Small Bowel Diseases

The small bowel, or small intestine, consists of a flexible tube many feet long that starts at the stomach and ends in the colon. Its surface absorbs water and nutrients from food.

Schematic of the Small Bowel


The diseases of the small bowel for which surgery may be required include:

  • Tuberculosis
  • Obstruction (blockage)
  • Benign tumors
  • Carcinoid tumors
  • Malignant (cancerous) tumors
The symptoms of small bowel disease vary depending on the site and type of the pathology. They include

  • Cramping abdominal pain, often in the centre
  • Nausea & vomiting
  • Loss of appetite and weight loss
  • Rectal bleeding

Often the patients present with acute intestinal obstruction or blockage in the small bowel caused by adhesions or a narrowing (stricture) caused by tuberculosis.

Many of the symptoms of small bowel disease are also present in other, more common, diseases. This can make diagnosis of small bowel problems difficult.After a detailed history and physical examination tests to visualize the small bowel are usually required.

These tests may include:

Barium series or small bowel enema: In this tests the patient is either given liquid barium to drink or this is introduced into the small bowel in a controlled manner via a thin tube placed through the nose. Multiple x-rays are then obtained to follow the passage of the barium through the intestinal loops and identify the area of the problem.
CT scan: A CT scan is obtained after the patient drinks a liquid contrast material. This helps identify the location and nature of the small bowel pathology.

A small bowel tumor seen on a barium study
A small bowel stricture seen on a barium stud

Endoscopy: Endoscopy involves passing a long tube with a light and camera down the throat or through the anus (colonoscopy). The small bowel is so long that it is difficult to see all of it this way, but advances are being made that allow a better look at the small bowel. This includes “capsule endoscopy” in which a tiny camera is swallowed in a pill. It takes pictures of the small bowel as it passes through and radios them out to a computer where your doctor can look at them.

  • Less pain from the incisions after surgery
  • Shorter hospital stay
  • Shorter recovery time
  • Faster return to normal diet
  • Faster return to work or normal activity
  • Better cosmetic healing

https://medlineplus.gov/ency/article/002943.htm
http://www.healthline.com/health/small-bowel-resection
https://medlineplus.gov/smallintestinedisorders.html

Publications and abstracts

  1. Bhandarkar DS, Shah RS. Gallstone ileus. Gastrointest Endosc 2003; 57: 720.

Presentations, invited lectures & videos

  1. Punjani RM, Bhandarkar DS, Shah RS. Laparoscopy in management of disease of the small bowel. Annual Conference of Maharashtra Chapter of ASI, Nasik, 2002.
  2. Bhandarkar DS, Shah R, Sen G. Laparoscopically assisted enterolithotomy for gallstone ileus. 5th Annual Conference of IAGES, Kolkata, 2002.
  3. Bhandarkar DS, Shah R, Sen G. Laparoscopically assisted enterolithotomy for gallstone ileus. Annual Conference of Maharashtra Chapter of ASI, Nasik, 2002.
  4. Bhandarkar DS, Punjani RS, Shah RS. Laparoscopy in management small bowel disorders. Annual Scientific Sessions, College of Surgeons of Sri Lanka, Colombo, 2002.
  5. Bhandarkar DS. Laparoscopic surgery for small bowel disorders. Conference on Basic & Advanced Minimal Access Surgery, Indore, 2003.
  6. Bhandarkar DS. Minimal access surgery for small bowel disorders. IAGES 2008, Jaipur, 2008.

Download Small Bowel Diseases Brochure

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