Healthy Small Intestine

The small intestine is an often neglected organ despite its average size (16 feet long). The surface area of the small intestine mucosa could cover a tennis court if stretched out. The small intestine has three parts: duodenum, jejunum, ileum. Why is it neglected? Because it never really has too many problems. If there were common diseases associated with it we would talk about it more. For example, it is very rare to develop cancer of the small intestine. It is much more common to develop oral, esophageal, stomach, colon, or rectal cancer. So how do you keep a healthy small intestine? Is there much you need to do?

In reality, there is not much that needs to be done to maintain a healthy small intestine. However, you need to pay attention to this organ and catch the signs that something may be wrong. The small intestine performs the important role of absorbing your nutrients once they have been digested. You need to maintain a healthy mucosa to perform this role.

What can cause the mucosa to be unhealthy?

Helicobacter pylori is a bacteria that causes 90% of the ulcers in the duodenum. Duodenal ulcers can be life-threatening as they can bleed profusely and even perforate. This organism was discovered a little over 10 years ago and was found to cause a significant number of ulcers primarily in the duodenum. Duodenal ulcers cause epigastric pain that radiates to the back. A bleeding ulcer can cause you to have black tarry stools. This ulcer can be caught through a upper GI series (barium swallow), esophagealgastroduodenoscopy (EGD), or a blood test for the bacteria. The treatment is a long course of antibiotics to eradicated the organism.

Celiac disease (celiac sprue) is an autoimmune disorder where the body reacts to the wheat protein gluten. This reaction results in inflammation and the loss of healthy intestinal mucosa. The loss of intestinal mucosa leads to poor absorption of nutrients. The symptoms may include diarrhea, weight loss, poor growth (in children), fatigue, abdominal pain, bloating, irritable bowel syndrome, aphthous ulcers (canker sores), or no symptoms at all. This disorder is becoming more and more common. The diagnosis can be made by a blood test, biopsy, or by elimination diet. Elimination diet is where you cut out all gluten. If your symptoms improve then it is a good possibility that you have the disorder.

Lactose intolerance can be caused by a genetic deficiency of the enzyme (lactase) needed to digest lactose. It can also be caused by damage of the cells that produce the enzyme such as celiac disease. Very rare that it is caused by a true allergy to lactose. It is estimated that 75% of adults have some form of lactose intolerance. It varies by your genetics (5% of northern europeans to 90% of some asians and africans).

Green indicates a low percentage. Red indicates a high percentage. There is a test for this diagnosis but again an elimination diet where you cut out all lactose may be all you need. You don't have to go overboard to do this. There is milk with the enzyme added (lactaid), yogurt has bacterial enzymes that helps digest lactose, cheeses have very little lactose (the harder the cheese the less the lactose).

Dairy product	Lactose Content
Yogurt, plain, low-fat, 240 mL	5 g
Milk, reduced fat, 240 mL	11 g
Swiss cheese, 28 g	1 g
Ice cream, 120 mL	6 g
Cottage cheese, 120 mL	2–3 g

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Small Bowel Obstruction is usually caused by another problem. It can be caused by the bowels twisting on themselves, by scar tissue from prior surgeries, by masses, or severe infections. People with SBO often present with intractable nausea and vomiting. The treatment is to avoid eating until it either resolves on its own or the problem is repaired.

The key with all of these problems is to listen to your body and to catch the problem early before it becomes a severe problem. Do not ignore nagging symptoms. The second hint is to find a doctor that is willing to listen and work with you as many of these symptoms can be vague and the diagnosis can be difficult. Physicians, like patients, get frustrated when they cannot put a diagnosis to a symptoms. Sometimes the best course is to experiment with an elimination diet to see if it helps before you even go to the doctor. Just don't go overboard and eliminate all nutrition.

Remember don't neglect those "small" bowels and keep em' healthy.