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Lymphocytic Duodenitis
Lymphocytic duodenitis, marked by excessive lymphocyte buildup in the duodenal lining, can disrupt nutrient absorption and trigger abdominal discomfort. At GastroDoxs in Houston, Dr. Nghia Nguyen offers personalized diagnostics, dietary guidance, medications and procedures to restore health and ease symptoms.
Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.
What Is Lymphocytic Duodenitis?
Lymphocytic duodenitis is inflammation of the duodenal lining—the first segment of the small intestine—caused by an abnormal accumulation of lymphocytes (white blood cells). It's most often identified through a biopsy during an upper endoscopy. If left untreated, it can lead to abdominal pain, malabsorption of nutrients, and ongoing digestive discomfort.
Common Causes and Risk Factors
Celiac disease or non-celiac gluten sensitivity
Helicobacter pylori (H. pylori) infection
Autoimmune disorders (e.g., thyroid disease)
Long-term use of NSAIDs or acid-blocking medications
Viral or bacterial gut infections
Family history of celiac disease or other autoimmune GI conditions
Signs and Symptoms
Recurrent abdominal cramps or pain
Bloating and excessive gas
Chronic diarrhea or loose stools
Unintentional weight loss
Fatigue, often due to iron or vitamin B12 deficiency
How Dr. Nghia Nguyen Diagnoses Lymphocytic Duodenitis -?
Dr. Nguyen uses a step-by-step approach:
Medical History and Examination
He reviews your epigastric pain patterns, dietary habits (including gluten intake), family history of celiac or autoimmune disease, and any medication use.
Blood Tests
We measure celiac serologies (tTG-IgA), complete blood count, iron and B12 levels, plus inflammatory markers to rule out other causes.
Endoscopy
A flexible endoscope is passed into your duodenum to inspect the lining for erythema, scalloping, or villous atrophy.
Biopsy and Histology
Multiple tissue samples are taken from the duodenal bulb and second portion. A pathologist counts intraepithelial lymphocytes to confirm lymphocytic duodenitis.
Additional Testing (if needed)
H. pylori assessment via biopsy urease test or breath test.
Capsule endoscopy to evaluate more distal small-bowel involvement.
Treatment
Our Team offers a full range of care for lymphocytic duodenitis.
1. Lifestyle and Diet Modifications
Gluten-free diet - when celiac disease or gluten sensitivity is identified
Balanced meals rich in lean protein, fiber, and probiotics
Stress-reduction strategies such as yoga, breathing exercises, and meditation
2. Medications
Proton pump inhibitors to calm stomach acid
Antibiotics to eradicate H. pylori infection
Short‐term corticosteroids for more severe inflammation
3. Minimally Invasive or Advanced Procedures
Follow-up endoscopy to assess mucosal healing
Capsule endoscopy for detailed visualization of the small intestine
Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.
Frequently Asked Questions
What causes lymphocytic duodenitis?
Most often, this swelling is triggered by gluten exposure from celiac disease or sensitivity. Other causes include H. pylori infection, autoimmune disorders, and certain medications (like NSAIDs or acid blockers).
What symptoms should I look out for?
Common signs include belly cramps, bloating, gas, chronic diarrhea, unexplained weight loss, and fatigue from nutrient malabsorption.
How is lymphocytic duodenitis diagnosed?
Dr. Nguyen will order blood tests to check for celiac or inflammation, then perform an endoscopy with a biopsy to confirm increased lymphocytes in the duodenal lining.
Is lymphocytic duodenitis the same as celiac disease?
Not always. Celiac disease is a frequent cause, but lymphocytic duodenitis can also result from infections, autoimmune issues, or long-term medication use.
Can dietary changes treat it?
If gluten sensitivity or celiac disease is identified, a strict gluten-free diet can resolve the inflammation. Other cases may require additional medications.
What treatments are available?
Treatment may include dietary adjustments, PPIs to reduce acid, antibiotics for H. pylori, short-term steroids, and follow-up endoscopies to monitor healing.
How soon will I feel better?
Many patients report symptom relief within weeks of starting treatment, though full mucosal healing may take longer and requires follow-up care.
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