The small bowel is the principal site of digestion and absorption, receiving food from the stomach and delivering undigested fecal material to the colon. Diseases of the small bowel range from mild, short-term disorders to severe, chronic illnesses. Treatments for small bowel diseases focus on restoring normal function and limiting potential complications.
Peptic Ulcer Disease
Peptic ulcers are erosive sores in the lining of the upper gastrointestinal tissues. They most commonly occur in the stomach or the duodenum, the first portion of the small bowel that connects to the stomach outlet. The most frequent causes of peptic ulcer disease are infection with the bacterium Helicobacter pylori and protracted use of nonsteroidal anti-inflammatory drugs, or NSAIDs.
A duodenal ulcer may cause dull abdominal pain or discomfort, which is characteristically relieved by eating or taking an antacid medication. Treatment of duodenal peptic ulcers includes temporarily blocking or decreasing stomach acid production with medications, discontinuation of NSAIDs and antibiotic treatment to clear H. pylori infection, if present. The National Institute of Diabetes and Digestive and Kidney Diseases reports that approximately 500,000 people in the United States are affected by peptic ulcer disease each year.
Crohn's Disease
Crohn's disease is a chronic digestive system disorder characterized by inflammation, ulceration and damage of the gastrointestinal tract. The disease most commonly affects the last portion of the small bowel, known as the distal ileum, and the large bowel, but may manifest anywhere in the gastrointestinal tract. The presence of inflammation through the full thickness of the intestinal wall is a distinctive characteristic of Crohn's disease.
Diseased bowel areas are frequently interspersed with unaffected segments, which is another hallmark feature of Crohn's disease. Intestinal abscesses frequently occur. Symptoms of Crohn's disease include abdominal pain, chronic diarrhea, unintentional weight loss, bloating and fever, according to the American Society of Colon and Rectal Surgeons. Anti-inflammatory and immunosuppressant medications are used to control Crohn's disease.
Celiac Disease
Celiac disease involves destruction of the absorptive small bowel structures, or the villi, due to an intensive immune system reaction to gluten, a dietary protein. Destruction of the villi can significantly impair the small bowel's capacity to absorb dietary nutrition. Symptoms depend on the level of destruction of the villi. People with mild celiac disease, also known as celiac sprue, may have few symptoms. In contrast, severe disease typically presents with unintentional weight loss, chronic diarrhea, abdominal pain and bloating, anemia, mouth sores and weakness, notes "The Merck Manual for Healthcare Professionals."
Definitive treatment for celiac disease is complete avoidance of dietary gluten, a constituent protein of wheat, barley and rye. A gluten-free diet involves avoiding all foods made with wheat flour, which includes most pastas, breads, bakery goods and processed foods. An increasing number of gluten-free products are available to address the dietary needs of the estimated 2 million Americans with celiac disease, notes the National Institute of Diabetes and Digestive and Kidney Diseases.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: H. Pylori and Peptic Ulcers
- American College of Gastroenterology: Peptic Ulcer Disease
- American Society of Colon and Rectal Surgeons: Crohn's Disease
- "Merck Manual for Healthcare Professionals": Crohn's Disease
- "Merck Manual for Healthcare Professionals": Celiac Sprue
