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Duodenal dyskinesia.
Last reviewed: 07.07.2025
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Motor-evacuation disorders (dyskinesia) of the duodenum are detected in lesions of the central and autonomic nervous system, endocrine disorders, systemic and parasitic diseases, in patients who have undergone stomach surgery. However, they most often occur in diseases of the duodenum itself and adjacent organs, being one of the earliest and most constant symptoms of these diseases.
In duodenal ulcer disease, duodenal dyskinesia was observed in 53.8-100% of cases, in gastric ulcer disease - in 66.7-76.5%, in diseases of the biliary tract - in 65-96.2%, in pancreatitis - in 46-75.6% of cases.
First of all, the attention of doctors was attracted by duodenal stasis - one of the types of evacuation disorders, accompanied in some cases by a pronounced clinical picture. Its development was initially associated with mechanical factors of a congenital or acquired nature: tumors, adhesions, arteriomesenteric compression, anomalies of the duodenum and adjacent organs. Then it was established that duodenostasis of this nature is rare, in most cases there was no organic obstruction of intestinal patency.
Etiology and pathogenesis. According to the currently generally accepted point of view, the immediate 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 causes (diseases of the central nervous system, endocrine, damage to the nerves and muscles of the duodenum, etc.).
Clinic. Functional disorders of the motor activity of the duodenum have been most thoroughly studied in chronic functional duodenostasis. The clinical picture is practically no different from that of chronic organic duodenostasis and is characterized by alternating exacerbations and remissions. P. N. Napalkov (1963) identifies the following stages of duodenostasis: compensation, subcompensation and decompensation.
Symptoms of duodenal dyskinesia
Diagnostics. The main significance in identifying motor disorders of the duodenum is the X-ray method of examination. The normal function of the intestine is so uniform and regular that any deviation from it requires the attention of a clinician. Violation of the tone and peristalsis of the intestine is radiologically manifested in the form of spasms in the area of the functional sphincters or in individual parts of the intestine, spastic deformation of the bulb, hypertension, hypo- and atony of the intestine, strengthening and weakening of its peristalsis.
Diagnosis of duodenal dyskinesia
Treatment of disorders of the motor-evacuation function of the duodenum should be comprehensive and strictly individual, with the aim of eliminating the exacerbation of the underlying disease and restoring its function. The diet largely depends on the nature of the underlying and concomitant diseases. In cases where motor disorders are accompanied by a violation of the drainage function of the intestine, frequent fractional meals are necessary (5-6 times a day, in small portions). Food should be easily digestible, rich in vitamins, and contain little fiber.
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