The principal signs of trouble having its origin in the intestine consist of pain somewhere about the abdomen, sometimes vomiting, and irregular bowel movements: constipation, diarrhoea or alternating bouts of these.
Several diseases and conditions are treated under separate headings. (See APPENDICITIS; CHOLERA; COLITIS; CONSTIPATION; CROHN'S DISEASE; DIARRHOEA; DYSENTERY; ENTERIC FEVER; HAEMORRHOIDS; HERNIA; INFLAMMATORY BOWEL DISEASE (IBD); ILEITIS; INTUSSUSCEPTION; IRRITABLE BOWEL SYNDROME (IBS); PERITONITIS; RECTUM, DISEASES OF; ULCERATIVE COLITIS.)
of the outer surface is called PERITONITIS, a serious condition. That of the inner surface is known generally as enteritis, inflammation of special parts receiving the names of COLITIS, APPENDICITIS, IRRITABLE BOWEL SYNDROME (IBS) and INFLAMMATORY BOWEL DISEASE (IBD). Enteritis may form the chief symptom of certain infective diseases: for example in typhoid fever (see ENTERIC FEVER), CHOLERA and DYSENTERY. It may be acute, although not connected with any definite organism, when, if severe, it is a very serious condition, particularly in young children. Or it may be chronic, especially as the result of dysentery, and then constitutes a less serious if very troublesome complaint.
of the bowel may take place as the result either of injury or of disease. Stabs and other wounds which penetrate the abdomen may damage the bowel, and severe blows or crushes may tear it without any external wound. Ulceration, as in INFLAMMATORY BOWEL DISEASE (IBD) or in APPENDICITIS, may produce an opening in the bowel-wall.
The contents of the bowel pass out through the perforation into the peritoneal cavity, and set up a general peritonitis. In consequence, the abdomen is painful, and after a few hours becomes extremely tender to the touch. The abdomen swells, particularly in its upper part, owing to gas having passed also into the cavity. Fever and vomiting develop and the person passes into a state of circulatory collapse or SHOCK. Such a condition may be fatal if not properly treated.
All food should be withheld and the patient given intravenous fluids to resuscitate them and then to maintain their hydration and electrolyte balance. An operation is urgently necessary, the perforated portion of bowel found, the lesion sutured and appropriate antibiotics given.
means a stoppage to the passage down the intestine of partially digested food. Obstruction may be acute, when it comes on suddenly with intense symptoms; or it may be chronic, when the obstructing cause gradually increases and the bowel becomes slowly narrower until it closes altogether; or subacute, when obstruction comes and goes until it ends in an acute attack. In chronic cases the symptoms are milder in degree and more prolonged.
Obstruction may be due to causes outside the bowel altogether, for example, the pressure of tumours in neighbouring organs, the twisting around the bowel of bands produced by former peritonitis, or even the twisting of a coil of intestine around itself so as to cause a kink in its wall. Chronic causes of the obstruction may exist in the wall of the bowel itself: for example, a tumour, or the contracting scar of an old ulcer. The condition of INTUSSUSCEPTION, where part of the bowel passes inside of the part beneath it, in the same way as one turns the finger of a glove outside in, causes obstruction and other symptoms. Bowel within a hernia may become obstructed when the hernia strangulates. Even a mass of hardened faeces may become jammed within the bowel and stop up its passage.
There are four chief symptoms: pain, vomiting, constipation and swelling of the abdomen.
As a rule the surgeon uses a laparoscope or opens the abdomen, finds the obstruction and relieves it or removes it altogether. It may be necessary to form a COLOSTOMY or ILEOSTOMY as a temporary or permanent measure in severe cases.
are rare in the small intestine and usually benign. They are relatively common in the large intestine and are usually cancerous. The most common site is the rectum. Cancer of the intestine is a disease of older people; it is the second most common cancer (after breast cancer) in women in the United Kingdom, and the third most common (after lung and prostate) in men. Around 25,000 cases of cancer of the large intestine occur in the UK annually, about 65 per cent of which are in the colon. In a middle-aged person, a history of altered bowel habit, in the form of increasing constipation or diarrhoea, or an alternation of these, or of bleeding from the anus, is an indication for taking medical advice. If the condition is cancer, then the sooner it is investigated and treated, the better the result.