The ileum. Functions, diseases, treatment

The ileum (from the Latin word "ileum") is the lower part of the small intestine. Such an element of the gastrointestinal tract has its functions and structure. About them you can find out a bit below.

The ileum: where is it located?

The ileum is located in the right ileum (or lower abdominal cavity) and is separated from the blind intestine by a buginium valve, or the so-called ileocecal valve. A small part of this organ occupies the epigastrium, the umbilical region, as well as the cavity of the small pelvis.

Structure

The ileum and the small intestine are quite similar in structure. The entire inner layer of such an organ is a mucous membrane, which is abundantly covered with villi (rise by about 1 millimeter). In turn, the surface of these elements consists of a cylindrical epithelium. In the center is the lymphatic sinus, as well as capillaries (blood vessels).

It should be especially noted that the villi in the ileal gut is much smaller than in the lean. However, they all participate in the process of obtaining useful and nutritious substances. Fats are absorbed into the lymphatic vessels, and amino acids and monosugars - through the venous. The entire ileal mucosa has a rather uneven surface. This is due to the presence of crypts, villi and circular folds. These formations significantly increase the overall surface of the intestinal membrane, which undoubtedly affects the absorption of digested food.

Features of the structure of the ileum

The lean and ileum have identical villi, the shape of which resembles leaves or fingers. It should be noted that they are only in the lumen of these organs. The number of villi in the ileal gut may range from 18 to 35 pieces per square kilometer. Mm. At the same time, they are slightly thinner than those located in the duodenum.

Intestinal crypts, or the so-called Liebercuin glands, are cavities in the shell, they have the shape of small tubules. Mucosa and submucosal ileum form circular folds. The epithelium on them is prismatic, single-layered, limy. By the way, the mucous membrane of this organ also has its own submucosa, followed by muscle tissue. The latter are represented by 2 smooth layers of fibers: external (or longitudinal) and internal (or circular). Between them is a loose connective tissue that has blood vessels and neural musculoskeletal plexuses. The thickness of this layer decreases towards the terminal section of the small intestine. It should be noted that the muscular membrane of this organ performs the function of mixing the chyme and pushing it.

The outer shell of the ileum is serous. It is covered with it from all sides.

The main functions of the ileum

The represented body performs several functions. They include the following:

• Isolation of enzymes;
• Absorption of nutrients, minerals and salts;
• Digestion of incoming food.

Features of the ileum

Intestinal juice of this organ begins to be released under the influence of chemical and mechanical stimulation of the walls by chyme. Within 24 hours its production can reach 2.4 liters. In this case, the reaction of the juice is alkaline, and its dense part consists of lumps-epitheliocytes, producing and accumulating enzymes. At the appropriate time, cells begin to tear themselves into the lumen of the intestine, and then collapse, thereby providing cavity digestion.

It should be noted that there is a microvillus on the surface of each epithelial cell. They are unique outgrowths, on which enzymes are fixed. Thanks to them, there is another level of digestion, called membrane (parietal). At this stage, the hydrolysis of food and its absorption takes place in the ileum.

As you know, the juice of the intestine contains exactly 22 enzymes. The main name is enterokinase. This enzyme is designed to activate pancreatic trypsinogen. In addition, the ileum divides the juice, which contains substances such as lipase, amylase, sucrose, peptidase and alkaline phosphatase.

Promotion of chyme to other parts of the intestinal tract is due to a reduction in the fibers of the muscle layer. Their main types of motion can be called peristaltic and pendulum. The second group of contractions produces mixing of the chyme. As for wormlike (peristaltic) waves, they promote food to the distal sections.

By the way, both of the presented types of digestion exist in direct connection. When the cavity is hydrolyzed more complex substances to the so-called intermediate. After that, the processed products are cleaved by membrane digestion. Next, the process of absorption of nutrients and nutrients begins. This is due to increased intramuscular pressure, as well as the motor skills of muscle tissue and the movement of villi.

Disorders of diseases of the ileum

The ileum (where this organ is located, described a little higher) is often subjected to inflammatory processes. All diseases of this part of the small intestine have similar manifestations. As a rule, they are based on a violation of the digestive, excretory, suction and motor functions. In medical practice, these abnormalities are usually combined under one common name - malabsorption syndrome.

Common symptoms of diseases

The ileum, whose diseases can occur for various reasons, almost always makes itself felt by the general signs of malaise. They include the following:

• Pain syndromes;
• Stool disorder;
• Rumbling in the intestine;
• Increased gassing.

Quite often patients complain to their doctors that they have long-lasting diarrhea with going to the toilet up to 4-7 times a day. At the same time in the stool can be found undigested remnants of food. In the morning, the patient often feels a rumbling in the intestines, which usually subsides only in the evening.

The affected ileum sometimes causes pain. They can have different localization (in the papular region, to the right of the midline of the abdomen and under the "spoon") and character (bursting, pulling and aching). As a rule, the intensity of such pains diminishes noticeably after the formation of the gases formed.

External symptoms of diseases of the ileum

Diseases of this part of the small intestine can be accompanied by extraintestinal manifestations. They are caused by a violation of absorption and cleavage of nutrients, vitamins and minerals. At the same time, patients quickly lose weight and can not recover in any way. Deficiency of vitamins of group B and iron often leads to the development of anemia, the formation of cracks in the corners of the lips and inflammation of the oral cavity. If the body begins to lack vitamin A, then it can manifest itself in the dryness of the conjunctiva and night blindness. If there are hemorrhages on the patient's body, this indicates a deficiency of vitamin K.

Crohn's disease

The most severe and common disease of this part of the small intestine is Crohn's disease (or the so-called terminal ileitis). Usually, with this diagnosis, the inflammation is localized in the last 15-20 centimeters of the ileum. Rarely, blind, thick and duodenal sections of the digestive tract are involved in the process.

Inflammation of the ileum, the symptoms of which we will consider below, should be treated on time. Otherwise, after 3-4 years the patient may develop complications such as intestinal obstruction, fistulas, abscesses, peritonitis, amyloidosis, bleeding and others.

Symptoms of Crohn's Disease

The symptoms of such a disease are different.

• Intense pain in the right region (often reminiscent of the clinic of acute appendicitis). At the same time, the patient is feverish, he is disturbed by constant nausea and vomiting. Usually, pain occurs 3-5 hours after eating.
• The development of anemia and exhaustion.
• Cicatricial changes in the ileum, which cause intestinal obstruction.
• Constant constipation or diarrhea, and rumbling in the intestines.
• Severe bleeding or a small amount of blood in the stool

Other diseases

Lymphoid hyperplasia of the ileum occurs against the background of immunodeficiency and proliferative changes in intestinal walls. Usually such changes are transitory in nature and often disappear without a trace by themselves. The reason for the development of such a deviation may be an inadequate reaction of the lymphoid tissue of the intestine, which occurs on external stimuli.

Symptoms of lymphoid hyperplasia

Symptoms include such things as:

• diarrhea;
• Abdominal pain;
• An admixture of blood and mucus in the stool;
• Increased gassing and bloating;
• Loss in weight;
• Reduced resistance of the body to various infections.

With severe hyperplasia, symptoms of intestinal obstruction may form . Among other things, diseases of this part of the intestine include enteritis and cancer.

Diagnosis of diseases and causes

Inflammation of the ileum is diagnosed by external signs and condition of the patient after the blood, urine and feces tests, as well as with the help of such a modern examination method as fiber-fibrous endoscopy. In this case, changes in the submucosal layer of the intestine are very often revealed in patients. Such nonspecific abnormalities can develop against a background of diffuse polyposis, chronic tonsillitis and functional disorders in the colon.

Treatment of diseases

Usually, lymphofollicular hyperplasia affects only the terminal section of the ileum. This disease is a concomitant condition, in connection with which it does not require treatment. As for Crohn's disease, cancer and other inflammatory processes, they can affect the entire gastrointestinal tract with delayed treatment, which will subsequently lead to death. In this case, therapy consists in the use of medications, including antibacterial drugs, which are prescribed only by an experienced gastroenterologist. By the way, often such diseases in advanced stages of development are treated with the help of surgical intervention.

It is also worth noting that along with medications for the treatment of diseases of the ileum of the small intestine, a strict diet is prescribed. As a rule, it includes only light, quickly digestible and vitamin-rich foods. In addition, the patient is strictly forbidden to drink alcoholic beverages, very salty, sharp, fatty, fried and heavy meat, fish, mushroom dishes. The patient's diet should include warm cereal, prepared on half-milk, white wheat bread of yesterday's production, sometimes butter, eggs, tea, compotes, fruit drinks, broths of wild rose, blueberries, bird cherries. If you follow the diet and take all the medicines prescribed by your doctor, the result of treatment of the inflamed ileum will be necessarily favorable.