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Duodenal Dyskinesia - Causes
Last reviewed: 06.07.2025
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According to the currently generally accepted point of view, the direct cause of functional evacuation disorders are changes in the motor function of the duodenum associated with disturbances in its regulation, which, according to a number of authors, can occur reflexively, against the background of diseases of adjacent organs, with damage to nerve conductors or due to other reasons (diseases of the central nervous system, endocrine, damage to the nerves and muscles of the duodenum, etc.).
Research by K. M. Bykov and his students indicates the possibility of cortical genesis of duodenal dyskinesia.
V. S. Levit (1934), L. Z. Frank-Kamenetsky (1948) and other authors, among the most probable causes of functional motor-evacuation disorders of the duodenum, identified disorders of the external innervation of the intestine, provided by the parasympathetic and sympathetic fibers of the autonomic nervous system.
No less important role in the nervous regulation of the motor function of the duodenum is played by the local intramural nervous apparatus, formed by five closely interconnected plexuses. According to A. P. Mirzaev, in acquired persistent atony, intestinal ectasia and duodenostasis, reactive and degenerative changes are found in the intramural nervous apparatus of the intestine, in particular in the nerve fibers of the muscular-intestinal (Auerbach's) plexus. In Chagas disease, the development of megaduodenum and evacuation disorders is associated with damage to the intramural nerve nodes of the duodenum by Trypanosoma Cruci. The results of anatomical and physiological studies confirm the existence of direct neuroreflex connections between organs, through which, in diseases of adjacent organs, disorders of the motor function of the duodenum can develop through the mechanisms of direct viscero-visceral reflexes. Humoral factors are also important in regulating the motor function of the duodenum, among which the group of gastrointestinal polypeptides should be noted first of all. Most of them were discovered relatively recently, and their properties have not yet been sufficiently studied. However, data have already been accumulated indicating that changes in the secretion and nature of the action of these substances (gastrin, cholecystokinin-pancreozymin, secretin, motilin, glucagon, insulin, vasoactive intestinal peptide, gastric inhibitory polypeptide, pancreatic polypeptide, substances P, etc.) can play a significant role in the occurrence of motor disorders of the duodenum. The range of humoral factors influencing the motor-evacuation function of the duodenum is not limited to hormones. According to A. G. Saakyan et al. (1978), V. G. Avdeev (1983) and others, gastric juice, bile, pancreatic enzymes and other local factors also affect the motor function of the intestine, in particular, an increase in gastric acid production is accompanied by an increase in the motor function of the intestine.
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