Duodenitis is an inflammation of the duodenum , most often only the mucous membrane, accompanied by a long-term process of changing its structure, a common disease that is more common in men.
If only the mucous membrane of the duodenal bulb is affected, the disease is called bulbitis, the area of the large duodenal papilla (papilla of Vater) is called sphincteritis or odditis. The disease is often combined with inflammation of the gastric mucosa (gastroduodenitis).
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Reasons for development
Intestinal infections cause inflammation of the intestinal mucosa, which arises from the action of toxins produced by pathogenic bacteria. The most common cause of inflammation is the bacterium Helicobacter pylori.
Prolonged neuropsychic overstrain caused by stress also negatively affects the condition of the intestines. The cause of the development of duodenitis in this case is vasospasm of the duodenal wall, which causes a deterioration in the blood supply to the mucous membrane and reduces its protective functions.
Abuse of fatty, fried, spicy and rough foods leads to damage to the duodenal mucosa. In this case, the products themselves can play the role of aggressive factors and cause inflammation. For example, crackers and chips are very harmful, which are often the cause of duodenitis in children (before the widespread use of these products, children suffered from gastritis and duodenitis much less often).
Poor diet may also be a cause of the problem. Too long periods between meals, fasting, as well as overeating, increase the load on the duodenum and significantly increase the likelihood of disease.
Eating before bed is a negative factor that can lead to the development of gastritis (inflammation of the stomach) and duodenitis. During sleep, the body should take a break from performing digestive functions and relax. The optimal time for dinner is no later than 2 hours before bedtime.
Drug abuse refers to groups of drugs such as non-steroidal anti-inflammatory drugs (paracetamol, aspirin), which irritate the mucous membrane.
Systematic consumption of alcohol - all alcohol-containing drinks cause an inflammatory reaction, the most dangerous in this regard are beer and wine. While cognac in small quantities helps reduce inflammation and heal ulcers or erosions.
Smoking (especially on an empty stomach) - nicotine causes vasospasm; when smoking, it mixes with saliva, enters the gastrointestinal tract and causes inflammation.
The cause of duodenitis is sometimes parasitic diseases (for example, hookworm, giardiasis, opisthorchiasis).
Duodenitis can occur against the background of chronic gastritis, peptic ulcer, duodenal diverticulosis, chronic pancreatitis, some diseases of the liver and biliary tract.
The development of duodenitis is facilitated by an increased content of hydrochloric acid and pepsin in gastric juice, a long delay in the evacuation of duodenal contents (duodenostasis), and insufficient production of secretin, leading to impaired neutralization of hydrochloric acid by pancreatic juice.
Kinds
There are the following types of duodenitis:
- superficial duodenitis - damage to the superficial layer of the mucous membrane,
- diffuse duodenitis - spread of the process to the entire depth of the mucous membrane,
- erosive duodenitis - the appearance of single or multiple erosions of the duodenum,
- atrophic duodenitis - occurs with moderate or severe atrophy of intestinal villi,
- phlegmonous duodenitis - phlegmon of the duodenum, acute purulent inflammation of the wall of the duodenum.
Duodenitis can occur acutely or chronically.
Symptoms of acute duodenitis
Acute duodenitis is manifested by the following symptoms:
- pain and feeling of fullness in the abdomen, in the epigastric region,
- salivation,
- nausea,
- vomit,
- loss of appetite,
- increase in body temperature.
The disease may be accompanied by headache, weakness, and low blood pressure.
Character of the course
Based on the nature of their course, duodenitis is divided into the following types.
- The ulcer-like form of duodenitis occurs most often. The main symptoms are pain reminiscent of a duodenal ulcer. However, the pain is less pronounced and is characterized by clear seasonal exacerbations.
- A gastro-like form, the main symptoms of which are a feeling of pain or discomfort in the epigastric region, heaviness, a feeling of fullness and early satiety.
- Cholecystitis- and pancreatitis-like forms, characteristic of sphincteritis (reminiscent of chronic cholecystitis or pancreatitis). The main symptoms are pain in the right hypochondrium or girdle pain in the upper abdomen, which intensifies after eating fatty foods.
- The neurovegetative form of duodenitis, which often occurs in young women, is characterized by autonomic disorders, weakness, increased fatigue or excitability, and headaches.
- Often, especially in older people, there is an asymptomatic course of the process (latent form).
Phlegmatous duodenitis
Phlegmatous duodenitis is rare. The reason for its development may be the penetration of microorganisms (streptococci, staphylococci, etc.) through the mucous membrane into the deeper layers of the duodenal mucosa.
This type of duodenitis is accompanied by the following symptoms:
- acute onset
- chills
- fever
- excruciating pain in the upper abdomen, usually on the right
- nausea
- persistent vomiting.
Additional signs are tachycardia, dry tongue, pain on palpation of the upper abdomen, tension in the muscles of the anterior abdominal wall, high leukocytosis with a shift in the leukocyte formula to the left.
Chronic duodenitis
The causes of chronic duodenitis are
- taking medications,
- food allergy,
- parasitic diseases (giardiasis, helminthiasis).
If the disease lasts up to 3 years, then most often only the duodenal bulb is affected. Subsequently, the process begins to spread further along the duodenum.
Symptoms
Chronic duodenitis manifests itself as exacerbations.
During the period of exacerbation, there is discomfort in the abdomen, cramping pain, which is paroxysmal in nature and occurs 1-2 hours after eating, sometimes on an empty stomach, rarely at night.
On palpation, pain is felt in the pyloroduodenal region, less often in the epigastric region and right hypochondrium. Pain persists for up to 1-2 weeks, tenderness on palpation for up to 2-3 weeks.
Complications
A complication of chronic duodenitis is periduodenitis. It develops during the transition of the inflammatory process to the serous membrane of the duodenum. Periduodenitis is manifested by increased pain, especially during physical activity or shaking of the body; sometimes there is low-grade body temperature and an increase in ESR.
Erosive duodenitis can be complicated by gastrointestinal bleeding (sometimes massive), manifested by blackening of stool, dizziness, weakness, decreased blood pressure up to collapse.
Erosive duodenitis often serves as a precursor to the development of peptic ulcer disease. As the process progresses, chronic cholecystitis, pancreatitis and other diseases of the digestive system may occur.
Phlegmonous duodenitis is often complicated by acute peritonitis, purulent pleurisy, liver abscess, thrombophlebitis of the portal and splenic veins, and sepsis.
Diagnostics
Acute duodenitis is diagnosed based on external symptoms and the results of a physical examination (pain on palpation in the pyloroduodenal area).
Chronic duodenitis is also diagnosed based on data from a patient survey, symptoms, and physical examination results.
In order to detect duodenal bleeding, it is necessary to take stool tests for occult blood . Probing of the stomach and duodenum has great diagnostic value in chronic duodenitis. With superficial and, especially, erosive duodenitis, an increase in the volume of gastric secretion is noted.
Atrophic duodenitis, on the contrary, is often characterized by a decrease in acid formation in the stomach. X-ray
is essential , in which changes in the relief of the mucous membrane and disturbances in motility of the duodenum are revealed.
X-ray signs of periduodenitis are a sharp deformation of the bulb, limited mobility of the duodenum, and a decrease in its lumen.
To accurately establish the diagnosis of chronic duodenitis, it is necessary to do an endoscopic examination, which allows us to determine the presence or absence of ulcerative defects, inflammatory changes in the mucous membrane of the stomach or duodenum.
X-ray examination of the stomach and duodenum shows a change in the relief of the mucous membrane and a violation of their motor function.
Cholecystography allows you to detect the presence of stones in the gallbladder and signs of a disorder of its contractile function.
Ultrasound examination reveals deformations and thickening of the gallbladder with cholecystitis, changes in the structure of the pancreas with pancreatitis, etc.
These examinations will help make an accurate diagnosis, since a number of diseases have similar symptoms, for example, gastritis, functional disorders of the stomach and duodenum, biliary dyskinesia, chronic pancreatitis.
Treatment at home
When treating duodenitis, the most important thing is to determine the cause of its occurrence and eliminate it.
For any type of disease, it is necessary to establish a diet. During exacerbations, a therapeutic diet is recommended 4 .
Treatment of duodenitis with folk remedies
There are a large number of recommendations for the treatment of inflammatory processes of the stomach and duodenum.
Good results are achieved by drinking herbal teas.
- Infusion of calendula officinalis flowers (marigold): pour 20 g of inflorescences with 1 glass of boiling water, let it brew. Drink half a glass 3 times a day between meals.
- Infusion of rose hips: pour 1 tablespoon of fruits with 2 cups of boiling water, leave in a thermos for 24 hours. Drink half a glass 2-3 times a day before meals.
- Infusion of common yarrow: pour 1 tablespoon of the herb with a glass of boiling water and leave. Drink one third of a glass 3 times a day before meals.
- Flaxseed helps with erosive duodenitis.
Pour one teaspoon of flax seed into a glass of boiling water and leave for 20 minutes. Strain. Take on an empty stomach before breakfast in small sips and before each meal.
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