Duodenitis: Definitions, Complications, Causes, Precautions
Duodenitis is an immensely discomforting condition which affects people all over the world. In this disorder, upper section of your small intestine between stomach and jejunum or the duodenum suffers inflammation. Usually, this condition is accompanied by other disorders like gastritis, Hepatitis or Dyspepsia. Gastritis and Duodenitis both have same symptoms, causes and even treatment. While Gastritis swells up the stomach lining, Duodenitis causes inflammation in the small intestine. As much as 5-9% of the people with Upper Gastrointestinal Haemorrhage succumb to Duodenitis too but the good thing about it is that with treatment, the disease resolves in a week in most of the cases. However, if it is a parasitic or bacterial infection that is being treated with antibiotic, the recovery time is expected to be around 2 weeks.
Symptoms of Duodenitis
Most prominent symptom is of course inflammation in duodenum. It causes a bunch of symptoms that help you realize you have an illness; though the intensity of these symptoms varies in everyone. Also, these could occur once in a blue moon or every day. Most common of the symptoms include abdominal pain, diarrhoea, abdominal bloating, and indigestion, loss of the appetite, gas, vomiting and nausea. Although these may seem less harmful, there are much more life threatening symptoms that surface too like bloody vomit, acute abdominal pain and bloody faces with black or red stool.
Causes of Duodenitis
Swelling in the stomach could be due to bacterial infections, medications or GERD.
Helicobacter pylori is the bacteria which affects nearly half of the world’s population and around 50% of the people above 60 years living in US have been infected by it sometime in the lives. This is the same bacteria which causes upper intestine inflammation which might or might have any plausible symptoms. In a few cases, the condition is accompanied with intestinal ulcers, gastritis, and in worse scenario, stomach cancer.
Non-steroidal anti-inflammatory drugs or NSAIDs like Peroxicam, Ketoprofin, Indomethacin and Ibuprofen can lead to inflammation in the stomach; larger doses of the drugs can increase irritation in the stomach. It is a possible side-effect of these medications – the drugs cause stomach irritation and decrease the production of Prostaglandin, a substance similar to hormone. This substance limits digestive acid secretion from the stomach, increases the secretion of the protective mucus and safeguards the intestine lining.
This condition is also associated with Gastroesophageal Reflux Disease which is more commonly known as GERD. In GERD, caustic bile gets discharged into the esophagus and leads to heartburn, indigestion and injury to esophageal lining.
Some of the other causes of Duodenitis are viral infections, Zollinger-Ellison Syndrome, Crohn’s disease, decrease in bloody supply to intestines, gall bladder inflammation and gastrointestinal haemorrhage.
Diagnosis and Treatment of Duodenitis
Generally, the diagnosis of Duodenitis begins with cross-examination about the symptoms and discomforts that the condition may be causing; the medical history is also analysed. Diarrhoea, nausea, vomiting, abdominal bloating, heartburn, loss of appetite, abdominal pain, excessive belching and flatulence are some of the discomforts that patients suffer from but these could also be due to surmountable stress so mostly physicians follow it up with a physical examination. The patient is checked for loss of weight, blood in stool, abdominal mass, increase in bowel sounds and enlargement of organs in the abdomen. The tests include the following:
- Upper Gastrointestinal series or upper gastrointestinal Tract Radiography: It is performed on the patient that visualizes the duodenum. The patient is asked to swallow Barium (radiopaque dye) and then x-ray of his GI is done.
- Endoscopy: A microscope, Endoscope, is passed down the esophagus inner lining of duodenum is visualized. Endoscope is a medical device which has a tiny camera – it may be used to do a minor surgery or inspect an organ. It gives live images of the organs of the body when it is used for diagnosis of a condition.
As a matter of fact, both these procedures provide only indefinite proofs and for further confirmation, samples of duodenum are acquired during Endoscopy for microscopic analysis. This procedure is called Endoscopic Biopsy. In case larger samples are required, Tube Biopsy is done in which a tubular device is used to obtain a large tissue piece.
Physicians treat the condition depending on what caused it. If it is bacterial infection that gave way to the condition, the patient is given antibiotics; proper therapy of antibiotics is important to cure the disease. He may also be suggested medications to protect lining of stomach and intestines and proton pump inhibitors are also prescribed in some cases to limit the production of acid in the body. In case it is a side-effect of taking NSAIDs, patients are asked by the doctor to discontinue them and alternatives are given to them. Therapy is provided to patients who have gastrointestinal disorder with Duedenitis; they are also advised against caffeine and alcohol and other such substances that have possibility of irritating the gastrointestinal tract.
However, if the medications fail to cure the illness, surgery might be necessary. Gastrectomy, in which portion of the stomach is removed; Pyloroplasty, in which valve between stomach and duodenum is opened and Vagotomy, in which fibres that control digestive acid secretion are cut are the three main procedures that are performed. As a matter of fact, most patients with Duodenitis and Gastritis start recovering within 2 days after treating them with antacids. Drug therapy for people with gastric ulcer can ensure healing in 6-8 weeks in 70% of the cases. Surgeries couple with drug therapy help in reducing production of acids successfully.
Home Remedies of Duodenitis
It is true that home remedies can effectively control and cure Duodenitis but the success depends on intensity of the cause. There are simple dietary and lifestyle changes one can instil in their life and make the condition go away. These include taking in meals rich in fibre like oats, barley and carrots, drinking chamomile tea at least two times a day, having yogurt and buttermilk daily for best results. Food rich in Vitamin A should be inculcated in the diet including watermelon, oranges, carrot juice, blackberries and peaches. These small things can help you control the inflammation in your upper intestine – it is much more natural than gulping pills or going for surgeries.
Complications of Duodenitis
There are possible complications that arise due to the disease. These include
- Haemorrhage – Formation of ulcer due to inflammation can result in bleeding.
- Iron Deficiency Anaemia – Iron amount in the bloodstream evidently decreases.
- Peritonitis – Swelling of tissues located in the abdomen leading to acute stomach ache.
- Pyloric Stenosis – Scarring in valves which narrow the valve between organs. It prevents stomach from passing the food to duodenum and gives the patient abdominal pain and causes vomiting.
Not treating the condition in time makes matters worse. Therefore, if even the symptoms like blood vomit or stool are remotely visible, you should immediately consult a doctor.
Management and Prevention of Duodenitis
In order to get best results, manage your condition by implementing a few exercises. If the patient has undergone a surgery, it would be best to practice breathing workouts to ensure faster recovery. Progressive muscle relaxation and deep-breathing exercises reduce the pain and help speed up the recovery process. These exercises a few times a day can definitely help deal with anxiety and ease up the pain and tension. Also, aerobic exercises like swimming or jogging can prove advantageous too as they support blood circulation. Nonetheless, after a surgery the patient should take extra care as to not lift heavy weight for it might aggravate their condition and keep the work to a bare minimum.
Duodenitis could be prevented with simple lifestyle changes. First of all, smoking and intake of alcohol should be restricted completely. Spicy food doesn’t go well with the body too so that should be avoided as much as possible. Anti-inflammatory drugs have side-effects and thus, it is highly recommended that you avoid them altogether. Other than that, controlling your stress level would keep you away from this condition positively.