The ileum (from the Latin word "ileum") is the lower part of the small intestine. Such an element of the digestive tract has its own functions and structure. You can learn about them a little below.
The ileum: where is it located?
The ileum is located in the right ileal fossa (or lower abdominal cavity) and is separated from the cecum using the bauginium flap, or the so-called ileocecal valve. A small part of this organ occupies the epigastrium, the umbilical region, as well as the pelvic cavity.
Structure
The ileum and lean intestines 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 the capillaries (blood vessels).
It should be especially noted that the villi in the ileum are much smaller than in lean. However, all of them are involved in the process of obtaining healthy and nutritious substances. Fats are absorbed through the lymphatic vessels, while amino acids and monosugar are absorbed 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 total surface of the intestinal membrane, which undoubtedly affects the absorption process of digested food.
Structural features of the ileum
The skinny and ileum have the same villi, the shape of which resembles leaflets or fingers. It should be noted that they are only in the lumen of these organs. The number of villi in the ileum can range from 18 to 35 pieces per 1 sq. mm Moreover, they are slightly thinner than those that are located duodenal.
Intestinal crypts, or the so-called liberkune glands, are recesses in the shell, have the form of small tubes. The mucous and submucous ileum form circular folds. The epithelium on them is a prismatic single-layer limbic. 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 loose connective tissue, which has blood vessels and nerve muscle and intestinal plexuses. The thickness of this layer decreases towards the terminal portion of the small intestine. It is worth noting that the muscular membrane of this organ performs the function of mixing the chyme and pushing it.
The external membrane of the ileum is serous. She is covered by it from all sides.
The main functions of the ileum
The presented body performs several functions. These include the following:
- enzyme isolation;
- absorption of nutrients, minerals and salts;
- digestion of incoming food.
Features of the ileum
The intestinal juice of this organ begins to stand out under the influence of chemical and mechanical irritation of the walls by the chyme. In 24 hours, its production can reach 2.4 liters. In this case, the reaction of the juice is alkaline, and its dense part is lumps of epithelial cells that produce and accumulate enzymes. At the right moment, the cells begin to be rejected into the intestinal lumen, and then collapse, thereby providing cavity digestion.
It should be noted that on the surface of each epithelial cell there is a microvilli. They represent a kind of outgrowths on which enzymes are fixed. Thanks to them, another level of digestion, called the membrane (parietal), occurs. At this stage, hydrolysis of food and its absorption occurs in the ileum.
As you know, intestinal juice contains exactly 22 enzymes. The main name is enterokinase. This enzyme is designed to activate pancreatic trypsinogen. In addition, the intestinal ileum secretes juice, which contains substances such as lipase, amylase, sucrose, peptidase and alkaline phosphatase.
The advancement of the chyme to other parts of the intestinal tract is due to the reduction of the fibers of the muscle layer. Their main types of movement can be called peristaltic and pendulum-like. The second group of contractions produces mixing chyme. As for the vermiform (peristaltic) waves, they promote food in the distal sections.
By the way, both presented types of digestion exist in direct connection. With abdominal hydrolysis of more complex substances occurs to the so-called intermediate. After this, the processed products are broken down by membrane digestion. Next, the process of absorption of nutrients and nutrients begins. This is due to increased intra-intestinal pressure, as well as the motility of muscle tissue and the movement of the villi.
Disorders in diseases of the ileum
The ileum (where this organ is located is described a little higher) is often exposed 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, absorbing, and motor functions. In medical practice, these deviations are usually combined under one common name - malabsorption syndrome.
Common symptoms of diseases
The ileum, diseases of which can occur for various reasons, almost always makes itself felt by common signs of malaise. These include the following:
- pain syndromes;
- upset stool;
- rumbling in the intestines;
- increased gas formation.
Quite often, patients complain to their doctors that they have long diarrhea with going to the toilet up to 4-7 times a day. In this case, undigested food residues can be found in the feces. In the morning, the patient often feels rumbling in the intestines, which usually subsides only in the evening.
The affected ileum sometimes causes pain. They can have different localization (in the umbilical 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 pain noticeably decreases after the discharge of the formed gases.
External symptoms of ileum diseases
Diseases of this part of the small intestine can be accompanied by extraintestinal manifestations. They are caused by impaired absorption and breakdown of nutrients, vitamins and minerals. At the same time, patients quickly lose weight and can not get better. Deficiency of B vitamins 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 this can manifest itself in dry conjunctiva and night blindness. If the patient has hemorrhages, 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, inflammation is localized in the last 15-20 centimeters of the ileum. Rarely, the blind, thick and duodenal sections of the gastrointestinal tract are involved in the process.
Inflammation of the ileum, the symptoms of which we will discuss below, should be treated in time. Otherwise, after 3-4 years the patient may develop complications such as intestinal obstruction, fistula, abscesses, peritonitis, amyloidosis, bleeding and others.
Symptoms of Crohn's Disease
The signs of such a disease are various.
- Intense pain in the right area (often resemble a clinic of acute appendicitis). In this case, the patient is in fever, worried about 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 admixture of blood in the stool
Other diseases
Lymphoid hyperplasia of the ileum occurs against the background of an immunodeficiency state and proliferative changes in the intestinal walls. Typically, such changes are transient in nature and often disappear without a trace on their own. The reason for the development of such a deviation may be an inadequate reaction of intestinal lymphoid tissue, which occurs on external stimuli.
Signs of lymphoid hyperplasia
Symptoms include:
- diarrhea;
- abdominal pains;
- an admixture of blood and mucus in the stool;
- increased flatulence and bloating;
- weight loss;
- reduced body resistance to various infections.
With severe hyperplasia, symptoms of intestinal obstruction may form . Among other things, enteritis and cancer can be attributed to diseases of this intestine.
Diagnosis of diseases and causes
Inflammation of the ileum is diagnosed by the external signs and condition of the patient after taking blood, urine and feces, as well as using such a modern examination method as fiber optic endoscopy. Moreover, in patients very often revealed changes in the submucosal layer of the intestine. Such non-specific abnormalities can develop against the background of diffuse polyposis, chronic tonsillitis and functional disorders in the colon.
Disease treatment
Typically,
lymphofollicular hyperplasia affects only the terminal ileum. This disease is a concomitant condition, and therefore it does not require treatment. As for Crohn’s disease, cancer and other inflammatory processes, with delayed treatment, they can affect the entire gastrointestinal tract, which will subsequently lead to death. In this case, the therapy consists in the use of medications, including antibacterials, which are prescribed only by an experienced gastroenterologist. By the way, often such diseases in the later stages of development are treated with 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 also 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, spicy, fatty, fried and heavy meat, fish, mushroom dishes. The patient’s diet should include warm cereals prepared in half milk, yesterday’s white wheat bread, sometimes butter, egg omelet, tea, fruit drinks, fruit drinks, broths of wild rose, blueberries, and bird cherry. If you follow a diet and take all the medications prescribed by your doctor, the outcome of treatment for an inflamed ileum will certainly be favorable.