Introduction
The small intestine with its 5-6 meters length connects the stomach with the large intestine. The small intestine is divided into 3 parts. At the beginning, directly following the stomach gate, there is the approximately 30 cm long duodenum (=doudenum), whose main task is the neutralization of the gastric hydrochloric acid as well as the decomposition of the food components with the help of the secretion of the pancreas and the bile.
This is followed by the jejunum and the ileum, whose main function is the absorption of food components into the body. In addition, 80% of the water is already removed from the food here. The remaining 20% are absorbed in the large intestine, which is located next to the small intestine.
Inflammations in the small intestine can occur in the area of the duodenum due to circulatory disorders, mucous membrane damaging drugs, autoimmune diseases or colonization with Helicobacter pylori. For an inflammation in the other sections of the small intestine there are several other important causes leading to a permanent inflammation of the small intestine. For example, coeliac disease, also known as sprue, is an intolerance of the cereal protein gluten and can be the cause of a permanent inflammation.
Here the immune system reacts to gluten, a very common cereal protein, and fights the cells of the intestinal mucosa that have direct contact with gluten. The cells react to this attack of the immune system with an inflammation. Gradually, the cells can no longer withstand the immune system and the intestinal mucosa becomes increasingly thinner (= atrophy) due to progressive cell death.
Also worth mentioning is Crohn’s disease, a chronic inflammatory bowel disease that leads to intermittent chronic inflammation of the bowel mucosa. In principle, this inflammation can occur in any part of the intestine, but often affects the small intestine. Like coeliac disease, the inflammation develops as an autoimmune disease, which means that the body no longer recognizes the intestinal mucosa as belonging to itself and fights it through the immune system, which manifests itself as an inflammation, as in coeliac disease.
In Crohn’s disease, not the entire mucosa is evenly affected and only changing parts of the intestinal mucosa show signs of inflammation. This results in a patchy picture in the intestine of inflamed and non-inflamed intestinal parts. The first signs of this disease often appear between the ages of 20 and 40.
An acute (i.e. sudden and limited time) inflammation usually occurs in the context of an infection with viruses, bacteria or other undesirable pathogens that trigger a typical “intestinal flu“. The germs nestle in the intestinal mucosa and lead to inflammation there after varying lengths of time. In medicine, this infection is then called enteritis.
Among the viruses, rotaviruses, adenoviruses or noroviruses are the best known representatives. Several of these pathogens, such as the norovirus, fall under the so-called legal obligation to notify and must be reported to the local health authority if detected. Other rare causes are an inflammation in the course of radiation treatment of a tumor disease or the inflammation caused by a reduced blood flow in the small intestine.
The symptoms of inflammation of the small intestine vary depending on the cause. Enteritis, i.e. inflammation caused by infection with bacteria, viruses or other pathogens, is often accompanied by diarrhea and abdominal pain, accompanied by nausea and vomiting. When listening to the stomach, an increased movement of the intestine (=peristalsis) can be perceived as “gurgling”.
Possibly, fever may be added, which then rather suggests a bacterial cause of the enteritis. Crohn’s disease, the permanent or intermittent inflammation of the mucous membrane of the small intestine, typically manifests itself during an episode with pain in the lower right part of the abdomen similar to an appendicitis, mild diarrhea and loss of appetite. Celiac disease, also characterized by inflammation of the small intestinal mucosa, manifests itself in childhood after the intake of gluten-containing foods.
The affected person can no longer absorb the nutrients in the food due to the destruction of the cells and symptoms such as weight loss, tiredness, failure to thrive but also unspecific symptoms such as abdominal pain, nausea, vomiting and loss of appetite occur. The visit to the doctor is often due to the increasing weight loss of the children. The symptoms increase due to the increasing and progressive destruction of the intestinal mucosa cells in the course of the disease, if the person affected does not switch to a gluten-free diet.
Enteritis usually ends by itself within a few days to a maximum of 2 weeks. A drug therapy is not necessary in most cases.Since the most common inflammations are caused by viruses, antibiotics are rarely necessary and should only be used if the bacterial cause is proven. The most important representatives of the antibiotics used are metronidazole, ciprofloxacin or trimetoprim in combination with sulfmethoxazole.
All these preparations are excellently suited for a wide variety of germs in the intestine, so that an exact determination of the bacterium is not always necessary. In all cases it is important to compensate for the loss of fluid due to diarrhoea as well as the loss of important salts in the body. This loss can lead to total dehydration of the body and in extreme cases can be life-threatening.
Especially babies and elderly people are threatened by dehydration quite quickly and for this group enteritis often ends with a hospital stay to compensate the loss of fluid and salt by direct fluid administration into the vascular system of the body. If the diarrhea persists or if it is to be stopped compulsorily on certain occasions, the drug loperamide can be used in exceptional cases, which can stop the diarrhea by stopping the intestinal movements. Celiac disease can only be controlled by a gluten-free diet, but not cured.
Gluten-free grains are corn, rice or millet. Prohibited are wheat, barley, rye, green spelt and spelt. Crohn’s disease, as an autoimmune cause of inflammation, cannot be cured, just like celiac disease, and accompanies those affected throughout their lives.
With optimal treatment, however, the affected person can live almost normally. The therapy consists on the one hand of cortisone as well as other medications that downregulate the immune system so that it does not fight against the body’s own structures. Additional antibiotics can be used during acute attacks. Important natural remedies for inflammations of the small intestine are garlic, basil, savory, ginger, mint, clove, cinnamon, lemon, juniper, propolis, Swedish herbs, thyme or even lavender.
