Gastroenterologist, Gastroenterology Journal

Question: Died doctor! I'm 40 years old. In the 12 had been diagnosed with gastritis, 30 was identified ulcer 12-duodenum. All my life I accompanies this stomach ailment, because the frequent exacerbation manifested erosive bulbitom, frequent treatment. . . I understand that with this disease need to throw smoke (smoke from 15 years), but throw prevent my stomach. I have the willpower to give up cigarettes sharply, which went through 4, 2 and half year ago. And throw easily, and for 3-5 days longer pulls, and I feel good, but every time after 30-35 days of my life without cigarettes begin to hurt the stomach. At first slightly, then stronger and stronger. I understand that starts peaking, and begin to take Omez (2t/den) or Kvamatel (2t/den) (in different cases were differently). And interestingly, the effect of antiulcer agents receive zero, because in spite of receiving these drugs, with each passing day the pain was not diminishing but increasing. After about 5-7 days, despite their drug I nachanayutsya even stomach pains at night – I wake up from them. And I'm beginning to suspect that the aggravation of peptic ulcer disease occurs in me because of the rejection of cigarettes, once even lekartva not help, and as a result, approximately 40-day, I light up. As soon as I light up, all symptoms of peptic ulcer go away within days. Taki way I tried three times to quit, and all three times experiencing this phenomenon with stomach pains for 30-35 days, which will not save even Omez and Kvamatel. Maybe it's something to do with regulation of the nervous system, but not much in it seems, because the field is how to quit smoking, I feel great, and absolutely do not observe the nervous excitability – easy to fall asleep, wake up easily, normal vital activity. How to be in a situation where the patient stomach – have quit smoking and quit smoking – begins exacerbation of chronic disease.

Answer: Two capsules per day omeza must remove the pain associated with ulceration / erosion of the mucous membranes, but gastroscopy with these periods, as understood, was not carried out, deterioration could be purely "clinical" (and therefore are in during the day). Dose omeza at the time of peak pain for a week for example, can be doubled (2×2), plus add Venter, and, of course, diet.

Question: I discovered an ulcer dvennadtsatiperstnoy intestine. Prescribe treatment Epicurus (2 capsules per day), Venter (2 tablets 3p. Per day for 40 minutes before eating), motilak (3 pp. Per day for 20 minutes before eating) and penzital (after eating). The question arose, whether the effective application of this scheme, 10 days Venter, and then replace it with de-nol and take it 4 weeks, along with the rest appointed by drugs. Go directly to the de-nol afraid, because in the new year, the doctor allowed alcohol or eat (only vodka), and de-nol with alcohol use is not recommended (other prescribed drugs, according to the attending physician, are not critical to the consumption of alcohol). P. S. The presence of bacteria heliobakter not been verified.

Answer: determining a reception Epicurus (lansoprazole), the duration depends on the endoscopic picture. The rest is not important.

Question: Please consult regarding treatment. I first asked the gastroenterologist about the problems, made FEGDS results are as follows: stomach, gastric mucosa is hyperemic (diffuse), the antral mucosa is hyperemic (diffuse). Folds enlarged, biopsies of H. p. , Invasion sharply positive, duodenal-ulcerogenic strain. Division passes freely, localization: onion KDP, peristalsis in the normal mucosa hyperemic follicles, mucosa zalukovichnogo Department hyperemic, enlarged fold lesions: ulcer, location: KDP bulb, medial wall, the form is incorrect, Size: maximum 0. 8 cm, the minimum 0. 5cm, the base (bottom) under the fibrin, the edge nodulated (non-uniformly convex), the surrounding mucosa infiltration, Vater papilla is not visualized. Unfortunately, I absolutely do not possess the above terms and can not objectively evaluate their diagnosis, therefore, be so kind as to tell me how to be treated and how all this is treated in general. Thanks

Answer: banal ulcer 12-duodenum with ulcer in the beginning stages of healing, "associated with Helicobacter pylori. It is treated and cured. Every doctor knows what to do.

Question: Dear doctor! 3 months ago after severe stress, there were abdominal pain, rumbling, bloating, severe nausea, weakness, occasionally abundant 1.2 times liquid stools, pain in the shoulder blade. Self (New Year's holidays were) taken 12 days kvamatel, Almagel, Rennie, but, Univ. Some improvement with minor aggravations. At the Uzi was diagnosed Mts. pancreatitis (small) and the bending of the gall bladder without stones + spikes (9 years ago was peritonitis due to missed ectopic with fetal attachment in the intestines). They appointed pancreatin-improvement, the food was perivarivatsya disappeared madhouse, but remained nausea. Analysis of blood Hp-73, reduced hematocrit, mikrotsitoz, anisocytosis, poikilocytosis, erythrocyte 3. 2, platelets 380, erythrocyte sedimentation rate 24, the rest is normal, elevated ALT-55 (N-34). They began to poke Ferrum-Lek. At FGS found 2 ulcers and pyloric pyloric division, diaphragmatic hernia and signs of mild pancreatitis. They appointed ultop (omeprazole) 20.2 times a day, month, mezim and valerian. Pancreatin was told to cancel, to the pancreas to work. After 2 days FGS black chair. At ultope was better, vanished nausea, pancreatin take one day at dinner, or inflate the stomach. Went on vacation at sea, everything is gone and without a strong diet, Hp is 116, everything else is normal, but only came to work-stress + weak and nauseated. Ultop reduced dose of 2 times and like 5 days worse. Must go for a second FGS, but familiar to doctors all say differently, it is felt that an ulcer rasstrevozhat nanervnechuyu again and I imagined it to study (my day always breaks before any investigation, even the ultrasound. And another question: how long can drink ultop and drink for me pancreatin (it helps me) Fresh amylase-90 (up to 100 standard), but for 2 days, I drank 1 tab. pancreatin. Thank you

Answer: There is a plague or not – still need a couple of weeks to resume reception ultopa in the previous dose. Ultop can drink indefinitely, also pancreatin. Social cause of the disease and here we can not help dramatically.

Question: Good day!'ll show please! 12 ulcers treated with duodenum. Endoscopy showed that the ulcer healed (the red scar stage). Once passed a course of treatment and stopped taking the medication 2 weeks later the pain came back in the right side, not always but periodically. Diet comply. Tell me again, I can be sore for a short period? More. 12 duodenum ulcer in my first time. Course of treatment 7 days Amoxicillin 1gr 2raza a day, clarithromycin 0.5 g 2 times a day, omeprazole in the morning-evening. 2 weeks kvamotel 40 g at night, tserukal 3 r day. After: (Held endoscopy which showed a small ulcer in the healed stage of red scar.) Next: 3 weeks kvamotel 20 grams at night, de Nol 2 times a day. 1 week mezim forte, hilak forte. After the abolition of drugs appeared a little heartburn mainly after breakfast and dinner, the evening never worried, began to take kvamotel 20 g at night, heartburn gone, but now there are periodical pain in the right abdomen. How successful could pass erradikatsiya helicobacter in this scheme of treatment? Will the trail of an ulcer? Can again at the moment I have an ulcer? Thank you.

Answer: 1. Eradication – means the complete elimination and the question "how" disappears. Held it or not, you can check. 2. Timely delivery of treatment prevents the occurrence of cicatricial deformation of the KDP, let's hope that you have no trace left. 3. Peptic ulcer occurs in different ways and to exclude a relapse you can not. The severity ulcer. Domestic standards of care assess severity of ulcer disease as follows: rare recurrent – sharpening 1 time in 5 years the flow of light – sharpening 1 time in 1-3 years; moderate – acute, 2 times a year; heavy – acute 3-4 times year; continuously-recurring – aggravation of 4 or more times a year, "light" periods do not exist; latent – hidden (it's 25% of all lesions detected and confirmed prophylactic endoscopic examinations).

Question: Very good, informative resource. Ulcer PDK 24. 03. 2008. Mucous membrane of the esophagus: normal color deficiency cardia: No, Mucus: a thick, viscous. The folds of the stomach: longitudinal. Mucous antrum: gipermirovana, puffiness. Folds thickened. (Is this good?). Local status: On the front wall of the bulb 12-n guts ulcerative defect in the oval shape with inflammation around the shaft, the bottom is covered with fibriozno-purulent coating. Size of ulcers 0.6 * 0.4 cm in the apex of the bulb mucosa multiple severe erosion. Mucous downward Division 12-n guts hydropic and niperemirovana. Conclusion: Duodenal ulcer, Chr. antral gastritis, erosive bulb, duodenitis. incl. installed the first time: Duodenal ulcer. Erosive bulb. Is that bad? Was treated Parietom, Clarithromycin, Amoxicillin, mezim forte, lineks. Often there is pulling pain in the left hypochondrium, the doctor said that 12P intestine is under the right hypochondrium, and the left can pull the intestines from the fact that taking antibiotics. Unfortunately, no link is not working. I would like to learn about nutrition. If ulcer rumen, then open it usually in the same place, or may open in another location. And whether it can heal without scar, and whether she then reappear in this place. How is the process of delaying ulcer (growing new tissue?). Sorry if a lot of questions.

Answer: Questions of general you have a lot, but data were not enough: for example, the duration of cure, diet, bad habits, the presumed cause. Please review the materials of the first section without options. Surprisingly, that did not know about the peculiarities of nutrition, they are in the "health food". It is necessary to establish normal contact with your doctor, take the dispensary registration with a gastroenterologist.

Question: Tell me please, before or after a meal to Epicurus? In testimony on the application is not written, the doctor also did not write. And whether the doctor made, prescribing Epicurus? Ulcers no ordinary gastritis and reflux ezofagonit (I think so written). In Epicurus, appointed more Motilak and Maalox. Is appointed treatment?

Answer: No matter when, it is important to regularly – at the same time every day. Excuse me, but appointed by other doctors do not discuss treatment in absentia.

Question: please, I was diagnosed with an ulcer bulbs 12-duodenum, I'm going to go to Egypt, treatment began on Wednesday appointed pariet and de-nol, and going to go on Saturday. The doctor is insisting that I suffered a trip said that affects everything, but it is not very fun, very rassraivatssya, no water park and вобще any excursions. Please explain how much this is true, and what way affect any of my emotional state Condition ulcers, Thank you, Hope

Answer: Actually, it all depends on many factors and the doctor will not take responsibility. If the plague of small size, shallow, and in a state of incipient scarring or bottom of its fibrin satisfied, then the treatment is continued good dose parieta risk of complications is low.

Question: Discharged "Pariet" and "De-sex". "Pariet" is expensive. Omeprazole has the same features and is much cheaper. Is there a big difference in the use of these drugs, or be replaced?

Answer: This is a question for the doctor. Possible without de-ethanol do if you think that expensive.

Question: The son (20 years) complained of frequent aching pain in the abdomen, died down after a meal. Gastroscopy showed duodenal ulcer 0.6 cm biopsy revealed no Helicobacter. Month took pariet (1 tab. In the morning), de-nol in half an hour before meals three times a day. Diet comply. Repeated gastroscopy in a month: stage of red scar and a new ulcer-ulcer pyloric 0, 6, see How can that be – inadequate treatment? Then why the first ulcer healed? A blood test showed antibodies class IgG 6,1. Now the doctor sends to pass a blood test for gastrin – check for Zollinger syndrome. . .

Answer: Standard adequate treatment. It proved ineffective, because the doctor considers it necessary to exclude rarer causes. But, in itself, peptic ulcer disease – a complex thing (http://doktor. Ru/qa/13938/qa. Html? Id = 76555).