Duodenitis
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
- Prevention
Duodenitis is an inflammatory process that affects the mucous membrane of the duodenum. This is one of the most common gastroenterological diseases. Women get it twice less often than men. In 95% of cases, duodenitis becomes chronic.
Duodenitis - inflammation of the duodenal mucosa
Causes and risk factors
The main reasons leading to the development of an inflammatory process in the mucous membrane of the duodenum are:
- abuse of fried, spicy, smoked and sour foods;
- abuse of drinks with a high caffeine content (energy drinks, coffee, strong tea, cola);
- smoking;
- alcoholism.
All of the above factors contribute to the increased secretion of hyperacid gastric juice, that is, containing an increased concentration of hydrochloric acid. It enters the duodenal cavity, causing first irritation and then acute inflammation of its mucous membrane. With the transition of the disease to a chronic form, atrophic and degenerative processes occur in the intestinal wall.
Duodenitis often develops as a secondary process against the background of a number of the following pathologies of the digestive system:
- peptic ulcer of the stomach and duodenum;
- chronic gastritis;
- infection of the stomach and duodenum with Helicobacter Pylori;
- violation of blood supply and innervation of the walls of the duodenum;
- chronic colitis, enteritis, pancreatitis, hepatitis;
- cirrhosis of the liver;
- helminthic invasions (giardiasis, ascariasis).
Duodenitis can develop due to infection of the stomach with Helicobacter pylori
Forms of the disease
Depending on the duration of the course of the disease and the activity of the inflammatory process, acute and chronic duodenitis are distinguished. Acute, in turn, is subdivided into catarrhal, ulcerative and phlegmonous.
Chronic forms of duodenitis are classified according to different criteria:
- on the localization of the lesion (diffuse, local, postbulbar, bulbar);
- by reason of occurrence (primary or secondary);
- by the degree of morphological changes (atrophic, interstitial, superficial);
- by the features of the endoscopic picture (nodular, erosive, atrophic, hemorrhagic, erythematous).
There are also special forms of the disease (tuberculous, fungal, immunodeficient duodenitis).
According to the peculiarities of clinical manifestations, the following forms of duodenitis are distinguished:
- Ulcerative. The patient complains of recurring "hungry" or night pains in the epigastric region, which are relieved by taking antacids or food. Bitter belching and heartburn are common.
- Gastritis-like. The pain occurs 20-30 minutes after eating. Dyspeptic syndrome is expressed (lack of appetite, nausea, vomiting, flatulence, unstable stools, belching).
- Pancreatitis-like and cholecyst-like. The clinical picture resembles an attack of biliary colic. Patients complain of severe acute pain in the left or right hypochondrium, dyspeptic disorders.
- Neurovegetative. It develops as a result of hormonal duodenal insufficiency and is manifested by dumping syndrome, asthenoneurotic autonomic disorders.
- Mixed. In the clinical picture of the disease, there are signs of various clinical forms.
- Asymptomatic. Most often observed in elderly patients. It proceeds without any signs and is discovered by chance when examining the gastrointestinal tract for another pathology.
Symptoms
One of the first symptoms is cramping, aching or stabbing pains localized in the epigastric region. In some patients, they occur on an empty stomach, and in others, a short time after eating. Also characteristic of duodenitis:
- overlapping of the tongue;
- heartburn;
- belching;
- nausea, vomiting;
- excessive sweating (hyperhidrosis);
- general weakness, dizziness.
One of the leading symptoms of duodenitis is epigastric pain of a cramping and stabbing nature
Diagnostics
Basically, the diagnosis of duodenitis is carried out according to the FEGDS data. As additional methods are used:
- contrast radiography of the gastrointestinal tract with barium sulfate;
- sounding of the stomach with laboratory examination of gastric juice (determination of pH, a number of biochemical tests);
- duodenal intubation;
- laboratory tests - complete blood count, blood biochemistry, coprogram.
Treatment
The treatment regimen for duodenitis includes:
- proton pump inhibitors, which reduce the secretion of hydrochloric acid by the parietal cells of the stomach;
- antiparasitic drugs for helminthic invasions;
- antibacterial agents for infection with Helicobacter pylori bacteria;
- antispasmodics;
- pain relievers.
Diet therapy is of great importance in the treatment of duodenitis.
In case of acute duodenitis and exacerbation of chronic duodenitis, table number 1 according to Pevzner is assigned. Alcohol, black coffee, chocolate, ice cream, pepper, mustard, fatty fish and meat, spinach, sorrel, bacon, fresh baked goods, smoked meats, pickles and mushrooms are excluded from the diet. The basis of the diet is oatmeal, buckwheat and semolina, mashed soups, eggs (1-2 pieces per day), lean meat, low-fat cottage cheese, yesterday's wheat bread, weak tea.
An important role in the treatment of duodenitis is played by diet therapy
For chronic duodenitis in remission (in the absence of digestive disorders and pain syndrome), Pevzner's treatment table No. 5 is recommended. The diet includes sweet fruits, crumbly cereals, boiled chicken or lean beef, soups with vegetable broth, low-fat cottage cheese, wheat bread, compotes, rosehip broth, weak tea. Alcohol, black coffee, ice cream, spices, fatty fish and meat, fresh baked goods, strong meat broths, spinach, bacon, sorrel are prohibited.
The phlegmonous form of acute duodenitis is an indication for surgical intervention.
Possible complications and consequences
The main complications of duodenitis:
- periduodenitis (inflammation of the serous membrane surrounding the duodenum);
- the development of erosive and ulcerative defects in the mucous membrane of the duodenum;
- perforation of the ulcer;
- ulcerative bleeding;
- malignant tumors of the duodenum;
- stenosis of the pylorus of the stomach (narrowing of the junction of the stomach into the duodenum);
- achlorhydria (a sharp decrease in the acidity of gastric juice);
- hormonal duodenal insufficiency;
- high intestinal obstruction (partial or complete);
- peritonitis (with perforation of an ulcer or the development of phlegmonous duodenitis).
Forecast
With timely and adequate treatment, the prognosis is generally favorable.
Prevention
Prevention of duodenitis includes:
- balanced diet;
- quitting smoking and drinking alcohol;
- timely detection and treatment of diseases of the gastrointestinal tract;
- regular moderate physical activity.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
