The ileum (from the Latin word "ileum") is the lower section of the small intestine. Such an element of the gastrointestinal tract has its own functions and structure. You can learn more about them below.
Ileum: where is it located?
The ileum is located in the right iliac fossa (or lower part of the abdominal cavity) and is separated from the caecum by means of the bauhinia valve, or the so-called ileocecal valve. A small part of this organ occupies the epigastric region, the umbilical region, and the pelvic cavity.
Building
The ileum and jejunum are quite similar in structure. The entire inner layer of such an organ is a mucous membrane, which is abundantly covered with villi (they 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 ileum are much smaller than in the jejunum. However, all of them are involved in the process of obtaining useful and nutritious substances. Fats are absorbed throughlymphatic vessels, and amino acids and monosaccharides - 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 lining, which undoubtedly affects the process of absorption of digested food.
Features of the structure of the ileum
The jejunum 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 vary from 18 to 35 pieces per 1 sq. mm. At the same time, they are slightly thinner than those that are located in the duodenum.
Intestinal crypts, or the so-called Lieberkühn glands, are depressions in the shell, shaped like small tubes. The mucosa and submucosa of the ileum form circular folds. The epithelium on them is prismatic single-layered 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: outer (or longitudinal) and inner (or circular). Between them is loose connective tissue, which has blood vessels and nerve musculo-intestinal plexuses. The thickness of this layer decreases towards the terminal part of the small intestine. It should be noted that the muscular membrane of this organ performs the function of mixing chyme and itspushing.
The outer shell of the ileum is serous. She is covered with it from all sides.
Main functions of the ileum
The presented body performs several functions. These include the following:
- isolation of enzymes;
- absorption of nutrients, minerals and s alts;
- digesting incoming food.
Features of the ileum
The intestinal juice of this organ begins to be released under the influence of chemical and mechanical irritation of the walls with 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 made up of lumps-epithelial cells that produce and accumulate enzymes. At the right moment, the cells begin to be rejected into the intestinal lumen, and then destroyed, thereby providing abdominal digestion.
It should be noted that on the surface of each epithelial cell there is a microvillus. They are a kind of outgrowths on which enzymes are fixed. Thanks to them, another level of digestion occurs, called the membrane (parietal). At this stage, food is hydrolyzed and absorbed in the ileum.
As you know, intestinal juice contains exactly 22 enzymes. The main one is called enterokinase. This enzyme is designed to activate pancreatic trypsinogen. In addition, the ileum secretes juice, which contains substances such as lipase, amylase, sucrase, peptidase and alkalinephosphatase.
Promotion of chyme to other parts of the intestinal tract is carried out due to the contraction of the fibers of the muscle layer. Their main types of movement can be called perist altic and pendulum. The second group of contractions produces agitation of the chyme. As for the worm-like (perist altic) waves, they move food to the distal regions.
By the way, both presented types of digestion exist in direct connection. With cavitary hydrolysis of more complex substances to the so-called intermediate occurs. The processed foods are then broken down by membrane digestion. Next, the process of absorption of nutrients and nutrients begins. This is due to an increase in intra-intestinal pressure, as well as the motility of muscle tissues and the movement of the villi.
Disorders in diseases of the ileum
The ileum (where this organ is located, described a little above) is quite often subject 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 deviations are usually combined under one common name - malabsorption syndrome.
General symptoms of diseases
The ileum, which diseases can occur for various reasons, almost always makes itself felt by general signs of malaise. These include the following:
- painfulsyndromes;
- stool disorder;
- rumbling in the intestines;
- increased gas formation.
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, 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 pains noticeably decreases after the discharge of the formed gases.
External symptoms of diseases of the ileum
Diseases of this part of the small intestine may 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 dryness of the conjunctiva and night blindness. If there are hemorrhages on the patient's body, then this indicates a deficiency of vitamin K.
Crohn's disease
The most severe and common disease of this part of the small intestine isCrohn'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, fistulas, abscesses, peritonitis, amyloidosis, bleeding, and others.
Crohn's disease symptoms
Signs of such a disease are different.
- Intense pain in the right area (often reminiscent of an acute appendicitis clinic). In this case, the patient is feverish, worried about constant nausea and vomiting. Usually pain occurs 3-5 hours after eating.
- Development of anemia and malnutrition.
- Cicatricial changes in the ileum, which cause intestinal obstruction.
- Persistent constipation or diarrhea, as well as rumbling in the intestines.
- Heavy bleeding or a little 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. Usually such changes are transient and often disappear without a trace on their own. The reason for the development of such a deviation may be an inadequate response of the intestinal lymphoid tissue, which occurs to external stimuli.
Signs of lymphoidhyperplasia
Symptoms should include:
- diarrhea;
- abdominal pain;
- admixture of blood and mucus in the stool;
- gas 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 part of the intestine.
Diagnosis of diseases and causes of occurrence
Inflammation of the ileum is diagnosed by external signs and the condition of the patient after taking blood, urine and feces tests, as well as using such a modern examination method as fiber-optic endoscopy. At the same time, changes in the submucosal layer of the intestine are very often detected in patients. Such nonspecific abnormalities can develop against the background of diffuse polyposis, chronic tonsillitis and functional disorders in the colon.
Treatment of diseases
Normally, lymphofollicular hyperplasia only affects 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, if they are treated late, they can affect the entire gastrointestinal tract, which subsequently leads to death. In this case, therapy consists in the use of medications, including antibacterial ones, which are prescribedonly 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 digested and vitamin-rich foods. In addition, the patient is strictly forbidden to consume alcoholic beverages, highly s alty, spicy, fatty, fried and heavy meat, fish, mushroom dishes. The patient's diet should include warm cereals cooked with semi-milk, white wheat bread of yesterday's production, sometimes butter, egg scrambled eggs, tea, compotes, fruit drinks, decoctions of wild rose, blueberries, bird cherry. If you follow a diet and take all the medicines prescribed by your doctor, the outcome of the treatment of an inflamed ileum will be necessarily favorable.
