Ulcerative Duodenitis Accompanying Ulcerative Colitis

Abstract

Ulcerative colitis (UC) is a chronic inflammatory disease of the colon of unknown etiology. There are varied manifestations in the natural course of UC. However, duodenum is not generally considered a target organ of UC. Here, we report two patients with steroid-responsive ulcerative duodenitis with colitis that was consistent with UC, but not with Crohn's disease. We also reviewed six cases of ulcerative duodenitis with UC. Duodenal lesion with UC may be a more common phenomenon, although infrequently clinically manifested under steroid therapy. Upper gastrointestinal tract inflammation in UC warrants further studies to ascertain whether the duodenum is a target organ in UC, especially in steroid-free conditions.

Inflammatory bowel disease in rats: Bacterial and chemical interaction

“…In both MC and B-treated groups the protein levels were 2-fold lower than the protein levels in the luminal flora and the immune system, based mostly on the disruption of the immunoregulatory mechanisms [28][29][30] . The present study showed that a UC model, using an SH blocker and enteropathogenic E. coli, closely resembles the human situation and is reproducible with findings indicative of chronicity.…”

“…The present study showed that a UC model, using an SH blocker and enteropathogenic E. coli, closely resembles the human situation and is reproducible with findings indicative of chronicity. The characteristics of the present model were colonic disease induced for nearly hundred days, the presence of clinical features such as weight loss (Figure 1), diarrhea and rectal bleeding, accompanied with macroscopic ( Figure 2) and histological alterations (Figures 3 and 4) typical of chronic ulcerative colitis in humans [16,17,29,31] . Moreover, an analysis of colonic myeloperoxidase activity [32] showed a consistent elevation of activity in the combined IA + B treatment group, indicative of severe mucosal inflammation of the descending colon ( Figure 5).…”

Gastroduodenitis associated with ulcerative colitis

“…Since Crohn's disease (CD), another IBD, can affect any portion of the digestive tract, the difference in distribution is one of the most common methods of discriminating between UC and CD; however, several cases of UC with upper gastrointestinal (GI) involvement have been reported recently. [1][2][3][4][5][6][7][8][9][10][11] The majority of such patients have duodenitis resembling UC both macroscopically and microscopically. [1][2][3] Greater spreading infl ammation such as gastroduodenitis or enteritis was also reported.…”

“…[1][2][3][4][5][6][7][8][9][10][11] The majority of such patients have duodenitis resembling UC both macroscopically and microscopically. [1][2][3] Greater spreading infl ammation such as gastroduodenitis or enteritis was also reported. [4][5][6] The prevalence rate of upper GI involvement is unknown, because all of these published types are case reports and there are no studies of case series in adult patients.…”

A contemporary and critical appraisal of ‘indeterminate colitis‘

“…Gastric and/or duodenal involvement has, rarely, been reported in association with UC. 29,30,[62][63][64][65][66] For instance, in a recent study by Lin et al, 65 esophageal, gastric and duodenal biopsies in 69 UC patients were compared with 97 non-UC controls. In that study, UC patients showed a higher prevalence rate of focal gastritis, basal mucosal mixed inflammation, superficial plasmacytosis and diffuse chronic, or chronic active, duodenitis (Figure 4).…”