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Inflammation within the duodenum or duodenitis is a common surgical complaint the diagnosis of which is reducing with the widespread use of drugs for symptoms of “indigestion” which completely suppress stomach acid production.
The recognition that duodenitis is caused by a bacterial infection or particular types of painkilling drugs has also changed the nature of the condition in the UK in the last twenty years.
Causes of duodenitis
Helicobacter Pylori Infection: A bacterium found in the stomach (often in individuals without symptoms) has been shown to have a role in the development of duodenitis
Excessive secretion of stomach acid: Is found in some but not all cases
Non-Steroidal Anti-inflammatory drugs (NSAID): Widely recognised to cause duodenitis
Smoking: May cause and certainly potentiates the development of duodenitis
Ill or hospitalised patients: A very common finding in this patient group usually with poor nutritional intake
- Abdominal Pain usually centrally in the upper abdomen
- Anaemia usually showing Iron deficiency
Duodenitis may be diagnosed by a variety of means but the most accurate and useful is an OGD (Oesophago-Gastro-Duodenoscopy). A flexible endoscope is inserted via the mouth into the stomach and duodenum. The inflammation may be diagnosed and biopsied. Samples may be taken for Helicobacter Pylori.
Duodenitis will usually heal with a six week course of acid suppression therapy using a proton pump inhibiting drug (Omeprazole, Esmoprazole etc) and eradication of Helicobacter Pylori (if present) with a week long course of two antibiotics in combination.
Clearly treatment should also address other stimulants of ulcer formation, smoking and NSAID (aspirin, Ibuprofen etc) use. Only very occasionally since the advent of complete acid suppression therapy, does the condition progress on treatment to duodenal ulceration.