Enteritis

“ Intense inflammation of the small intestine may exist without diarrhoea or other symptoms betokening the real nature of the attack. Flint30 mentions having met with three such instances, and Goodhart31 records thirteen cases of enteritis with marked lesions in which no diagnosis had been made before death. Rilliet and Barthez report twenty-four autopsies in children with intestinal lesions in which no symptoms had been observed.32
30 Clinical Medicine, Philada., 1879, p. ”

“ Normally the intestine contains an extremely large number of different microbes, which may prove of service so long as circulation, secretion, and peristalsis continue normal; but as soon as any perturbation occurs, either in the blood supply or in the movement of the bowel, normal secretion is impeded; abnormal organic fermentation commences, producing irritant principles or toxins which at once set up local irritation, or, being absorbed, produce that complex of symptoms which we recognise as enteritis, intoxication of intestinal origin, or even infection. ”

“ Long-continued obstruction of the bowels or displacement resulting in death are preceded by enteritis.
Symptoms.—The symptoms differ somewhat with the cause and depend also, to some extent, upon the chief location of the inflammation. In general the animal stops eating or eats but little; it shows colicky pain; fever develops; the pulse and respiration become rapid; the mucous membrane becomes red; the mouth is hot and dry. Pressure upon the abdomen may cause pain. Intestinal sounds can not be heard at the flank. There is constipation in the earlier stages that is, followed later by diarrhea. ”

“ At any moment the foreign body may lodge, become impacted in the canal, and all the grave symptoms of enteritis and general peritonitis present themselves. Symptoms of inflammation may appear, and after a longer or shorter time suddenly disappear, as if the foreign body had glided over some point of obstruction and again begun its descent through the tube. ”

“ The usual foul surroundings of the pig and the abundance of microbes and toxins taken in, serve to make enteritis in this animal much more redoubtable than in other domestic animals.
The lesions are usually common to stomach and intestine, and consist in abundant mucopurulent discharge, extensive congestion, points and extensive patches of blood extravasation, and of lymph infiltration, ulcers, congested peritoneum and mesenteric glands, and congestions and ecchymosis in distant organs. ”

“ In the present state of our knowledge dysentery would be known by marked tenesmus, by the grave general symptoms, the reddish fluid stools with flocculi, and by its occurrence in epidemic form.
Enteralgia presents the following features which distinguish it from intestinal catarrh: The tongue in enteralgia is clean or coated white, but with no red tip and edges; the appetite is capricious, but not lost; the bowels are constipated; the pain bears no relation to the ingestion of food or drink, as in enteritis. Fever is accidental, and there are other nervous phenomena. ”

“ The diagnosis is rather difficult, for the condition is very apt to be confused with primary dyspepsia, or with inflammation of the gastric compartments. It might also be mistaken for acute enteritis of the first part of the small intestine; but as gastritis is very often complicated with duodenitis, such a mistake is without serious consequences.
Prognosis. The prognosis is grave, not because death is a frequent termination, but because the disease very often leads to chronic incurable lesions. ”

“ Enteritis (Inflammation of the Bowels) :
Symptoms: Attack often commences with vomiting. There is generally slight rise of temperature and a quickened pulse, pain on pressure of abdomen; there may be constipation or diarrhœa, but in any case mucus is generally passed with the motion. The dog seems ill, lies about, and is disinclined to move. There is loss of appetite, and the thirst is generally excessive.
Chronic enteritis is a more common complaint; there is no temperature as a rule, and the pulse is quiet, though it generally becomes very weak as the disease advances. ”

“ From toxic gastro-enteritis it is distinguished by the absence of any history or lesions showing the ingestion of a poison and by the concentration of the lesions on the large intestines whereas in poisoning with irritants, the stomach and small intestines are the most liable to suffer. ”

“ As the disease very often implicates the stomach (gastro-enteritis) , the usual lesions of gastritis will be seen. Most commonly the lesions are best marked in the small intestine, and again in other cases in the colon, but usually there is more or less change in all parts of the intestinal canal. The small intestine is almost devoid of aliments and the mucosa deeply congested in patches or striæ, with at points thickening, softening so that it crushes under the finger, hemorrhagic discoloration, and even ulceration, and necrotic changes. ”

“ Up to this time constipation was the chief symptom of enteritis. The meeting of the streams, the affixing the symptom diarrhoea to its appropriate lesion, was brought about hypothetically at first by J. Carmichael Smith in these words: "I think it is probable (for we can have no positive evidence of the fact) that in diarrhoeas from catching cold the villous or interior coat of the stomach is sometimes slightly inflamed."3
3 Paper read Jan. ”

“ The local inflammation is at first superficial but the increasing toxicity of the fluids that are held on these parts causes the inflammation to take on ulceration.
The inflammation or ulceration may remain superficial, and be located in the lower portion of the small intestine, then the disease is enteritis. ”

“ The perpetual vomiting in ileus is caused in like manner by the defective excitement of the sensorial power of association by the bowel, which is torpid during the intervals of pain; and the stomach sympathizes with it. See Enteritis, Class II. 1. 2. 11. Does this symptom of vomiting indicate, whether the disease be above or below the valve of the colon? Does not the softer pulse in some kinds of enteritis depend on the sympathy of the heart and arteries with the sickness of the stomach? ”

“ The lesions are those of acute gastro-enteritis—congestion of the mucous membrane, abomasum, and intestine, submucous infiltration, shedding of the epithelium, which sometimes attains the stage of ulceration, suffusion and intestinal or superficial hæmorrhage, dilatation of the capillaries, etc.
The symptoms of poisoning are produced by the absorption of toxic products, which pass from the intestine into the blood current.
Poisoning is frequently complicated by infection produced in a similar manner. ”

“ This form is only a variety of acute enteritis, but is grave, because complications due to hæmorrhage or infection are very liable to occur.
In certain cases movement causes groaning. In the slighter forms the patient may recover spontaneously. If fed with easily digested materials, the symptoms diminish in intensity. Towards the eighth day the fæces become normal, appetite and rumination reappear, and the secretion of milk which had fallen off rises to its normal amount. ”

“ The weight of the bowel and its contents, along with the rapid distension of the intestine above, fixes the gut in this state of torsion and effectually prevents it from untwisting. A semi-rotation of the paretic and distended bowel about the mesenteric axis is sufficient to interfere with the supply and return of blood and provoke enteritis. Indeed, the rotation is rarely sufficiently great to produce complete obstruction, and the symptoms are frequently rather those of inflammation than of internal strangulation. ”

“ Las infecciones intestinales conocidas como gastroenteritis, son causadas por Intestinal infections, known as gastroenteritis, are caused by bacteria, viruses or parasites that harm the intestinal mucous causing diarrhea, vomiting, abdominal pain, and fever.
Depending on the intensity of the medical condition or the type of infection, the patient may become dehydrated. Children and the elderly are at risk for dehydration. Infectious diarrhea is considered one of the most serious health problems in undeveloped countries, being one of the main causes of childhood diseases and mortality. ”

“ The nervous symptoms are restlessness in sleep, unpleasant dreams, starting in fright, grating of the teeth, and muscular twitchings. In more aggravated cases, especially in children, epileptic fits may occur. If the parasites are numerous, they produce diarrhoea with copious mucus discharges, and may induce enteritis with all its attendant symptoms. When the worms wander into the stomach, they induce colic, nausea, retching, and vomiting, all of which disappear with the expulsion of the parasites. ”

“ Acute Enteritis, as Acute Gastritis, is usually caused by a strong irritant,—either by some food which disagrees, or by a mass of undigested food. A fast of two or three days is the initial dietetic treatment. A free drinking of water not only soothes the irritated intestines but it cleanses the intestinal tract and assists the kidneys in eliminating elements of fermentation ”

“ The large majority of cases of enteritis can be prevented by practising the necessary preventive measures. It is very necessary that animals exposed to cold be provided with dry sleeping quarters that are free from draughts. Where a number of animals are fed a heavy grain ration, or fed from the same trough, they should be kept under close observation. This is necessary in order to detect cases of indigestion or overfeeding early, and resort to the necessary lines of treatment, so as to prevent further irritation to the intestinal tract. ”

“ Long residence of a foreign mass at any point in the intestinal canal is certain to produce some chronic enteritis and effusion of lymph and subsequent stricture of the bowel, or the presence of the foreign body may produce an ulcer; and when this is healed the resulting cicatrix may end in serious obstruction from the natural tendency of the new material to contract. Signs of constriction of the bowel may not be noticed for some time after the escape of the foreign body. ”

“ The lower portion of the intestinal tract may become involved in disease by direct extension from the colon, as in dysentery following enteritis or entero-colitis. Habersham says that diarrhoea arises generally from an irritated condition of the large intestine, catarrhal and mucous diarrhoea from slight inflammatory disease closely allied to ordinary coryza affecting the mucous membrane of the large intestine. "In the diarrhoea of soldiers the lesions of the large intestine have been either those of congestion with varying degree of extravasation or of ulceration more or less extensive. ”

“ These may extend forming deep unhealthy ulcers, with increasing salivation and fœtor. As the disease advances the initial dullness and prostration become more profound, and debility and emaciation advance rapidly. Unless there is early improvement an infective pharyngitis, or enteritis sets in, manifestly determined by the swallowing of virulent matters from the mouth, and swelling, redness and tenderness of the throat, or colics and offensive black diarrhœa hasten a fatal issue. ”

“ Fig. 5.—Entamœba histolytica (tetragena form) , showing three successive changes of form due to movement. × 1100. (After Hartmann.)
The history of the development of these species, which give rise to amœbic enteritis as distinguished from bacillary dysentery, was formerly not so well known as that of E. coli. Upon being introduced into cats (per anum) dysenteric amœbæ provoke symptoms similar to those in man. In the latter, besides metastatic liver abscesses, abscesses of the lungs, and, according to Kartulis, cerebral abscesses are occasionally produced. ”

“ Paratyphoid infections may give the clinical picture of a colitis and such cases at times show a large amount of blood in the dysenteric stools. Usually the symptoms are rather those of an entero-colitis or a gastro-enteritis.
3. In Japan, dysentery-like epidemics of a very fatal disease, termed ekiri, occur among young children. The organism is very motile, producing gas and acid in glucose, but not in lactose media. It is reported at times to show indol production. ”

“ The bladder is empty and contracted. Nothing special is to be noted in the nervous system .
If death have occurred during the stage of reaction, the tissues are moist; the venous system is less congested; the lungs are probably congested and œdematous, perhaps inflamed. Very probably there are evidences of extensive enteritis.
Microscopical examination of the contents of the bowel during the acute stage of the disease discovers, in most instances, the comma bacillus. ”

“ If abscesses form, they should be lanced.
GASTRO-ENTERITIS.
This disease—otherwise known as wood-evil, or moor-ill—arises from eating the buds of oak, young ash, and other trees, which are of a very highly stimulating or irritating character. As the intestinal canal is liable to inflammatory action from irritant substances admitted into it, animals are found to become diseased from eating too freely of these vegetable substances.
Symptoms.—Loss of appetite and suspended rumination; mouth hot; skin dry; pulse from sixty to seventy; swelling and pain of the belly; obstinate constipation ”

“ The intestinal mucous membrane, the peritoneum and the mesenteric glands are the chief sites of tubercular infection in the digestive organs. Rarely met with in the gullet and stomach, and comparatively seldom in the mouth and Infective lesions. lips, tubercular inflammation of the small intestine and peritoneum is common. Tubercular enteritis is a frequent accompaniment of phthisis, but may occur apart from tubercle of other organs. Children are especially subject to the primary form. ”