Small Intestinal Disorders

The small intestine is the least accessible portion of the intestinal tract and is fortunately not often the site of major problems.

Several conditions need further elaboration:

1. Small intestinal bacterial overgrowth, where colonic bacteria migrate into the small bowel. Symptoms include abdominal pain or discomfort, bloating and diarrhoea. It may be confused with Irritable Bowel syndrome and other conditions. The diagnosis is confirmed by doing a Hydrogen Breath Test, and treatment is with cyclical antibiotics.

2. Coeliac disease, a condition where the small intestinal lining is damaged by gluten, found in wheat, oats etc. The diagnosis rests on abnormal blood tests and is confirmed by doing a gastroscopy and small bowel biopsy.

3. Crohn’s disease-discussed elsewhere 

4. Lactose intolerance. This condition occurs when the enzyme lactase is deficient, resulting in the inability to absorb lactose or milk sugar. The symptoms occur following lactose ingestion. Symptoms include bloating, crampy abdominal pain and diarrhoea.

5. Small bowel vascular abnormalities. The small intestine may be the source of intestinal blood loss in patients with abnormal blood vessels. This condition is diagnosed with small bowel video capsule endoscopy. The abnormal vessels can be treated with electro-cautery

6. Small bowel polyps and cancer. These abnormalities are much less frequent than polyps and cancer in the colon. Small bowel video capsule endoscopy is the investigation of choice.