Duodenitis - What Is It? Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-17 02:10

Duodenitis: symptoms and treatment

Duodenitis is an inflammation of the duodenal mucosa. The disease occurs frequently, in about 5-12% of people. In women, pathology is diagnosed less often than in men, about 2 times. This is due to the fact that males are more susceptible to bad habits.

Duodenitis can be acute, or it can become chronic. Acute inflammation develops when the body is poisoned, when eating spicy foods that irritate the intestines. Erosions form on it, which heal without leaving behind scar areas. The severe course of the disease can lead to the formation of purulent phlegmon. If you follow medical recommendations and adhere to a diet, then you can cope with the pathology in 7-14 days. The probability of transition of duodenitis into a chronic form with its recurrence is 90%.

Chronic duodenitis manifests itself in the case when a person has other pathologies of the digestive system, for example, pancreatitis or gastritis. Also, serious errors in the diet can provoke the disease. As the disease progresses, the mucous membrane of the duodenum begins to atrophy, or will become covered with erosions. The chronic course of duodenitis is accompanied by periods of exacerbations that occur when the body is exposed to negative factors. Coping with the chronic form of the disease is more difficult than with the acute one.

Content:

• Causes of acute duodenitis
• Causes of chronic duodenitis
• Duodenitis symptoms
• Diagnostics
• Features of the course of the disease in childhood
• Duodenitis treatment

Causes of acute duodenitis

The following reasons can provoke the development of acute duodenitis:

• Eating fast food, as well as foods that can irritate the intestinal mucosa. It can be coffee, fried, spicy and fatty foods. For this food to be digested, a significant amount of hydrochloric acid is needed. It, in turn, negatively affects the protective functions of the intestine.

• Food poisoning, which was caused by pathogenic microflora: staphylococci, streptococci, clostridia, enterococci. Infection with Helicobacter pylori, lamblia and helminths can also cause acute duodenitis. Microbes lead to the development of local inflammation, the production of bile and pancreatic juices is disrupted. All this is fundamental for the occurrence of duodenitis.
• Reflux or reflux of intestinal contents into the duodenum. The cause of this pathology is a violation of the patency of the small intestine, for example, due to a growing tumor. The bacteria that live in the small intestine enter the duodenum, provoking its inflammation.
• Alcohol abuse.
• Ingestion of substances that can provoke a burn of the mucous membranes into the digestive tract. These can be acids, alkalis, chlorine-containing agents.
• Mechanical damage to the duodenum due to the ingress of foreign objects into it.

Causes of chronic duodenitis

Such factors as can provoke a chronic form of the disease:

• Diseases of the intestine, which lead to a deterioration in its contractility, to congestion, overstretching of the walls of the organ and atrophy of its mucous layer. This includes long-term constipation, intestinal adhesions, impaired blood supply, problems with nervous regulation.
• Pathologies of the liver, gallbladder, pancreas. All these disorders affect the functioning of the duodenum.
• Allergy to food.
• Long-term emotional shock.
• Taking medications for a long time.
• Adherence to bad habits: substance abuse, smoking, alcoholism.

Duodenitis symptoms

Since duodenitis is often combined with diseases of the digestive system, for example, with gastritis or a stomach ulcer, its symptoms directly depend on the specific pathology.

The main manifestations of the disease in adults include:

1. Pain in the epigastric region, which becomes more intense when palpating the abdomen. Depending on the nature of the pathology, the pain will have the following features:

   • If duodenitis is chronic, then pain will be present on an ongoing basis. It becomes more intense when a person is hungry. It has the character of seizures, occurs 2 hours after eating.
   • If duodenitis develops due to intestinal obstruction, then the pain expands the stomach from the inside, has the character of attacks, manifests after the intestines are full.
   • If duodenitis occurs against the background of gastritis with high acidity, then the pain appears 20 minutes after eating, when food enters the duodenum.
   • If the disease is provoked by Helicobacter pylori, then the pain will be especially strong on an empty stomach.
   • If there is a violation of the outflow of bile from the gallbladder, the area around the nipple of Vater becomes inflamed. The pain is intense, reminiscent of an attack of hepatic colic. Discomfort occurs in the right hypochondrium.
2. Increased fatigue and weakness. This is due to the influence of toxins on the body. They are formed as a result of an inflammatory reaction.
3. Body temperature can rise up to 38 ° C.

4. Digestive processes are impaired, this is manifested by symptoms such as:

   • Nausea.
   • Decreased appetite.
   • Increased gas formation.
   • Belching. At the same time, a bitter taste arises in the mouth, which is due to the ingress of bile into the stomach and back.
   • Constipation or diarrhea.
5. The skin and mucous membranes may turn yellow. Swelling of the nipple of Vater leads to the clogging of the lumen of the bile duct, bile enters the bloodstream and accumulates in it.
6. Dumping syndrome. It develops after eating large amounts of food. When the duodenum is overfilled, blood flow is redistributed in a different way. There is an outflow of blood from the head and its rush to the digestive organs. Therefore, a person experiences dizziness, heaviness in the abdomen, drowsiness, fever in the upper half of the body.

Sometimes duodenitis does not manifest itself in anything. The disease can be detected by chance, after gastroduodenoscopy.

Diagnostics

Reception of the patient begins with questioning his complaints and examination. The doctor palpates the abdomen. In the region of the duodenum, painful sensations arise.

To confirm the diagnosis, the doctor will refer the patient to such instrumental examinations as:

1. Fibrogastroduodenoscopy. During its execution, the stomach and duodenum are examined. If there is inflammation, then the mucous membranes of the organ will be swollen and red.

   Depending on the form of the disease, its clinical manifestations will differ:

   • Superficial duodenitis is expressed by reddening of the intestinal epithelium.
   • In the erosive form of the disease, the intestines will be covered with erosion.
   • If the folds of the organ are smoothed, then this indicates a decrease in its tone.
   • Nodules appear with a nodular form of inflammation.
   • Hemorrhagic duodenitis is accompanied by the appearance of bruising on the mucous membrane.
   • Atrophy of intestinal cells is observed in the atrophic form of the disease.

2. Fluoroscopy using a contrast agent. Barium sulfate is used as a contrast. During the study, violations in the structure and functioning of the intestine are found.

   This is manifested by such signs as:

   • If there are areas of narrowing, then this will indicate adhesions, tumors or abnormalities of the intestine.
   • If areas of enlargement are found, a decrease in the tone of the organ, blockage of the intestinal sections located below, impaired permeability of food, disruptions in the nervous regulation of the organ can be suspected.
   • Ulcers and erosions are manifested as a niche symptom.
   • The accumulation of gases in the duodenum is a sign of its obstruction.
   • The absence of folds on the epithelium of the organ is a sign of inflammation and swelling.
   • If the contents of the duodenum are thrown into the stomach, this may indicate reflux.

In addition to instrumental examination, the patient will have to pass the following tests:

• Blood for general analysis. In patients, an increase in ESR is found, which indicates inflammation. If a person develops anemia, then this is a signal of bleeding.
• Blood for biochemical analysis. At an early stage of the development of the disease, the level of alkaline phosphatase and enterokinase increases, as the pathology progresses, their values decrease.
• Feces for occult blood. It will be found in the analysis in the case when the patient develops erosive duodenitis.

Features of the course of the disease in childhood

Duodenitis in childhood most often develops due to excessive consumption of dry foods, with pronounced errors in the nutrition of the child. However, allergies, hereditary predisposition, parasite infestation and infectious diseases cannot be ruled out.

Children often misread body signals and indicate that they have a stomach ache. Common symptoms of pathology include nausea, weakness, constipation, heartburn, belching. Exacerbations of pathology occur in the spring and autumn seasons. In children over 10 years of age, the symptoms of duodenitis are similar to those in adults.

Treatment must be comprehensive. When parasite infestation becomes the cause of the disease, you need to take drugs for worms.

Duodenitis treatment

To cope with pathology, you need to solve the following tasks:

• Stop the inflammatory response.
• Prevent the transition of chronic inflammation to the acute phase.
• Bring the duodenum to normal.
• Restore digestive function.

If the disease has an uncomplicated course, then the treatment is carried out on an outpatient basis. A person will need to eat right, observe a regime of rest and work, minimize stress, give up bad habits, do not take alcoholic beverages, and stop smoking.

Hospitalization may be required in the following cases:

• The acute course of the disease.
• The likelihood of a tumor in the body.
• High risk of bleeding.
• Heavy state of health of the patient.

Therapy is carried out in such areas as:

• Compliance with a diet.
• Taking medicines.
• Physiotherapy.
• Treatment with mineral waters.

Diet

It is proper nutrition that plays a decisive role in the treatment of duodenitis. If a person does not follow a diet, then it will not be possible to cope with inflammation.

The acute course of the disease requires compliance with table 1a according to Pevzner. You can eat slimy decoctions of rice or oats, mashed soups, liquid cereals in a mixture of milk and water.

Basic principles of nutrition for patients with acute duodenitis:

• Food should be warm, mashed, steamed.
• You need to eat 6 times a day, but in small portions.
• There should not be long breaks between approaches to the table.
• You can't overeat.

Sample menu for 1 day:

• First breakfast. Buckwheat porridge on a mixture of water and milk with butter, a glass of milk.
• Lunch. A glass of milk.
• Dinner. Cereal soup with milk (composition: oatmeal, milk, butter, sugar, water), boiled low-fat beef puree with butter and milk, compote with dried apples.
• Afternoon snack. A glass of milk and a soft-boiled egg.
• Dinner. Rice porridge on a mixture of milk and water, an egg in a bag, a glass of milk.
• Before bedtime. A glass of milk.

As the inflammatory process fades away, the diet becomes more varied.

Approximate menu of patients depending on the form of duodenitis:

	Ulcerative duodenitis, table number 1	Gastritis-like duodenitis, table number 2	Duodenitis on the background of pancreatitis or cholecystitis, table number 5
1 breakfast	Rice porridge with milk. Compote with sugar	A glass of milk and curd cheese	Vinaigrette and toasted bread, milk tea
2 breakfast	Yogurt	Baked pumpkin	Carrot juice
Dinner	Noodle soup, zrazy, beet salad, jelly and bread	Soup with vegetables, meatballs, mashed potatoes, compote with dried fruits	Vegetable soup with sour cream, boiled fish, mashed potatoes, compote with dried apricots
Afternoon snack	Pear compote	Crackers, rowanberry broth	A glass of milk
Dinner	Milk noodles	Stewed pollock and vegetables	Curd casserole, tea with sugar
2 dinner	A glass of milk	A glass of milk	Kissel

Products that are recommended to be consumed by patients with duodenitis:

• Boiled low-fat meat, which is ground in mashed potatoes.
• Fermented milk drinks and products, milk.
• Baked and boiled vegetables without peel, vegetable puree.
• Soft-boiled eggs or scrambled eggs.
• Vegetable oil, butter.
• The juice.
• Dried bread.
• Honey, mousses, jellies.

Products that are prohibited to eat during duodenitis:

• Raw vegetables and fruits.
• Canned food and smoked products.
• Hot dishes, spices, garlic and onions.
• Fatty fish, meat, mushroom broths, meat broths.
• Ice cream.
• Sparkling drinks.
• Alcohol.

Diet recommendations for patients with duodenitis:

• Food should be taken in small portions, 6 times a day. You don't have to wait until you feel hungry. This can lead to painful sensations.
• Dishes should not be hot or cold.
• You need to process food in a gentle way, that is, boil, steam, grind.
• It is forbidden to overeat and eat at night.

Taking medications

Like any other disease, duodenitis requires medication.

Drug category	How do they work	Drug names	How to use
Proton pump inhibitors	They do not allow hydrochloric acid to be produced in significant quantities, due to which the duodenum will not undergo inflammation	Emaner. Omeprazole, Ultop, Zulbeks.	20 mg 1-2 times a day. The course of treatment is 7-10 days.
		Doxycycline 100-200 mg	2 times a day. The course of treatment is 7-10 days.
		Clarithromycin, Amoxicillin, Metronidazole	2 times a day. The course of treatment is 7-14 days.
H2-histamine blockers	Suppresses the production of hydrogen chloride	Ranitidine	2 times a day. The course of treatment is 30-45 days.
		Famotidine	2 times a day
Antacids	Neutralize hydrogen chloride, envelop the intestinal mucosa, relieve pain	Almagel, Maalox, Gastal	3 times a day if heartburn is worried
Prokinetics	Normalize intestinal peristalsis, promote the movement of food through the intestines	Itomed, Ganaton	1 tablet 3 times a day
Enzymes	Contributes to the normalization of food digestion processes	Pancreatin, Creon	After every meal
Antispasmodics	Reduce pain	No-shpa, Drotaverin, Platyphyllin	1 tablet 3 times a day
Sedatives	Relieve nervous tension	Valerian, motherwort	Within 10-14 days

The drug De-nol is prescribed to patients with duodenitis to provide antibacterial, anti-inflammatory and antacid effects. It protects the intestinal mucosa and promotes its regeneration. Adults are advised to take 1 tablet 4 times a day, after each main meal and before bedtime. The drug should be taken with water. During the period of treatment, you should refrain from consuming milk, as the effectiveness of therapy will be reduced. Children under 12 years of age are prescribed 1 tablet 2 times a day. The duration of therapy is 1.5 months.

The doctor combines the rest of the drugs at his own discretion. To get rid of Helicobacter pylori, treatment with antibiotics is required. When stressed, sedatives should be taken. If the patient is diagnosed with an acidic stomach, antacids, histamine blockers and proton pump inhibitors should be used.

Physiotherapy treatment. Patients with duodenitis are shown to undergo ultrasound treatment, phonophoresis, and magnetotherapy.

Treatment with mineral waters. Patients with duodenitis are shown to use non-carbonated mineral waters: Borzhomi, Essentuki No. 4, Smirnovskaya No. 1, Slavyanovskaya, Berezovskaya. The water should be warm. They drink it an hour after eating.

An integrated approach to treatment allows you to get rid of the disease and achieve full recovery.

The author of the article: Gorshenina Elena Ivanovna | Gastroenterologist

Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.