Small Intestinal Inflammation: Causes and Treatment Options

Inflammation of the small intestine

Hello! My elder, approximately 85 years old, underwent surgery for small bowel obstruction four months ago (during which a hernia was also discovered).
They are now hospitalized due to abdominal distension and vomiting.
Upon examination, it was found that the small intestine is swollen to the size of the large intestine, suggesting possible adhesions.
After receiving antibiotics for about 10 days, they are now able to pass stool, but the abdominal distension and lower abdominal pain have not resolved (they are only able to consume a small amount of thin rice porridge).
Further examinations revealed no obstruction in the small or large intestine, and the doctor mentioned that he is unsure of the cause.
Could this possibly be due to pathology in other organs? Additionally, which hospital in the northern region would be best for treatment? They have rarely been ill before, only having gallstones (which they have avoided treating due to their age), and the doctor has now indicated that their kidney function is poor.
Thank you.

Popo, 50~59 year old female. Ask Date: 2007/05/23

Dr. Liu Nanshan reply Gastroenterology and Hepatology

Hernias can be a cause of small bowel obstruction.
Postoperative adhesions are a common complication after abdominal surgery, varying in severity, with severe cases requiring reoperation.
Patients may experience recurrent abdominal cramping, causing significant distress.
Examination of the colon and small intestine has ruled out obstruction and other causes of blockage.
Overall, this can largely be attributed to postoperative adhesions.
If further reassurance is needed, more invasive procedures, such as a colonoscopy to assess for inflammatory responses in the terminal ileum, can be considered, but the physical condition and risks for an 85-year-old patient must be taken into account.

Reply Date: 2007/05/23

More Info

Understanding small intestinal inflammation, especially in elderly patients, requires a comprehensive approach that considers the patient's medical history, current symptoms, and potential underlying conditions. In your case, your elderly relative has undergone surgery for small bowel obstruction and hernia repair, and is now experiencing abdominal distension and vomiting, which are concerning symptoms that warrant further investigation.

Small intestinal inflammation can arise from various causes, including infections, inflammatory bowel diseases (IBD) such as Crohn's disease, ischemia (reduced blood flow), or complications from previous surgeries, such as adhesions or strictures. Given your relative's recent surgical history, it is plausible that adhesions (bands of scar tissue) could be contributing to her symptoms. Adhesions can form after abdominal surgery and may cause bowel obstruction or lead to abnormal bowel motility, resulting in symptoms like bloating and pain.

The fact that your relative has been treated with antibiotics suggests that the healthcare team is considering the possibility of an infectious process, which could include bacterial overgrowth or an infection related to the surgical site. However, the persistence of abdominal distension and pain, despite antibiotic treatment, indicates that there may be other factors at play.

In elderly patients, it is also essential to consider the impact of comorbidities, such as kidney dysfunction, which you mentioned. Kidney issues can lead to fluid retention and contribute to abdominal distension. Additionally, the age of the patient can complicate the clinical picture, as older adults may present atypically and have a higher risk of complications from gastrointestinal disorders.

Given the complexity of your relative's condition, it is crucial to work closely with a gastroenterologist who can perform a thorough evaluation. This may include imaging studies such as a CT scan or MRI to assess for any structural abnormalities, as well as endoscopic procedures if necessary. These tests can help identify any strictures, obstructions, or other abnormalities in the gastrointestinal tract.

In terms of treatment options, management will depend on the underlying cause of the inflammation and symptoms. If adhesions are confirmed, surgical intervention may be required to relieve the obstruction. If an inflammatory condition is diagnosed, medications such as corticosteroids or immunosuppressants may be indicated. Nutritional support is also vital, especially if the patient is unable to tolerate regular food intake. A dietitian can help design an appropriate diet that meets the patient's needs while minimizing discomfort.

As for where to seek treatment in Northern Taiwan, it would be advisable to consult a reputable medical center with a strong gastroenterology department. Hospitals affiliated with universities often have the resources and specialists needed to manage complex cases. You may consider institutions like National Taiwan University Hospital or Taipei Veterans General Hospital, both of which are known for their comprehensive care and specialized services.

In summary, your relative's symptoms warrant a thorough investigation to determine the underlying cause of her small intestinal inflammation. Collaboration with a gastroenterologist and possibly a surgical team will be essential in providing the best care. Additionally, addressing her nutritional needs and managing any comorbid conditions will be crucial in her recovery.

Similar Q&A

Understanding Small Intestinal Inflammation: Causes, Diagnosis, and Treatment Options

Hello Doctor: I have been experiencing intermittent lower abdominal pain since November of last year. I underwent a stool test, blood tests, and an abdominal CT scan on August 8th. The results indicated edema and inflammation in a portion of the small intestine, while other organ...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Necessary to consider small bowel imaging/small bowel endoscopy/small bowel capsule endoscopy. CT scans are primarily used to evaluate larger tumors or extraluminal diseases.

Understanding Crohn's Disease: Symptoms, Diagnosis, and Treatment Options

Hello doctor, I recently experienced discomfort in my lower right abdomen, often feeling air trapped in my abdomen. I underwent a colonoscopy and found that area to be inflamed and swollen. I've been experiencing diarrhea for a whole year, often needing to go right after eat...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Crohn's disease is a chronic, transmural inflammatory condition that can affect any part of the gastrointestinal tract from the mouth to the anus. Approximately half of the patients will have rectal involvement, and it is often associated with various extraintestinal ...

Understanding Rectal Issues: Symptoms, Diagnosis, and Treatment Options

Hello Doctor: In April of this year, I started consuming a lot of spicy foods and sitting for long periods, which led to sudden difficulties with bowel movements. I experienced frequent urges to defecate, but each time the stool volume was very small or nonexistent. Sometimes, th...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello Mr. Zhang, if your colon examination was normal, it is possible that you may have Irritable Bowel Syndrome (IBS) given your age. You can improve your lifestyle by reducing the intake of irritants and spicy foods, increasing your consumption of fruits and vegetables, drinkin...

Understanding Red Mucus: Gastrointestinal Inflammation and Recovery

Hello doctor, previously I underwent a colonoscopy, and the doctor mentioned that my intestines were inflamed. He said it was just a mild inflammation and that taking antibiotics would help. The doctor also noted that there seemed to be slight bleeding, but since I experienced so...

Dr. You Ligang reply Gastroenterology and Hepatology
Hello, if the enteritis does not improve, a stool test can be conducted to check for the presence of white blood cells or pus. Inflammation of the intestines can heal on its own. Wishing you good health. Sincerely, Dr. Liu Li-Kuang, Taoyuan Hospital, Department of Health.