patients are not bothered by anything. During an exacerbation, it first appears pain in the upper abdomen, which, depending on the location of the ulcer, radiates to the left half of the chest, scapula, chest and lumbar spine, left and right hypochondrium, various parts of the abdomen.

About 75% of patients with peptic ulcer complain of pain, 1/3 of patients experience intense pain, and 2/3 - pain of low intensity.

Pain is often associated with eating, and the time of onset of pain depends on the location of the defect. When the ulcer is localized in the upper part of the stomach (otherwise called cardiac), pain occurs 1-1.5 hours after eating

(see fig. 2)

With an ulcer in lower section(pyloric) and duodenal ulcer, pain occurs 2 to 3 hours after eating, and the patient may be disturbed by “hungry” pains that occur on an empty stomach and disappear after eating, and night pains (see Fig. 3).

In addition to pain, the patient is worried , belching sour, nausea, vomiting at the height of pain, bringing relief, tendency to constipation . The disease is characterized by autumn-spring exacerbations.

An ulcer can lead to such formidable complications as:

• stomach bleeding, in which the vomiting is bloody or looks like coffee grounds, and the stool becomes black, tarry. The person turns pale, there is a cold sweat and other signs of collapse.
• perforation (perforation) ulcer defect (Fig. 4). during perforation, the patient experiences the so-called. "Dagger" pain, vomiting joins.
• cancerous degeneration- the pain is constant, the appetite disappears, the patient feels sick, he is disgusted with meat, there is weight loss.

At the first symptoms indicating a possible gastric and / or duodenal ulcer, an urgent visit to the doctor is necessary. And also, if a patient is diagnosed with gastritis or gastroduodenitis, then it is worth treating these diseases in a timely manner, as well as following the diet necessary for these diseases.

Diagnosis of peptic ulcer of the stomach and duodenum

Diagnosis of a patient with peptic ulcer should begin with the collection of complaints and a history of the disease, and it is also necessary to conduct a physical examination (a method of examining the patient's doctor using the senses) and additional research methods.

Clinical blood test often remains unchanged, but a decrease in hemoglobin is rarely observed, which indicates overt or latent bleeding, with complicated forms of peptic ulcer, leukocytes and ESR may increase.

Spend also fecal occult blood test, it is positive for bleeding from an ulcer.

The most important and informative of additional methods research is gastroduodenoscopy(endoscopic examination of the stomach and duodenum), with this study a special probe (endoscope) is inserted into the stomach, with the help of which the doctor can detect an ulcer, determine its depth, determine its location, and take a biopsy (tissue sampling from the altered area for diagnostic purposes).

Also carry out x-ray examination stomach to detect ulcer niche (this is an ulcerative defect of the mucosa, into which the barium suspension used in X-ray examination enters) (see Fig. 5)

IntragastricpH-metry has important diagnostic value, because allows you to determine the indicators of gastric secretion, depending on the localization of the ulcer.

Finally, blood tests for Helicobacter pylori.

It should be noted that there may be asymptomatic carriage of Helicobacter pylori. Only if positive tests on the HP combined with the clinic of peptic ulcer (or gastritis), as well as the data of endoscopic examination, then HP requires eradication.

In order to determine the infection of the body with Helicobacter pylori, a method is used PCR diagnostics or polymerase chain reaction. The method consists in the fact that in the taken material (biopsy) of the gastric mucosa and duodenum, DNA sections of Helicobacter pylori are determined.

Method ELISA diagnostics, stands for enzyme immunoassay and is also designed to help with diagnosis. In the blood, antibodies IgA, IgM and IgG (immunoglobulins) to Helicobacter pylori are determined. If IgA and IgM are detected, we can say about early infection - the patient became infected a few days ago. If there are IgG antibodies, then they talk about late infection - already a month after infection.

I would also like to say about the widely used respiratory urease test for Helicobacter pylori. Helicobacter pylori in the process of life produces the enzyme urease. A special device helps to compare the level of the gas composition in the initial state, in the normal version, and also with high urease activity.

Treatment of gastric and duodenal ulcers

A special place in the treatment of peptic ulcer is diet.

1. Patients with peptic ulcer need to eat boiled meat, boiled fish, pureed cereal soups (hercules, rice), steamed food
2. Eat less foods that promote flatulence - cabbage, legumes, milk
3. For patients with peptic ulcer, it is necessary to exclude fried foods, rich meat and fish broths, do not overeat, eat 5-6 times a day
4. Do not consume foods that promote heartburn: strong tea, coffee, chocolate, carbonated drinks, alcohol, onions, garlic, butter

Treatment is aimed at eliminating the cause, suppressing the symptoms of the peptic ulcer, and regenerating during the recovery period.

During the period of exacerbation, the patient needs bed rest for 1-3 weeks, since this mode reduces the motor activity of the stomach. In addition, an ulcer often occurs against a background of stress, and bed rest, in simple terms, calms the nervous system.

Preparations for the treatment of stomach ulcers are prescribed by a competent doctor. There are certain treatment regimens. Each patient requires an individual approach, since the causes of ulcers in each patient vary. Attention, self-treatment of peptic ulcer is not effective and dangerous.

Local antacids are used that reduce the acidity of the stomach, astringent and enveloping drugs that increase the resistance of the gastric mucosa to aggressive factors. Of the antacids, preference is given to drugs such as Gaviscon and Rennie, which contain carbotates, in contrast to Almagel and Maalox, which contain aluminum.

Also, for the treatment of peptic ulcer, drugs that reduce the acidity of gastric juice are used. - proton pump inhibitors .

They are divided into five generations.

1. Omeprazole (Omez)
2. Lansoprazole (Lanzap)
3. Pantoprazole (Nolpaza, Zipantol)
4. Rabeprazole (Pariet)
5. Esomeprazole (Nexium)

H2-histamine receptor blockers are also used for peptic ulcer disease. Despite their similarity in sound to antihistamines, they do not treat allergies, but reduce the production of gastric juice. These are, for example, preparations based on Ranitidine (ranitidine itself is now rarely used, it is considered obsolete): Zantak; Ranital; Gistak; Novo-Ranitidine. However, preference is given to proton pump inhibitors.

For the treatment of peptic ulcer associated with Helicobacter pylori, antibiotics are used that are sensitive to this bacterium.

A month after the eradication of Helicobacter pylori, it is necessary to take a second blood test and, if necessary, resolve the issue of repeated eradication, taking into account the patient's complaints.

To eliminate motor disorders of the gastrointestinal tract, which are manifested by symptoms of nausea and vomiting, drugs such as Metoclopramide (Cerukal) and Domperidone (Motilium) are used. However, the drug Cerucal is not recommended for use alone, because. it is necessary to exclude vomiting of infectious genesis.

De-nol, which has a gastroprotective, antiulcer and antibacterial effect, is also widely used. This drug forms a protective film on the surface of the stomach and duodenum, and it also increases the resistance of the gastric and duodenal mucosa to aggressive factors, is effective against Hp and has an astringent effect. In relation to Hp, it is used only in combination with antibiotics. This drug is also prescribed only by a doctor.

During the recovery period, regenerative drugs are prescribed, for example, methyluracil.

Dispensary observation of patients with peptic ulcer of the stomach and duodenum

Patients with peptic ulcer of the stomach and duodenum are examined 2-3 times a year, when exacerbations occur frequently. Also, such patients are regularly examined by a therapist or gastroenterologist - at least 4 times a year. With persistent remission, when the symptoms of the disease do not appear, it is necessary to be examined and examined by a specialist once a year.

Be healthy!

Therapist E.A. Kuznetsova

Peptic ulcer of the stomach and duodenum is a chronic disease, which is based on the formation of an ulcer.

The reasons: infectious factor (Helicobacter pylori infection), nutritional factor (rough food, abuse of fried, spicy, spicy dishes, pickles, marinades, smoked meats and other irritating foods, irregular meals), smoking and alcohol abuse, neuropsychic factors (negative emotions, intense intellectual activity), genetic predisposition, exposure to certain medications.

The predominant manifestation of duodenal ulcer is pain. The pain is localized in the epigastric region (more on the right), acute, painful, develops on an empty stomach, often at night. The pain subsides after taking soda, food or vomiting. In addition to pain, heartburn, bloating, nausea are noted. Exacerbations of duodenal ulcer often occur in spring and autumn. The duration of exacerbations is from 1 to 2 months. Gastric ulcer is characterized by pain in the epigastric region (more on the left). Pain occurs after a short period of time after eating. The intensity of pain varies. The pain is accompanied by heartburn, belching, nausea, vomiting at the height of the pain attack, which brings relief. Peptic ulcer can be complicated by the development of gastrointestinal bleeding, perforation of the ulcer, its malignancy.

There is an opinion that diseases of the stomach and gastrointestinal tract have become a real disease of the century, they are so common among our fellow citizens. Complaints of stomach pain poor digestion and even bouts of gastric and duodenal ulcers evoke only sympathy and sighs: "Oh, and I have been suffering from the same pain lately, probably, as usual, I ate something wrong." There are more and more such "as usual" ones, and finally, a very deplorable result - the harsh diagnosis of doctors "gastric and duodenal ulcers." Needless to say, I have nothing to congratulate you on, the disease is quite unpleasant, especially during an exacerbation, and it is not easy to treat it, even with the help of modern medicines. The worst thing is that this ailment can subsequently develop into a perforated ulcer, which will require surgical intervention.

What factors become "accomplices" of chronic and acute forms diseases of the stomach? Of course, irregular wrong mode nutrition, abuse of various medicinal chemicals that irritate the mucous membrane of the stomach and duodenum, nervous overload, stress, addiction to alcohol and smoking.

It is very sad that diseases of the gastrointestinal tract have ceased to be a "privilege" only for elderly and middle-aged people. Constantly there is a "replenishment" of young people suffering from all kinds of gastritis and colitis.

In some cases, this disease is transmitted by inheritance, but, basically, the main cause of peptic ulcer is a violation of the diet. The main "risk group" includes students, students, young people who are careless about their health.

Causes of the disease:

1. Hereditary genetic predisposition.

2. Infectious lesions of the stomach.

3. Violation of the diet and diet (spicy, rough, smoked food, dry food, food in a hurry).

4. Smoking, abuse of coffee and alcoholic beverages.

5. Physical overexertion.

6. Insufficient sleep and rest, stress, mental stress.

7. Frequent use of non-steroidal anti-inflammatory drugs.

Manifestations of the disease

Pain is the most important symptom of a peptic ulcer. With a stomach ulcer, pain is usually located in the epigastric region on the left, and in the case of a duodenal ulcer, on the right. Pain can be of different nature. Aching, dagger-like, cutting, cramping. It always starts at the same time as eating. With "early" pain, that is, with pain that occurs on an empty stomach and immediately after eating, there is a stomach ulcer. With “late” pains, “nighttime”, and occurring 2 hours after eating, we are talking about a duodenal ulcer. Sometimes at the height of the pain, vomiting occurs, which, as a rule, brings temporary relief. Appetite is preserved, but stool disorders appear - constipation. Exacerbations, as a rule, occur in the spring-autumn period.

Diagnosis consists in the careful collection of complaints, examination and laboratory research. Treatment during an exacerbation is recommended to take place in a hospital. Bed rest is prescribed, meals should be frequent, but in small portions. Food should be ground, warm and without seasonings. Salinity, smoked meats, canned food are prohibited! From medications appointed: antibacterial agents, antisecretory and antimicrobials. Antacids are also prescribed, the purpose of which is to reduce pain.

The prognosis is relatively favorable with diet and adequate treatment. Complications may occur: bleeding, breakthrough of the wall of the stomach or intestines at the site of the ulcer, narrowing and transformation into malignant neoplasm. In this case, the prognosis becomes unfavorable.

Prevention of gastric and duodenal ulcers

Quitting smoking, coffee and alcohol.

Compliance with the diet and prescriptions of the doctor.

Refusal of non-steroidal anti-inflammatory drugs.

Compliance with the regime of work and rest.

Dispensary supervision.

Stone oil has a strong antiseptic and healing effect. But most importantly, stone oil will prevent the transformation of an ulcer into an oncological disease. With an ulcer, as with gastritis, take a solution of stone oil inside.

Dilute 5 g of stone oil in 3 liters of water. Drink 1 glass 3 times a day 30 minutes before meals.

An important place in the treatment of peptic ulcer is diet. With an exacerbation of the disease, frequent (4-5 times a day) meals in small portions are shown.

Flax (seeds). Pour 1 part of whole flaxseeds with 30 parts of hot boiled water, shake for 15 minutes, strain and squeeze. The resulting mucus, take 1/4 cup 30 minutes before meals 3 times a day. The course of treatment is 2-3 weeks.

Chaga (birch mushroom). Wash the mushroom with water, then soak in boiled water so that the mushroom body is immersed in water, and leave for 4-5 hours. Grind the soaked mushroom on a grater or through a meat grinder. Use the water in which the mushroom was soaked to prepare the infusion: pour 1 part of the chopped mushroom with 5 parts (by volume) of this water, heated to a temperature of 50 ° C.

Infuse for 48 hours, then drain the infusion, squeeze the sediment through gauze. Dilute the resulting liquid to the original volume. Drink 3 glasses a day.

If you are an adherent of traditional medicine and support a course of treatment with dairy products, I will remind you once again of the need to eat right and regularly every day, even if your illness is not acute. Otherwise, the miraculous powers of milk will not help.

What do you need to change in your daily diet? First of all, especially during an exacerbation of the disease, be sure to exclude spicy and fried foods, salted and pickled vegetables, raw fruits and vegetables, pastries, meat and fish dishes, mushrooms, fresh fruit and berry juices, canned fruit and vegetable compotes, wholemeal bread , hot and spicy seasonings.

Combine the intake of medicinal products, the basis of which are milk and dairy products, with the use of products that do not irritate the gastric mucosa. These can be various soups cooked in milk, with the addition of guis, pasta, buckwheat, wheat or barley groats, soft-boiled eggs, dishes from chicken meat or lean beef, steamed, mashed potatoes, pureed cereals cooked with milk, steamed omelet, pureed boiled vegetables (except white cabbage), baked apples, low-fat cottage cheese, creamy and vegetable oil, milk, jam, honey, sweet weak tea, cream, sour cream, cottage cheese, mild cheese, rosehip broth.

The treatment of stomach ulcers is mainly reduced to taking a certain amount of whole cow's milk in its pure form or in mixtures with other medicinal, but only natural ingredients.

One of the most acceptable and accessible, in our opinion, methods of treatment is the regular intake of cow's milk, in which an ordinary garden pumpkin was steamed. Peel the (ripe) pumpkin, remove all the seeds and cut into small pieces across the fibers. Take 200-250 g of raw pumpkin for 1 liter of milk. Pour milk into an earthenware or enamel bowl. Put the pumpkin pieces into the milk and close the lid tightly. a pot of milk in a slightly preheated oven and steam until the pumpkin is completely softened over low heat.Taking the pan out of the oven, wrap it with a wide towel and leave the pumpkin for 15-20 minutes in a warm place, then mash it with a mortar right in the pan with milk and stir well.Drink the resulting mixture 1/2 cup daily 3 times a day for half an hour before meals.

If you are not allergic to honey, we can offer another very healing medicine, which in the old days healers healed patients with stomach ulcers.

1 st. l. honey should be melted over low heat, diluted with one glass of hot boiled cow's milk, cooled slightly and warm, take this remedy 3 times a day: in the morning - an hour before meals, in the afternoon - an hour and a half, and, finally, in the evening - after 2 - 3 hours after dinner.

This medicinal drug gives excellent results (with good tolerance of honey and milk by the body). Exhausting pains in the stomach calm down or are easier to bear, many unpleasant "companions" of peptic ulcer disappear - nausea, gag reflexes, weakness, general malaise. In addition, this medicinal drink has the ability to stimulate appetite, contributing to increased secretion of gastric juice. With regular intake of the drink, a partial restoration of the damaged gastric mucosa occurs.

Significant relief for patients with gastric ulcer brings treatment with a folk remedy, which was practiced by the Ural healers. This is fresh goat's milk diluted with warm potato broth.

For half a glass of goat milk, take 1/3 cup of potato broth, mix and take twice a day on an empty stomach, 1.5 - 2 hours before meals, preferably in the morning and evening. If goat milk is well tolerated by the body, you can increase the dose of this remedy up to 3-4 times a day. This drink eliminates severe pain in a stomach.

Usually in such cases, 50 g of birch buds are taken for treatment, they are insisted for 10 days on 500 g of vodka and allowed to drink tincture from half to one teaspoon With water three times a day 15-20 minutes before meals. This remedy causes a good appetite in the patient, promotes the healing of stomach and duodenal ulcers.

For treatment in traditional medicine using cabbage juice. It is widely used in the treatment of stomach With low acidity, a also in inflammatory bowel disease. Shredded raw and sour cabbage enhances the secretion of the stomach, increases appetite, improves the digestion process, and normalizes bowel activity. Sauerkraut is a good prophylactic against chronic dyspepsia, scurvy.

To be treated with tincture of birch buds on vodka: take half a bottle of buds for a bottle of vodka, insist for a month; drink one glass every hour until vomiting stops. For peptic ulcer of the stomach and duodenum, take 40 drops 3-4 times a day.

1. Collection used for gastric and duodenal ulcers: chamomile (flowers) - 10 g, fennel (fruits) - 10 g, marshmallow (root) - 10 g, couch grass (rhizome) - 10 g, licorice (root ) - 10 g.

2 teaspoons of the mixture per cup of boiling water. Insist, wrapped, 30 minutes, strain. Take a glass of infusion at night.

2. Collection used for gastric and duodenal ulcers: 1 fireweed leaves - 20 g, lime blossom - 20 g, chamomile (flowers) - 10 g, fennel (fruits) - 10 g.

2 teaspoons of the mixture per cup of boiling water. Insist, wrapped, 1.5-2 hours, strain. Take one to 3 glasses of infusion throughout the day.

3. Gastric ulcer with pain. Cancer necks (roots) - 1 part, plantain (leaf) - 1 part, horsetail - 1 part, St. John's wort - 1 part, valerian (root) - 1 part, chamomile - 1 part.

1 tablespoon of the mixture per cup of boiling water. Steam 1 hour. Take 100 g 3 times a day before meals.

4. A string - 100 g, celandine - 100 g, St. John's wort - 100 g, plantain - 100 g.

All is good to crush, mix. 1 tablespoon of the mixture per cup of boiling water. Insist, wrapped, 2 hours, strain. Take 1 tablespoon 3-4 times a day one hour before meals or 1.5 hours after meals.

5. Licorice, root - 10 g, orange peels - 6 g, water - 100 g. Steam over low heat until half the original volume. Add 60 g of honey. Take this dose throughout the day in 3 divided doses. The course of treatment is 1 month.

6. Boil peeled potatoes in an enamel pan, do not salt. Then pour off the decoction. This decoction is taken 0.5-1 cup 3 times a day. Drink daily fresh broth, avoiding smell and spoilage.

7. White cabbage. Drink the juice of fresh cabbage 1/2 cup 2-3 times a day for an hour before meals in a warm form.

8. Sea buckthorn. For the treatment of gastric ulcer and 12 duodenal ulcer, take 1 teaspoon of sea buckthorn oil 3 times a day before meals for 3-4 weeks. In the first 3-4 days of treatment, heartburn intensifies and sour belching appears. To prevent these unpleasant sensations, 1/4 cup of a 2% SODA solution is added to sea buckthorn oil before use and shaken well. With systematic ingestion, pain, heartburn, and belching decrease or completely disappear. Oil does not significantly affect the acidity of gastric juice.

In addition to oil, fresh and canned sea buckthorn fruits are widely used as a valuable multivitamin remedy. The fruits of sea buckthorn are washed, put in a clean enamel bowl, covered with an equal amount of granulated sugar by weight, and stirred well. Then the mixture is transferred to half-liter glass jars, filling them by 4/5 of the volume, and covered with sugar on top. Banks are covered with parchment and tied. In this form, sea buckthorn can be stored in a cool, dark place throughout the winter without losing its taste and healing properties.

Peptic ulcer is a chronic disease that simultaneously affects the mucous membrane of the stomach and duodenum, and is characterized by the formation of ulcers on it. It refers to common ailments and is diagnosed in 10% of the population over the age of 30 years. It is better to ask a question in a timely manner than to treat a stomach and duodenal ulcer than to endanger your life.

At the initial stage, the ulcer is treated with medications, advanced forms require surgical intervention. The pharmacological market represents a large number of drugs that can relieve the symptoms of peptic ulcer, eliminate inflammation and protect the mucosa. Medications should be taken only as directed by a gastroenterologist, after certain laboratory tests.

With a peptic ulcer, you need to follow a diet.

Complex therapy of peptic ulcer disease consists of the following components:

1. Treatment with drugs of various pharmacology, which tighten the ulcer, reduce the secretion of gastric juice, and eliminate painful symptoms. Exclusion of irritating factors (smoking, alcohol, regular stress, fatty, spicy foods).
2. Compliance. During the period of exacerbation, the patient must be on a strict diet, and in remission, also do not consume prohibited foods so as not to provoke a relapse.
3. Physiological procedures are shown individually during the period of weakening of the disease. In addition, stomach ulcers are highly treatable with proven folk methods.

Medical treatment of peptic ulcer

Almagel will help relieve the symptoms of the disease.

Medical treatment includes the following areas:

• Antibacterial therapy. Carried out after discovery.
• Reducing or neutralizing the acidity of gastric juice. Protecting the intestines from harmful influences, increasing the functionality of the membrane and healing wounds. Normalization nervous system and mental state.
• The variety of drugs prescribed for treatment is quite large. Now there is the possibility of using special protocols, which indicate the main treatment regimens, recommended drugs and dosages.
• In the presence of Helicobacter pylori infection, several antibiotics are prescribed to which these bacteria are sensitive, most often Amoxicillin, Metronidazole, Bismuth drugs.
• To neutralize the effects of gastric juice on the membrane, antacids are prescribed. They have an astringent and absorbent effect. These drugs are not able to cure an ulcer, but they greatly alleviate the symptoms. Among the most commonly prescribed are Maalox, Phytolysin.
• Histamine receptor blockers such as cimetidine reduce the synthesis of hydrochloric acid and reduce its acidity.
• Prokinetics are also shown, which help to speed up the movement of food through the intestines and prevent bloating, nausea and vomiting. Assign most often, Tsirukal, Metoclopramide.
• If it is necessary to eliminate the pain syndrome, antispasmodics are recommended - drotaverine, which can relieve pain of low and moderate intensity. Depending on the individual characteristics organism and the specifics of the course of the disease, it may be necessary to prescribe additional drugs.

It's important to know! You should not arbitrarily refuse to take medication, even when your health has improved, and nothing bothers you for several days.

Treatment by surgery

Resection - removal of part of the stomach or intestines.

If a drug treatment does not lead to the desired results, the recovery of the body does not occur, and peptic ulcer provokes other digestive diseases, then a planned operation is prescribed.

The decision on surgical intervention is made collectively after a thorough examination of the whole organism. Types of operations for an ulcer can be as follows:

1. Resection - removal of the part of the stomach or intestine affected by an ulcer.
2. Vagotomy - the nerve endings responsible for the production of gastrin (a hormone involved in the regulation) are blocked
3. Endoscopy - the surgeon makes several abdominal punctures, through which he introduces special equipment, the doctor will cut off the posterior vagus nerve with it.

Absolute indications for immediate surgical treatment of the disease are as follows:

• profuse gastric bleeding;
• narrowing of the pylorus (food does not pass into the duodenum);
• perforation (breakthrough of an ulcer into the abdominal cavity or other organs);
• magnilization (degeneration of an ulcer into a malignant tumor).

Other indications for surgery for an ulcer may include:

1. the disease is not treatable with drugs;
2. frequent exacerbations
3. the disease spreads to neighboring organs
4. large areas of ulcerative lesions
5. patients over 50 years of age
6. individual intolerance to prescribed drugs
7. deformation of the stomach
8. gastric polyposis.

It should be noted that operations are more often needed for gastric ulcers than duodenal ulcers.

Proper diet and diet

Food should not irritate the gastric mucosa.

Treatment of gastric and duodenal ulcers is carried out in a complex manner, and plays one of the main roles in this.

The diet should have maximum nutritional value and include a sufficient amount of proteins, fats, carbohydrates, minerals and vitamins. The food consumed should not irritate the gastric mucosa and. Food temperature should be close to body temperature for better absorption.

Products that increase the secretion of gastric juice and those that irritate the membrane are prohibited, namely:

• fresh rye bread, rich bakery products;
• meat: tough, fatty, salty, smoked and fried;
• mushrooms;
• fatty fish, caviar;
• with high fat content (cream, sour cream, milk)
  vegetables with hard-to-digest fiber: radishes, white cabbage, spinach, garlic, onions, cucumbers
• Fruits and berries with high acidity: citrus fruits, apricots, pineapples, kiwi, watermelon
• Too sweet foods, chocolate
• From drinks coffee, cocoa, strong tea.
• Alcoholic beverages and smoking are strictly prohibited.
• spicy sauces
• Canned products.

1. Boiled soups from cereals enveloping the stomach: oatmeal, rice, pearl barley
2. Bread is not rich, crackers
3. Dishes from low-fat varieties of meat, poultry, fish boiled in whole pieces, or steamed in the form of cutlets, soufflé.
4. Soft-boiled eggs or steamed scrambled eggs.
5. Small and well-cooked pasta
6. Vegetable puree from potatoes, cauliflower, carrots
7. Low-fat kefir, cottage cheese, milk

Drinks such as fresh juices from non-acidic fruits, compotes, weak teas from rose hips, wheat bran, and chamomile will also be useful. In the acute course of the disease, an even more sparing diet is used. Bakery products, fruits are completely excluded. All dishes are consumed only in liquid or mushy form.

Such a diet lasts from 2 to 4 weeks, depending on the severity of the course of the disease. After, the introduction of new foods into the diet should occur gradually - no more than one product per day in small quantities.

Folk methods of treatment

Olive oil help in the treatment of peptic ulcer.

There is indisputable evidence of the treatment of gastric and duodenal ulcers using folk methods.

However, they should be used only after careful diagnosis and consultation with a doctor.

Recipes prepared at home are designed to eliminate unpleasant symptoms and heal ulcers. Folk recipes that help in the treatment of the disease:

Honey. Honey is a unique healing product for the treatment of peptic ulcer. It reduces the high acidity that occurs with ulcers, cleanses the mucous membrane of germs and soothes inflammation. Effective Recipes:

• Honey dissolves in a water bath (it is important to ensure that the product does not boil) and is consumed in small sips. The daily dose should be from 100 to 120 gr. Consume in equal amounts before breakfast and lunch and after dinner.
• 1 cup of goat milk is mixed with 1 tablespoon of butter and 1 teaspoon of honey. Heat the mixture over a fire and add the egg, stir everything thoroughly. Take 10-15 days.
• 0.5 liters, 0.5 kg of honey and the juice of two lemons are mixed, the medicine is taken 3 times a day on an empty stomach.

Quail eggs. Quail eggs contain enzymes that help heal ulcers on the walls of the stomach and intestines. The essence of the treatment is that every morning, half an hour before meals, drink 3 eggs. Relief can be felt after a week, the course of treatment is 4 months.

Olive oil. Olive oil has long been famous for its healing properties and efficacy in the treatment of peptic ulcer. To prepare the recipe, you need to fill a glass container with St. John's wort and pour olive oil to the top.

The bottle is placed in a pot of water, which, in turn, is also placed in a large pot. All this is put on a slow fire for 6 hours. The broth is filtered and taken 1 tablespoon before meals.

Oats. Oats contain a lot in their composition, have healing properties, fill the body with energy, and reduce the acidity of gastric juice. To prepare the medicine, 1 cup of well-washed oats is poured into 4 cups of water and boiled for 30 minutes.

The broth is well filtered and stored in the refrigerator. You need to drink in a warm form, 0.5 cups 3 times a day before meals. For increase medicinal properties in oatmeal broth, before use, you can add a little goat's milk, a spoonful of honey and butter.

If you find a stomach ulcer and duodenal ulcer, do not despair, although the disease is dangerous, in most cases it can be treated well. Preventive measures for relapses are proper nutrition, giving up bad habits, avoiding stress, physiotherapy, application.

How to treat stomach and duodenal ulcers, the video will tell:

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