|
Small Bowel
The small intestine is the major
site for the digestion (breakdown of nutrients from food and liquid) and
absorption (passage into the bloodstream) of nutrients so they can be
used by the body. The small intestine is about 10 feet long, starts at
the end of the stomach, and continues until it empties into the colon or
large intestine. It is divided into 3 parts. The first section is the
duodenum (approximately 12 to 18 inches in length) and is followed by
the jejunum and then the ileum. In the duodenum, the acid mixed with the
food delivered from the stomach is neutralized by water and bicarbonate
which is secreted by the pancreas. This is important because the
digestive enzymes and processes of digestion in the small bowel occur in
a neutral, not acidic, environment.
Intestinal Disorders
Duodenal Ulcer, Peptic Ulcer Disease -
If a body fails to neutralize the acid from the stomach or if the
stomach makes too much acid and overcomes the ability of the duodenum to
neutralize it, an ulcer may develop in the first portion of the
duodenum. The symptoms caused by an ulcer may be pain when the stomach
is empty (often relieved when food or antacid is ingested), nausea,
vomiting or digested blood in the stool (bowel movement). The stool
would appear black, sticky and have a foul odor. If bleeding occurs, one
should consult his physician immediately! Most ulcers can be
treated medically with a variety of medications. Surgery is indicated
for any of the four following reasons:
- Intractable pain -
pain uncontrollable with medication.
- Obstruction - scar
tissue associated with the ulcer that has caused a narrowing of the
small intestine.
- Hemorrhage - bleeding
which cannot be controlled by medical means.
- Perforation - the
ulcer has penetrated through the wall of the small intestine causing
leakage of the contents into the abdominal cavity.
Lactose Intolerance - The normal
small intestinal cells contain an enzyme called lactase which is
necessary to digest the sugar called lactose contained in milk and dairy
products. Many people in the United States, particularly as they get
older, are unable to digest milk because of an inadequate amount of this
enzyme. This is particularly true in blacks and people of Chinese,
Eastern European and Mediterranean descent. It is now possible to
provide the enzyme lactase which can be added to milk so some people can
have milk without the symptoms of gas, cramps, abdominal bloating or
diarrhea.
Sprue, Celiac Disease, Gluten
Enteropathy - A rather rare condition in which the small
intestinal cells are sensitive to a substance called gluten which is
contained in wheat and some other grains. Consumption of gluten causes
damage to the lining of the small intestine and consequently prevents
adequate absorption and digestion of nutrients. Symptoms include
abdominal pain, cramps, gas, bloating and diarrhea with weight loss. The
treatment is a gluten-tree diet.
Crohn's Disease, Regional Enteritis - A disease named after Dr. Burrell Crohn who first described it. It is
a disease of unknown cause which can affect any part of the intestinal
tract from the mouth to the anus. It most commonly affects the last few
inches of the small intestine (the terminal ileum). It may affect this
area alone or in combination with other segments of the small intestine
or colon. The disease process results in ulceration of the lining of the
intestine. The ulcers may become deep and actually erode through the
bowel wall into an adjacent structure. This communication is called a fistula.
Fistulas can occur between loops of bowel, from the bowel into the
urinary bladder or vagina or out the abdominal wall. Symptoms of Crohn's
disease include abdominal pain, cramps, distention, and diarrhea often
associated with weight loss. Medical treatment is usually sufficient to
control the disease and will heal the ulceration present in the bowel.
If medical treatment is unsuccessful or if a fistula has developed
surgery may be necessary to remove a segment of the diseased bowel. Many
patients with Crohn's disease have involvement of the anus. This can
result in scarring and narrowing of the anus. Sometimes fistulas can
occur starting in the rectum or anus and exiting through the skin near
the anus.
Travelers Diarrhea, Turista, Tijuana
Trots - Patients who travel outside the United States, particularly
to Mexico or to third world countries, are very prone to develop
traveler's diarrhea. This is often caused by a microorganism called E.
coli. All of us in the United States have E. coli in our intestinal
tract. However, the type of E. coli we have differs from that of people
who live in other countries. It is not unusual to develop diarrhea when
traveling abroad. If you are going to be traveling for a short time,
medications are available that can significantly reduce your chances of
developing this problem, and you should discuss this with your doctor
before you leave. The symptoms frequently experienced are intense
abdominal cramps, sometimes with fever, and watery diarrhea.
BACK
|
