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"Oh...so that's where you ended up." My intro to duodenal Crohn's

So we got H's biopsy report and now the Crohn's has ended up in the duodenum. New to us.
Her TI is healed and the colon and stomach look good this time (colon shows chronic but not active disease).
There is shortening of the villi in the duodenum, and inflammation but not ulcers.
She has been tested negative many times for Celiac, so does Crohn's shorten villi?
She is now on Humira monotherapy, 40 mg weekly (has been for a long while) but he added shakes 3×day.
Anyone deal with duodenal Crohn's?
Sorry--no experience with Crohn's in the duodenum, but I'm glad to hear that everything else looked good. Has she been having Crohn's symptoms?

my little penguin

Staff member
Ds has shorten villi in the duodenum at dx and inflammation no ulcers
No celiac
Took a while eventually calmed down
Multiple scopes showed duodenitis a few years in a row
But he ended up with mild gastroparesis from the duodenum not working properly .
That seems to have gotten a lot better recently and last scope looked good there just not in TI
Pdx - no symptoms. I really did hope we were looking at remission.

GI had even tossed around possibility of reducing Humira but....not going to happen.

MLP it seems like the small intestine Crohn's is a shape shifter. I will keep watch for possible gasroparesis complications.


Staff member
S had inflammation in the duodenum when he was diagnosed. But I can't offer any advice or experience. At dx and after, none of his symptoms were ever attributed to his duodenum specifically and it was never brought up again. It just resolved when other areas cleared.


Staff member
M had inflammation in her duodenum at one scope, but never after that. She also ended up with fairly severe Gastroparesis, but in her case, her GI does not think it related to Crohn's at all, since her duodenum has always been fine on other scopes.

Inflammation in the stomach or duodenum can mimic Gastroparesis and cause delayed gastric emptying but if it's caused solely by inflammation then it should go away once the inflammation is controlled. So if she starts complaining of nausea after eating or being full after a few bites, don't panic. It doesn't necessarily mean she will have delayed gastric emptying forever. Liquids are easier to tolerate with delayed gastric emptying and duodenal inflammation, so shakes make should help make sure she is at least getting enough calories.

Other symptoms to watch for - severe nausea, bloating, vomiting, reflux, weight loss, stomach pain.

Given that she still has chronic colonic inflammation and new inflammation in her small bowel, I agree with you -- I definitely would not reduce Humira! You have worked so hard to get her to this point - why mess with it?! I'm surprised her GI even suggested it.

I'm glad that scopes didn't look too bad though - that's exciting 🎈🎈🎉🎉!
T has duodenal disease but she has ALL small bowel disease. Her colon looked pristine. We don't treat the duodenal disease specifically. WE just treat her Crohn's. Her hallmark symptoms are nausea and pain when in a flare.

They found a duodenal ulcer with one of O's scopes. Couldn't tell you the status now as her last scope was just colon. I never saw the girls' biopsy reports from the old hospital so not sure if any mention of villi was on there.

So glad that her problem areas are calm now. Hopefully the duodenum falls line soon!