duodenitis

Posted By Chris on January 26, 1999 at 16:24:30:







I recently had an EGD performed after having chronic problems with diarrhea, Zn, and Fe deficiencies.
The duodenal biopsies showed slight shortening of the villi in some areas, but the findings were not
consistent with Celiac/Sprue or Whipple's.  Gliadin and endomysial abs negative, no organisms were
identified.  There was marked chronic inflammation within the lamina propria consistent with chronic
duodenitis.
More recently, I had a colonoscopy after having blood and mucus in my stool on several occasions.
The macroscopic diagnosis was proctitis, but the pathologist's report noted only mild edema and
lymphoid aggregate in the colorectal tissue.  The microscopic findings were not consistent with
ulcerative colitis.  My gastro believes the proctitis was caused by the bowel preparation prior
to colonoscopy - no hemorrhoids found.  ESR was normal, WBC of 3800.
Questions:
1)  Does a diagnosis of duodenitis require any follow-up?  I use NSAIDs very infrequently.
2)  Can duodenitis cause malabsorption?  I know Zn and Fe are preferentially absorbed in the duodenum.
3)  What could be causing the proctitis?  The bowel prep explanation does not explain blood and mucus
several weeks prior to procedure.
4)  Is there an explanation which would explain all these results (EGD, bleeding, etc.)?
5)  How should I proceed, if at all?
Thanks,
Chris