Diseases of Intestine

 Diseases of Intestine

Structure of Intestine

Intestine is divided into two parts, small intestine and large intestine.

Small intestine

1.It is a 8 foot long tube. However due to relaxation of its muscle after death,its length measure 20 to 21 feet at the time of a postmortem examination.

2.It begins at the pyloric end of the stomach and ends at the caecum.

3.It is divided into three parts.

           .Duodenum

           .Jejunum.

           .Ileum.

4.It has four layers.

            .Serosa:Outer layer of visceral peritoneum.

            .Muscularis:Layer of smooth muscle under the serosa.

             .Submucosa:Layer of loose connective tissue under the muscularis.

             .Mucosa:Mucosa membrane lining the lumen of the intestine.

5.Undigested food is emptied into the large intestine.

6.The following digestive juices are emptied into the small intestine for digestive of food:-

 

Digestive Juices Emptied into Small Intestine

Source	Digestive juice
Liver and gall bladder	Bile
Pancreas	Pancreatic juice.
Small intestine	Intestinal juice.

 

Large Intestine

1.It is a 5 feet long tube with a diameter of 2.5”.

2.It extends from the end of ileum to the anus.

3.It has the following parts:-

        .Caecum.

           .Colon.

           .Rectum.

           .Anal canal.

4.Caecum is in continuity with the end of the ileum.Ileocaecal valve is found at the junction of the two.The appendix tissue in the appendix  protects from infection.

5.The wall of large intestine is thicker than that of the small intestine.There longitudinal bands of smooth muscle along its outer surface called taenia coli.

6.There are small tags of fat attached to its outer surface called  appendices epiploicae.

7.The taenia and appendices are not seen in the wall of the rectum and anal canal.

8.At the lower end of the anal canal is the anal sphincters, external and internal.

 

Function

Part of intestine	Function
Small intestine	.Digestion of food. .Absorption of products of digestion of food. .Propulsion of undigested food to the large intestine for excretion.
Caecum	.Receptacle at the beginning of the large intestine. .Asorption of water.
Colon	.Absorption of water so that solid stool is formed. .Absorption of electrolytes and glucose. .Propulsion of undigested food to the rectum for excretion.
Appendix	.Presence of large amount of lymphoid tissue protects from infection. It is a vestigial organ.
Anal canal	The anal sphincters prevent passage of stool until it socially acceptable to pass stool.

Symptoms of Disturbance of Large Intestine

Abnormal Stool

Abdominal Colic.

Constipation.

Flatulence.

Diarrhoea.

Dysentry.

 

Observation of Stools

Variable	Normal	Abnormalities            Feature	Cause
Colour	Light or dark brown	Blackish	.Green leafy vegetables. .Iron therapy. .Upper intestinal haemorrhage.
		Clay	.Jaundice.
		Red	.Blood in stools.
		Pea soup	.Typhoid.
		Rice Water	.Cholera.
Odour	Sour	Foul	.Indigestion.
	Obnoxious.	Rotten fish	.Pus in stools
		Dysentry	.Sour.
Volume	10 to 12 oz	Large	.Greater high residue diet.
Volume		Low	.Low residue diet. .Fasting,with only milk intake.
Consistency	Medium passed easily.	Hard	.Constipation.
		Liquid	.Diarrhoea.
		Blood and mucus	.Dysentery.
		Rice water	.Cholera.
		Pea soup	.Typhoid.
		Froth ,oily	.Hepatitis.
Frequency	1/ 2 per day.	>2 days	.Constipation.
		>2 days	.Diarrhoea,dysentery,colitis,cholera,indigestion.
Reaction	Slightly alkaline.	Acid	.Diarrhoea,dysentery.
Defecation	Painless	Painful and difficult	.Constipation .Fissure in ano. .Perianal abscess. .Prolapsed, thrombosed piles.
		With colic	.Dysentry. .Gastroenteritis.
Microscopy	Undigested foodparticles	Worms(round worm,hook worm,thread worm),eggs of worms,E .histolytica,blood,mucus.

 

 

Abdominal Colic

It is an important and common symptom of diseases of intestine. It is due to spasmodic contraction of the smooth muscle of the bowel. It is sudden in onset and subsides slowly.

Aetiology

1.Indigestion

2.Ingestion of certain fruits and vegetables which are difficult to digest.

3.Ingestion of a strong purgative.

4.Intestinal obstruction.

5.Lead poisoning.

6.Neurological disease.

Clinical features

1.Abdominal pain begins as described above.

2.Nausea and vomiting begin.

3.Sometimes there is constipation or diarrhea.

4.Pain is some what relieved by pressing on the abdomen.

5.The patient is restless and anxious.

Treatment

1.The cause is treated.

2.  Except for intestinal obstruction, the following measures are taken:-

            .Abdominal fomentation is done with hot water bag.

            .Flatus tube is passed to remove flatus from colon.

             .Simple enema is given to remove faeces.

3.Achild with an abdominal  colic has a tight abdomen.It is screaming while its lower limbs are drawn to its irregulary and in large volume,constipation,or diarrhea. The treatment is as follows:-

      .Burping is done by holding the child erect on one shoulder and then patting its back. That removes gas from its stomach and relieves pain.

       .A small flatus tube is passed through the anus so that gas is removed from the colon.

       .Abdominal fomentation is done with a hot water bag filled with water at 104 degree F to 105 degreeF. The child’s skin is quite delicate and care must be taken to avoid burns.

        .The child is given boiled and cooled water every day in adequate quantities to prevent constipation.If the constipation is still not relieved,a small roll of paper smeared with liquid soap is passed through its anus so that it passes stools and feels better.