[Is active autonomous duodenitis a precursor of duodenal ulcer?]

Up to today, the relationship between autonomous nonspecific duodenitis (ANSD) has not yet been defined. ANSD has been noticed in about 26% of dyspeptic population. With reference to the presence of active inflammation, ANSD has been divided into chronic duodenitis (CD) (77.7%) and in active duodenitis (AD) (22.3%). The two duodenitis groups have been compared with a group of patients with duodenal ulcer (DU) in relation with the presence of duodenal gastric metaplasia (GM), of duodenal Helicobacter pylori (Hp) infection, of antral chronic gastritis (AG), of antral Hp infection, and in relation with the gastric secretion behaviour. The data concerning AD are superimposable to those of DU with presence of high percentage of duodenal GM, of duodenal Hp infection and of Hp positive AG. Furthermore, they present a gastric secretory profile similar to DU with prevalence of hyperchlorhydria and hyperpepsia. CD without activity, on the contrary, present values superimposable to dyspeptic population without duodenitis and DU. It is, therefore, that Hp positive AD can be considered as a possible precursor of DU. In periulcerous site, in fact, AD is present in more than 90% of cases.