it is most often a chronic inflammation in the duodenum the portion of the digestive tract, which is located after the outlet of the stomach and is the original division of the small intestine.
Because the duodenum is created by an alkaline environment, and its mucosa is able to repair cells, its shell is resistant to aggressive factors of gastric contents, pancreatic enzymes and concentrated bile.
Mechanisms of development of duodenitis have not been studied. Typically the process of inflammation develops under the influence of irritating and damaging factors in the protective mechanisms of gastroduodenal zone.
In accordance with the nature of the symptoms of the disease distinguish acute and chronic duodenitis. Acute is rare and is usually accompanied by inflammation in the stomach or the intestine. The chronic form is divided into primary and secondary duodenitis.
Primary duodenitis may develop as a result of earlier acute form of the disease. Secondary chronic duodenitis is one of a number of the most common pathologies of the duodenum. This type of duodenitis develops as a complication on the background of certain chronic diseases of the digestive system.
The process of inflammation in the duodenum occurs in response to action of damaging factors on the mucous of the intestinal tract that causes violations of mutual balance of the factors of aggression and protection.
The factors of aggression is a complex of factors, including the damaging effects of hydrochloric acid and enzymes of the digestive system, injuries of the mucous membrane and duodenum. Factors protection condition normal cell regeneration, blood circulation of the duodenal mucosa.
Primary duodenitis can be considered as an independent disease. They develop after acute duodenitis or due to factors that have a damaging effect on the mucosa cells of the intestine.
Such factors may include
- flaws in the diet (a predominance in the diet of fatty, fried, spicy food, etc.)
- excessive alcohol
- excessive consumption of coffee and tea
- traumatic injury of the duodenum foreign body.
The secondary duodenitis is a complication of chronic diseases of the digestive system. Any disease of the gastrointestinal tract duodenum may be involved in the pathological process, because it has close connection with other digestive organs.
- ulcer of the mucosa of the digestive system
- gastritis with chronic
- chronic diseases of pancreas and biliary tract
- gastrointestinal diseases associated with H. pylori infection
- chronic hepatitis.
Diseases of individual systems and organs can also provoke secondary duodenitis. For example, is a disease of the lungs, heart and blood vessels that cause oxygen starvation of cells and tissues, or kidney failure, which impairs the excretory function of the kidneys, and excretion of toxic products of nitrogen metabolism takes place through the mucous membrane of the duodenum. Also in the development of the disease plays a role heredity, so often duodenitis in children can cause the syndrome of vegetative dystonia and allergies.
Symptoms of duodenitis depends on the form of the disease and differ in many respects. The acute form is very rare and is usually associated with inflammation in the stomach or the intestine. Acute duodenitis can have different types. This is a catarrhal duodenitis, erosive duodenitis, erosive and ulcerative and abscess. In acute duodenitis the patient’s condition significantly worsens and the pain and tension in the muscles, fever, may be expressed symptoms of intoxication, the body temperature rises, there is vomiting and nausea. Here is necessary surgery, as the effects and complications can be very serious.
With regard to chronic duodenitis, it is worth noting features such as multiple and non-specific symptoms that can be similar to signs of other diseases of the gastrointestinal tract. Chronic proximal duodenitis can often be combined with ulcer, chronic gastritis, enteritis, chronic diseases of the biliary tract. For each form of diseases such as duodenitis, the symptoms can vary. For example, the ulcerative form is severe pain, which is particularly felt at night or on an empty stomach. When gastrototonic form (reflux duodenitis) typical troubles of digestion, pain after meals, nausea, vomiting and other unpleasant symptoms that can also be observed in cases of poisoning.
Chronic duodenitis can occur in mixed form, they are characterized by a combination of various symptoms that are typical of the different forms of the disease. There is also a hidden form of chronic duodenitis is asymptomatic.
Complications the duration of the current chronic duodenitis can become peptic ulcer, intestinal bleeding, periduodenit. Periduodenit is inflammation of the outer membrane of the duodenum, which develops with the spread of inflammation from the mucosa to the outer shell wall of the duodenum.
Periduodenit can pass without symptoms or can cause pain in the epigastric region. The pain intensifies in physical load, sudden change of position of the body, sleep disorders and nutrition. With accompanying inflammation in the gallbladder attacks of periduodenit often resemble acute attacks of cholecystitis, therefore, to determine the correct diagnosis can be very problematic.
Diagnosis of duodenitis is
or physician. To confirm the diagnosis to be conducted such tests as pH meter (determination of acid-base balance of certain regions of the GI) tract, fibrogastroduodenoscopy with biopsy (examination of the gastrointestinal tract with an endoscopic tube, equipped with a video camera, followed by the capture of a piece of tissue for analysis) and antroduodenal manometry (measurement of pressure and assessment of the motility of the gastrointestinal tract).
In the case of catarrhal and erosive and ulcerative duodenitis acute may cure itself in a few days, but in some cases the disease may become chronic. Superficial duodenitis involves hospital mode and fasting for 12 days. The third day is a transition to a healthy diet. Dehydration is appointed plentiful drink, if vomiting saline solutions. May be exposed to antibiotics and surgical treatment. When the disease such as duodenitis, the symptoms and treatment are closely linked, because the former determine the course of therapy.
In this form of chronic duodenitis treatment is developed depending on the stage and clinical type of the disease, and the presence of other diseases of the gastrointestinal tract. Medical treatment of duodenitis includes antacids, antisecretory drugs, and prokinetics in the case of disorders of duodenal patency.
In atrophic process in the gut and the extinction of its secretory functions of the applied substitution therapy, herbal medicine. In the case of neurovegetative disorders used tranquilizers and sedatives, if there are anxiety-depressive syndrome, it can be shown antidepressants. In chronic duodenal obstruction need surgical treatment of duodenitis. Plays the role of correction of lifestyle and nutrition of the patient. Diet for duodenitis is assigned depending on the characteristics of the disease.
In complex therapy of chronic duodenitis is used physiotherapeutic treatment, which has analgesic and anti-inflammatory effect and helps to normalize the motor-evacuation function of the gastrointestinal tract. The most effective are complex, which include a combination of hardware methods of physiotherapy, balneotherapy and mineral water treatment. In case of neurasthenic syndrome useful techniques electrosleep. Patients who are prone to exacerbations, shows the mud treatment, application of paraffin and ozokerite.