Treatment of peptic ulcer of the stomach and duodenum

Pathogenetic treatment for peptic ulcer involves the appointment of a general and dietary regimen, as well as drugs that normalize the neuroendocrine regulation of the function of the alimentary canal, providing local digestion conditions that are optimal for ulcer scarring.
The initial stage of treatment for exacerbations, it is advisable to carry out in stationary conditions in compliance with bed or semi-bed mode. This allows you to protect the child from external adverse effects. A few weeks after the start of treatment, when the condition improves, the child can be switched to a free regime, which excludes, however, significant physical and emotional stress, which adversely affects the motor function of the stomach and duodenum.
Diet therapy for peptic ulcer is based on the antacid properties of food and the influence of its ingredients on the secretory-motor function of the alimentary canal. For this purpose, food is prescribed in fractional doses, but often (6 – 7 times a day). The diet includes only mashed potatoes and liquid dishes from products that excite the secretory and motor activity of the stomach and duodenum as little as possible. The great need of a growing child’s body for complete food ingredients determines the relative frequency of application of a strict restrictive diet. The composition of this diet includes vegetarian mashed and mucous soups with milk and cream, mashed cottage cheese, yogurt, soft-boiled eggs, butter and vegetable oil, jelly, juices from carrots, cabbage, oranges, table salt – 2 g per day.
By the end of the first week, the child is transferred to a diet No. 16, which additionally contains crackers, boiled meat, passed through a meat grinder, mashed cereals. Subsequently (after 2 weeks), vegetable purees, steam cutlets, white stale bread, dry non-butter cookies are introduced (diet No. 1c). Further, as the condition of the child improves, a diet No. 1 is prescribed for 4 – 6 months, which includes, in addition to the above-mentioned dishes, low-fat boiled meat, noodles, well-soaked herring, boiled sausages and sausages, steam slightly fried cutlets, fresh bread, normal amount of salt . Further expansion of this transitional diet is carried out taking into account the patient’s condition, however, even with complete well-being for several years after peptic ulcer exacerbation, it is necessary to avoid the use of spicy foods and seasonings, pickles and beggars containing saturated fats.
In case of ulcerative bleeding, the child’s nutrition in the first days is reduced to the appointment of small portions of milk every 2 hours, mucous soup, kissel (except for cranberry ). Next, add the egg, sugar, milk and cream mixture. Subsequently, a strict antiulcer diet with a more gradual expansion is prescribed .
Given the nutritional limitations of peptic ulcer, it is necessary to additionally prescribe vitamins, especially ascorbic acid and group B, at the maximum age dosage. In recent years, give the value contained in the fresh cabbage antiulcer factor called vitamin U. Because antacid medicaments reducing pepsicheskuyu activity of gastric juice and promoting a decrease in the spasm piloroduodenalnoy zones, are most common prescription containing equal amounts of magnesium oxide, sodium carbonate (or magnesium trisilicate with a tendency to constipation), as well as bismuth nitrate. With the success also apply almagel and vikalin having, in addition, analgesic effect, gastrofarm . A distinct normalizing effect on the secretory-motor function of the stomach and intestines is exerted by peripheral anticholinergics (M- anticholinergics ) – metacin , atropine, platifillin , as well as no-shpa and quateron , which has a pronounced ganglion-blocking effect. Clinical observations indicate that treatment for peptic ulcer in children with oxyferrisorbone , which has a direct reparative , decongestant, and anti-inflammatory effect , is highly effective . The prescribed dose (half or all of the contents of the vial – 0.03 g of dry matter diluted in 3 ml of isotonic sodium chloride solution) is administered intramuscularly 1 time per day for 20 days. As stimulants, fractional hemotransfusions , metacil or pentoxyl , hormonal and non-hormonal anabolites – methandrostenolone and potassium orotate can be used . Of the physiotherapeutic procedures, iontophoresis of calcium, novocaine, bromine, hydrotherapy, shown soon after the exacerbation, is more often used. As for thermal procedures , they are permissible only in the period of stable remission. Gastrointestinal bleeding is an indication for the appointment of strict bed rest, cold on the stomach, blood or plasma transfusion and other measures used for internal bleeding. If their effectiveness is insufficient, the question of surgical intervention should be timely resolved. Sanatorium treatment for peptic ulcer in children is carried out in Zheleznovodsk, Essentuki, Truskavets and other resorts. In the complex of inpatient and outpatient treatment, mineral waters of Smirnovsky and Slavyansky sources can also be used.

Prevention of peptic ulcer of the stomach and duodenum

Among the measures to prevent peptic ulcer of the stomach and duodenum and its exacerbations, we should first name timely treatment for chronic gastritis (gastroduodenitis) and disorders of the secretory-motor function of the alimentary canal. Strict adherence to a rational general and nutritional regime is also of great importance, which is especially important for children with a family predisposition to diseases of the stomach and intestines. Observations of recent years indicate the undoubted effectiveness of the follow-up and systematic (twice a year) courses of anti-relapse treatment prescribed about a month before the expected exacerbation (a two-week cycle of administration of anticholinergic drugs or monthly vikalin , almagel ).

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