Enteropathy - Causes, Symptoms, Diagnosis and Treatment

Enteropathy - Chronic intestinal pathology noninflammatory genesis, which is based on fermentopathy or congenital abnormalities of the small intestine. Clinically manifested by pain in the umbilical region, with diarrhea of ​​varying severity and malabsorption. For the diagnosis of malabsorption are used: X-ray barium passage through the small intestine, videokapsulnaya endoscopy, morphological study of biopsy specimens. Treatment involves finding and eliminating the causes of disease development, the appointment of an appropriate diet and the use of enzyme preparations, antibiotics and intestinal eubiotics to improve digestion in the small intestine.

  • Reasons enteropathy
  • Symptoms enteropathy
  • Diagnosis enteropathy
  • Treatment enteropathy
  • Malabsorption - treatment

  • Malabsorption


    gastroenterology.

    celiac disease, or gluten intolerance, develops in genetically conditioned violation produce enzymes to digest gluten in the intestines. As a result, upon receipt of cereal products such as rye, wheat and oats, the patient progresses enteropathy, diarrhea accompanied by breach of digestion in the small intestine.

    If you can clearly establish the cause of the disease, in most cases it turns out to achieve a full recovery. When excluding the impact of etiological factors of pathological intestinal mucosa completely recovers its structure and function, which is accompanied by remission. However, not all types of enteropathy have a clear cause. Some forms of the disease is more severe and have a worse prognosis. For such diseases include collagen sprue autoimmune enteropathy, Crohn's disease, refractory and gipogammaglobulinemicheskaya sprue, eosinophilic gastroenteritis etiology, as well as post-transplant and exudative enteropathy. From the most common disease of the above embodiment pericardial pathology of the small intestine, which may be either primary or secondary to limfangioektazii background. Secondary exudative enteropathy develops in the lymph outflow disturbances in the intestine due to cancer or inflammatory diseases. As a rule, this pathology progresses in the defeat of vessels of the abdominal cavity, right ventricular failure, and Whipple's disease.

    malabsorption) eventually leads to a multi-vitamin deficiency. In this increasingly disturbed uptake of fat-soluble vitamins A, E, D and K. Severe disease accompanied by a breach of electrolyte metabolism, protein metabolism deterioration. Also with malabsorption may develop anemia due to insufficient iron absorption in the small intestine. Because this group of diseases is difficult absorption of protein and fat in the intestine, the person loses weight until the development of complete exhaustion. The pain of this disease is expressed to a small extent, but to the damage of bowel patency she is the leading clinical syndrome. Pain is mainly localized in the umbilical region and anecdotal. They are associated with periodic spasm of smooth muscles of the small intestine.

    The clinical picture is one of the most common congenital enteropathy, celiac disease, has no characteristic differences. All manifestations of the disease occur by eating cereals, which include wheat, oats, rye and barley. Symptoms of celiac disease begin in early childhood bother when introduced cereal lure. When switching to a diet that does not contain gluten, there is regression of clinical manifestations.

    Nongranulomatous idiopathic enteropathy, which has no clear reasons, usually accompanied by severe abdominal pain, lack of appetite, weight loss, fever, diarrhea, with increasing amounts of fat in the feces. If enteropathy arteriovenous anomalies occur in the small intestine mucosa, the feces can detect blood elements. The exudative form of the disease characterized by profuse speeded up chair with a lot of mucus. One of the most severe forms is enteropathy that develops against the backdrop of T-cell lymphoma. This is a serious pathology manifests pronounced swelling on the background of malabsorption of proteins, which are not corrected by introducing the protein components.

    blood chemistry. In the presence of inflammatory changes observed increase in C-reactive protein and fecal calprotectin. Due malabsorption determined decrease the concentration of calcium, magnesium, chloride, potassium, protein, and cholesterol. To a large extent these changes are observed in the form of gipogammaglobulinemicheskoy sprue. In severe forms of malabsorption detected reduction of albumin in the blood chemistry. To confirm the specific forms of the disease using techniques histochemical study of the small intestine mucosa.

    From instrumental studies using X-ray small intestine passage barium, which plays an important diagnostic role in the presence of severe mucosal lesions, such as Crohn's disease. With this study we can detect large ulcer, the presence of constrictions and intestinal fistula. Modern methods of examination in enteropathies considered MDCT of the abdomen, through which evaluate the level of destruction of the intestinal wall and the degree of its severity. Important information gives endoscopy, during which rendered pathological changes in the mucosa, narrowing of the intestinal lumen, flattening wrinkles, as well as the presence of erosive and ulcerative lesions. All these symptoms are not specific to any particular form of the disease. A highly advanced method of diagnosis appears videokapsulnaya endoscopy, allowing detail to assess the condition of the intestinal mucosa throughout.

    The essential role played by specific diagnostic tests that allow you to differentiate between different forms of enteropathy. In particular, for the production of "celiac disease" diagnosis used stress tests to gliadin. If gluten intolerance, this sample leads to a rapid increase in blood levels of glutamine. Importance in differential diagnosis of a biopsy of the small intestine mucosa. For example, celiac disease marked atrophic changes in the mucous layer. In addition, to help diagnose gluten enteropathy determination of antibodies to the transglutaminase. To identify the autoimmune form of the disease, in addition to the classic symptoms, antibodies to enterocytes. Further, to differentiate the immune enteropathy, celiac help lack of response to a gluten-free diet.

    allergic enteropathy recommended the exclusion from the diet of allergenic foods. For treatment Whipple's disease requires prolonged use of antibiotics. Therapy tropical sprue and infectious forms of the disease is carried out by intestinal antibacterial agents.

    Pathogenetic treatment includes correction of malabsorption syndrome. To this end, used enzyme preparations and eubiotics. They allow normalize digestion in the small intestine and improve the absorption of nutrients and trace elements. Patients with malabsorption recommended a complete protein diet, intake of iron and calcium supplements, as well as the use of multivitamin supplements. By reducing the level of protein in the blood must be intravenous albumin. Therapy enteropathy without a clear etiology provides for the appointment of anti-inflammatory drugs. In these diseases taken immunosuppressants, corticosteroids and aminosalicylates. They have a special effect in Crohn's disease and other forms of autoimmune disease.

    Prevention enteropathy is to use a rational diet and proper treatment of diseases of the small intestine. Depending on the shape of prognosis favorable can vary from celiac disease on the background to the correct treatment in adverse enteropathy-associated T-cell lymphoma.