Erosive bulbitis is an inflammatory disease in which there is a lesion of the duodenal ampulla with the occurrence of single or multiple erosions on the mucous membrane. The disease is found in 1–3% of individuals during gastroscopy for epigastric pain. Erosive bulbitis affects men and women with approximately the same frequency.. The chronic form of the disease is more often recorded in the age group over forty.. In the structure of all bleeding of the upper gastrointestinal tract, the share of erosive bulbite accounts for 4%.

With erosive bulbitis, erosions are observed on the mucous membrane of the duodenum. Causes and risk factors In some cases, the development of erosive bulbitis does not have an obvious relationship with some pathological effect.. Single erosions on the mucous membrane of the bulbar section of the duodenum are also found in clinically healthy individuals. As a rule, the primary erosive bulbit is usually formed as a result of exposure to pathogenic microflora (Helicobacter pylori).

Secondary erosive bulbitis can develop as a result of the action of certain medications (long-term use of corticosteroids, nonsteroidal anti-inflammatory drugs, etc.). ), as well as against the background of injury, burns, exposure to toxic substances, including the use of alcoholic beverages, in the postoperative period, as well as in patients with pathologies of the urinary tract, respiratory tract, cardiovascular system, liver.

Primary erosive bulbitis is due to infection with Helicobacter pylori. Risk factors include:.

genetic predisposition;

immune disorders;

disorders of the endocrine and nervous systems;

infectious processes;

foreign body entering the stomach;

poor nutrition;

chronic stress;

radiation and chemotherapy.

These factors cause disturbances in the functioning of the protective barrier of the duodenum. Against this background, an increase in the aggressive action of pepsin and hydrochloric acid, which enter the duodenum with the contents of the stomach, give a start to the pathological process. In addition, the development of the disease is facilitated by a decrease in the components of the mucous membrane of the walls of the bulbar part of the duodenum and a violation of the normal processes of its regeneration..

Forms of the disease Depending on the etiological factor, erosive bulbitis is subdivided into primary, i.e.. inflammation first developed precisely in the duodenal bulb and secondary, in which inflammation of the duodenal bulb is one of the symptoms of a general disease.

By the nature of the course, erosive bulbitis is divided into acute and chronic.

Erosive bulbitis, especially erosive-ulcerative and erosive-hemorrhagic forms of the disease, can be complicated by the development of duodenal ulcer.

According to the results of endoscopy, the following morphological forms of the disease are distinguished:.

erosive focal bulbitis - limited lesions on the mucous membrane of the bulbar part of the duodenum;

catarrhal-erosive bulbitis - a superficial lesion in which the goblet cells of the upper layer of the intestinal epithelium and its cytoplasmic outgrowths, or microvilli, are involved in the pathological process;

erosive-ulcerative bulbitis - deep erosion, while not only the epithelium and its own plate are affected, but also the muscle plate of the mucous membrane of the bulbar part of the duodenum;

erosive-hemorrhagic bulbitis - the pathological process extends to the submucosal layer with blood vessels;

drainage erosive bulbit - there is a fusion of individual lesions with the formation of a fibrin film on the affected area.

Symptoms The main symptom of acute erosive bulbitis is pain in the epigastric region, which can occur both on an empty stomach (during the day and / or at night), and some time after eating, can radiate to the navel, back or chest. In addition to pain, nausea, sour belching, bloating, flatulence, a feeling of bloating in the abdomen, unstable stools are observed. Heartburn occurs after eating.

The first symptom of erosive bulbitis is pain in the epigastric region When bleeding from erosion, the bowel movements become dark in color (melena), it is possible to open vomit that looks like coffee grounds.

Profuse internal bleeding is manifested by pallor of the skin, increasing weakness, dizziness.

With the development of a secondary erosive bulbit with single lesions, its signs, as a rule, are masked by the symptoms of the main pathological process.

In chronic erosive bulbitis, the symptoms of the concomitant pathological process dominate, with which this form of the disease is usually combined. There is a tendency to constipation, nausea may disturb. Bleeding chronic erosive bulbitis is not typical.

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