Peptic Duodenitis: Know the Causes and Symptoms

What Is Peptic Duodenitis?

Peptic duodenitis can happen with gastritis. Gastritis is inflammation in the stomach lining. When gastritis and duodenitis occur together, it is termed gastroduodenitis. Duodenitis is inflammation of the duodenum. Duodenum is the initial section of the small intestine, located below the stomach.

Duodenitis can occur in both men and women of all age groups. Peptic duodenitis can be acute or chronic in nature. The acute forms are the sudden and short-time ones. Whereas the chronic form develops slowly and can last for a long time. Duodenitis can be treated completely and does not have any long-term complications.

What Is the Duodenum?

The upper part of the small intestine is called the duodenum. The duodenum digests and breaks down food. Duodenum receives chyme from the stomach and breaks it with the help of enzymes and intestinal juices. The gallbladder, liver, and pancreas secrete these enzymes into the intestine.‌ The duodenum too releases a few hormones for digestion. These hormones include:‌

• Secretin neutralizes acid in the duodenum by moving sodium bicarbonate and water to the intestine and reduces the pH.‌ Cholecystokinin is released from protein and fat. Protein digestion releases this hormone and prevents the stomach from emptying.

• Along with food digestion, blood vessels take up vitamins and nutrients and are converted into usable forms for the body.

• Inflammation in the lining of the duodenum causes problems with digestion and absorption of nutrients from food.

What Are the Causes of Peptic Duodenitis?

The most common cause of duodenitis, along with gastritis, is a bacterial cause; this bacteria is called Helicobacter pylori. This bacteria can invade the stomach and cause inflammation. H. pylori can spread from person to person, but the method of spread is unclear. It can spread through contaminated food and water.

Other causes of gastritis and duodenitis include the following.

• Long-term use of medications like Aspirin, Ibuprofen, or Naproxen.

• Excessive use of alcohol.

• Crohn’s disease.

• Atrophic gastritis.

• Celiac disease.

• Bile reflux.

• Herpes simplex.

• Injury to the stomach or small intestine.

• Breathing support.

• Stress due to major surgery.

• Ingestion of caustic substances.

• Smoking.

• Radiation therapy.

• Chemotherapy.

• Gastritis, duodenitis, and inflammatory bowel disease.

  • Inflammatory bowel disease (IBD) is the chronic inflammation of the digestive tract. IBD may be due to an immune disorder. A combination of environment and genetics play a role. IBD includes ulcerative colitis and Crohn’s disease. Crohn’s disease can affect part of the digestive tract and spread to the intestinal lining. People with IBD are at risk of developing a form of gastritis or duodenitis. The most common cause of duodenitis is Helicobacter pylori bacteria. Generally, people have H. pylori present in the stomach; when this bacteria gets out of balance, it can cause infections and diseases like peptic stomach ulcers. The bacteria can move out of the stomach into the duodenum and cause peptic ulcers. Overuse of pain medications, non-steroidal anti-inflammatory drugs, or NSAIDs, like Aspirin or Ibuprofen, also cause ulcers, bleeding, and duodenitis.‌

• Drinking alcohol, smoking cigarettes, and chewing betel quid can all cause ulcers and duodenitis.‌

• Celiac disease, an autoimmune disease, causes the body to produce immune proteins.

• Stomach acid helps with digestion by producing accurate pH. Too much acid causes heartburn and ulcers, leading to inflammation in the lining or duodenitis.‌

What Are the Symptoms of Peptic Duodenitis?

Gastritis and duodenitis do not have any specific signs or symptoms. However, the following symptoms are seen.

• Nausea.

• Vomiting.

• Stomach burning.

• Stomach cramps.

• Stomach pain that refers to the back.

• Indigestion.

• Feeling of fullness

• Stools may appear black in color.

• Vomit looks like coffee grounds.

• The symptoms might be due to internal bleeding.

Other digestive symptoms seen are as follows.

• Feeling of fullness.

• Gas.

• Bloating.

• Feeling sick.

• Vomiting.

• Cramps.

• Burning.

• Iron deficiency anemia‌.

• Sometimes, sores in the lining of the duodenum can lead to ulcers. These ulcers cause peptic duodenitis.

How to Diagnose Peptic Duodenitis?

The following tests are done to diagnose duodenitis.

• Upper endoscopy involves the use of a camera to evaluate through the throat into the duodenum and to collect biopsies to look for the presence of H. pylori.

• Stool samples to test for infections.

• Blood tests to detect celiac disease.

• Upper gastrointestinal X-ray tests to examine the upper digestive tract.

• Breathing tests for H. pylori evaluation.

How to Treat Peptic Duodenitis?

Treatment for duodenitis is as follows.

• Antibiotics.

• Antacids.

• Proton pump inhibitors.

• Discontinue NSAIDs.

• Stop smoking.

• Reduce alcohol consumption.

• Eat a gluten-free diet‌

Antibiotics:

If H. pylori is the reason for the infections, it can be treated with antibiotics. A combination of drugs can be recommended to kill the infection. Antibiotics are generally prescribed for two weeks or longer.

Acid Reducers:

Reduction of acid production is an important step in treating gastric ulcers. Over-the-counter acid-blocking drugs work to reduce the amount of acid released in the digestive tract. These drugs are as follows.

• Cimetidine.

• Famotidine.

Proton pump inhibitors block cells that produce acid. Commonly used proton pump inhibitors include:

• Esomeprazole.

• Lansoprazole.

• Omeprazole.

Antacids:

For temporary relief of symptoms, antacids can be suggested to neutralize stomach acid and relieve pain. Antacids include Calcium carbonate, Magnesium hydroxide, Calcium carbonate, and Magnesium hydroxide.

Antacids prevent the body from absorbing other medications, so it is advised to take antacids an hour before other medications in order to avoid side effects. Antacids should be used occasionally. The doctor should be consulted for symptoms of heartburn, indigestion, or gastritis.

Lifestyle Changes:

Smoking, alcohol, and medications like Aspirin and NSAIDs increase inflammation of the digestive tract. Smoking and excessive alcohol use increase the risk of stomach cancer. Complete cessation of smoking and drinking alcohol is recommended. It is vital to discontinue the usage of pain relievers such as Aspirin, Naproxen, and Ibuprofen if those medications are the reason.

What Are the Complications of Duodenitis?

Duodenitis can cause serious problems like,

• Bleeding.

• Throwing up blood or vomit.

• Black, tarry stool.

• Severe stomach pain.

• Fast weight loss.

• Pain.

• Fever‌.

Conclusion:

Duodenitis occurs due to inflammation in the duodenum, which is the first part of the small intestine. It can lead to abdominal pain, bleeding, and digestive symptoms. Duodenitis mainly occurs due to infections, medicines, alcohol, or tobacco use.