duodenitis

[Chris__0__0]

  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
_____
Dear Chris,
1) The duodenitis does not require followup.
2)Absorption is a function of the villi length.  Inflammation can cause nonsignificant impairment of absorption.  You should discuss with your physician possible explanations for the malabsoprtion.
3) The bowel preps can cause proctitis similar to that which you describe.Other explanations include infection and ulcerative proctitis, neither which seems likely.
You should discuss nest stepes with your doc.
HFHSM.D>-rf
*keywords: diarrhea, malabsorptiom
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