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GI Tract In Disease_Small Intestine

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This document reviews major diseases of the small intestine, including celiac disease, obscure gastrointestinal bleeding, small bowel obstruction (SBO), and mesenteric ischemia.<br /><br />Celiac disease is an autoimmune disorder triggered by gluten, a protein found in wheat, barley, and rye. It damages the small intestine in genetically predisposed individuals. Symptoms may include fatigue, anemia, abdominal pain, cramping, diarrhea, malabsorption, weight loss, growth failure in children, and osteoporosis. Diagnosis is based on serologic testing, especially tissue transglutaminase antibody, ideally while the patient is eating gluten; biopsy via endoscopy may also be used. Treatment is strict lifelong gluten avoidance.<br /><br />Obscure GI bleeding is bleeding that continues without a clear source after endoscopy and accounts for about 10% of GI bleeding cases. Most sources are in the small intestine. Evaluation includes repeat upper endoscopy and colonoscopy, capsule endoscopy, and deep/device-assisted enteroscopy such as double-balloon, single-balloon, or rotational enteroscopy. These methods can help diagnose and treat lesions like angioectasia, tumors, ulcers, or Meckel’s diverticulum. Treatment depends on cause and severity and may include iron, transfusions, endoscopic therapy, embolization, or surgery.<br /><br />SBO is a mechanical or functional blockage of the small intestine causing abdominal pain, distension, nausea, vomiting, and constipation. Common causes include adhesions, hernia, tumors, intussusception, strictures, and bezoars. Diagnosis is typically made with abdominal X-ray and CT scan. Treatment includes NG tube decompression, IV fluids, electrolyte correction, and surgery when needed.<br /><br />Mesenteric ischemia results from inadequate blood flow to the small intestine. Acute ischemia is often caused by a clot in the superior mesenteric artery and presents with severe abdominal pain, often out of proportion to exam findings. Chronic ischemia is usually due to atherosclerosis and causes post-prandial pain, weight loss, and fear of eating. Diagnosis uses imaging such as CT angiography or angiography, and treatment may require surgery or angiographic intervention.

Keywords

celiac disease

small intestine

obscure gastrointestinal bleeding

small bowel obstruction

mesenteric ischemia

gluten intolerance

capsule endoscopy

angiography

abdominal pain

malabsorption