Brunner's gland hyperplasia

Looking for information or guidance. We have a 9yo boy that has had stomach pain for 4 months. He describes it as pressure right at the belly button. His symptoms include: pressure, nausea, loss of appetite, constipation.
The symptoms are present everyday but do flare causing symptoms to be worse. The flares can happen at anytime but definitely after eating & car rides.
When doing a endoscopy BGH was found. We are trying to find the root cause of these glands to be hyperactive and so far have only managed to wrack up thousands of dollars in medical bills & our sweet 9 year old is still in pain everyday.
A little background: in March he was diagnosed with a histamine disorder, we chose to use supreme nutrition herbs to aid in gut healing. Since he was a baby he has never had a normal stool and has battled with skid marks his entire life. He’s struggled with rashes around his mouth, on his elbows & knees. He often get stye’s in his eyes & canker sores. He also has tics, some are verbal & some non verbal. Along with chronic congestion.
In March we pulled gluten & dairy from his diet & the rashes, chronic congestion, styes, canker sores & tics have since improved. The end of April is when his stomach pain began and he went from pooping daily to constipated. However, looking at the skid marks we wonder if he’s been chronically constipated his entire life and since removed his trigger foods his body is now relearning how to have a normal bowel movement. But how does the Brunner Gland Hyperplasia fit in? What could be the root cause? Is this all apart of the healing process or is there an underlying condition and if so, where do we go from here? From a GI standpoint BGH is a normal finding but all my research shows is actually rare & typically a response to something else going on. We are desperate to help our boy and are hoping this might bring some light and help us find him some relief.

Hi @lakelady55 and welcome to Mayo Clinic Connect. I see that you are looking for Brunner's symptoms and treatment.
Here are a few references that I think you could gain more information from.
Case report of Brunner’s gland hyperplasia: A rare “mimic” of malignant pathology: https://www.sciencedirect.com/science/article/pii/S221026122100328X

The medical treatment is to control gastric hyperacidity, which is one cause of Brunner's gland hyperplasia. However, the regression of Brunner's gland hyperplasia is rare (7). Therefore, excision appears to be the treatment of choice." --- Brunner's Gland Hyperplasia: Treatment of Severe Diffuse Nodular Hyperplasia Mimicking a Malignancy on Pancreatic-Duodenal Area: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2526515/

While I find other people who can relate to your experience, can you tell me a little more about your situation?

Hi LakeLady55,
Sorry you are dealing with this.

I have been diagnosed with Brunner’s gland hyperplasia (BGH) in my duodenum and foveolar hyperplasia in my stomach on my most recent endoscope. I have had a whole host of GI issues and various diagnosis over the years but I won’t get into that here because I think you are looking for information on how to get relief so I will not bore you with my details.

I have researched this quite a bit and also had found the articles the moderator provided here. Long story short, from what I understand (as a layman) is that the condition can be caused by bile reflux. I had my gallbladder removed so for me, it has caused bile to back up into the duodenum and stomach causing the change in the cells. I have tried a few medications like bile binders, prevalite, proton pump inhibitors, etc. Unfortunately, they have not provided much relief and some can make bloating worse.

Not sure if your BGH is caused by bile but it may be a question for you to ask you gastroenterologist about. If medications don’t work and you are symptomatic your doctor will need to thoroughly evaluate the situation. There are surgeries to divert bile further down in the small intestine that studies show improve BGH.

My doctor said it is benign so there is really not much to do. I question this tactic a bit because while it is usually a benign lesion, there are other case studies that show it can become malignant. Hence why it is so important to be sure what it is so no hugely invasive surgeries are done to remove it if it isn’t cancerous or causing a blockage.

I get reflux both bile and acid, vomiting bile (sometimes blood), abdominal distention, and abdominal pain. I have a whole host of other organ systems that are affected due to chronic inflammation so these symptoms just add to the list of things to overcome during the day. Since we are doing the wait and see approach, for symptomatic relief I try to rely on coping skills I learned with cognitive behavior therapy. Mind over matter is not what I am saying because what is happening in our bodies is not something that can be wished away. It is rather a set of tools that I use like relaxation techniques, distraction, pacing myself, etc. I have tried many diets like elimination, FODMAP, etc. but with little success. I have learned that things like tomato, onion, garlic, alcohol are triggers so I do best to avoid them. You may want to try keeping a good journal to see if you notice any patterns when you aren’t feeling well. Then try to remove those offending things.

Hi @lakelady55 and welcome to Mayo Clinic Connect. I see that you are looking for Brunner's symptoms and treatment.
Here are a few references that I think you could gain more information from.
Case report of Brunner’s gland hyperplasia: A rare “mimic” of malignant pathology: https://www.sciencedirect.com/science/article/pii/S221026122100328X

The medical treatment is to control gastric hyperacidity, which is one cause of Brunner's gland hyperplasia. However, the regression of Brunner's gland hyperplasia is rare (7). Therefore, excision appears to be the treatment of choice." --- Brunner's Gland Hyperplasia: Treatment of Severe Diffuse Nodular Hyperplasia Mimicking a Malignancy on Pancreatic-Duodenal Area: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2526515/

While I find other people who can relate to your experience, can you tell me a little more about your situation?

Thank you!