Crohn's disease of the small intestine( small intestine)

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This chronic pathology of the digestive tract, like Crohn's disease, can affect any department located in the digestive tract, but most often develops in the terminal part of the small intestine. Characterize it usually the following symptoms:

  • Inflammation of the mucosa, which has a chronic stage;
  • Strong stenosis of the affected parts of the digestive organ;
  • Formation of fistula( pathological canals that arise between internal organs and its walls);
  • Numerous manifestations not related to the digestive tract.

There is no exact cause of the development of Crohn's disease to this day, there are only a few theories of its origin in the stomach, large or small intestine. The most widespread ones are those that are based on bacterial or immunological factors.

This pathology of the digestive organs is completely unaffected, and has only a slight genetic predisposition. In order to more accurately diagnose Crohn's disease, which is localized in the small intestine, usually use a colonoscopy, as well as its X-ray study. In addition, in order to more accurately diagnose this inflammatory pathology of the digestive organs, differential diagnosis with a large number of chronic diarrhea, both infectious and non-infectious, is necessary.

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Pathological anatomy of Crohn's disease of the small intestine

When Crohn's disease affects the small intestine, and this happens in 2/3 of all diagnosed cases, it is characterized by a segmental lesion of the digestive organ, which has a very clear boundary with adjacent healthy segments:

  • Before the beginning of the affected area, its wall has a significant thickening, due to which the internal lumen strongly narrows;
  • The mucosa of the small intestine is affected by numerous lateral cracks and slit-like ulcers. Appearance in her with Crohn's disease becomes like a "cobblestone pavement";
  • There are cases when in this type of pathology perforation of ulcers occurs, and in their place intraperitoneal fistulas are formed, which can easily communicate with surrounding organs and skin, as well as abscesses.

Microscopic view of the walls of the small intestine in Crohn's disease is an inflammatory infiltrate, located in their entire thickness and consisting of eosinophils, plasma and lymphocytes. In them, from the epithelioid or giant multinucleate cells, specific granulomas are formed, in which there is not yet a curdled necrosis.

As a result of the chronic inflammatory process accompanying Crohn's disease, a large amount of scar tissue develops on the walls of the small intestine, which contributes to the development of stenosis( constriction) of the internal lumen. Also, this disease is characterized by pathological lesions of the lymph nodes and the development of lymphomacrofagal hyperplasia and epithelioid granulomas in them.

How to treat Crohn's disease of the small intestine?

Since the moment the patient is diagnosed with this pathology, the specialist selects the optimal method of initial treatment, which is almost always conservative. At present, there is no universal remedy for Crohn's disease localized in the small intestine.

But the existing method of drug therapy, based on the use of several drugs, aims at earlier treatment of this inflammatory pathology and relief for the patient of all its severe manifestations. The most effective medications for all specialists are corticosteroids, as well as various modern drugs with anti-inflammatory effect.

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