There is a kind of intestinal disease that even a gastrointestinal endoscope can’t “see”, and 8 abnormalities should be vigilant

When abdominal pain and indigestion are frequent, most people may think of gastroenteroscopy for the first time, but no abnormality is found after the examination. This does not mean that there is no problem with the stomach, because some lesions are hidden in the “deep” – the small intestine, and cannot be seen by a gastroenteroscope at all.

Life Times (search for “LT0” in WeChat Follow) Interview an expert to identify the symptoms of small bowel disease and teach you how to protect your gut health.

Interviewed experts

Guo Qin, Director and Deputy Chief Physician, Department of Enteroscopy, The Sixth Affiliated Hospital of Sun Yat-sen University

< span>Wei Yanling, Deputy Director, Department of Gastroenterology, Army Specialty Medical Center

There is a kind of intestinal disease that cannot be seen by gastrointestinal endoscopy

The small intestine is tortuous and lengthy, and is the main site of human digestion, absorption and secretion. The length is 5~7 meters, accounting for 70%~75% of the total length of the digestive tract, and it is also the longest organ in the digestive tract.

Through the oral cavity, the main observation is the upper gastrointestinal tract such as the esophagus, stomach and duodenum;

< span>◎Colonoscopy is inserted through the anus, mainly to observe the lower gastrointestinal tract. Once lesions occur in the small intestine, which resides in the middle gastrointestinal tract and the nine and eighteen bends, it is difficult to diagnose and treat.

In the past, due to the inability to perform routine direct visual inspection of the deep small intestine, clinicians were relatively unfamiliar with small bowel diseases, and small bowel disease became the disease with the highest rate of misdiagnosis and missed diagnosis.

When the patient has unexplained gastrointestinal (small bowel) bleeding and iron deficiency anemia, suspected small bowel tumor or proliferative lesions, small bowel malabsorption syndrome, suspected small bowel Crohn’s disease or bowel tuberculosis, relevant examinations suggest the presence of small bowel For organic lesions, as well as unexplained diarrhea or protein loss, gastrointestinal endoscopy is often “no abnormality”, which may indicate that the lesions are hidden “deep” in the small intestine.

How to “discover” small bowel lesions?

Gastrointestinal endoscopy cannot be detected, and capsule endoscopy can be used to examine the small intestine.

Although capsule endoscopy provides the convenience of examination, capsule incarceration may occur in patients with diverticula, congenital malformations of small bowel development, strictures, and small bowel strictures caused by inflammatory diseases. At the same time, even if capsule endoscopy finds lesions in the small intestine, it cannot be removed for pathology or treatment in time.

In addition, the biggest problem of small bowel CTE, thoracic pelvic MRI, bowel color ultrasound and other examinations is that the small bowel cannot be removed immediately disease, make a definite diagnosis.

Therefore, enteroscopy is often recommended in clinical practice: Enteroscopy is to enter the mirror through the mouth, through the anus, or through the mouth and through the anus to complete the entire small intestine. The non-blind-spot examination can not only comprehensively examine the mucosa of the entire small intestine, but also obtain the lesion site, which is also of great value in the diagnosis of some special inflammatory diseases.

What’s more, enteroscopy can be carried out at the same time, such as small bowel stricture, hemorrhage, benign tumor, foreign body removal (such as capsule endoscopy incarceration), etc. Endoscopic treatment can serve multiple purposes.

Wu Qike, director of the Department of Endoscopy Center, Peking University Cancer Hospital, enteroscopy

Small bowel disease, with 8 clinical manifestations< /strong>p>

The small intestines are curved, close to each other, far away from the mouth and anus, the site is deep and not fixed, the onset is relatively insidious, and it is difficult to make a clear diagnosis.

The main clinical manifestations of small bowel disease are abdominal pain, abdominal distension, diarrhea, abdominal mass, bleeding, anemia, weight loss, obstruction, etc. .

Small bowel bleeding

It is difficult to distinguish small bowel bleeding from other parts of the bleeding from clinical manifestations alone, but if repeated bleeding and multiple hospitalizations Treatment, especially when repeated gastroscopy and colonoscopy fail to detect the bleeding site, should focus on small bowel bleeding.

Small-intestinal vascular-related disease

If you have a history of cardiovascular disease, sudden severe acute abdominal pain accompanied by vomiting, diarrhea or bloody stool, especially if the early signs and symptoms do not match, Should be suspected of this type of disease, and in-depth and careful medical history and physical examination, do relevant examinations.

Inflammatory diseases of the small intestine

Crohn’s disease, intestinal tuberculosis, acute hemorrhagic enteritis, perforation of typhoid fever, antibiotic-associated enteritis, etc., require detailed medical history and combined clinical manifestations and auxiliary examinations to help diagnose.

A guide to gut health

The gut is the “gas station” of the human body, and 90% of the nutrients need to be absorbed by the gut; “Sewage plant”, 80% of the metabolic wastes of the human body are excreted by the intestine; the intestine is also the largest immune organ of the human body, and 70% of the immune function comes from the intestine.

Therefore, gut health directly affects the body’s important functions such as nutrition, metabolism and immunity, and protecting the gut can ensure good health.


Prevention of disease from mouth >

Wash your hands before and after meals; wash with running water before eating raw fruits and vegetables, and avoid drinking raw water.

Do not eat spoiled food. The food should not be stored in the refrigerator for too long. It must be fully heated before eating again.

Pay attention to kitchen hygiene to prevent pathogenic microorganisms from contaminating food and tableware.


Ensuring a balanced diet

Three meals a day should be thick and thin In combination, eat foods rich in dietary fiber such as potatoes, taro, fresh vegetables and fruits. The dietary fiber of fruits and vegetables has strong water absorption, which can increase the volume of feces, which is conducive to the formation of feces and prevents constipation.

Recommended drink at least 1.5 liters of warm water every day after getting up. , to develop the habit of regular bowel movements, will help prevent constipation. If you have already suffered from constipation, you should follow the doctor’s advice for symptomatic treatment. Self-use of laxatives can easily lead to weakening of intestinal function. In addition, onions, beans, garlic, carrots and other foods are also rich in prebiotics, which can supplement nutrients for intestinal probiotics and help the balance of intestinal microbes.


Keep your mood happy

Good gut microbiome and happiness The mood can promote each other, which is beneficial to the health of the body.



Exercise can not only promote the secretion of “happy hormone”, but also It can promote intestinal peristalsis, accelerate defecation, and prevent intestinal aging.

Summer and autumn are the seasons of high incidence of intestinal infections. Pain, nausea, vomiting, or fever, loss of appetite and other symptoms, you should go to the hospital in time, it is likely to be an acute gastrointestinal infection. ▲

Editor of this issue: Deng Yu, etc., in the lower right cornerclick< span>I’m watchingGo ahead