human duodenum
What do you know about the duodenum? By the way, this is one of the most important organs of the gastrointestinal tract, responsible for the digestion of food and its further movement through the intestines. We will learn how the duodenum looks and works, and also why it can hurt

The duodenum is the first section of the human small intestine, which immediately follows the stomach. It is the thickest and shortest section of the small intestine. The name of the organ was due to the fact that the size of the intestine is equal to 12 diameters of the fingers of the hand. The mucosa of the duodenum has villi that provide absorption of nutrients. Also in the mucous layer are glands that secrete intestinal juice. It contains enzymes necessary for the digestion of food.

What is important to know about the human duodenum

Lengthabout 30 cm
Departments• bulb (ampoule);

• descending part;

• horizontal part;

• ascending part.

Nipples• papilla of Vater – pancreatic duct and gallbladder;

• small duodenal papilla;

functions• secretory – production of intestinal juice for the digestion of food;

• motor – contractions of the muscle layer provide mixing of the contents with enzymes;

• evacuation – the promotion of the contents of the duodenum 12 into the small intestine.

Blood supplyPancreaticoduodenal arteries
Venous outflowThe pancreaticoduodenal veins that accompany the arteries of the same name.
Innervation• two vagus nerves;

• branches of the solar plexus;

• branches of the superior mesenteric plexus;

• branches of the hepatic plexus;

• branches of the gastric and gastroduodenal plexus.

Where is the human duodenum located?

The location of the duodenum changes with age, weight fluctuations, and other factors.

The upper border of the body in relation to the spine begins with the 12th thoracic vertebra. The lower border is the 3rd lumbar vertebra. The younger the person and the greater the weight, the higher the duodenum is located. With age and weight loss, the gut drops a little.

The duodenum is located in the right hypochondrium and borders on many organs:

  • from above – the lower edge of the liver, gallbladder, portal vein;
  • below – the right kidney, right ureter, renal vessels, colon, pancreas;
  • horizontal part – part of the colon, loops of the small intestine;
  • ascending part – loops of the small intestine. The internal bend of the duodenum fuses with the head of the pancreas.

What does the human duodenum look like and how does it work?

The duodenum is the part of the small intestine immediately after the stomach. Its main task is the effect of bile and pancreatic juice on the contents and the promotion of the digestive lump further along the intestines. Contractions of the muscular wall provide the motor function of the intestine.

Why can the duodenum hurt in humans

Pain in the duodenum can cause a variety of diseases of the gastrointestinal tract. Let’s consider the main ones.

Duodenitis

Duodenitis is an inflammation of the mucous membrane of the duodenum, which is often accompanied by a change in the structures of the membrane and atrophy of the glands.1.

Allocate acute and chronic duodenitis.

Acute duodenitis occurs due to irritation and damage to the mucous membrane with food. It can be spicy, fried, salty, stale food, as well as alcohol.

Chronic duodenitis is characterized by a prolonged inflammatory process, which has periods of exacerbation and remission. The disease usually develops against the background of other pathologies of the digestive system: infection with the bacterium Helicobacter pylori, hepatitis, chronic gastritis and pancreatitis, gastric ulcer1.

Symptoms:

  • pain in the stomach and under the right rib;
  • heaviness after eating;
  • bitter belching;
  • a feeling of fullness and bloating in the abdomen;
  • nausea, sometimes vomiting.

Chronic infectious duodenitis

Chronic inflammation in the duodenum can cause bacteria, viruses, parasites, fungi of the genus Candida. Symptoms of infectious duodenitis are the same as usual duodenitis1.

The most common cause of inflammation is Helicobacter pylori. This is a spiral-shaped bacterium that affects the mucous membrane of the stomach and duodenum. It is worth noting that 70% of the adult population are carriers of this bacterium.

By itself, the presence of Helicobacter pylori does not require immediate treatment. Therapy with antibiotics is carried out for pain, stomach and duodenal ulcers, atrophic gastritis and after surgery for stomach cancer.

Gastroduodenitis

Gastroduodenitis is an inflammation of the mucous membrane of the stomach and duodenum.

The reasons:

  • regular violations in the diet (fatty, fried, spicy foods, alcohol, snacks on the go);
  • chronic stress;
  • infections (Helicobacter pylori);
  • taking certain drugs that irritate the gastrointestinal mucosa (for example, aspirin);
  • other diseases of the gastrointestinal tract: hepatitis, pancreatitis, cholecystitis.

Symptoms:

  • pain and heaviness in the epigastric region, usually occurring after eating;
  • feeling of heaviness;
  • nausea;
  • sour or bitter belching;
  • lack of appetite, weakness, weight loss.

Bulbit

Bulbitis – inflammation of the duodenal bulb. It is one of the variants of duodenitis and most often develops against the background of chronic gastritis and peptic ulcer of the stomach and duodenum.

The causes of bulbitis are the same as gastroduodenitis: malnutrition, infections, stress.

Symptoms:

  • aching pain in the epigastric region, which occurs 1-2 hours after eating (may radiate to the umbilical region);
  • nausea;
  • belching bitterness;
  • general weakness, weight loss.

Duodenal ulcer

Duodenal ulcer is a chronic relapsing disease that in most cases develops in patients with gastritis and duodenitis2. It has periods of exacerbation and remission. The main symptom of this disease is the formation of an ulcer.

The reasons:

  • infection with the bacterium Helicobacter pylori;
  • hereditary predisposition;
  • systematic errors in the diet;
  • bad habits (alcohol, smoking);
  • frequent use of NSAIDs (ketonal, aspirin);
  • chronic stress.

Symptoms:

  • pain in the epigastric region, which appear 1-2 hours after eating (may radiate to the lumbar region, hypochondrium, other parts of the abdomen);
  • “hungry” pain – on an empty stomach and at night, and the pain disappears after eating;
  • heartburn;
  • possible nausea, vomiting, lack of appetite;
  • asthenia (fatigue, loss of appetite, lack of mood);
  • internal bleeding, which can be recognized by black coloration of the stool2.

Small intestine cancer

Small intestine cancer is a malignant tumor that originates from the tissues of the small intestine, but as it progresses, it can spread to neighboring organs.

The disease is quite rare (only 2% of all malignant tumors of the gastrointestinal tract), but is most often diagnosed in the last stages, when surgery will no longer help. Older men are more commonly affected.

The causes of cancer are not yet fully understood. Provoking factors can be polyps in the small intestine, chronic inflammatory diseases of the gastrointestinal tract (Crohn’s disease, ulcerative colitis, duodenitis, and others), smoking, alcohol abuse.

Symptoms:

  • dull pain in the abdomen (may radiate to the interscapular or lumbar region);
  • nausea, vomiting, bloating;
  • jaundice (if the tumor compresses the bile ducts);
  • digestive disorders;
  • intestinal obstruction;
  • causeless weight loss;
  • increased fatigue.

functional dyspepsia

Functional dyspepsia is a violation of the digestive system, which is not associated with pathological changes in the digestive tract. Functional dyspepsia, according to various sources, is observed in 20-30% of adults.

The exact causes of this condition have not been established, but most doctors attribute them to:

  • improper diet;
  • prolonged stress;
  • smoking;
  • genetic predisposition.

Symptoms:

  • pain or burning sensation in the abdomen;
  • feeling of early satiety;
  • heaviness in the stomach after eating.

How is the human duodenum treated?

Treatment of diseases of the duodenum is always complex. Prescribing drugs can only be effective if you follow a diet, avoid alcohol and smoking, minimize stress, and get enough sleep and rest.

Diet

It implies compliance with the rules of therapeutic nutrition. Tables No. 1, 2, 3, 4 according to Pevzner are recommended. During the period of remission, table number 15 is assigned.

PPIs (proton pump inhibitors)

The drugs of this group block a special enzyme (proton pump) in the cells of the stomach and thereby reduce the secretion of hydrochloric acid. This reduces the effect of hydrochloric acid on the mucous membrane of the stomach and duodenum.3.

Recommended drugs: Omeprazole, Nolpaza, Pariet, Rabeprazole, Lancid, Ultop.

H2 blockers of histamine receptors

This group of antiulcer drugs block H2 receptors (or histamine receptors) in the gastric mucosa. This leads to a decrease in the production of hydrochloric acid in the lumen of the stomach and reduces its aggressive effect on the duodenum.4.

Recommended drugs: Famotidine, Ranitidine, Acilok, Zantak.

Antacids

Preparations from this group neutralize hydrochloric acid and create a protective film on the mucous membrane of the gastrointestinal tract. Antacids prevent mucosal damage and accelerate its healing.

Recommended preparations: Phosphalugel, Rennie, flax seeds

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Adsorbents

Adsorbents absorb toxic substances, viruses, bacteria, their toxins and waste products from the lumen of the duodenum (and other parts of the gastrointestinal tract) and remove them from the body.

Recommended drugs: Smecta, Polysorb, Enterosgel, Activated carbon.

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Means that normalize the intestinal microflora

These include eubiotics, probiotics, and prebiotics. Their main task is the restoration of the natural intestinal microflora and the fight against opportunistic microorganisms. Also, drugs are involved in the synthesis of vitamins (K, B, C), which are necessary to increase local immunity.

Recommended drugs: Linex, Hilak Forte, Enterol, Atsilakt.

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Antibiotics

They are prescribed to fight the bacterium Helicobacter pylori and other microorganisms. The doctor can prescribe both broad-spectrum and narrow-spectrum antibiotics (taking into account sowing and determining the sensitivity of the pathogen).

Antiemetics

Stimulate the motility of the stomach, duodenum, help to cope with bouts of nausea and vomiting.

Recommended drugs: Cerucal, Motilium, Motilak.

Surgery

Surgical treatment is usually resorted to with the development of complications of the underlying disease – bleeding, perforation, malignant tumor. The doctor may prescribe both endoscopic (minimally invasive) and abdominal surgery. It all depends on the severity of complications, the general condition of the patient and concomitant diseases.

How to keep your duodenum healthy at home

Taking care of the health of your duodenum is quite simple. To do this, you must follow a few simple rules:

  • treatment tables No. 1, 2, 5 during the period of exacerbation of diseases and table No. 15 during remission5;
  • consume a sufficient amount of vitamins both in the form of fresh fruits and vegetables, and as biologically active food supplements;
  • give up bad habits (alcohol, smoking);
  • ensure healthy sleep;
  • avoid stress;
  • regularly undergo examinations and take the necessary tests with a therapist;
  • Once a year, undergo FGDS (fibrogastroduodenoscopy) and ultrasound of the abdominal cavity;
  • timely treat chronic concomitant diseases;
  • do not take medicines without consulting and prescription from a doctor.

Popular questions and answers

We discussed important issues related to the duodenum with therapist Tatyana Pomerantseva.

Which doctor treats the human duodenum?

– The main doctor who treats the duodenum is a gastroenterologist. Sometimes it may be necessary to consult specialized specialists – an endoscopist, a surgeon, a nutritionist, a radiologist.

What are the first signs of problems with the duodenum?

– There are no specific symptoms that will help to accurately determine the diagnosis. Therefore, consider the most common manifestations that occur with damage to the duodenum:

• pain in the epigastric region (may be aching, cutting, stabbing or pressing). The pain may radiate to the back, the umbilical region, to the scapula;

• pain appears 1-2 hours after eating;

• “hungry” or night pains;

• nausea;

• loss of appetite.

What foods are good for the human duodenum?

– It is impossible to name products that positively affect only the duodenum. It is important to follow the principles of a healthy diet and consume enough vitamins. To normalize the work and prevent diseases of the duodenum, you should follow the rules of treatment tables.

For diseases of the gastrointestinal tract, the following are relevant: table No. 1, 2, 5. Table No. 15 is universal and is recommended to everyone as a preventive measure or during the recovery period:

• lean meat (preferably rabbit, turkey, pork, beef);

• seafood and lean fish;

• vegetables and herbs (you can either fresh or boiled or steamed);

• fruits and berries (preference should be given to sweet and sour types: currants, pears, apples, raspberries, consumed in the first half of the day);

• dairy products (whole milk no more than 1 glass a day, low-fat cottage cheese, cheese, sour-milk drinks);

• flour and pasta products from durum wheat;

• decoctions of wild rose, chamomile, barberry, homemade fruit drinks, compotes.

Sources:

  1. Clinical recommendations “Gastritis, duodenitis”, 2021-2022-2023. http://www.gastro.ru/userfiles/R_gastrit-duodenit.pdf
  2. Clinical guidelines “Peptic ulcer”, 2019. http://www.gastro.ru/userfiles/R_Yaz_2019.pdf
  3. Kolesnikova I.Yu., Volkov V.S. Diagnosis and treatment of acid-dependent diseases of the digestive tract. A Guide for Physicians / M .: OOO Publishing House Medical Information Agency, 2014. – 432 p. https://www.gastroscan.ru/literature/authors/12322
  4. Alekseenko S.A., Loginov A.F., Maksimova I.D. The use of small doses of H2 blockers of the III generation in the treatment of dyspepsia // Consilium-Medicum. – 2005. – Volume 7. – No. 2. https://www.gastroscan.ru/literature/authors/2211
  5. Borodulin V.I. Canons of dietetics and life lessons. In memory of prof. M.I. Pevzner (1872–1952) / Borodulin V.I., Kaganov B.S., Topolyansky A.V. // Issues of dietology. – 2013 – Volume 3, No. 1. – P. 6-28. https://foodandhealth.ru/diety/lechebnaya-dieta-15/

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