Duodenitis

Duodenitis is a highly discomforting condition that has a worldwide prevalence. Read and know all about this disorder along with its causes, symptoms, diagnosis and treatment.

Duodenitis Definition

It is a condition marked by inflammation in the duodenum, or the upper section of the small intestine that lies between the jejunum and the stomach. This inflammatory condition usually arises with other abdominal disorders, such as Gastritis, Dyspepsia or Hepatitis.

Duodenitis ICD 9 Code

The ICD 9 Code for Duodenitis is 535.6.

Duodenitis Incidence

The disease is found to arise in as many as 5 to 9% of all individuals suffering from Upper Gastrointestinal Hemorrhage.

Duodenitis Symptoms

This condition is primarily characterized by an inflammation of the stomach lining. This may result in a number of symptoms which can in intensity from person to person. Some of the most common symptoms of Duodenitis occur daily or only once in a while. These include:

• Abdominal pain
• Abdominal bloating
• Diarrhea
• Gas
• Indigestion
• Loss of appetite
• Nausea, with or without vomiting
• Vomiting

In some cases, these symptoms may become severe and also life-threatening. Particularly severe symptoms include

• Acute abdominal pain
• Bloody vomit
• Bloody feces, with stools appearing black, red or tarry in color

These symptoms might develop along with associated abdominal disorders.

Duodenitis Causes

Swelling of the upper intestine can occur for a number of reasons. Some of the main causes include:

Bacterial infection

Duodenal inflammation often occurs when the stomach is infected by a type of bacteria known as H. pylori or Helicobacter pylori. This form of bacteria infects around half of the world population. Approximately 50% of all Americans over 60 years of age are found to be infected with this bacterium at some point in their lives. This bacterial infection often exhibits no symptoms in patients. But in some cases, the infection can result in the development of accompanying conditions like gastritis, intestinal ulcers, stomach ulcers and even stomach cancer.

Medications

The disease may also arise due to a side-effect of using non-steroidal anti-inflammatory drugs (NSAIDs) such as Ketoprofin, Peroxicam, Ibuprofen and Indomethacin. These medications lead to an irritation of the stomach lining and reduce the production of a hormone-like substance called Prostaglandin. This substance protects the lining of the intestine and stomach by limiting secretion of digestive acids and encouraging secretion of protective mucus. The possibilities of an obtrusive stomach or duodenal irritation increase when larger doses of NSAIDs are used for a longer period of time.

Gastroesophageal Reflux Disease (GERD)

Duodenitis is also associated to GERD, a chronic condition in which caustic bile is released into the esophagus. This gastric acid reflux involving the lower esophageal sphincter leads to acid indigestion, heartburn and possible trauma (injury) to the esophageal lining.

The condition may also result from other causes like:

• Crohn’s disease, which results in intestinal inflammation due to unknown reasons
• Gall bladder inflammation
• Gastrointestinal hemorrhage
• Low blood supply to the intestines
• Zollinger-Ellison syndrome, which leads to excessive acid production
• Viral infections

Duodenitis Diagnosis

Physicians typically begin the diagnosis of this condition by checking the symptoms and analyzing the medical history of the patients. Patients are asked whether they are suffering from discomforts like:

• Abdominal bloating
• Diarrhea
• Excessive belching
• Flatulence
• Heartburn
• Loss of appetite
• Nausea
• Sense of fullness after eating
• Slight abdominal discomfort or pain
• Vomiting

These symptoms are found to arise more at times when patients are in stress. Physicians can follow this up with a physical examination of the patient to check for physical signs like:

• Abdominal distention (due to excessive flatulence)
• Abdominal mass
• Blood in stool
• Enlargement of abdominal organs
• Increase in bowel sounds
• Loss of weight

Diagnosis also includes medical tests like:

Upper Gastrointestinal (GI) Series

Also known as “Upper Gastrointestinal Tract Radiography”, this medical examination involves visualizing the duodenum through imaging. The patient is made to swallow a Radiopaque dye (Barium) after which an X-ray image of his or her GI tract is taken.

Endoscopy

It is used to visualize the mucosa or inner lining of the duodenum and involves passing a Fiberoptic microscope, known as Endoscope, down the esophagus. Endoscope is a slender medical tool that is fitted with a tiny camera. It is used to perform a minor surgery or examine the inside of a bodily organ. During diagnosis, it is mainly inserted into the body to acquire live images of one or more internal organs.

However, both Upper GI Series and Endoscopy only provides indirect proof of Duodenitis. Due to this reason, physicians should acquire tiny samples of the duodenum during Endoscopy for a definitive microscopic analysis. The procedure is known as Endoscopic Biopsy. In some cases, larger duodenal samples are needed for an analysis. This can be done with Tube Biopsy, a process that uses a tubular sampling device to get a larger piece of tissue.

Duodenitis Treatment

Treatment for Duodenitis depends on the actual cause of the inflammation. If the swelling is found to result from a bacterial infection, patients may be put on an antibiotic course. Infections by H. pylori or Giardia require proper antibiotic therapy to be cured. They may also be recommended medications such as sucralfate that protect the lining of the intestines and stomach. In some cases, physicians might use drugs such as proton pump inhibitors that limit acid production within the body.

If intake of NSAIDs is found as the cause, patients may be asked to discontinue them for some time. Alternatives to such medications may be provided.

If Gastrointestinal Disorder accompanies Duodenitis, treatment usually involves therapy. Medications, beverages like caffeine or alcohol and all types of substances that can irritate the gastrointestinal tract should be restricted or avoided completely.

If medications or therapies fail to improve the situation, it is necessary to use a surgical intervention. This involves operative procedures like:

Gastrectomy

It involves surgical removal of a part of the stomach.

Pyloroplasty

The process involves opening the valve located between the duodenum and the stomach.

Vagotomy

The procedure includes cutting the fibers of the vagus nerve that control secretion of digestive acids.

If patients suffer from chronic or severe symptoms of Duodenitis, such as bloody vomit or stool, their family members should immediately call a doctor.

Duodenitis Home Remedies

The condition is frequently seen to go away with home remedies. The effectiveness of these remedies depends on the intensity of the underlying cause in patients.  Remedies mainly involve lifestyle and dietary modifications, such as:

High Fiber Intake

Foods rich in high fiber such as barley, beans, oat, carrots, lentils and soya products are very effective in inhibiting the cause of the condition.

Drinking Dandelion Tea

Intake of lukewarm dandelion tea or cold chamomile tea can help heal any type of infection. It is advised that patients drink the tea at least twice a day with proper intervals in between.

Vitamin A

The symptoms of this condition can also be reduced by daily intake of fruits rich in vitamin A, such as blackberries, carrot juice, oranges, peaches, raw cabbage and watermelon. These should be consumed at steady intervals all through the day.

Yoghurt

Daily intake of one bowl of yogurt can help soothe the intestinal system and reduce abdominal pain.

Butter Milk

Consuming butter milk is considered to be one of the simplest remedies for this disorder. For better effects, you may add powdered cumin seeds or black pepper powder to a glass of buttermilk and consume it at regular intervals. Having the drink for 2-3 times a day can yield best results.

Duodenitis Prognosis

The prognosis for this disease is based on the effectuality of the cure implemented for curing the underlying cause. Most individuals affected with Duodenitis as well as Gastritis exhibit signs of recovery within 1-2 days of treatment including antacids, modification of beverage intake or inhibition of stomach acid production. If the condition arises along with duodenal or gastric ulcer, drug therapy can ensure good healing within 6 to 8 weeks in around 70% of all cases. In most cases, surgical intervention and prolonged drug therapy helps in effectively reducing acid production in patients.

Duodenitis Recovery

Most cases of this disease resolve within a week. Bacterial or parasitic infections that are treated with antibiotic medications usually need a longer course of therapy. In such cases, the time for recovery can be expected to vary between 10 to 14 days.

Duodenitis Complications

Some of the possible complications of this disease include:

Hemorrhage

This can be a possible complication if there is an underlying gastrointestinal condition. Inflammation of the stomach lining may lead to the formation of an ulcer (lesion) within the duodenum or stomach. This may result in bleeding (hemorrhage) and substantial loss of blood.

Iron Deficiency Anemia

If hemorrhage becomes chronic in nature, it may cause Iron Deficiency Anemia which is characterized by a reduction in the amount of iron in the bloodstream.

Peritonitis

If untreated stomach or duodenal ulcers penetrate the lining of the Gastrointestinal (GI) tract, it may lead to Peritonitis. This condition results from a swelling of the tissues located within the abdomen. It occurs due to the abnormal release of hydrochloric acid, blood and partially digested food into the abdominal cavity. Individuals affected with this condition suffer from acute stomach pain and need immediate hospitalization and professional medical care.

Pyloric Stenosis

In some patients, ulceration or inflammation may cause formation of scars in a valve known as Pylorus that is located between the stomach and the duodenum. Scarring may result in the narrowing of the valve between the organs. This condition is known as Pyloric Stenosis. This prevents the stomach from passing food particles into the duodenum thereby causing discomforting symptoms like abdominal pain, belching and vomiting.

Ulcers

Alcohol intake can aggravate the possibility of ulcer development, which may lead to other discomforts in turn.

Duodenitis Management

For best results, an episode of Duodenitis should be followed up with proper ways of management. These include:

Aerobic exercises

A regular exercise regimen can reduce stress, postoperative pain and speed up recovery. Aerobic workouts like such as swimming jogging or even walking can be quite beneficial. Each workout session should continue for 30 to 45 minutes. Lying on the back and performing crossed-leg muscular contractions, knee bends or ankle flexes may help promote blood circulation and make it easier to walk for patients.

Breathing exercises

If surgical intervention is performed for treatment, patients may find it necessary to practice positive pressure breathing workouts intermittently to avoid pulmonary complications.

In some cases, exercises like as deep-breathing techniques and Progressive muscle relaxation (PMR) may be recommended to accelerate recovery and reduce postoperative pain. Performing these for a few times every day can help reduce anxiety and relax muscular pain and tension.

Patients who undergo a surgical treatment should stick to light or sedentary work for 2-4 weeks after operation. He or she should also avoid lifting heavy weights as it can worsen the condition and compromise recovery.

Duodenitis Prevention

This syndrome is typically prevented with lifestyle and dietary modification measures, which include:

• Avoiding foods that are very spicy
• Avoid smoking
• Restricting or eliminating intake of alcohol
• Controlling stress levels
• Avoiding consumption of anti-inflammatory drugs, such as Ibuprofen and Aspirin

Duodenitis and Gastritis

Both Duodenitis and Gastritis are often found to have the same causes, symptoms and modes of treatment. Gastritis causes swelling of the stomach lining while Duodenitis results in inflammation of the first segment of the small intestine (duodenum). Duodenitis is often accompanied by Gastritis.

Call your health care provider immediately if you find any of your family member displaying symptoms of Duodenitis. As aforesaid, this is a discomforting condition that often causes life-threatening symptoms. Hence, timely treatment is extremely necessary in curing this disease. If diagnosed and treated well on time, the disease can go away within a short time without causing any further complications. It is essential to manage the disorder properly in order to prevent its recurrence or aggravation.

References:

http://www.bettermedicine.com/article/duodenitis

http://www.mdguidelines.com/duodenitis

http://answers.webmd.com/answers/1198395/What-is-duodenitis

http://www.organicfacts.net/health-benefits/home-remedies/home-remedies-for-duodenitis.html