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Duodenitis

What is Duodenitis?

It is an irritation and inflammation that occurs in the lining in the beginning of the small intestine, which is called the duodenum. The duodenum is connected to your stomach and is a tube that is about twelve inches long and curves into a C-shape. The far end of this tube blends into the rest of your small intestine. This is all part of the digestion system and is what connects your stomach to the rest of this system. This medical condition is similar to gastritis, which is inflammation of the lining of your stomach. Most of the time, these two medical conditions occur together. There are different types of duodenitis. Many times this will lead to the formation of duodenal ulcers, which are open sores in the lining of this tube.


Types of Duodenitis

The types of duodenitis include:

  1. Chronic and acute – acute means that they begin suddenly and last for a short period of time and chronic lasts for a long period of time that could be months, maybe even years.
  2. Non-erosive and erosive – when you non-erosive duodenitis the walls of the tube are inflamed but no erosions and erosive is when the inflamed wall is eroded and forms open sores.
  3. Post-bulbar and bulbar – in post-bulbar the inflammation is located in all parts of the tub after the first two inches, which is the duodenal bulb and bulbar is when the inflammation is in the duodenal bulb.

Symptoms

Because this medical condition results in inflammation of the lining of your stomach, there are a number of symptoms that are associated with duodenitis. How intense these symptoms are varies from person to person. You may experience these symptoms on a daily basis or just every so often. These common symptoms at any time can become serious symptoms and may need medical attention. Some of the common symptoms of duodenitis may include:

  • Bloating in your abdomen that gives you a sense of fullness.
  • Pain in your abdomen that is usually in the upper middle of your abdomen. The pain can be from an ache that is gnawing and dull to a pain that feels like severe burning.
  • Loss of appetite because eating may make your pain worse.
  • Nausea that may or may not include vomiting.
  • Gas along with excessive belching.
  • Bleeding from the intestine.
  • Chest pain
  • Indigestion
  • Dizziness

There are cases where this can be a life-threatening situation and if this happens you need to get immediate medical attention. These symptoms can include:

  • Stool that is bloody. The blood may appear to be black, tarry, or red in texture.
  • Abdominal pain that is severe
  • Vomiting blood

There may also be a sign of intestinal obstruction but this is rare. When a person has acute duodenitis this is when they usually have symptoms that are severe. If it is chronic duodenitis there are periods of severe symptoms

Causes

Basically duodenitis can be caused by any factor that:

  • In the duodenum, the protective mechanisms have been compromised
  • Infiltrates and/or irritates the duodenal wall lining
  • Increases the secretion of gastric acid, including the acidity (lowers pH) or the quantity.

There can be a variety of reasons for a person to have duodenitis. The most common causes are:

  • Due to the excess use of non-steroidal anti-inflammatory drugs (NSAID’s). This is a common over-the-counter medication used for pain. Taking it for an extended period of time or using them excessively in a short period of time can compromise the mucus barrier and increase the gastric acidity. Some of this type of medication includes naproxen, aspirin, and ibuprofen.
  • Infection caused by Helicobacter pylon (H.pylori). This is a bacteria that can also cause gastritis and is able to withstand gastric acid. It borrows in the wall of your duodenum and stomach and compromises the secretion of mucus. It also increases the secretion of gastric acid.

There are other factors that while they do not cause duodenitis, they could make it worse and cause worsening symptoms. Some of these factors may include:

  • Substance abuse like cocaine or alcohol
  • Using tobacco for a long period of time
  • Any major illness that is debilitating
  • Stress
  • Medications such as corticosteroids
  • Crohn’s disease also known as inflammatory bowel disease
  • Autoimmune disorders
  • Pernicious anemia
  • Other infections such as fungi, bacteria, parasites, or viruses other than H. pylori.
  • Radiation therapy

Treatment

The first line of treatment is to visit your physician, tell them your symptoms, and get the right diagnosis so treatment can begin. Before a diagnosis can be determined and treatment began, the physician may do, in addition to a physical exam and medical history, blood tests, stool sample, and urine test.

If your condition is caused by the H.pylori infection the main treatment would be to use antibiotic therapy. When you begin to take the antibiotics you need to follow it exactly as prescribed so it does not reoccur again or you become re-infected. You will usually have to take the antibiotics for fourteen days. Some of the antibiotics that they may use include:

  • Biaxin (Clarithromycin)
  • Flagyl (Metronidazole)
  • Tetracycline
  • Amoxicillin

Sometimes the physician will prescribe medications known as histamine H2-receptor antagonists and proton pump inhibitors. They will help to decrease the amount of acid there is in your stomach. These can also be effective in treating duodenitis. Some of these include:

Proton pump inhibitors

  • Nexium
  • Prevacid
  • Prilosec
  • Aciphex
  • Protonix

Histamine H2-receptor antagonists

  • Tagamet
  • Axid
  • Zantac
  • Pepcid

You should also try to avoid:

  • Fatty and spicy foods
  • Preserved and processed foods
  • Caffeinated beverages
  • Smoking
  • Drinking alcohol

  1. I had an upper GI endoscopy 7/7/14. I had a esophageal ring fixed and I also was diagnosed with focal acute duodenitis. I don’t understand why he diagnosed it as acute as I’ve suffered for many years. I either have horrible diarreah that I have to wear a diaper with or awful constipation with bloat ( actually look 9 months pregnant). I no longer have H Pylori. All my doctor told me was to take 4 Tablespoons of Benefiber with my 104ounces of water each day and take a docusate every day. Nothing is working yet. I also have a lot of pain with the cyst on my sciatica nerve. What kind of pain pill can I take with this acute duodenitis?

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