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Wednesday, 4 December 2013

Enteritis - The Symptoms

Acute Enteritis, in most cases is defined as a condition of inflammation of the small intestine as a result of eating and drinking contaminated water and foods infected by virus and bacteria. But according to the study by the University Hospital Aintree, chronic radiation enteritis is an increasing problem, as more patients receive radiotherapy as part of their cancer therapy and as the long-term survival of these patients improves(a). Other study indicated that acute radiation enteritis is almost inevitable in the curative treatment of malignant tumors of the abdomen and pelvic area. It is frequently a self-limiting disorder of intestinal function associated with reversible mucosal changes of the intestine(b). The prevalence of the disease although is decreasing, it still affects millions (approx 1 in 83 or 1.20% or 3.3 million people in USA ) of people in the U.S alone, according to the statistic. Chronic enteritis is a condition of inflammation caused by other health conditions, such as Crohn's or celiac disease.
Symptoms 
1. Abdomen Pain, diahrrea and fever
There is a report of a case of Cytomegalovirus ileitis with multiple small bowel perforations in a young man with human immunodeficiency virus (HIV) infection. The patient developed abdominal pain with diarrhea and fever, and eventually acute abdomen with pneumoperitoneum(1).

2. Post-infectious fatigue and abdominal symptoms
Some patients with Severity of Giardia infection after treatment may be experience Post-infectious fatigue and abdominal symptoms. According to the study by Haukeland University Hospital, Protracted and severe giardiasis seemed to be a risk factor for post-infectious fatigue and abdominal symptoms two years after clearing the Giardia infection(2).

3. Bloating, Iron and vitamin deficiency
Patient with Campylobacter jejuni enteritis may be experioence with symptoms of persistent diarrhea, new-onset bloating and the development of iron and vitamin deficiencies.
There is a report of  a young woman with no previous gastrointestinal complaints who was initially diagnosed with postinfective irritable bowel syndrome (IBS) after a confirmed case of Campylobacter jejuni enteritis. However, because of persistent diarrhea, new-onset bloating and the development of iron and vitamin deficiencies(3).

4. Hematochezia
Hematochezia is defined as a condition of passing fresh blood through the anus and in or with stools. In most cases it is caused by the bleeding of lower gastrointestine.

5. Dizziness
Patient with cryptogenic multifocal ulcerous stenosing enteritis, may be experiencerecurrent colicky abdominal pain and dizziness(4).

6. Acute intestinal obstruction or perforation
Although Acute intestinal obstruction or perforationare rare in patient with enteritis. There is a report of a case of a case of eosinophilic enteritis, hitherto unreported, presenting as an ileal obstruction, and followed by jejunal bleeding, which was visualized by capsule endoscopy. A 62-year-old man received a 15 cm single segmental ileal resection at a point 50 cm from the IC valve due to symptoms of obstruction, which were diagnosed as eosinophilic enteritis(5).

7. Constipation
There is a report of a case of mucosal Eosinophilic gastroenteris (EG) presenting as constipation and abdominal pain in a 43 year old female.  EG should be considered in the differential diagnosis of patients presenting with constipation and abdominal pain and can easily be diagnosed with mucosal biopsies and treated with steroid therapy(5a).

8. Others
Patients may be also experience to symptoms of loss of appetite, dehydration, vomiting, thirst, change in stool pattern, high CRP and leucocytosisetc, etc(5b). 
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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/19897345
(b) http://www.ncbi.nlm.nih.gov/pubmed/3310287
(1) http://www.ncbi.nlm.nih.gov/pubmed/23379792
(2) http://www.ncbi.nlm.nih.gov/pubmed/20003489
(3) http://www.ncbi.nlm.nih.gov/pubmed/17637949
(4) http://www.ncbi.nlm.nih.gov/pubmed/23012673
(5) http://www.ncbi.nlm.nih.gov/pubmed/15906955
(5a) http://www.ncbi.nlm.nih.gov/pubmed/22803505
(5b) http://www.ncbi.nlm.nih.gov/pubmed/19758501