Chronic duodenitis - Symptoms

The most characteristic symptoms of chronic duodenitis are the following:

• Pain in the epigastric region of varying intensity (from relatively mild to very pronounced). Usually the pain is aching, less often cramping, and occurs more often 1-2 hours after eating. In most patients, the pain decreases or even disappears after eating and taking antacids. This type of pain is most often observed with bulbitis and resembles the pain of peptic ulcer disease (ulcer-like variant of chronic duodenitis). This type of pain is usually caused by dyskinesia of the duodenum.

Pain in distal duodenitis can be localized mainly in the right hypochondrium and radiate to the right subscapular region, provoked by the intake of fatty and fried foods (cholecystitis-like variant of chronic duodenitis). This type of pain is usually associated with biliary dyskinesia.

In some patients, the pain is localized in the upper epigastrium and is accompanied by a feeling of heaviness and distension (gastritis-like variant of chronic duodenitis).

In a small number of patients, the pain radiates to the back, left hypochondrium and is of a girdle nature (pancreatitis-like variant of chronic duodenitis). Usually, this type of pain is caused by papillitis (in which the evacuation of pancreatic juice and bile from the duodenum is disrupted), as well as dyskinesia of the biliary tract.

• Dyspeptic symptoms often accompany chronic duodenitis. Patients are bothered by a feeling of heaviness, distension in the epigastrium (this is especially characteristic of gastroduodenitis), nausea. With the development of gastroduodenal reflux, bitterness in the mouth and bitter belching appear. With a pronounced exacerbation of chronic duodenitis, vomiting is possible. Patients are often bothered by heartburn.
• Vegetative dysfunctions are usually observed in the acute phase of chronic duodenitis. They manifest themselves as severe weakness, sweating, palpitations, hand tremors, and sometimes the urge to defecate and loose stools. These symptoms resemble the clinic of dumping syndrome and usually appear 2-3 hours after eating. A sudden feeling of hunger is possible. Vegetative dysfunctions are more often observed in young people and are largely due to dysfunction of the gastrointestinal endocrine system.
• An objective examination of patients reveals a coated tongue, moderate local pain in the pyloroduodenal zone and epigastric region, where there may be slight tension in the muscles of the anterior abdominal wall during an exacerbation.

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