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Duodenitis

The duodenum is the first part of the small intestine, just past the stomach. Duodenitis is an inflammation of the lining of the duodenum.

Causes of Duodenitis
The most common cause of duodenitis is infection by Helicobacter pylori (H. pylori) bacteria. Another common cause is long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. Other causes may be less common, but need to be taken into consideration as well.
  • Helicobacter pylori (H. pylori) infection: H. pylori is a type of bacteria found in the stomach (often in individuals without symptoms). H. pylori stimulates increased acid production by the stomach that triggers inflammation of the duodenum. H. pylori infection has been shown to have a role in the development of duodenitis.
  • Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs are the most commonly used medications. It can increase gastric acidity and compromise the mucus barrier. This is most likely to occur with long term use of NSAIDs or excessive use even in the short term. Commonly used NSAIDs includes aspirin, ibuprofen and naproxen.
  • Other causes: A number of factors increase the risk of developing duodenitis. Not all people with risk factors will get duodenitis.
    • Excessive secretion of stomach acid
    • Smoking
    • Alcohol abuse
    • Crohn’s disease (inflammatory bowel disease that can affect any part of the intestine)
    • History of radiation therapy
    • Stress or severe illness
    • A bacterial, fungal, or viral infection
    • An injury to the stomach or small intestine
  • Upper abdominal pain
  • Bloating, indigestion
  • Nausea with or without vomiting
  • Loss of appetite
  • Bloody stool (blood may be red, black, or tarry in texture)
The doctor will ask about your signs and symptoms and examine you. You may need tests to confirm that you have an H. pylori infection. You may also need any of the following:
  • Endoscopy is used to look for problems in your stomach or duodenum. The doctor will use an endoscope (a tube with a light and a camera on the end) during the procedure and may take a sample from your duodenum to be tested.
  • Blood tests may be used to show an infection.
  • A breath test may show if H. pylori is causing duodenitis. You will be given a liquid to drink. Then you will breathe into a bag. The doctor will measure the amount of carbon dioxide in your breath. Extra amounts may mean you have an H. pylori infection.
Treatment will depend on what is causing your duodenitis. Duodenitis is treated using one or more of the following:
  • Antibiotic medicines to kill H. pylori.
  • Medicines to reduce the amount of acid the stomach makes.
  • Stopping non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. However, if you take aspirin for a medical condition, such as heart disease or stroke, do not stop until you check with the doctor. If you take NSAIDs for arthritis or pain, check with your doctor about alternatives.
  • Avoiding alcohol.
  • Stopping smoking.
  • Do not smoke.
  • Limit or do not drink alcohol.
  • Do not take non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin unless directed.
  • Do not eat foods that cause irritation.

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