Duodenum- Anatomy, Functions and Conditions

Duodenum, Duodenum Anatomy, DUODENUM functions, DUODENUM Conditions, DUODENUM disorders, DUODENUM Diganosis

The duodenum is the first and shortest of three sections that make up the small intestine, including the jejunum and ileum. At 8 to 10 inches long, it is a key organ in the gastrointestinal (GI) system, working to digest nutrients and make them available for absorption into the bloodstream.

Duodenum- Anatomy, Functions and Conditions

Overview

Just as the esophagus connects to the stomach so that food can enter it, the duodenum is connected to the stomach so that food can leave it and begin its course through the intestines.

In this article you will learn about the anatomy and function of the duodenum in the digestive system of the body. Also, you will learn about conditions that may affect the duodenum, as well as their diagnosis and treatment.

Duodenum Anatomy

The duodenum has been described as a C-shaped or horseshoe-shaped segment of the small intestine. It is located below the stomach.

Duodenum Anatomy

The duodenum can be separated into four segments. Each segment has a different anatomy (shape) and performs a different function. The lining of the duodenum is composed of four layers, each with its own specialized function.

Duodenum Structure

The duodenum’s “C” shape surrounds the pancreas, where it receives pancreatic enzymes for digestion. The duodenum also connects to the liver via a structure called the hepatoduodenal ligament. This junction is where the duodenum receives bile to mix with chyme, an important part of the chemical digestive process.

Segments of the Duodenum

Duodenum segments

The segments of the duodenum are-

The duodenal bulb connects to the liver via the hepatoduodenal ligament. This connection allows nutrients to move from the small intestine to the liver. It also allows the duodenum to receive bile from the liver.
The descending duodenum is located above the right kidney and extends down. It connects to the pancreas via a small tube called the pancreatic duct, which feeds enzymes into the duodenum to help break down food. The common bile duct carrying bile from the liver also enters this second part of the duodenum.
The transverse duodenum extends horizontally across the abdomen. It is located in front of the aorta and travels from right to left, behind a network of blood vessels.
The ascending part of the duodenum extends up, passing atop or slightly to the left of the aorta. This final segment leads to the jejunum, the middle portion of the small intestine.

Layers of the Duodenum

The walls of the duodenum are composed of four layers. Sometimes called duodenum histology, to describe the cells and tissues, these layers include:

The mucosa layer is the innermost layer made up of mucus glands and microvilli, the fingerlike projections that work to absorb nutrients.
The submucosa layer is primarily composed of connective tissue. It has a rich network of blood vessels and nerves traveling the length of the duodenum. This submucosal layer also contains Brunner’s glands, which secrete mucus to help enable food to move through, and bicarbonate. Bicarbonate is a chemical that neutralizes acid in the chyme ahead of further digestion.
The muscularis externa layer is made up of smooth muscle tissue that's responsible for contractions in the GI tract. The muscles churn the chyme, mix it with digestive enzymes, and cause the food to move into the jejunum. This muscle movement is called peristalsis.
The serosal layer, which is the outermost layer of the duodenum. It is composed of squamous epithelium, a single layer of flat cells that provides a barrier to other organs.

Location of Duodenum

The small intestine is located below the stomach. While the small intestine includes the duodenum, jejunum, and ileum, it's the duodenum that is connected to the stomach. Where it meets the stomach is its start. It ends where it connects to the jejunum.

Anatomical Variations

Duodenal atresia, also called duodenal stenosis, is a rare congenital (present at birth) disorder of the duodenum. It involves complete closure of a portion of the tube-like opening, or lumen, inside the duodenum.

Signs and symptoms of duodenal atresia in the fetus include a buildup of amniotic fluid during pregnancy, called polyhydramnios. Duodenal atresia also causes intestinal obstruction in newborns.

Digestive Function of Duodenum

The duodenum's primary function is to begin the digestive process of breaking down and absorbing nutrients needed by the body. The duodenum begins this process by preparing the chyme so that nutrients can then be absorbed easily.

While chemical digestion begins in the mouth with saliva, food that is swallowed and travels down the esophagus into the stomach will then mix with gastric (stomach) acid. It then enters the duodenum, to begin the body's process of absorbing vitamins, minerals, and other nutrients.

The duodenum is considered the mixing pot of the small intestine because of the churning process that takes place there. It mixes the chyme with enzymes to break down food, adds bicarbonate to neutralize acids, and prepares the chyme for the breakdown of fats and proteins in the jejunum, where most of the body's nutrient absorption occurs.

Specific functions of the duodenum include:

Receiving the mixed, churned small pieces of food from the stomach
Neutralizing the acidity (pH level) in chyme
Advancing the digestive process with bile from the liver, digestive enzymes from the pancreas, and intestinal juices secreted by the duodenum walls and other digestive organs
Preparing the chyme for further digestion by mixing in bile to help break down fats
Absorbing certain nutrients, such as folate, iron, and vitamin D

Duodenum's Other Functions

The duodenum contributes to other important digestive processes in the body. This includes the release of two key hormones:

Secretin, which is released when the pH of the duodenum needs adjusting (specific pH levels are needed for proper digestion of fats and proteins)
Cholecystokinin, which is released to aid in the digestion and absorption of nutrients such as fats and proteins

Another important function of the duodenum is immune support. The duodenum acts as a barrier to prevent harmful microbes from entering the body.

The friendly bacteria in the duodenum and other parts of the small intestine take up space and compete for food inside the duodenum. As a result, pathogens (disease-causing germs) have a difficult time multiplying there.

Symptoms of Duodenal Disorders

The duodenum is affected by disorders or disease that may be acute (short-term and severe) or chronic (long-term). Symptoms such as discomfort or a burning sensation in the abdominal region may be present. Other symptoms may include:

Feeling bloated after eating (even small amounts)
Nausea and vomiting
Indigestion
Pain in the lower abdomen (or in some cases, pain felt in the lower back)
Black tarry stools, which can occur if there is intestinal bleeding

A condition affecting the duodenum may not result in any symptoms at all. It may be diagnosed when a person is being examined for another type of digestive disorder.

Duodenum and related Health Conditions

The duodenum can be affected by a number of health conditions common to people of any age. For example, the duodenum is a common source of abdominal discomfort, with symptoms of indigestion, heartburn, and upper abdominal pain.

Duodenum and Cancer

Due to a complex connection between the duodenum and the accessory organs of digestion, such as the liver and pancreas, cancer cells are often seen at the same time in both the duodenum and pancreas, as well as the bile duct of the liver.

Other common disorders of the duodenum include:

Inflammatory bowel disease (IBD), which may cause inflammation in the duodenum or the stomach. Inflammatory bowel disease has two types: Crohn's disease and ulcerative colitis. Only Crohn's disease affects the duodenum. Ulcerative colitis does not affect the duodenum.
Celiac disease, a condition that particularly impacts the duodenum due to adverse effects when a person eats gluten or wheat products.
Excessive alcohol consumption, which can cause duodenitis, an inflammation of the duodenum
Duodenal ulcers, lesions similar to stomach ulcers that form in the lining of the duodenum

Duodenitis can have several different causes, including a Helicobacter pylori infection (H. pylori) that commonly causes ulcers and inflammation in the stomach and duodenum. Other types of bacterial infection may cause inflammation too. Additional causes of duodenitis include:

Viral infections
NSAIDs (nonsteroidal anti-inflammatory drugs), a class of pain medications such as Advil (ibuprofen) that can lead to inflammation with long-term use.
Duodenal lymphocytosis, a condition involving an increase of small white blood cells, called intraepithelial lymphocytes, in the lining of the duodenum (discovered via a biopsy)
Smoking tobacco (heavy use)
Accidental injury or surgery affecting the duodenum
Chemotherapy or radiation therapy
Idiopathic (unknown causes)

Different types of duodenitis are treated in different ways, including antibiotics to treat an infection. It's an especially effective treatment in cases caused by H. pylori infection. Duodenitis is curable in most cases, though, some instances may become a chronic condition.

Can You Live Without the Duodenum?

Yes, but it's likely you'll experience complications. For example, a pancreaticoduodenectomy (Whipple procedure) can be done to treat duodenal and pancreatic cancer. It's a complex procedure, with side effects that include digestive problems and bowel habit changes.

Duodenum and Diagnosis

Several tests are commonly used to diagnose conditions of the duodenum, including duodenitis. These include:

Blood or stool samples (to test for H. pylori)
A urea breath test to test for H. pylori, done before and after a person drinks a solution
Upper endoscopy, or EGD, a test used to diagnose the cause of abdominal pain or prolonged symptoms by enabling your healthcare provider to view the lining of the duodenum and check for the presence of ulcers or other symptoms, such as inflammation or bleeding
A biopsy to check for cancer cells or to diagnose duodenal lymphocytosis

When to see a doctor

The duodenum is a key organ in digestion, and symptoms may suggest a health condition that requires treatment. See your healthcare provider for diagnosis and treatment when you face any of the above mentioned symptoms.

Reference

This Article is authored by

Dr Avinash Tank (Mch) (Gastroenterologist)

Published on : 1st October 2022

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A patient from Jaipur initially diagnosed with only appendicitis turned out to have colon cancer- cancer survivor story

A common symptom between appendicitis and colon cancer is feeling frequent stomach pain/ cramps. That is what happened with Mr. Mukesh Tank as well.

Learn about the latest study on Gallstones risk factors and prevalence in Central India

Gallstone disease represents a significant burden for healthcare systems worldwide and is one of the most common disorders among patients presenting to emergency rooms with abdominal discomfort.

Is the new medicine Tirzepatide really effective for weight loss?

Recently the medicine Tirzepatide has been creating headlines for aiding in weight loss upto 20% of body weight in the medical trials. Read to learn more about the medicine and its effects.

Centre issues health advisory as India reels under intense heatwave, check out the dos and don'ts

India’s First Association of Robotic Surgeons ARIS formally launched in Guwahati, Assam

Assam Cabinet minister Chandra Mohan Patowary formally launched the Association of the Robotic and Innovative Surgeons (ARIS), the country’s first robotic surgeons association, in Guwahati on 30th of April, 2022.

GIST Cancer- What it is and what are its risk factors

Gastrointestinal stromal tumors (GISTS) happen when cells lining your digestive tract grow and divide in an uncontrolled way, creating a mass of tissue called a tumor.

Best GIST Cancer Treatment in Ahmedabad, Gujarat, India

Being diagnosed with cancer is never easy, we are here to help you.

GIST Cancer Diagnosis and Staging

Learn about the diagnosis and staging of GIST cancer.

GIST Cancer Postoperative Recovery and Care

Things to keep in mind while recovering from GIST cancer treatment.

Asthma drug blocks coronavirus from replicating, new IISc study suggests

Researchers at the IISc found that Montelukast, used to reduce inflammation caused by conditions like asthma, blocks SARS-CoV-2 from replicating.

Diabetes is home for 55+ other medical illness

New study suggests that People with type 2 diabetes are at higher risk of developing 57 health conditions compared with non-diabetics.

Whipple Procedure- What is it? When it is done? Which organs are removed? Complications & Post Surgery Care

Learn about Whipple Procedure. What it is and why is it performed.

Ahmedabad, India launches first-of-its-kind heat wave preparation and warning system

A coalition of organisations has teamed up with the Ahmedabad city government in Gujarat, India, to launch a heat health action plan, with the support of Climate & Development Knowledge Network (CDKN).

Artificial sweetener linked with increased risk of cancer- new study suggests

Love to consume soft drinks with no added sugars, table-top sweeteners, and yogurt/cottage cheese containing artificial sweeteners? Beware, you may be at increased risk of cancer, warns a study.

Don’t let your Reflux/ GERD to progress into Advanced Stage

Advanced stages of GERD involve worsening symptoms and can lead to complications that will also need treatment.

Do DNA-based diets really work?

Can your genes really tell which diet will work best for you?

Living as a Liver Cancer Survivor

Learning to live after cancer treatment can be difficult and stressful. Here are things to know/ consider while living as a Liver Cancer Survivor.

Liver Cancer- What it is and what are its Risk Factors?

In this article you will learn about liver cancer and its risk factors.

Liver Cancer Treatments- Surgery, Chemotherapy, Radiation and Biologicals

In this article, you will learn about the different types of treatments doctors use for people diagnosed with liver cancer.

Liver Cancer Diagnosis and Staging

Learn about the diagnosis and staging of Liver cancer.

Cost of Liver Cancer treatment in India

What is the Cost of Liver Cancer Treatment with Top Hospitals and Top Surgeons in India?

Is Coffee Bad For Me?

Although early studies of coffee suggested that it could lead to health problems, recent research provides strong evidence that drinking coffee in moderate amounts actually has a variety of health benefits.

Pain of appendix may be due to cancer

Recent studies suggest that appendicitis may be a sign of cancer, cancer of appendix to be precise.

Appendix Surgery: Best Doctor & Best Hospital in Ahmedabad, Gujarat, India

Appendix Surgery Best Doctor and Best Hospital in Ahmedabad, Gujarat.

Appendicitis: Recovery from Surgery and patient testimonials

The treatment for appendicitis usually is antibiotics and appendectomy (surgery to remove the appendix).

Know the diet and lifestyle of the longest living yoga guru Swami Sivananda who received Padma Shri award at the age of 125 years

Swami Sivananda, a 125-year-old yoga guru from Kashi, received the Padma Shri award from President Ram Nath Kovind on Monday, March 21, for his contribution to the field of Yoga making him the oldest man to be conferred with the Padma Shri award.

Vaccine for young children between 12 to 14 years will start from tomorrow

Those between 12-14 years of age will be administered the Corbevax manufactured by the Hyderabad-based pharma giant Biological E Limited, govt had stated.

Shane Warne, Australia cricket legend, dies of sudden heart arrest. Know more about sudden cardiac arrest.

Australia cricket legend and the greatest leg-spinner of all-time, Shane Warne passed away at the age of 52. Warne’s management released a brief statement stating that he passed away in Thailand of a suspected heart attack.

World Obesity Day 2022: Learn about the health risks of Obesity and how we can beat them

World Obesity Day is observed annually on March 4 to create awareness about the disease, which has become a global epidemic that affects billions of people around the world.

Experts predict 4th wave of COVID-19 in India

A recently posted study by IIT- K researchers suggests a possible new COVID-19 wave to hit around the end of June ‘22 and last upto 4 months.

New Guidelines for Diabetes Treatment issued by American Diabetes Association 2022

Learn about the latest clinical practice standards to diagnose and manage diabetes in the American Diabetes Association’s (ADAs) 2022 Standards of Medical Care in Diabetes.

Indian Music composer and singer Bappi Lahiri dies due to obstructive sleep apnea a complication of untreated obesity

Indian Music composer and singer Bappi Lahiri dies due to obstructive sleep apnea, a complication of untreated obesity

Best hernia specialist doctor and hospital in Ahmedabad Gujarat

With an experienced team of doctors and a world class facility, here is how we can help you with Hernia.

Hernia Treatment cost in India

Hernia surgery is also known as Hernia repair surgery. It is a surgical procedure which involves either placing the displaced tissues back to their original position or a mesh over the weak region of the muscle.

GERD Recovery from Surgery and Live testimonial

Here is all you need to know about stages of recovery after GERD Treatment.

GERD Preparation of Surgery

In some cases, a doctor might suggest his patient undergo surgery for treating GERD. Here is what you should know.

Case Study 12 Year old gets surgery for pancreas after getting hit with a bicycle handle

Here is a case study of one of our recent patients in an effort to share our experience with healthcare providers and with patients who may benefit.

Use of Antibiotic linked with increased risk of colon cancer

Prolonged use of Antibiotic may increase the risk of colon cancer as confirmed by researchers at Umeå University, Sweden. Here is how-

Overeating may not be the only cause of obesity the Carbohydrate Insulin Model can better determine causes research claims

Real Life Tarzan who lived in the jungles for 41 years dies of liver cancer

Real Life Tarzan, who lived in the jungles for 41 years, dies of liver cancer. Here's how modern day city lifestyle may lead to heath hazards.

4 ways how recent Covid 19 restrictions can disrupt economic recovery

Several states including Maharashtra have imposed partial lockdowns due to a sharp rise in new Covid-19 cases. If these curbs get stricter, India's economic recovery could face serious roadblocks. Here's why.

Gallstones treatment cost in India

Find out Gallstones treatment cost in 15 major cities of India here.

Gallstones Recovery from Surgery and live testimonial

If you experience persistent and severe abdominal pain from gallstones, your doctor may recommend to have your gall bladder removed.

Snooze to Lose The Sleep and Weight Loss Connection

Learn how sleeping adequate amount can assist in gaining healthy weight.

How to Avoid Falling into Old Habits after Weight-Loss Surgery

Tips & tricks to avoid falling into old habits after obesity surgery.

Know about India's Covid 19 vaccines Covishield and Covaxin

Living as a Stomach Cancer Survivor

A patient shares his experience of successful stomach cancer treatment and adjusting to his new 'normal' life

Life after Stomach cancer for survivors

Life after stomach cancer means returning to some familiar things and making some new choices.

Stomach Cancer Screening for self and family Tests and Guidelines

Screening is testing for a disease, such as cancer, in people without symptoms. Here is a guide on how it is done.

Stomach Cancer Prognosis and Life Expectancy

Survival rates may help give you a better understanding of how likely it is that your treatment will be successful.

Stomach Cancer Treatment Surgery Chemotherapy Radiation and Biologicals

Learn about the different types of treatments doctors use for people diagnosed with stomach cancer.

Stomach Cancer Diagnosis and Staging

Learn about the diagnosis and staging of stomach cancer.

Colon Rectum Cancer Postoperative Recovery and Care

Know about Colon-Rectum Cancer Postoperative Recovery and Care

Vyapaar Jagat awards Dr. Avinash Tank (Dwarika Clinic) as Obesity Doctor of the year 2020

Vyapaar Jagat awards Dr. Avinash Tank (Dwarika Clinic) as Obesity Doctor of the year 2020 in their annual awards and recognition function.

Bariatric Surgery now covered under insurance in India- Know all the details

Bariatric Surgery is now covered under health insurance in India. Here is all that you need to know.

What Foods and Drinks Should You Avoid After Bariatric Surgery

Check out this article to find out the foods and drinks to avoid after Bariatric Surgery.

Cost of Colon-Rectum Cancer treatment in India

Read to find out what is the Cost of Rectal Cancer Treatment with Top Hospitals and Top Surgeons in India.

Living as a Colorectal Cancer Survivor

Learning to live after cancer treatment can be difficult and stressful. Here are things to know/ consider while living as a Colorectal Cancer Survivor.

Colon-Rectum Cancer- Things to know prior to surgery

Things you should know prior to Colon-Rectum Cancer surgery.

Colon-Rectum Cancer- Diagnosis & Staging

Eggs vs Paneer which is a better source of protein and beneficial for weight loss

Wondering whether Egg or Paneer can be a better source of protein and benefit your weight loss plan? Read to find out.

Diego Maradona's age-long battle against obesity

Know about Diego Maradona's age-long battle against obesity

6 Primary Causes of Obesity

Know about 6 Primary Causes of Obesity in children and adults.

CDC Says Virus Can Spread Indoors in Air Beyond Six Feet

Recent reports from CDC state that COVID-19 can spread indoors beyond 6 feet in enclosed spaces with poor ventilation. Read to find out more.

COVID-long haulers: People who have tested negative but continue to battle the symptoms

All you need to know about COVID-long haulers: People who have tested negative but continue to battle the symptoms.

Stomach Cramps After Eating: What It Could Mean

If your stomach hurts after eating, this could be why.

Childhood Obesity- Causes & Consequences

What are causes and consequences of Childhood Obesity?

3 ways to prevent stress eating

Here are 3 proven ways to prevent stress eating

Obesity now recognised as a â€œchronic diseaseâ€ by World Obesity Federation

Obesity is now recognised as a â€œchronic diseaseâ€ by World Obesity Federation. Read to find out more.

Is COVID 19 the same as SARS

There were several speculations whether COVID-19 was the same as SARS or MERS. While there are similarities between the illnesses, the differences are more substantial.

Best way to stay protected, Wear Masks