Diseases of the Duodenum

Doctor listening to woman patient during checkup
Doctor talking to a female patient (Image: Comstock/Stockbyte/Getty Images)

The duodenum, the starting point of the small intestine, attaches to the stomach at one end and the jejunum, the middle portion of the intestine, at the other. The first of three sections making up the small intestine, the duodenum is short, only about 8-inches long. The bile duct and pancreatic ducts empty into the duodenum at the ampulla of Vater, secreting digestive juices that help break down food. Several diseases can affect the duodenum.

Cancer

Cancer in the small intestine occurs rarely, but most small intestine cancers develop in the duodenum, near the ampulla of Vater, the American Cancer Society reports. Thirty to 40 percent of duodenal cancers, called adenocarcinomas, originate in the cells lining the small intestines. Adenocarcinomas begin as polyps that mutate into cancerous growths over time.

Factors that increase the odds of developing duodenal cancer include a history of Crohn’s or celiac disease, two diseases that can affect the duodenum. Others are having familial adenomatous polyposis or eating a high fat diet, the Cleveland Clinic reports. Symptoms of this cancer include weight loss, blood in the stool, pain or stomach cramps or a lump in the abdomen. Intestinal blockage can occur. Surgery, radiation and chemotherapy may all be used to treat duodenal cancer.

Crohn's Disease

Crohn’s disease, a chronic inflammatory disease of the intestines, most often affects the lower part of the small intestine, the ileum, but can also affect the duodenum. Crohn’s often runs in families, with 20 percent of people with Crohn’s having a blood relative with the disease, the Ohio State University Medical Center reports. Symptoms of Crohn’s include diarrhea, rectal bleeding, abdominal pain, weight loss, fevers and joint pain. While medications such as steroids to reduce inflammation or antibiotics can help control Crohn’s disease, no cure exists.

Duodenal Ulcers

Peptic ulcers affect the stomach and duodenum, with duodenal ulcers being the most common, according to the Merck Manual. The most common causes of duodenal ulcers are infection with the bacteria Helicobacter pylori, found in 50 to 75 percent of people with peptic ulcers or use of aspirin and non-steroidal anti-inflammatory medications. Smoking also increases the chances of developing peptic ulcers. Duodenal ulcers cause pain, often severe enough to wake the sufferer in the night. Drinking milk of eating often relieves the pain temporarily, which then recurs several hours later. Antibiotics and antacids treat duodenal ulcers.

Familial Adenomatous Polyposis

Familial Adenomatous Polyposis, often shortened to FAP, is an inherited disease that causes 1 percent of all colorectal cancers and can occur in the duodenum. People with FAP have hundreds to thousands of polyps that develop in their teens; all develop colorectal cancer by their 40s, the Cleveland Clinic warns. Removal of the colon is usually recommended. Preventing duodenal cancer, the second leading cause of death in FAP patients, requires frequent removal and biopsy of polyps that develop.

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