Intestinal Diseases, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
()
About this ebook
This book describes Intestinal Diseases, Diagnosis and Treatment and Related Diseases
The intestines consist of:
1.Small intestine - 30 feet, help in digestion of food
2.Large intestine - 6 feet, absorbs nutrients from digested food and fluid involved in digestion
Functions of small intestines:
1. Bile salts-500cc from liver.
They are stored in the gallbladder and passed on to the duodenum
Bile salts neutralize the acid and make fatty acid more soluble.
Bile salts from the liver emulsify fats.
It aids full use of proteins and carbohydrates, stimulates the activity of small intestine, convey waste material for excretion.
Cholesterol is also produced from liver and gallbladder.
2. Pancreatic juices have many enzymes digestion of fats, protein and carbohydrates.
3. Intestinal juice from gland in mucosa – water, salt enzyme and activator of enzymes which transforms protein to amino acid and decompose nucleic acid.
Actions:
Neutralization:
Bicarbonate ions from the pancreas and bile from the liver counteract stomach acid to form a pH environment that is appropriate for pancreatic and intestinal enzymes.
Digestion:
Enzymes from the pancreas and the small intestine lining finish the breakdown of food molecules.
Absorption:
The circular folds, villi, and microvilli raise surface area.
Most nutrients are actively or passively absorbed.
Most of the consumed water or the water in digestive tract secretions is absorbed in the intestines.
Mixing and propulsion:
Segmental contractions combine the chyme, and peristaltic contractions transport the chyme into the large intestine.
Excretion:
Bile from the liver contains bilirubin, cholesterol, fats, and fat-soluble hormones.
Protection:
Mucus supplies lubrication, stops the digestion of the intestinal wall and defends the small intestine from stomach acid.
Peyer’s patches defend against microorganisms.
Functions of Large Intestines
1. It serves as a reservoir for the intestinal contents (cecum, ascending colon, rectum).
2. It absorbs water and electrolytes, so the 500–1500 mL of chyme that reaches the large intestine can be reduced to about 100–200 mL.
The large intestine is not an essential organ.
Large segments of the intestine can be excised e.g., for treatment of cancer.
Actions:
Absorption:
The proximal 50% of the colon absorbs salts (e.g., sodium chloride), water, and the vitamins (e.g. Vitamin K) synthesized by bacteria.
Storage:
The distal half of the colon retains feces until it is removed.
Mixing and propulsion:
Slight segmental mixing happens.
Mass movements pushes feces toward the anus and defecation removes the feces.
Protection:
Mucus supplies lubrication; mucus and bicarbonate ions defend against acids produced by bacteria.
Diseases of Intestines:
Most diseases involved the large intestines than small intestines:
1, Intestinal motility disorder (both small and large intestines)
2. Inflammatory Bowel Disorders such as Crohn disease (small intestine) and ulcerative colitis (large intestine)
3. Irritable Bowel syndrome (large intestine)
4. Colorectal polyps, tumor and cancers (large intestine)
5. Diverticular disease of colon (large intestine)
6. Intussusception and volvulus (both small and large intestines)
7. Intestinal infections (both small and large intestines)
8. Intestinal obstruction (both small and large intestines)
9. Intestinal hernias (both small and large intestines)
TABLE OF CONTENT
Introduction
Chapter 1 Intestinal Diseases
Chapter 2 Intestinal Motility Disorder
Chapter 3 Intussusception
Chapter 4 Crohn’s Disease
Chapter 5 Volvulus
Chapter 6 Diverticular Disease
Chapter 7 Irritable Bowel Syndrome
Chapter 8 Colorectal Cancer
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Intestinal Diseases, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Intestinal Diseases,
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2019 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes Intestinal Diseases, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.
(What You Need to Treat Intestinal Diseases)
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog: http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Disorders
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 800 eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical disorders.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
The Intestines
Small Intestine
The Small Intestine is a coiled tube 22.5 feet in length extending from pylorus to the large intestine.
It is enclosed in the central and lower part of the abdominal cavity.
It is surrounded above and at the sides by the large intestine.
Part of it spreads below the superior aperture of the pelvis and remains in front of the rectum.
It is attached in front with the greater omentum and is joined to the vertebral column by a fold of peritoneum, the mesentery.
The main parts of the Small Intestine are:
1. Duodenum
It is termed duodenum from being about equal in length to the breadth of twelve fingers (10 inches).
It is the shortest, the widest, and the most fixed part of the small intestine, and has no mesentery being only partially enveloped by peritoneum.
It starts at the pylorus it passes backward, upward, and to the right, beneath the quadrate lobe of the liver to the neck of the gall-bladder.
It then makes a sharp curve and descends along the right margin of the head of the pancreas.
It now makes a second bend and passes from right to left.
As it joins with the jejunum it turns abruptly forward forming the duodendo-jejunal flexure.
2. Jejunum
This is the middle part of the small Intestine and spreads from the duodenum to ileum.
It is about 9.5 feet long
The Jejunum has a wider diameter of about 4 cm.
It is thicker, more vascular, and of a deeper color than the ileum.
The circular folds of its mucous membrane are large and thickly set.
Its villi are bigger than in the ileum.
The aggregated lymph nodules are almost absent in the upper part of the jejunum, and in the lower part are less often found than in the ileum.
By grasping the jejunum between the finger and thumb the circular folds can be palpated through the walls of the gut.
3. Ileum
This is about 12.5 feet long.
It start from the end of jejunum to the large intestine..
At the end of ileum, it enters into the cecum of the large intestine.
The Ileum is narrow with a diameter of 3.75 cm and its coats thinner and less vascular than those of the jejunum.
It forms few circular folds, and they are small and disappear entirely toward its lower end, but aggregated lymph nodules (Peyer’s patches) are larger and more numerous
The jejunum for the most part stays within the umbilical and left iliac regions, while the ileum stays within chiefly the umbilical, hypogastric, right iliac, and pelvic regions.
The terminal part of the ileum normally remains in the pelvis, from which it ascends over the right Psoas and right iliac vessels.
It ends in the right iliac fossa by opening into the medial side of the commencement of the large intestine.
4. Ileocecal valve
This portion is the end of the ileum and consists of:
a. Ileal orifice
b. Valve which allow flow of food into the cecum
5. Ileal orifice
This is the opening of the ileum into the cecum of the large intestine
The circular folds stop the passage of the food along the intestines, and provide a greater surface for absorption.
The surfaces of the valve directed toward the ileum are enclosed with villi, and manifest the typical structure of the mucous membrane of the small intestine.
Those surfaces turned toward the large intestine are destitute of villi and marked with the orifices of the numerous tubular glands peculiar to the mucous membrane of the large intestine.
Intestinal motility is autonomously regulated by the enteric nervous system but is affected by hormones and external innervation
There are 4 forms of small