Certain microbe-sensing proteins, known as Toll-like receptors, found on the surface of cells in the body are also thought to be involved in these processes.Gutworms and similar parasites are present in untreated drinking water in developing countries, and were present in the water of developed countries until the routine chlorination and purification of drinking water supplies. Recent research has shown that some common parasites, such as intestinal worms (e.g., hookworms), secrete chemicals into the gut wall (and, hence, the bloodstream) that suppress the immune system and prevent the body from attacking the parasite. This gives rise to a new slant on the hygiene hypothesis theory—that co-evolution of humans and parasites has led to an immune system that functions correctly only in the presence of the parasites. Without them, the immune system becomes unbalanced and oversensitive. In particular, research suggests that allergies may coincide with the delayed establishment of gut flora in infants. However, the research to support this theory is conflicting, with some studies performed in China and Ethiopia showing an increase in allergy in people infected with intestinal worms. Clinical trials have been initiated to test the effectiveness of certain worms in treating some allergies. It may be that the term parasite could turn out to be inappropriate, and in fact a hitherto unsuspected symbiosis is at work. For more information on this topic, see Helminthic therapy.
Mechanism/Pathophysiology
Megaduodenum can be passed down through families, it occurs when a patient inherits one copy of a muted megaduodenum gene from one parent. When the gene gets interrupted in the cells, it causes tumors. Acute pancreatitis, adhesions, aneurysm all clinically lead to Megaduodenum. Diagnosis
Diagnostic tests and procedures can vary for different types of intestinal disorders. These can include colonoscopy, upper GI endoscopy, capsule endoscopy, endoscopic ultrasound. Since patients with megaduodenum often have atypical symptoms such as hematemesis, steatorrhea, and acute pancreatitis. Therefore, physical and histological examination helps demonstrate the grade of distention and the nutritional status of the patient. Many of the physical examinations include: blood pressure, bowel sounds, blood tests, and thyroid function. In addition, a histological examination such as upper endoscopy, an X-ray of the abdomen, and biopsies can also be performed to diagnose megaduodenum efficiently. Prevention/Treatment
The treatment mainly depends on the underlying conditions and the degree of distention of the duodenum. It can be symptomatic and based on diet and control of bacterial overgrowth. To relieve the obstructive symptoms, latero-lateral duodenojejunostomy, gastrojejunostomy, duodenal-jejunal bypass (DJB), enteral and parenteral nutrition may be helpful. Therefore, early diagnosis and treatment may improve patients outcome and reduce morbidity. Prognosis
As long as Megaduodenum is treated promptly, the chances of making full recovery is possible. Posturing maneuvers during meals may be helpful in some patients, also to relive any compression of the duodenum the patient may lie down in right decubitus position. If the conservative treatments fail, surgery may be performed.