Duodenitis

The reasons

Symptoms of chronic duodenitis

Treatment

Diagnostics

Prevention

Duodenitis is an inflammatory disease of the duodenum in which its mucosa is most severely affected.

The duodenum is one of the most important organs of digestion. In it, food is processed by the digestive juices of the pancreas, abdominal digestion occurs – a stage that prepares food for absorption. Also, the duodenum produces some hormones that regulate the activity of the digestive system, the body’s metabolism.Therefore, despite the prevalence of this disease, duodenitis is a very serious problem.

The reasons

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The causes of duodenitis are quite diverse. Most often it develops in childhood, as a result of the weakness of the hormonal apparatus of the duodenum, its improper location. One of the reasons for the development is the bacterium Helicobacter Pylori, which is the main cause of gastritis.

The risk of falling ill with duodenitis exists in people of all age groups. There are acute and chronic forms of duodenitis. The acute form of duodenitis is catarrhal, erosive, ulcerative and phlegmonous.

Chronic duodenitis

Chronic duodenitis can be primary and secondary. Primary chronic duodenitis occurs when malnutrition (use of acute, irritating, hot food, alcohol), smoking.

More common secondary chronic duodenitis – it develops against the background of existing inflammatory diseases, for example, chronic gastritis;   duodenal ulcer; improper treatment of acute duodenitis.

Duodenostasis plays a major role in the development of secondary duodenitis – insufficient duodenal motility due to obstruction or poor motility.

According to the degree of structural changes, there are several variants of chronic duodenitis:

  • superficial (inflammatory process captures only the upper layers of the mucous membrane);
  • atrophic (thinning of the duodenal mucosa with the extinction of its secretory function);
  • interstitial (without damage to the glands ); erosive and ulcerative (characterized by the appearance of small erosions and ulcers on the mucosa);
  • hyperplastic (with excessive tissue proliferation).

Symptoms of chronic duodenitis

  • feeling of bursting in the upper abdomen,
  • loss of appetite
  • heartburn,
  • belching,
  • sometimes nausea or vomiting with bile,
  • constipation.

During periods of exacerbation – constant pain in the stomach, aggravated by fasting or 1.5-2 hours after eating. There are night pains.

Some patients complain of headaches, weakness, irritability, shortness of breath and heart palpitations, which is associated with impaired hormonal function of the duodenum.

Treatment

Treatment of chronic duodenitis during periods of acute illness is carried out in a hospital. Treatment is prescribed depending on the cause of the disease.

  • In the presence of giardiasis and helminth infections prescribe the appropriate chemotherapy ( flagel , furazolidone , chloxin ).
  • When detecting Helicobacter pylori infection use antibiotics.
  • With increased acidity – drugs that reduce the secretion of hydrochloric acid ( omeprazole, ranitidine ) and antacids, neutralizing the acidity of the gastric juice ( almagel , maalox, phosphalugel ).
  • For the protection of the mucous membranes prescribe enveloping drugs ( denol , sulfacrate ). For anti-inflammatory purposes, it is recommended to use chamomile and yarrow decoctions. To restore digestion, enzyme preparations are prescribed.

If the cause of duodenitis was a violation of motility of the duodenum ( duodenostasis ), for example, obstruction, it is necessary to establish its cause. If it is associated with a violation of any functions of the digestive organs, the treatment of duodenitis is conservative. It is shown that frequent meals in small portions, drugs that bind bile and promote its secretion (choleretic). Effectively duodenal intubation with duodenal lavage.

In the presence of adhesions, mechanical obstructions and other types of obstruction, intractable by therapeutic treatment, surgical treatment of duodenitis is indicated.

In secondary duodenitis, treatment of the underlying disease is necessary.

Acute duodenitis

Symptoms

  • pain in the stomach,
  • nausea,
  • vomiting
  • weakness.

Acute duodenitis usually occurs on the background of acute inflammation of the stomach and intestines.

Acute treatment

Acute catarrhal and erosive-ulcerative duodenitis usually do not require special treatment and, if the correct regimen is observed, they disappear within a few days, but in case of repeated manifestations, the disease may become chronic.

The patient is prescribed bed rest and hunger for 1-2 days. Sometimes it is recommended to wash the stomach with a weak solution of potassium permanganate. After washing to clean the intestines drink 25-30gr of magnesium sulfate, diluted in a glass of water. Starting from the third day, the patient is prescribed medical diet No. 1 (food is limited, irritating the intestinal walls, dishes are cooked pureed, boiled in water or steamed, very cold and hot dishes are excluded). Astringent and enveloping drugs are prescribed, and for pain, antispasmodics (No-shpa, drotaverin, papaverine).

In case of phlegmonous duodenitis, surgical treatment is indicated, as well as antibiotic treatment. Possible complications – intestinal bleeding, perforation of the intestinal wall, acute pancreatitis.

Diet with duodenitis

One of the most important components of competent treatment of duodenitis is a properly formulated diet.

Within 10-12 days you need to adhere to the most gentle nutrition. Food should be taken 4-5 times a day in small portions. All foods that irritate the mucous membrane (spicy and fried foods, spices, pickles, fresh bread and bakery products, and vegetables) are excluded from the diet. Allowed mucous soups from oatmeal, rice and semolina, liquid porridge, soft-boiled eggs (no more than 3 per day), steam omelets, kissels from sweet fruits and berries.

After 10-12 days allow steamed meat and fish patties, pureed soups. With good health and with the permission of the doctor, the diet can be expanded, but sharp and irritating foods should be excluded for a long time. Strongly contraindicated alcohol. 
Also prescribed physiotherapy, spa treatment is recommended.

Diagnostics

Because the nature of duodenitis is diverse and similar to many diseases of the gastrointestinal tract, its diagnosis is based on instrumental methods of research:

  • fibrogastroduodenoscopy (EGD) with biopsy;
  • duodenoscopy;
  • pH-metry;
  • radiography of the stomach and duodenum;
  • biochemical blood examination;
  • fecal examination;
  • ultrasound examination (ultrasound)

In the case of phlegmonous duodenitis fibrogastroduodenoscopy is contraindicated.

Prevention

Prevention of duodenitis should include full and regular meals, restriction of acute and irritating food, alcohol, timely detection and treatment of diseases of the digestive system, parasitic diseases.

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