Acute Enteritis

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Acute Enteritis

In medicine, enteritis refers to inflammation of the

small intestine. It is most commonly caused by the

ingestion of substances contaminated with pathogenic

microorganisms.[1] Symptoms include abdominal

pain, cramping, diarrhea, dehydration and fever.[1]

See also inflammation of related organs of the

gastrointestinal system: gastritis (stomach),

gastroenteritis (stomach and small intestine), colitis

(large intestine), and enterocolitis (large and small

intestine).

Description
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Enteritis is an inflammation of the intestine; the term

applies chiefly to the small intestine. In the context of

cancer, enteritis is a functional disorder of the large

and small bowel that occurs as a result ofradiationtherapy applied to the abdomen, pelvis, or rectum. It

occurs at the onset of radiation therapy (acute

radiation enteritis) and may also reappear after

completion of the radiation treatment (chronic

enteritis).

Enteritis also occurs in connection with such

disorders as Crohn's disease and infection by such

pathogens asHelicobacter pylori. Patients who receive

hemodialysis for kidney disorders as well as cancer

patients have an increased risk of enteritis.

Causes

Radiation enteritis occurs because the large and smallintestines are sensitive to all forms ofionizing

radiation. Some areas of the gastrointestinal tract are

more sensitive to radiation than others; the colon is

more sensitive to the effects of radiation than the

small intestine, for example. Although the probability

oftumor control increases with the radiation therapy

dose, so does the probability of damage to normalhealthy tissues. Since the doses required to destroy

many tumors are very high, acute side effects to the

intestines also occur, chief among which is enteritis.

Thus, the majority of patients undergoing radiation

to the abdomen, pelvis, or rectum will show signs of

acute enteritis.
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Symptoms of the disorder are observed during the

first course of radiation treatment and take about

eight weeks to become acute. Chronic radiation

enteritis may also occur months to years after apatient has undergone a course of radiation therapy.

The symptoms include colicky abdominal pain,

bloody diarrhea, tenesmus, weight loss, nausea and

vomiting, bowel obstruction and rectal bleeding,

sometimes very severe.

Several factors influencing the occurrence and extent

of radiation enteritis have been identified. They

include the dose of radiation given to the patient, the

size of the tumor being treated, the concomitant

prescription ofchemotherapy and the general state of

the patient's health. For example, enteritis will be

more severe in patients with a history of

hypertension, diabetes or inadequate nutrition.
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Acute Radiation Enteritis

Acute Radiation Enteritis

Diagnosis

Radiation therapy mainly affects rapidly dividing cells such

as the cells lining the large and small bowel. An increasing

number of cells die, leading to other problems over the next

few days and weeks. Patients with acute enteritis may

complain of nausea, vomiting, abdominal cramping, the

frequent urge to have a bowel movement, and watery

diarrhea. With diarrhea, the gastrointestinal tract does not

function as efficiently, and fat, lactose, bile salts, and


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vitamin B12 are not well absorbed. Symptoms of an inflamed

rectumincluding a mucus-like discharge, rectal pain, and

rectal bleedingmay result from radiation damage to the

anus or rectum.

Symptoms of acute enteritis usually get better 2 to 3 weeks

after treatment ends.

Doctors can often diagnose radiation enteritis from a

medical history and physical examination. In some cases,

doctors may want to visually examine the bowels with

endoscopy or take a sample of fluid from the small intestine

to look for an overgrowth of bacteria in the bowel. Controlof bacterial overgrowth with medicine may help reduce

diarrhea. Tests results generally are available to the

physician in Mayo's state-of-the-art electronic medical

record within hours of testing.

Symptoms of radiation enteritis can include:

Diarrhea

Weight loss

Nausea

Flatulence


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Assessment

Patients should be examined and asked questions about the

following:

Usual pattern of bowel movements.

Pattern of diarrhea, including when it started;

how long it has lasted; frequency, amount, and type of

stools; and other symptoms (such as gas, cramping,

bloating, urgency, bleeding, and rectal soreness).

Nutrition of the patient, including height and

weight, usual eating habits, any change in eating

habits, amount of fiber in the diet, and signs ofdehydration (such as poor skin tone, increased

weakness, or fatigue).

Current level of stress, coping ability, and

changes in lifestyle caused by the enteritis.

Treatment

Treatment of acute enteritis includes treating the diarrhea,loss of fluids, poor absorption, and stomach or rectal pain.


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These symptoms usually get better with medications,

changes in diet, and rest. If symptoms become worse even

with this treatment, then cancer treatment may have to be

stopped, at least temporarily.

Medication may be prescribed, including antidiarrheals to

stop diarrhea, opioids to relieve pain, and steroid foams to

relieve rectal inflammation and irritation. If patients with

pancreatic cancer have diarrhea during radiation therapy,

they may need pancreatic enzyme replacement, because not

having enough of these enzymes can cause diarrhea.

Acute colitis


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Definition:

Colitis Overview

Colitis is the term used to described inflammation of the

colon There are a variety of causes of colitis including

infections, poor blood supply, and autoimmune reactions.

The colon (large bowel or large intestine) is responsible for

collecting and storing the waste products of digestion. It is a

long muscular tube that pushes undigested food towards the

anus for eventual elimination as a bowel movement. As the

liquid mixture of undigested food makes its journey, it mixeswith mucus and normal bacteria residing in the colon. As

well, water is reabsorbed into the bloodstream, and the feces

start to solidify.

Diagnosis:

Diagnosis of colitis and its causes always begins with the

taking of the patient's history. The information the patientprovides helps the physician guide the direction for

diagnosis and treatment.

In patients with abdominal pain and diarrhea, it

is important to find out when the symptoms began,

how long they have lasted, whether they come and go,

and what makes them better or worse. Questions may

be asked about travel because infections may arise

while traveling, particularly in undeveloped countries.Patients often ask if the cause of symptoms is food

poisoning, but that is often a difficult question to

answer immediately.

If the patient has blood with bowel movements

(which in general, is not normal) further questions may

be explored to screen for colon cancer or polyps.
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Food poisoning not due to bacterial infections

usually does not cause blood in the stool. Evaluation of

the body's other systems (cardiovascular, neurological,

etc.) may be necessary.

Other examinations:

2-physical examination

3-blood tests

4-imaging.

parasitic enteritis

Introduction:

There are two main types of intestinal parasites: helminths

and protozoa. Helminths are worms with many cells, and

are generally visible to the naked eye in their adult stages.

Tapeworms, pinworms, and roundworms are among the

most common helminths in the United States. In their adult

form, helminths cannot multiply in the human body.

Protozoa have only one cell, and can multiply inside the
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human body, which contributes to their survival and enables

serious infections to develop. Transmission typically occurs

by fecal-oral route (for example, through contaminated food

or water). In the U.S., the most common protozoa are

giardia and cryptosporidium.

Signs and Symptoms of parasiticenteritis:

Parasites can live within the intestines for years without

causing any symptoms. When they do, symptoms include the

following:

Abdominal pain

Diarrhea

Nausea or vomiting

Gas or bloating

Dysentery (loose stools containing blood and mucus)

Rash or itching around the rectum or vulva

Stomach pain or tenderness

Feeling tired Weight loss

Passing a worm in Mucus in the bowel movement

Diagnosis :

Diagnosis can be often suspected from history of prolongedbloating or diarrhea and can be confirmed by the following

tests:

Ova and parasites (O&P) test of the stool. The

test is often false negative so three stools from three

different days (at least two days apart) should be

tested.

Hemoccult test may reveal blood in the stool


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Blood tests often reveal elevated eosinophilsand

IgE antibodies and lowered ferritin, hemoglobin or red

cells

CT or biopsy are needed to find cysts in the liver,

lungs or brain

Necrotic Enteritis

Introduction

An acute or chronic enterotoxemia seen in chickens, turkeys

and ducks worldwide, caused by Clostridium perfringens and

characterised by a fibrino-necrotic enteritis, usually of the

mid- small intestine. Mortality may be 5-50%, usually

around 10%. Infection occurs by faecal-oral transmission.

Spores of the causative organism are highly resistant.

Predisposing factors include coccidiosis/coccidiasis, diet

(high

protein), in

ducks

Figure 25. Severe lesions of necrotic enteritis affecting

the small intestine of broilers. The sample at the bottom

of the picture is still focal, the upper has formed a thick

crust of necrotic material.
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possibly heavy strains, high viscosity diets (often associated

with high rye and wheat inclusions in the diet),

contaminated feed and/or water, other debilitating diseases.

Signs

Depression.

Ruffled feathers.

Inappetance.

Closed eyes.

Immobility.

Dark coloured diarrhoea.

Sudden death in good condition (ducks).

Diagnosis

A presumptive diagnosis may be made based on flock

history and gross lesions Confirmation is on the observation

of abundant rods in smears from affected tissues and a good

response to specific medication, usually in less than 48

hours.

Documents

Acute Enteritis