Gastritis and Duodenitis - Causes, Symptoms, Diagnosis, and Treatment

Creator: Dr. Ancy Jose
Published: 2023-03-13T18:27:16

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These are both inflammatory conditions affecting the upper gastrointestinal tract. Read below to know more about it.

Written by

Dr. Ancy Jose

Medically reviewed by

Dr. Ghulam Fareed

March 13, 2023

May 2, 2023

Contents

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Contents

What Are the Causes?
What Are the Symptoms?
How to Diagnose the Disease State?
What Are the Treatment Modalities?
What Are the Complications?
How to Prevent?

Introduction

Gastritis and duodenitis are common disease conditions affecting the gastrointestinal tract (GIT). The duodenum, a part of the small intestine, follows the stomach. The meaning of "itis" is inflammation. As the name suggests," itis" is inflammation, gastritis means stomach inflammation, and duodenitis means duodenum inflammation. It affects both men and women. It can affect any age group of people. Gastritis and duodenitis share the same characteristic features in symptoms, causes, diagnosis, and treatment plan. Due to their similar nature, it is not easy to differentiate between them. Gastritis and duodenitis, if treated properly, do not cause any life-threatening issues.

What Are the Causes?

Helicobacter pylori (H pylori) is the main causative agent for gastritis and duodenitis. This bacteria causes inflammation and destruction in both the stomach and duodenum.
Chronic smoking is a causative factor for irritation. The contents in tobacco and cigarettes irritate the GI tract leading to inflammation.
In chronic drinkers, excessive intake of alcohol irritates the GI tract leading to inflammation.
Prolonged use of painkillers like Ibuprofen which is under the group of Nonsteroidal Anti-inflammatory Drugs (NSAID)s which cause chronic irritation to the stomach and duodenum, leading to inflammation.
Sometimes, the patient's body produces antibodies against the cells, which leads to destruction and inflammation in the stomach and duodenum. These types of disease conditions are known as autoimmune diseases.
Any accident or trauma resulted in injury to the duodenum and stomach.
Stress is also a factor in gastritis and duodenitis.
When age progresses, atrophy may occur, especially in older age, which could lead to inflammation.
Inflammation of the duodenum and stomach is seen along with conditions like Crohn's disease, celiac disease, and HIV.
In treating cancer, chemotherapy, and radiation therapy, causes inflammation of the stomach and duodenum.
Any recently done surgery to the GI tract can lead to duodenitis and gastritis.
If the patient accidentally intakes any harmful substances, it may lead to inflammation of the GI tract.
If the bile produced by the gallbladder moves back into the stomach instead of moving into the duodenum it will result in inflammation. This moving back of bile into the stomach is known as acid reflux.

What Are the Symptoms?

Some patients experience strong symptoms, whereas, in some, it remains asymptomatic. Symptoms vary from patient to patient. However, gastritis and duodenitis share almost the same symptoms. The mainly occurring symptoms are listed below.

The patient experiences a feeling of fullness in the stomach even if a small amount of food is consumed. This condition is known as bloating.
A feeling of burning felt in the abdomen sometimes at night time.
Some patients experience an urge to vomit, which is referred to as nausea.
Due to this fullness in the stomach, the patient has less appetite or loss of appetite.
The patient experiences pain around the abdominal area.
A proper digestion process cannot occur, leading to indigestion of food substances.
In some severe cases, the fecal matter appears black due to bleeding.
The patient may feel hiccups.
During vomiting, it appears as coffee grounds due to bleeding.

How to Diagnose the Disease State?

A good healthcare provider will help to diagnose gastritis and duodenitis. First, the healthcare provider will ask for the history of the disease state. It includes the progression of the disease state, any medications taken, aggravating and relieving factors, and any family history. After that, a physical examination is done. Finally, certain tests and imaging techniques are done to confirm the diagnosis.

Testing of Fecal Matter: A sample of the patient's stool is obtained and sent to the lab to test the presence of H pylori bacteria. It helps to rule out the cause and treat them effectively.
Testing of Blood: Blood count is tested to rule out any other disease conditions. It helps to understand if any infections are present based on the values. It also helps to find out H pylori infection with the help of testing the titer of antibodies present in the blood against H pylori.
X-Rays: X-rays are taken to view the stomach and the duodenum. The patient is asked to swallow barium for clear visualization of the structures in it. This barium coats over the structures and helps to provide a detailed view of X-rays. This procedure helps identify the site of inflammation, whether in the stomach or duodenum.
Breath Test: Helicobacter pylori can be identified with the help of breath tests also. The patient is asked to inhale a capsule containing radioactive urea in the breath test. After inhaling, the patient is asked to exhale into a bag. The bag is then sealed for diagnostic purposes. If the urea is converted to carbon dioxide, then the presence of H pylori bacteria is detected.
Endoscope: The diagnostic procedure is done to view the upper gastrointestinal tract using an endoscope. It helps to identify the site of inflammation, suppose it is present in the stomach or duodenum. Endoscopy is the name of the procedure. In this procedure, a healthcare provider inserts a long flexible tube through the mouth into the esophagus, stomach, and duodenum. The patient might feel slight discomfort as the tube passes down. At the tip of the tube, there is a camera called an endoscope which helps in easy visualization. Sometimes, small tissue scrapings are taken during endoscopy and sent for biopsy.
Biopsy: A biopsy helps to identify any abnormal changes and the presence of H pylori bacteria.

What Are the Treatment Modalities?

The treatment plan is made based on the cause of the disease state.

If the causative factor is H pylori bacteria, it should be treated. It can be treated with the help of certain antibiotics. The antibiotics used mainly are Amoxicillin or Metronidazole. It is usually given for 14 days. After this diagnostic procedure, associated H pylori is done again to make sure the H pylori is no more in the GI tract.
Acid production that irritates the stomach can be reduced with the help of antacids, proton pump inhibitors, and histamine blockers.
Antacids are medications that are prescribed to patients to neutralize the acid produced.
Proton pump inhibitors are the other choice drug. It acts by blocking the acid production in the stomach. The commonly used drugs are Omeprazole and Pantoprazole.
Histamine blockers (H-2 blockers) are also considered. It acts by decreasing the acid produced in the stomach. The mainly used drugs are Famotidine and Cimetidine.
If the cause is alcohol or smoking, the patient is advised to quit the habit because it irritates the stomach and duodenum.
The chronic use of painkillers such as NSAIDs should be restricted.
The patient is advised to avoid food substances that can cause irritation and inflammation of the stomach and duodenum. For example, some food substances like carbonated drinks, spicy food substances
Supplements of glutamine can help in the prevention of mucosal damage.
Intake of probiotics will improve the good bacteria present in the gut.
As a home remedy, crushed ginger and garlic can be considered to get relief from the symptoms.

What Are the Complications?

If gastritis and duodenitis are left untreated, it may lead to ulcers in the stomach and duodenum.
If gastritis and duodenitis continue with gastrointestinal bleeding, it may lead to anemia.
The causative agent H pylori bacteria is not treated properly, which can lead to cancer formation in the stomach.

How to Prevent?

Avoid intake of unnecessary medication.
Avoid habits like alcohol drinking and smoking.
Avoid eating acidic and fried food items.
Avoid eating a whole meal at a time. It can be taken in small amounts at frequent intervals of time.
Avoid overstress and live happily.

Conclusion

Gastritis and duodenitis share the same causes, symptoms, diagnosis, and treatment plan. The only difference is the site of inflammation. Gastritis and duodenitis, if identified early and treated, will provide the best results. These conditions do not cause any life-threatening conditions.

Frequently Asked Questions

1. What Foods Should Be Avoided With Gastritis and Duodenitis?

Foods such as spicy and acidic foods, including hot peppers, chili powder, citrus fruits and juices, tomatoes, and vinegar; high-fat foods, such as fried foods, fatty cuts of meat, full-fat dairy products, caffeinated beverages, carbonated beverages, alcohol, processed and high-sugar foods, cigarettes, and tobacco should be avoided.

2. Is Duodenitis a Type of Ulcer?

No, duodenitis is not a type of ulcer. Duodenitis refers to inflammation of the duodenum, the initial portion of the small intestine. Various factors, including infection, certain medications, alcohol consumption, smoking, and autoimmune diseases, can cause it.

3. Does Duodenitis Cause Gas?

Yes, duodenitis can cause gas and bloating. When the duodenum is inflamed, it may affect the proper digestion and absorption of nutrients, resulting in the fermentation of undigested food by bacteria in the gut. This fermentation process produces methane, carbon dioxide, and hydrogen, increasing gas production.

4. What Kind of Foods Can Be Eaten for Breakfast for Someone With Gastritis?

Plain, non-flavored oatmeal can be soothing and easy to digest. Avoid adding acidic fruits or sweeteners, and opt for toppings like a small amount of honey or a sprinkle of cinnamon instead. Choose plain, low-fat yogurt without added sugars or artificial sweeteners. Bananas are generally well-tolerated and can provide nutrients such as potassium and fiber. Eggs are an excellent source of protein for breakfast. Boiling or poaching them instead of frying reduces the fat content and can make them easier to digest. Blend a combination of non-acidic fruits like bananas, berries, or melons with non-dairy milk or yogurt for a gentle and nutritious breakfast option.

5. How Common Is Duodenitis?

Duodenitis, inflammation of the duodenum, is a relatively common condition. However, the exact prevalence of duodenitis can vary depending on the population studied and the specific underlying causes. Duodenitis can occur in people of all age groups, including children and adults.

6. Could Duodenitis Be Cured on Its Own?

Duodenitis, like other forms of inflammation, can sometimes resolve independently without specific treatment. But, if an infection causes duodenitis, such as Helicobacter pylori (H. pylori), treatment with appropriate antibiotics is typically necessary to clear the infection and allow the inflammation to subside. Similarly, if duodenitis is caused by nonsteroidal anti-inflammatory drugs (NSAIDs), discontinuing or reducing these medications can help resolve the inflammation.

7. What Is the Surgical Treatment for Duodenitis?

Surgical treatment for duodenitis is not typically the first-line approach, as most cases can be managed effectively with non-surgical methods. If duodenitis is accompanied by a duodenal ulcer that is not responding to medical treatment, surgical options such as vagotomy (partial or complete severing of the vagus nerve) or antrectomy (removal of the lower part of the stomach) may be considered. In some instances, endoscopic procedures may be performed to treat duodenal ulcers associated with duodenitis.

8. Can Stress Cause Duodenitis?

While stress does not directly cause duodenitis, it can worsen the symptoms in some individuals. Stress can affect the functioning of the gastrointestinal system, including the duodenum, and may worsen certain digestive disorders.

9. What Is the Choice of Antibiotics to Treat Duodenitis?

The most commonly used antibiotics for treating H. pylori infection and associated duodenitis include Clarithromycin, the first-line antibiotic for H. pylori infection. Amoxicillin is frequently used with Clarithromycin and a proton pump inhibitor (PPI) for treating H. pylori infection. Metronidazole is another antibiotic commonly used in H. pylori eradication regimens. It is often included in combination with Clarithromycin and a PPI or amoxicillin.

10. How Long Does Duodenitis Take To Heal?

The healing time for duodenitis can vary depending on several factors, including the underlying cause, the severity of inflammation, individual response to treatment, and adherence to recommended lifestyle changes. The healing process for duodenitis may take several weeks to months.

11. What Are the Biopsy Findings of Duodenitis?

Biopsy findings of duodenitis refer to the microscopic examination of tissue samples taken from the duodenum, specifically the lining of the duodenal mucosa. Common biopsy findings in duodenitis include infiltration of inflammatory cells, architectural changes, increased immune cell presence, and specific pathogens.

12. How does the duodenum Look in an Endoscopy?

Under normal conditions, the duodenum typically appears as follows during an endoscopy:
- Color: The normal duodenal mucosa is pale pink to light yellowish.
- Surface texture: The surface of the duodenal mucosa appears smooth and velvety.
- Folds and wrinkles: The duodenum has natural folds and wrinkles called rugae, allowing expansion and contraction.
- Villi: The duodenal mucosa is lined with tiny finger-like projections called villi. These villi play a role in nutrient absorption and are fine, hair-like structures on the mucosal surface.

13. Can Colonoscopy Detect Duodenitis?

No, a colonoscopy is not explicitly designed to detect duodenitis. A colonoscopy examines the colon (large intestine) using a flexible tube and a camera at the end called a colonoscope. Conversely, duodenitis is the inflammation of the duodenum, which is part of the small intestine.

14. Can Endoscopy Detect Duodenitis?

An endoscopy, specifically an upper endoscopy or esophagogastroduodenoscopy (EGD), is the primary diagnostic procedure used to detect and evaluate duodenitis. During an upper endoscopy, a flexible tube with a camera (endoscope) is inserted through the mouth and down into the esophagus, stomach, and duodenum, allowing for direct visualization of the upper gastrointestinal tract.

15. Is Gastritis a Serious Condition?

Gastritis can vary in severity, and the seriousness of the condition depends on several factors, including the underlying cause, the extent of inflammation, and the individual's overall health. In many cases, gastritis is a temporary and self-limiting condition that can be managed effectively with proper treatment and lifestyle modifications.

Sources

Dr. Ghulam Fareed

Medical Gastroenterology

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