ASSESSMENT OF COMPLIANCE FACTORS IN PATIENTS WITH DUODENAL ULCER COMPLICATED BY STENOSIS

Aim.This study was conducted to assess the compliance of patients with duodenal ulcer disease during the dispensary observation.Materials and methods.We carried out an examination and a prospective observation of 1896 patients with uncomplicated duodenal ulcer and 43 people with sub- and decompensated scar-ulcerative stenosis of the duodenum.Results. The analysis confirmed that the compliance of patients with duodenal ulcer depends on the professional employment of patients, their gender, the level of education, presence of comorbidity, absence of undesirable effects of the taken medication, contact establishment with the patient, and presence of non-adaptive types of attitude to the disease.Conclusion.The interaction between different factors affecting the compliance should be taken into account when planning the tactics of dispensary observation of patients with uncomplicated duodenal ulcer and after eliminating the complications as wel.

Characteristics of the course of gastric and duodenal ulcer disease concurrent with duodenal insufficiency

Aim. To comprehensively study the course of gastric ulcer disease (GUD) and duodenal ulcer disease (DUD) concurrent with chronic duodenal insufficiency (CDI). Materials and methods. Ulcer disease (UD) was verified on the basis of the results of clinical and fibrogastroduodenoscopic examinations. The data of contrast duodenography and cavitary manometry were used to identify CDI. Gastroduodenal motor activity was investigated using the peripheral electrogastrograph EGG-4M. The results of pH measurements were employed to assess the state of gastric acid secretion and duodenal pH values. Results. A comprehensive examination was made in 106 patients with UD concurrent with CDI (a study group) and 30 UD patients without CDI (a comparison group). Epigastric pain was noted in the patients with GUD in the study and comparison groups (91.5 and 84.6%, respectively), but the pain was mainly aching in the patients with concomitant CDI and more intense (77.8%) in those without this condition. In the study group, heartburn was more common in patients with GUD and DUD (75.3 and 71.4%, respectively) than in those with UD in the comparison group (28.5 and 37.5%, respectively). Helicobacter pylori tests were positive in 23.8% of the patients in the study group and in 57.2% in the comparison group. Electrogastrography indicated that the patients with GUD and CDI had bradygastria and hypokinesis on an empty stomach; the electrical activity was reduced after eating. In the comparison group, tachygastria and hyperkinesis were detected on an empty stomach; these postprandial indicators were elevated. H. pylori tests were positive in 34.7% of the patients with DUD and CDI and in 63.6% of those with DUD without CDI. The postprandial electrical activity increased in patients with DUD and decreased in the comparison group. The specific features of changes in gastric and duodenal pH values in GUD and DUD concurrent with CDI in comparison with the isolated course of UD. Conclusion. The immediate and long-term follow-ups show that GUD and DUD concurrent with CDI run a more persistent course; the time of ulcer healing increases and the periods of remission decrease.