VERIFIED CONTENTAuthor: lek. Maciej Grymuza, a graduate of the Faculty of Medicine at the Medical University of K. Marcinkowski in Poznań.

Intestinal diseases are a common cause of gastrointestinal complaints, especially abdominal pain. It is worth finding out what other symptoms may indicate intestinal diseases and what are the most common diseases of these parts of the gastrointestinal tract.

Bowel diseaseshave many symptoms both with ailments of other parts of the digestive tract and with ailments of other systems.

The spectrum of symptoms of intestinal diseases is not large, but the number of diseases is quite the opposite, so you can guess that many diseases cause similar ailments, which makes diagnosis much more difficult.

It is often useful to have a detailed description of ailments, e.g. in the case of pain: place, time of origin, intensity.

Precise definition of your symptoms is very helpful, because it narrows down the number of diseases that should be considered in the diagnosis.

So it is worth considering before the medical visit when symptoms occur, how long they last, whether something reduces or intensifies them. It should be remembered that even mild symptoms, such as anemia, may indicate a serious illness such as cancer.

On the other hand, rectal bleeding may result from the presence of harmless hemorrhoids, but may also occur in the course of cancer.

In the case of symptoms suggesting bowel diseases, basic diagnostics is carried out by a family doctor and it is the family doctor who should first visit him, if necessary, he or she refers the patient to a gastroenterologist - a specialist in diseases of the gastrointestinal tract, including the intestines.

Symptoms of intestinal diseases

Mostbowel diseaseshave many common symptoms, and most of them can also occur in other conditions, not only those affecting the gastrointestinal tract.

Therefore, the diagnosis of intestinal complaints is often complicated and requires a lot of research.Symptoms that appear in the course of intestinal diseases are primarily :

  • diarrhea,
  • stomach pains,
  • nausea and vomiting,
  • constipation.

Diarrhea

We deal with it when the number of bowel movements is greater than 3 a day and they dothey are too loose in consistency. It may be caused by a malabsorption of substances from the intestines, such as when the membrane transport mechanism is damaged, non-absorbable substances are present in the intestine or the passage is too fast.

Diarrhea may also occur as a result of the increased secretion of electrolytes and water from the intestinal wall to its lumen, i.e. in the opposite direction to the normal state.

There are many causes: the most common of them is gastrointestinal infection or ingestion of toxins (it is more than 90% of cases), then: side effects of drugs - antibiotics, heart drugs, anticancer drugs, food hypersensitivity, intestinal and pancreatic diseases, thyroid, deficiency of digestive enzymes (e.g. lactase), infections.

The causes of diarrhea are primarily considered to be infection, only after its exclusion, more detailed diagnostics is undertaken: blood count, liver and thyroid tests, iron and electrolyte metabolism, celiac disease diagnostics.

Even more detailed tests include: various types of imaging, endoscopy, biopsy.

Diarrhea that occurs in people traveling to countries with less hygienic standards is a separate entity called travelers' diarrhea.

Diarrhea associated with antibiotic therapy is a separate diagnosis, it is caused by damage to the digestive tract or beneficial bacteria living in the large intestine.

Due to the risk of this ailment, it is necessary to take probiotics during antibiotic therapy, and in the event of post-antibiotic diarrhea, they are the basis of treatment.

Stomachache

They are most often associated with diseases of the gastrointestinal tract, but apart from intestinal diseases, it can also be caused by stomach, liver, pancreas, urinary and reproductive system diseases, diseases of the vessels and organs of the chest.

The diagnosis of this symptom is therefore quite complicated, the possible cause can be determined on the basis of its location, e.g. the small intestine hurts most often in the middle of the abdomen, the thick intestine in the lower parts - on the right or on the left side.

Nausea and Vomiting

Their causes are rarely intestinal diseases, more often stomach and esophagus, but they can also be drugs, diseases of the nervous system, the balance organ, liver, pancreas or urinary system.

Constipation

We talk about constipation when the number of bowel movements is lower than 2 per week, most often its cause is unexplained - idiopathic constipation, if the cause can be determined, we usually deal withwith diseases of the large intestine, but it also happens in diseases of the small intestine, anus, thyroid gland, diseases of the nervous system, or after taking medications.

The diagnostics includes: blood count, blood calcium concentration, thyroid evaluation and endoscopic examinations.

Gastrointestinal diagnosis

There are many diagnostic possibilities of intestinal diseases , in addition to the basic laboratory tests mentioned above, tests such as:

  • Small intestine endoscopy- viewing it from the inside with a special device, similar to a gastroscope or a wireless camera enclosed in a capsule that is swallowed (capsule endoscopy). The camera takes many photos or records a video, which is saved in the device memory, and after its expulsion, it watches the collected material.
  • Gastroscopy(actually esophagogastroduodenoscopy), it allows you to see the initial section of the small intestine - the duodenum, as well as the stomach and esophagus.
  • Rectoscopyandcolonoscopy , in these examinations we have the option of assessing the large intestine - whole in colonoscopy or only the final section in rectoscopy.

Of course, apart from the above-mentioned methods, the following are also useful: abdominal ultrasound, computed tomography and magnetic resonance imaging.

Diseases of the small intestine

The small intestine consists of the duodenum, jejunum and ileum. The first of them enters the pancreatic and bile ducts, they provide substances necessary in the digestive process.

The small intestine is responsible for the digestion of food and its subsequent absorption, the intestinal villi are a characteristic feature of the structure, which facilitates this task.

Like the large intestine, it is in constant motion - a perist altic wave propagates along the intestines causing food to pass, which is essential for the proper functioning of the digestive tract.

Celiac disease

The full name of celiac disease is gluten-dependent celiac disease. The substrate is immune - the immune system produces antibodies to gluten (protein present in wheat, rye, barley), which causes an inflammatory reaction and the disappearance of intestinal villi.

Symptoms only occur if the diet contains the aforementioned gluten and they are from the gastrointestinal tract: diarrhea, abdominal pain, weight loss, aphthae, vomiting, malnutrition.

This disease can also appear on the skin in the form of blisters and erythema (the so-called Duringa disease), or cause a delay in puberty.

The following are carried out in diagnostics: laboratory tests - mn. in. blood count, serological tests to detectcharacteristic autoantibodies, endoscopic (with specimen collection) and genetic tests.

Treatment is the elimination of gluten from the diet, i.e. products containing wheat, rye or oats, it is a completely effective therapy, therefore immunosuppression is rarely used.

Diseases with a similar course and treatment method, but with a different mechanism of origin, are wheat allergy and non-celiac gluten hypersensitivity.

Duodenal ulcer

The reason is the increase in the amount of hydrochloric acid entering the duodenum and damage to the mechanisms that protect the mucosa against acid, it causes the destruction of the mucosa and the formation of cavities in it.

Usually the causes are: bacterial infectionHelicobacter pyloriand long-term or intensive use of non-steroidal anti-inflammatory drugs (e.g. acetylsalicylic acid), peptic ulcer disease is more common in people over 60 years of age .

The most common symptom is abdominal discomfort or pain, located in the upper part, below the breastbone, typically after a meal or early in the morning, and resolves with antacids, less often with alkaline foods such as milk.

Nausea and vomiting occur less frequently.

The diagnosis of peptic ulcer disease is based on endoscopy, which allows you to see defects in the mucosa and to diagnose infectionsH .pylori .

This infection can also be identified by blood tests, stool tests and a respiratory test.

Treatment of peptic ulcer disease is primarily diet, drugs that reduce the amount of hydrochloric acid in the stomach and elimination of infection, and, exceptionally, surgical treatment.

Peptic ulcer disease may affect the stomach or stomach and duodenum simultaneously.

Short Bowel Syndrome

It is not a common ailment, it happens after operations involving the removal of a fragment of the intestine or in the course of other diseases of the digestive tract, so it occurs only in people who have been ill before.

Short bowel syndrome occurs when a large part or all of the small intestine is excluded from food passage, significantly reducing nutrient and water absorption.

It causes intestinal failure - natural nutrition is insufficient to maintain he alth despite providing a complete diet.

Symptoms are long-lasting and include: diarrhea, dehydration, malnutrition and cachexia, mineral and element deficiencies.

They, in turn, can cause mental disorders andneurological, disturbances in heartbeat and its efficiency, gallstones and kidney stones, disturbances in bone mineral composition and fractures.

Bacterial overgrowth

Bacterial overgrowth is characterized by an excessive multiplication of bacteria living in the large intestine, and in the course of this disease, they move to the small intestine, which is properly devoid of microorganisms.

The result is malabsorption, they mainly concern fats, because bacterial enzymes interfere with their digestion, and vitamin B12, because it is consumed by microorganisms.

The bacterial overgrowth syndrome occurs in the course of other diseases, e.g. in acidity of gastric juice, immunodeficiency, it can also be a complication after operations on the gastrointestinal tract.

The symptoms of this disease are: fatty diarrhea (passing stools with an unpleasant, putrid, greasy stool) and impaired absorption of fat-soluble vitamins: A, D, E and K, leading to night blindness and osteoporosis, as well as megaloblastic anemia (caused by vitamin B12 deficiency) and nervous system disorders.

In addition, the symptoms are: weight loss, malnutrition, abdominal pain and gas.

In the field of laboratory tests, it is useful to assess the morphology of peripheral blood, test the stool for fats, and the contents of the small intestine for the presence of bacteria. Treatment of the disease, which has led to the growth of bacteria, and adequate nutrition are the key to treatment.

Protein Loss Enteropathy

It is a symptom complex caused by a deficiency of proteins present in the blood plasma, they are lost in the pathological process of penetrating into the intestinal lumen.

The cause is damage to the lymphatic vessels and obstruction of the outflow of the lymph, hence its accumulation in the intestinal vessels, which causes an increase in pressure and the penetration of fluid into the intestinal lumen.

Another cause may be inflammation of the intestinal mucosa, which results in the formation of an exudate, i.e. a fluid that is the body's normal response to inflammation, when its amount is large, it begins to penetrate the digestive tract.

The symptoms of enteropathy are: chronic fatty diarrhea, nausea, vomiting, leg swelling, and malnutrition.

Treatment is based on eliminating the cause of the disease (damage to the lymphatic vessels or intestinal diseases leading to exudate) and introducing an appropriate diet (low in fat and high in protein).

Irritable bowel syndrome

It is the most common chronic bowel disease, affecting up to 10% of the population. The reason for thisthe disease has not been known so far, a psychological background is suggested, the more so that about 80% of people with this disease have various emotional ailments.

There are no morphological or enzymatic changes in the gastrointestinal tract in the course of this syndrome.

The symptoms of irritable bowel syndrome are varied, there are no specific complaints that make a certain diagnosis.

People suffering from this disease most often complain of: cramping abdominal pain, most often in the lower abdomen. Irritable bowel syndrome can occur with diarrhea, it occurs after meals, stress and in the morning, and is preceded by a sudden urge.

The figure with constipation is completely different, then the stool is passed with effort and there is a feeling of incomplete bowel movement.

Other symptoms include: gas, nausea and vomiting, and heartburn. The ailments can be bothersome, but the disease never has serious complications.

Characteristic is the lack of deviations in additional examinations, including imaging and endoscopy, which are performed mainly to exclude other diseases.

The treatment uses adequate nutrition, mental support and medications that reduce the severity of troublesome symptoms.

Diseases of the small and large intestine

Intestinal ischemia

May be in the small intestine, large intestine, or both. It occurs as a result of a sudden inhibition of blood flow in the vessels supplying the intestines, the most common cause is a blood clot or embolism, to which, for example, people suffering from atrial fibrillation or atherosclerosis are predisposed.

When the artery is suddenly closed, the symptoms are violent - there is a very severe abdominal pain, vomiting, the patient's condition is very serious, after the diagnosis is made, immediate surgery is required.

On the other hand, if the process is slow, the symptoms are due to insufficient blood flow to the intestines and do not appear until this flow is severely restricted and makes it impossible to collect all the digested substances.

The most common ones are: persistent diarrhea, weight loss and abdominal pain appearing several minutes after a meal, especially heavy. Treatment is usually based on endovascular restoration of the arteries.

Crohn's disease

Crohn's disease belongs to the so-called inflammatory bowel diseases. It can affect any part of the digestive tract, but is most often located at the end of the small intestine.

In the course of this disease, systemic symptoms are characteristic:weakness, fever, weight loss, there are also gastrointestinal complaints: abdominal pain and diarrhea, often with blood, as well as lesions around the anus: ulcers and abscesses.

The latter pay special attention to the need to diagnose Crohn's disease.

In determining the diagnosis, the doctor relies primarily on the characteristic image in imaging, endoscopy and microscopy of the sections.

The course is many years with periods of exacerbation and remission of symptoms, unfortunately there is no effective method of cure. The therapy uses anti-inflammatory and immunosuppressive drugs, so-called biological drugs, and in the event of complications, surgical treatment.

Intestinal obstruction

It is always a medical emergency and requires immediate action as it quickly causes peritonitis.

The symptoms form a characteristic triad: severe pain, nausea and vomiting as well as gas and stool retention, the general condition is usually serious.

There are many reasons for the obstruction, for example: postoperative adhesions, inflammations within the abdominal cavity (e.g. pancreatitis or appendicitis), neoplasms, hernias. Of course, the treatment is surgery.

Food hypersensitivity

This is an allergic or non-allergic abnormal reaction of the body to certain foods. It is found when symptoms are reproducible and always occur after eating a particular food or ingredient.

The most allergenic foods are: cow's milk proteins, eggs, fish, seafood and nuts.

Sometimes a so-called cross-reaction occurs, which is the appearance of symptoms after eating foods other than those to which hypersensitivity has been found, but they are always the same foods.

There are two forms of this disease on the part of the intestines:

  • anaphylactic gastrointestinal reaction
  • allergic eosinophilic gastroenteritis.

The first is nausea, vomiting, abdominal pain and diarrhea, typically within 2 hours of ingestion of the allergen, often accompanied by rash and shortness of breath.

Eosinophilic inflammation is also characterized by abdominal pain and vomiting, but it also includes irritability, lack of appetite and anemia.

The diagnosis of food hypersensitivity is difficult, because its symptoms can occur in many other diseases, and it can manifest itself outside the gastrointestinal tract - on the skin or in the respiratory system.

The probability of this diagnosis is greater if the patient already has asthma, allergic conditionrhinitis or any other allergic disease or family history of allergy sufferers.

The diagnostics uses skin tests, as well as the so-called elimination and provocation tests, while the treatment mainly consists in excluding allergens from the diet and using antiallergic drugs

Food poisoning

Food poisoning often occurs in the form of gastroenteritis and is a very common ailment caused by the consumption of food containing pathogenic bacteria or their toxins.

The aforementioned gastroenteritis is a group of symptoms occurring, for example, in a viral infection or food poisoning, including nausea and vomiting, diarrhea, weakness, cramping abdominal pain and fever.

Symptoms appear several hours or even days after poisoning.

In treatment, you should first of all ensure proper hydration and supply of electrolytes, because poisoning usually resolves spontaneously.

In addition, it is worth paying attention to your diet and in case of poisoning, eat easily digestible foods such as: boiled rice, porridge, bananas, natural yoghurt, cooked meat, all in small portions. However, fried foods and milk are not recommended.

Antibiotics are used less often, as poisoning is rarely caused by a bacterial infection - more often viral or toxins.

Constipation medications are most often inadvisable, because they leave toxins in the body for a longer time, and thus prolong the course of the disease.

Prevention of food poisoning is primarily hand hygiene, eating food from a known source, and drinking bottled water when traveling abroad.

Parasitic diseases

The most common are giardiasis, tapeworm and ascariasis.

Giardiasisis caused by a protozoan called giardia lamblia, it lives in the duodenum and jejunum, infection occurs through the digestive tract - through contaminated food, water and dirty hands.

Giardiasis is found most often in developing countries, it is one of the infections that we can bring with us from distant travels, our country is also not free from this microorganism, the source of infection is human clusters.

The main protection against infection is hygiene and drinking boiled water.

Giardiasis may occur in the form of gastroenteritis (diarrhea, pain in the upper abdomen, weakness, anorexia), in a chronic form with malnutrition and repeated episodes of diarrhea, and asymptomatic.

Ascarisis a roundworm infectionhuman, the adult form of which lives in the small intestine. You can become infected by eating unwashed vegetables and fruit and by dirty hands. The course of the infection is usually asymptomatic, and if symptoms appear, it is a cough, shortness of breath and abdominal pain.

Tapiemczycais an infection of the small intestine that can occur as a result of eating raw, contaminated pork, beef or fish meat. Infection is usually asymptomatic, abdominal pain, nausea and weight loss are rare.

Diseases of the large intestine

The large intestine consists of the caecum with appendix, colon, sigmoid colon and rectum. It is responsible for the absorption of water, and the beneficial bacteria in it, among others, for the production of vitamins.

Acute appendicitis

It is caused by clogging, usually with fecal stones, and an overgrowth of bacteria in the appendix.

This causes a severe, sudden pain in the abdomen, usually around the navel, then moving to the lower right part of the bellybutton over the next few hours.

In addition, there is nausea and vomiting, a lack of appetite and a fever.

Diagnosis is made on the basis of symptoms, laboratory tests and ultrasound rarely predict the diagnosis as there are no specific tests for this condition.

The treatment is the surgical removal of the appendix, if the inflammation develops into an abscess, drainage is necessary, but in mild cases, antibiotic treatment can be performed.

Ulcerative colitis

Ulcerative colitis, like Crohn's disease, belongs to the so-called inflammatory bowel diseases, with the difference that it only affects the large intestine.

This disease causes inflammation and damage to the mucosa for unknown reasons.

Symptoms of ulcerative inflammation are mainly: diarrhea (up to a dozen bowel movements a day) with an admixture of blood, also weakness and weight loss, less often fever.

The course of the disease is many years with remissions and intensities. The diagnosis is made on the basis of imaging, laboratory and endoscopic examinations.

The treatment uses anti-inflammatory and immunosuppressive drugs, and in the event of complications or no improvement after conservative treatment - surgical procedures.

Colon diverticula

These are small protrusions on the outside of the intestinal wall, most often located in the sigmoid colon (the end of the large intestine). Their incidence increases with age, and it is believed to be frequentelderly people, estimates say that every third person over 60 has diverticula.

They typically do not cause any discomfort and are most often detected incidentally, but when symptoms do occur, they are usually of a minor intensity and include: abdominal pain, diarrhea alternating with constipation and flatulence.

Diverticula can also cause inflammation and abscess within the abdominal cavity, as well as lower gastrointestinal haemorrhage. These complications are serious conditions that require hospitalization and intensive treatment.

Microscopic Colitis

It is characterized by the absence of changes in imaging examinations and endoscopy, and the diagnosis is made on the basis of microscopic examination of the specimens. Symptoms of the disease include profuse, watery diarrhea, weight loss, abdominal pain and gas.

Sheep

This is the most common colon infection. The human pinworm lives in the large intestine, the female lays eggs on the skin near the anus, their swallowing causes infection.

It comes to it mainly due to the lack of proper hygiene - dirty hands, bed linen, towels, and, less often, contaminated food. Symptoms of pinworms include itching around the anus, especially at night, irritability and sometimes a lack of appetite.

Colon polyps

A polyp is a bulging of the intestinal wall inside, they have different causes and structure. The structure of a polyp may have an angioma, lipoma, neoplasm, they can also arise in the course of inflammation.

The most common cause of a polyp is the excessive multiplication of mucosal cells and, due to the lack of space for them, bulging into the intestinal lumen. There are several types of polyps:

  • non-cancerous (do not tend to turn into cancer): juvenile, inflammatory, or so-called Peutz-Jaghers polyps;
  • adenomatous - these are the most common polyps in adults, unfortunately they tend to become malignant and turn into cancer.

They are manifested by rectal bleeding, pressure on the stools and passing stools with mucus, but most of the symptoms are absent.

This is why colonoscopy screening is so important, it enables the detection and removal of asymptomatic polyps before they develop cancer.

Colorectal cancer

90% of colorectal cancer develops from adenomatous polyps and is most common in old age.

Symptoms depend on its location - if the cancer appears on the right side of the large intestine, it causes not very bothersome and often unnoticed symptoms - anemia and weak abdominal pain, left side locationcauses visible bleeding and irregular bowel movements - constipation alternating with diarrhea.

There are no typical symptoms for colorectal cancer, but a condition that is always worrying is passing blood in your stool, so see your doctor immediately.

The most important test to diagnose colon cancer or to exclude it is colonoscopy, its additional advantage is the fact that it allows you to take specimens and confirm the diagnosis after examining them.

Screening tests are primarily colonoscopy, but also sigmoidoscopy and faecal occult blood testing.

The frequency of these tests is determined by the doctor, based on the patient's age, family history of cancer and the results of previous tests.

It is believed that every he althy person should have a colonoscopy at least every 10 years from the age of 50, and more often if they have ever had polyps removed.

The basic method of treatment is surgery, chemotherapy and radiotherapy are also used depending on the stage of the tumor.

Bow. Maciej GrymuzaA graduate of the Faculty of Medicine at the Medical University of K. Marcinkowski in Poznań. He graduated from university with an over good result. Currently, he is a doctor in the field of cardiology and a doctoral student. He is particularly interested in invasive cardiology and implantable devices (stimulators).

Category:

Research