Duodenitis occurs associated with acute gas tritis (q.v.), and has the same symptoms, ex cept for the pros rice of jaundice due to the closure of the bile-ducts. The disease runs its course ordinarily in a few weeks without any treatment except rest in bed for a few days, simple diet and mild cathartics to relieve the constipation.
Chronic Intestinal Catarrh results from a severe' attack of acute inflammation in which the mucous membrane is 'left with 'pertnitnent' changes, or from repeated, attacks of mation. Cases of chronic may occur without previous evidence of acute at-. tacks. The symptoms vary much in kind and intensity, but pain, flatulence and disturbance of the bowels are usually complained of. There may be pronounced constipation, alternating constipation and diarrhoea, daily unformed movements not distinctly diarrliceal; or what is most common, a constant -More or less admixture of mucus in the stools is usually observed. Sooner or later there is apt to bea loss of flesh and strength. Wh..n the large bowel is much involved in such a process there is usually a coating of the stools with mucus, or the passage of clear mucus.
In the treatment it is best to rely mainly on carefully regulated life— exercise,' baths, fresh air, sufficient rest, avoidance of properly selected diet. In diems, the .ohjgcts are the regulation.of the bowels and the avoidance of irritation. When there is diar rhcea it is wise to avoid fruits, salads, cabbage, coarse-fibred breads, sugars, honey, pastry, sour and sweet wines and carbonic beverages. In cases attended with constipation most of these may be allowed, but sati,ages, rich dressings.. cucumbers, cabbage and very bread; should he forbidden. Mineral waters are fre quently used with success, such springs as Carlsbad and Vichy for the diarr. cam:a, and such as Marienbad, Hathorn an. 'Congress. for those attended with constipation. Chronic' catarrh of the large bowel is treated, with small. doses of castor-oil and irrigations of the bowel' with water, to which may be added antiseptics or astringents.
Intestinal Hemorrhage, or blood passed rom the bowel, may be due to piles„, tumors, dysen tery, colitis, typhoid fever, tuberculosis of the intestinal tract, ulcers of the duodenum,. portal obstruction as in cirrhosisof the liver, hemo philia,purpura and the hemorrhagic forms of the infectious diseases. When blood coming' from the stomach or high up in the- small intes-J tine is passed by rectum' it is changed to 'a tarry appearance This is due to the action of the digestive juices and bacteria. The farther
down the intestine the blood the red is it found when passed.
Intestinal Obstruction is a term that chides a great variety of conditions in the ab domen having the common feature of obstruc tion to the passage of the contents along the bowel; and in addition there is in the acute condition some injury to the bowel resulting special symptoms. Two varieties are different bated, the acute and the chronic. Acute intes-0 final obstructions are caused by foreign bodies,. gall-stones and hardened or'large collections of faces in the canal; by contracting scars, on tumors of the wall, twists of the gut (volitu Ins), intussusceptions (invagination' of a por—. tion above into the part beiow); by adhesions: of the peritoneum, causing constricting bandsti and by strangulations of pcirtions'of the bowel Contained in hernia. Besides these causes, frond local or general there is apt to be a condition of paralysis .of a portion of- the bowel,' giving rise to the same state. The symp-) toms vary considerably with the' cause of ,titei obstruction and tht part of the-bowel but in general the symptoms are j+-rtt3C5s enentry of a colicky sort—constipation, ny to pass gas—with resulting. tympanites vomiting, first from the and later from reversed peristalsis, until at 'length the vomitus' is bilious and finally even faecal. of these symptoms and the injury to 'the nerves• of the intestine resulting in there 'is a gradually increasing prostration. Certain features indicating that the obstruction is in the small intestine are early 'vomiting, the. pas sage of fakes from the lower bowel and the, greater swelling of the centre of the abdomen. Absolute constipation 'from the first is apt to mean an obstruction low' down' in the large bowel. The cause of the obstruction may be indicated by the presence of a turrior, or by something in the previous 'history. Intussus ception is the most 'common cause 'of the pb= struction in children; a tumor may be felt on the outside,'or the bowel may be felt 'in the rectum. Faecal impaction' is indicated by a long history of constipation, and rectal examination shows the hardened masses. If intestinal ob-' struction be not relieved, the patient may die of shock, with gradual exhaustion from gangrene of the bowel — the blood supply usually shut off — and sometimes from peritonitis.