Symptoms of duodenitis

With a better life and full pockets, people eat better and drink more. A few days ago, I heard from a friend that he ate seafood and drank beer every day in Qingdao, and as a result, he had a duodenal surgery after staying there for a few months. I say this to tell you that our current life puts a great burden on our stomach and intestines, causing some inflammation, which in turn triggers a series of diseases, such as duodenitis. So what is duodenitis? What are its symptoms?

Upper abdominal pain and nausea and vomiting are the main manifestations of duodenitis. Patients may also suffer from indigestion and other conditions.

Clinically, it often manifests as irregular upper abdominal pain or discomfort, nausea, poor appetite, belching, loss of appetite and other indigestion symptoms. Some patients present with typical steatorrhea: large amount of stool, shapeless, brown or slightly gray, foul smelling, with a greasy sheen on the surface, and a large number of fat globules can be seen under microscopic examination.

Duodenitis refers to inflammation of the duodenum, which can be divided into primary and secondary types. The primary type is also called nonspecific duodenitis. Due to the clinical application of fiberoptic duodenoscopy, the diagnosis of duodenitis is increasing.

Symptoms of duodenitis include

1. Upper abdominal pain

Patients will experience upper abdominal pain, nausea and vomiting, and will also have many adverse symptoms.

2. Duodenal ulcer

Sometimes it resembles duodenal bulb ulcer, presenting with periodic, rhythmic upper abdominal pain, stomach pain on an empty stomach, which can be relieved by food or antacids, and repeated black stools or vomiting of coffee-like fluid, but the bleeding usually stops automatically. Some patients may not have any symptoms.

3. Mild tenderness in the upper abdomen

In addition, patients with duodenitis often have mild tenderness in the upper abdomen, and some patients may have symptoms such as glossitis, anemia, and weight loss.

4. Indigestion

Symptoms may include upper abdominal fullness, acid reflux, belching, nausea, vomiting, etc. Some patients may have no symptoms or signs.

5. Upper gastrointestinal bleeding

The patient will have upper gastrointestinal bleeding, which is a condition of erosive duodenitis, and will also have black stools.

6. Common signs

There is mild tenderness in the upper abdomen, and some patients may have glossitis, anemia, and weight loss.

Causes of duodenitis

Gastric acid factor

The acidity is normal at the beginning of inflammation, but as the inflammation progresses, it interferes with the duodenum's inhibitory process on gastric juice secretion, leading to high acid production and the formation of ulcers.

Inflammatory factors

In duodenitis, epidermal cells are lost due to inflammatory destruction, but the proliferation of glandular duct cells can compensate for it. When the glandular duct cells cannot compensate for the loss due to exhaustion, erosion may occur, followed by the formation of ulcers.

Other disease factors

Specific duodenitis is mostly caused by Crohn's disease, intestinal tuberculosis, parasites such as hookworms, Giardia lamblia, fungi, eosinophilic gastroenteritis, etc., which affect the duodenum and cause specific inflammation.

Western medicine causes

Primary duodenitis can be caused by irritating foods, drugs such as aspirin, drinking, radiation exposure, etc. Patients with chronic superficial gastritis and atrophic gastritis often have duodenitis, suggesting that this disease may have the same cause as some chronic gastritis.

Secondary duodenitis or specific duodenitis is a group of duodenitis caused by various specific causes, including infection with parasites, tuberculosis, fungi, molds, hemorrhagic duodenitis caused by cerebrovascular disease and myocardial infarction, portal hypertension, heart failure, etc., and other diseases such as hepatitis, pancreatic and biliary diseases, which cause duodenal blood supply disorders due to local compression or spread. It can be seen from this that this disease is a multi-causal disease, with different causes and different pathogenesis.

Pathogenesis

The duodenal mucosa is congested, edematous, eroded, hemorrhagic, with reduced glands and villous atrophy. The mucosal and submucosal layers are infiltrated with inflammatory cells, including lymphocytes, plasma cells, and monocytes. According to the degree and distribution of inflammation, it is divided into three types: superficial, interstitial, and atrophic.

Superficial

This type is common, accounting for about 50% to 80%. The inflammation is limited to the villi, which become shorter, blunt or deformed. The epithelial cells often degenerate, the cells tend to be flat, vacuoles appear in the cytoplasm, the nuclear chromatin is sparse or condensed, the brush border becomes thinner or disappears, the intervillous area is filled with inflammatory cells, and the muscularis mucosa and duodenal glands are basically normal.

Interstitial

Inflammatory cell infiltration is mainly seen in the intestinal glandular crypts close to the muscularis mucosa, sometimes involving the entire lamina propria, accompanied by proliferation of lymphoid follicles.

Atrophic

The mucosa becomes thinner, and the villi show varying degrees of atrophy. There is often severe epithelial cell degeneration, and large pieces of shedding occur, resulting in erosion, and sometimes gastric epithelial metaplasia is seen; the intestinal glands decrease or even disappear, goblet cells, mucous cells and argyrophilic fibers proliferate, the mucosal muscularis is ruptured and proliferates, and the muscle fibers undergo degeneration; the propria has extensive inflammatory cell infiltration, mainly lymphocytes and plasma cells, and there is hyperplasia of lymphoid follicles.