Swelling in bowel disease
Edema in diseases of the intestine are more commonall with enteropathy with increased protein loss. In this syndrome, due to increased permeability of the blood or lymphatic vessels of the gastrointestinal mucosa, excessive protein loss occurs.
Is formed hypoproteinemic edematous syndrome,manifested an ansarca and dropsy. Patients noticeably lose weight. Frequent long-term diarrhea, a syndrome of impaired absorption. In feces an increased content of plasma proteins is detected. In the blood - hypoproteinemia with pronounced hypoalbuminemia. There is no pathology of the heart, liver and kidneys.
Enteropathy with increased protein loss may occur with intestinal lymphangiectasia, sprue syndrome (celiac disease), small intestinal tumors, Whipple's disease.
Intestinal lymphangiectasia is a congenital orthe acquired lesion of the lymphatic vessels of the small intestine, accompanied by difficulty in lymph drainage, which can be blocked due to inflammation of the lymphatic vessels or enlargement of the lymph nodes of the mesentery (tumor, metastases). Periodically, diarrhea is noted. Generalized edema appears. A reliable diagnosis of intestinal lymphangiectasia can be established after an aspiration biopsy of the small intestine.
The sprue syndrome is a condition that occurs in conditionsviolation of absorption of nutrients from the small intestine and increased permeability of its capillaries for plasma proteins. There aminopterin (intolerance to cow milk) and gluten (intolerance to cereal plants) enteropathy. The latter is often called celiac disease.
The disease usually begins in childhood. Relapses occur in adulthood and occur with a change in exacerbations and remissions. There is diarrhea with an abundant, sometimes frothy stool and a pungent odor. Appetite is not significantly changed, but patients lose body weight. Gradually, anemia, increased bleeding, glossitis, hyperkeratosis of the skin, muscle weakness join the diarrhea. Paresthesia, seizures, and osteoporosis begin to occur. All the symptoms are associated with the development of the syndrome of impaired absorption.
In severe cases, hypoproteinemia appears, followed by generalized edema. After switching to the gluten-free diet, all manifestations of the disease disappear. The diagnosis is confirmed by aspiration biopsy.
To the development of edema and ascites can leadSmall intestinal tumors originating from lymphoid tissue. This symptomatology occurs with lymphosarcoma. The father's syndrome is preceded by a long period of diarrhea. The life expectancy of patients with lymphosarcoma from the time of diarrhea does not exceed two years.
In some patients with lymphosarcoma edema may beare also caused by impaired lymph flow due to tumor compression of lymphatic vessels. In such cases, edema occurs earlier, they are asymmetric, they have a clear border with a neoteca tissue, they are located distal to enlarged lymph nodes.
Whipple's disease (intestinal lipodystrophy)develops mainly at the age of 30-50 years. Men are more often ill. The disease begins with fever (during an exacerbation up to 39 C, with chills) and "flying" polyarthritis. In the future, it is possible to join lymphadenopathy, hyperpigmentation of the skin, anemia, pleurisy, endocarditis, memory impairment. The small intestine is always affected with the formation of the syndrome of impaired absorption and increased loss of protein. Diarrhea is combined with anorexia and cramping pains in the abdomen, which is not the case with celiac disease. After prolonged diarrhea, hypoproteinemic edema may occur.
To clarify the diagnosis, a biopsy of the mucosashell of the small intestine. The effectiveness of antibiotic therapy is characteristic. In differential diagnosis with lymphosarcoma, decisive importance is given to lymph node biopsy. In addition, with lymphosarcoma, there are no arthralgias and high fever.
Casuysticheski rarely hypoproteinemic edema can occur with ulcerative colitis, Crohn's disease, infectious gastroenteritis.