The duodenum is situated at the beginning of the small intestine between the pylorus and jejunum. Inflammation, a nonspecific immune response occurring in reaction to any type of bodily injury, can affect the duodenum.

The cause of inflammatory bowel disease is unknown, but there are several theories. One theory is based on genetics, relating to inflammatory diseases of the bowel occurring in families. There is also evidence, suggesting an association between changes in the body's immune system and the presence of inflammatory disease.

Common symptoms include pain in the abdomen, diarrhea, and weight loss. There may also be rectal bleeding and fever. Chronic bleeding may lead to anemia.

Endoscopy is recognized as an important diagnostic tool in duodenal conditions. Double contrast barium x-ray is utilized as an alternative method.

Interventions to correct the condition include dietary modification, emotional support, and medications, such as anticholinergic or antiinflammatory preparations.

Poor response to medical management may result in complications, such as excessive bleeding, perforation, fistula formation, ulceration, and obstruction; and chronic illness, such as recurrent intestinal obstruction, intractable fistulas or abscesses for which surgery is indicated. After initial surgery, further surgery is required in nearly 50% of cases. However, recurrence rates appear to be reduced by early postoperative prophylaxis with antiinflammatory medications.

1. This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under §3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of §3.307 are also satisfied [38 CFR §3.309 [Disease subject to presumptive service connection], §3.309(a) [chronic disease].