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SILS Small Bowel Resection

Your small intestine, around 20 feet long, connects the stomach to the large intestine, folds to fit in your abdomen, and is responsible for most food digestion, comprising the duodenum, ileum, and jejunum.

What is the Small Bowel?
Small Bowel Resection.webp

Amyloidosis

Celiac disease

Ddysmotility

Infections

IBD

Intestinal Lymphangiectasia

Intestinal lymphoma

Lactose intolerance

Small bowel obstruction

Tropical Sprue​

Tumors of the small intestine 

Whipple's disease

Signs & Symptoms

Amyloidosis

Blood tests and urine tests can be used to look for abnormal proteins that could indicate amyloidosis. 

Celiac Disease

To diagnose celiac disease, begin with blood tests for gluten autoantibodies (IgA, while on gluten diet) and a small bowel biopsy. These tests are essential before considering a gluten-free diet, and consult your healthcare provider for guidance.

Dysmotility

  • Blood Tests 

  • X-ray Studies 

  • Motility/Transit Studies 

  • Biopsies

Infections

  • Blood tests may be ordered looking for different causes of anemia, electrolyte imbalance, and vitamin deficiencies.

  • Breath tests may be considered to measure the byproducts of digestion

  • Upper GI endoscopy allows a gastroenterologist to look at the inside of the upper part of the small intestine and take biopsies or small bits of tissue that can be examined under the microscope. 

IBD

  • Tests for anemia or infection 

  • Fecal occult blood test

  • Colonoscopy 

  • Flexible sigmoidoscopy

  • Upper endoscopy 

  • Capsule endoscopy

  • Double-balloon endoscopy 

  • X-ray

  • Computerized tomography (CT) scan. 

  • Magnetic resonance imaging (MRI)

  • Small bowel imaging.

Intestinal Lymphangiectasia

  • Biopsy

  • Sometimes contrast lymphangiography

  • Other blood tests are done to look for complications of the disorder. People may have low levels of protein, cholesterol, and white blood cells in the blood. The low protein levels result in tissue swelling.

Intestinal lymphoma

  • The diagnosis is typically made by biopsy at the time of endoscopy. Several endoscopic findings have been reported, including solitary ulcers, thickened gastric folds, mass lesions and nodules. As there may be infiltration of the submucosa, larger biopsy forceps, endoscopic ultrasound guided biopsy, endoscopic submucosal resection, or laparotomy may be required to obtain tissue.

  • Imaging investigations including CT scans or endoscopic ultrasound are useful to stage disease. Hematological parameters are usually checked to assist with staging and to exclude concomitant leukemia. An elevated LDH level may be suggestive of lymphoma.

Lactose intolerance

  • Lactose tolerance test

  • Hydrogen breath test. 

  • Stool acidity test. For infants and children who can't undergo other tests, a stool acidity test may be used.

Small Bowel Obstruction

  • Blood tests

  • X-rays of the abdomen

  • CT scanning

  • Ultrasound

  • Biopsy

Tropical Sprue

  • Bone density test

  • Complete blood count

  • Folate level

  • Vitamin B12 level

  • Vitamin D level

  • Enteroscopy

Tumors of the small intestine

  • Physical exam and history 
    Blood chemistry studies 
    Liver function tests 
    Endoscopy 
    Laparotomy
    Biopsy 
    Upper GI series with small bowel follow-through
    CT scan (CAT scan)
    MRI (magnetic resonance imaging)

Whipple’s disease

  • Physical exam
    Biopsy
    Blood tests

Diagnosis

The appendix is a narrow, small, finger-shaped portion of the large intestine that generally hangs down from (within) the lower right side of the abdomen

Appendicitis is a sudden inflammation of the appendix. Although the appendix does not seem to serve any purpose, it can become diseased and, if untreated, can rupture, causing infection and even death.

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Amyloidosis

  • Chemotherapy, to stop the growth of abnormal cells that produce amyloid.

  • Peripheral blood stem cell transplant

  • AA amyloidosis. The underlying condition is treated with medication 

  • Hereditary amyloidosis

  • Dialysis-related amyloidosis. Options include changing your mode of dialysis or having a kidney transplant.

Celiac Disease

There is no cure for celiac disease; the only treatment is a gluten-free diet.

Dysmotility

  • Diet: Diet manipulation is individually tailored to your needs.

  • Medicines

  • Surgery: Surgery is rarely used to treat dysmotility

Infections

  • The treatment for SIBO includes controlling and treating any underlying associated illness. 

  • Antibiotics are one of the treatments that are helpful in controlling the excess bacteria.

  • While a single course of antibiotics for 1-2 weeks may be sufficient, SIBO has a tendency to relapse, and sometimes-repeated courses of antibiotics may be required. In some people, the antibiotics will be routinely cycled, meaning that they will alternate a 1-2 weeks on the antibiotic with 1-2 weeks off.

IBD

  • Anti-inflammatory drugs are often the first step in the treatment of inflammatory bowel disease.

  • Immunosuppressant drugs reduce inflammation, but they target your immune system rather than directly treating inflammation. Instead, they suppress the immune response that releases inflammation-inducing chemicals in the intestinal lining. For some people, a combination of these drugs works better than one drug alone.

  • People with ulcerative colitis who run fevers will likely be given antibiotics to help prevent or control infection.

  • If diet and lifestyle changes, drug therapy, or other treatments don't relieve your IBD signs and symptoms, your doctor may recommend surgery.

Intestinal Lymphangiectasia

  • The administration of water pills (diuretics) may sometimes be helpful.

  • Albumin infusion is sometimes proposed in patients with important serous effusion or uncomfortable lower limb edema.

  • Very occasionally surgical removal of the diseased portion of the intestine may be beneficial if the damage is limited to a local area.

  • In some cases, octreotide is proposed in association with the diet.

  • Compression stocking is used to stabilize in associated lower limb lymphedema.

Intestinal lymphoma

  • Chemotherapy

  • Biological therapy

  • Surgery

  • Radiation therapy

Lactose intolerance

  • Avoiding large servings of milk and other dairy products

  • Including small servings of dairy products in your regular meals

  • Eating and drinking lactose-reduced ice cream and milk

  • Drinking regular milk after you add a liquid or powder to it to break down the lactose

Small Bowel Obstruction

  • Placing an intravenous (IV) line into a vein in your arm so that fluids can be given

  • Putting a nasogastric tube through your nose and into your stomach to suck out air and fluid and relieve abdominal swelling

  • Placing a thin, flexible tube (catheter) into your bladder to drain urine and collect it for testing

  • If nothing is able to pass through your intestine, you'll usually need surgery to relieve the blockage.

Tropical Sprue

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Tumors of the small intestine

  • Surgery

  • Chemotherapy

  • Radiation therapy

Whipple’s disease

  • The health care provider prescribes antibiotics to destroy the T. whipplei bacteria and treat Whipple disease.

Treatment

The appendix is a narrow, small, finger-shaped portion of the large intestine that generally hangs down from (within) the lower right side of the abdomen

Appendicitis is a sudden inflammation of the appendix. Although the appendix does not seem to serve any purpose, it can become diseased and, if untreated, can rupture, causing infection and even death.

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