Duodenitis

What is duodenitis?

Duodenitis (pronounced “DOO-ah-deh-NY-tis”) is inflammation in the first part of your small intestine (duodenum). Your duodenum is the part that’s closest to your stomach. The duodenum has a protective lining that keeps out germs (like bacteria, viruses and parasites). It also shields against damage from your stomach’s highly acidic digestive juices.

Duodenitis happens when your immune system senses a threat to this lining, like an infection or damage from stomach juices. It triggers inflammation in your duodenum to fight infection-causing germs and heal the damage.

Duodenitis is similar to gastritis, inflammation in your stomach lining. Inflammation that affects your small intestine in general (not just the first part) is called enteritis.

Is duodenitis serious?

Usually, duodenitis is short-term and isn’t serious. The inflammation goes away on its own. Long-lasting symptoms are a sign of chronic duodenitis. Chronic duodenitis requires a healthcare provider’s treatment, which may involve taking one or more medicines. Treating duodenitis usually eases the inflammation and prevents complications, like damage to your duodenum’s lining.

What are the symptoms of duodenitis?

Not everyone has symptoms. When they do, people experience them differently. Symptoms may come and go. They may be ongoing but mild. Or you may have sudden, severe symptoms that alert you that it’s time to see a healthcare provider.

Duodenitis symptoms include:

• Upper abdominal pain (a gnawing or burning sensation that improves when you eat).
• Bloating (tight, full or painful feeling in your stomach).
• Nausea and vomiting.
• Diarrhea.
• Fatigue.
• Gas.
• Loss of appetite.

Bleeding in your digestive tract is sometimes a sign of severe duodenitis. Signs include:

• Blood in your vomit (may look like coffee grounds).
• Blood in your poop (may look dark-colored or tarry).

You should see a provider if you notice these signs, which may mean you have duodenitis or another digestive system condition that needs treatment.

What causes duodenitis?

Duodenitis happens when something threatens your duodenum’s protective lining. In response, your immune system launches an attack that leads to inflammation. Think of inflammation as evidence that something happened to trigger your immune system to activate protection mode.

By far, the most common cause of inflammation in your duodenum is H. pylori infection. H. pylori is a bacterium that’s present in 50% to 75% of the world’s population. It’s usually in your stomach, but it can travel to your duodenum, too. For most people, it doesn’t cause problems. But H. pylori bacteria that multiply out of control can cause an infection that eats away at your duodenum lining.

Other causes include:

• Other germs. Although H. pylori is the most common germ that causes infection and inflammation in your duodenum, others can cause problems, too. Small intestinal bacterial overgrowth (SIBO) and giardiasis (an infection caused by the giardia parasite) can cause duodenitis.
• Overusing NSAIDs. NSAIDs (nonsteroidal anti-inflammatory drugs), like aspirin, ibuprofen and naproxen sodium, can relieve aches and pains. Used too often, though, they can eat away at your duodenum (or stomach) lining, triggering inflammation.
• Excess stomach acid. Stomach acid can leak into your duodenum and wear away the lining. The damage triggers inflammation.
• Autoimmune diseases. Celiac disease can lead to duodenitis. With celiac disease, your body launches an immune response when you eat gluten.
• Crohn’s disease. Crohn’s disease is an inflammatory bowel disease that affects your small and large intestines.
• GERD. GERD, or chronic acid reflux, can trigger inflammation throughout your GI tract, including your duodenum.
• Consuming foods or drinks that irritate your gut. Food allergies, including sensitivities to milk and soy, can cause inflammation. Certain drinks, like caffeinated beverages (coffee, tea) can also irritate your gut and lead to duodenitis.
• Smoking and drinking too much alcohol. The chemicals from smoking tobacco can irritate your gut. Excessive alcohol can cause problems, too.
• Cancer treatments. Radiation therapy and chemotherapy treatments that kill cancer cells can also cause inflammation in your digestive tract, including your duodenum.

Is duodenitis contagious?

The inflammation isn’t contagious, but the H. pylori bacteria that usually cause the inflammation are. They spread from person to person through saliva (spit), poop and contaminated food and water. For example, you can contract H. pylori from kissing. You can also get it from eating food prepared by an infected person who didn’t wash their hands after going to the bathroom.

What are the complications of duodenitis?

Left untreated, duodenitis can progress to:

• Peptic duodenitis: Excess stomach acid can lead to long-term and severe inflammation in your duodenum. Risk factors include H. pylori infection, overusing NSAIDs and smoking.
• Duodenal ulcers: Eventually, the damage to your duodenal lining can lead to painful, open sores called duodenal ulcers. These are similar to peptic (stomach) ulcers. These sores sometimes bleed. Blood in your poop or vomit may mean you have a duodenal ulcer.

Vomiting and diarrhea associated with duodenitis can also cause dehydration, or not having enough fluid. Dehydration is especially dangerous in children and adults age 65 or older.

Inflammation can also prevent your duodenum from doing one of its most important jobs — helping you absorb nutrients (like iron) from food. Duodenitis can prevent you from absorbing enough iron. Iron is a key ingredient your body needs to make red blood cells. This can lead to iron-deficiency anemia.

How is duodenitis diagnosed?

Your healthcare provider will ask about your medical history and symptoms. If they suspect duodenitis, they’ll perform tests to figure out what’s causing the inflammation. Tests may include:

• Blood tests: A blood sample can show if you have a germ, like H. pylori, that’s causing an infection. A blood test can also show if you have antibodies for gluten (as in celiac disease). Antibodies are proteins your immune system makes to fight germs.
• Stool test: Your poop can show if you have an H. pylori infection.
• Breath test: Your breath can also show if you have an H. pylori infection. This test determines whether you have an infection by measuring levels of carbon dioxide gas in your breath.
• Upper endoscopy: This procedure uses a scope with a tiny camera attached to show the inside of your upper gastrointestinal (GI) tract — your esophagus, stomach and duodenum. The scope contains instruments that can take tissue samples for lab testing.
• Upper GI series: This series of X-rays takes images of your upper GI tract. It can show how these organs work together so your provider can better understand what’s causing inflammation in your duodenum.

What is the treatment for duodenitis?

Duodenitis often improves on its own in time. If it doesn’t, treatment depends on the cause. You may need medicines to kill H. pylori or reduce stomach acid damaging your duodenum lining. You may need to make lifestyle changes to protect your gut from becoming irritated and inflamed.

Treatments include:

• Antibiotics. These medicines kill H. pylori bacteria.
• Stomach acid reducers. Medicines may include antacids and proton pump inhibitors.
• Lifestyle changes. You may need to stop taking NSAIDs if overuse is causing duodenitis. You may need to steer clear of gluten if you have celiac disease. Changing what you eat, quitting cigarettes and cutting back on alcohol can also help.

If you have severe damage to your duodenum, you may need surgery to repair the tissue. But this is rare.

How long does it take to cure duodenitis?

It depends on what’s causing the inflammation and how severe it is. If you have an H. pylori infection, you may need to take antibiotics for two weeks to clear things up. You should take all medications as prescribed, even if your symptoms improve.

How can I lower my risk of duodenitis?

You can follow good hygiene practices to reduce your risk of infection. Make sure your lifestyle includes going easy on your gut.

• Wash your hands. Proper handwashing techniques done at the right times can keep you from getting sick. Wash your hands when you’re preparing food and before eating. Wash your hands each time you finish using the toilet.
• Don’t smoke. If you do smoke, work with your healthcare provider on a plan to quit.
• Don’t drink in excess. The Centers for Disease Control and Prevention (CDC) recommends no more than two drinks daily for people assigned male at birth (AMAB) and no more than one drink for people assigned female at birth (AFAB).
• Don’t overuse NSAIDs. Don’t take an NSAID for more than three days for fever or more than 10 days for pain unless your provider says it’s OK.
• Don’t consume food or drinks that irritate your gut. This includes gluten if you have celiac disease and foods you’re allergic to.

What foods should I eat or avoid with duodenitis?

You can:

• Steer clear of foods that can irritate your gut, including spicy foods and highly acidic foods like citrus or tomato-based foods.
• Avoid drinks that can irritate your gut, including caffeinated drinks like coffee, tea or soda.
• Stop drinking alcohol or reduce your intake.

Try switching to bland foods until your symptoms improve. It’s a good idea to try the BRAT diet, which stands for bananas, rice, applesauce and toast. Gradually, you can include foods with a bit more nutritional value, like chicken soup and broth. Instead of eating big meals, aim for a few smaller meals spread out throughout the day so you’re not stressing your digestive system.

Regardless of what you eat, try not to eat anything three hours before bedtime. Allow your digestive system plenty of time to wind down so you can sleep easily.

When should I see my healthcare provider?

Contact your healthcare provider if your symptoms haven’t improved within three or four days, or if:

• You’ve been vomiting for two days straight.
• You haven’t been able to keep liquids down for 24 hours.
• You had diarrhea for more than 24 hours.
• You have signs of dehydration.

Seek immediate medical care if you have:

• A fever higher than 102 degrees Fahrenheit (39 degrees Celsius).
• Blood in your vomit or poop.
• Sudden, severe pain or swelling in your abdomen.

A note from Cleveland Clinic

Duodenitis is usually short-term and goes away on its own. But if you have symptoms like vomiting, diarrhea or abdominal pain that persists or worsens, see a healthcare provider. You may need medicines to clear an infection or reduce your stomach acid. It’s important to treat the issue early to prevent problems related to severe inflammation, like peptic duodenitis or an ulcer.