Granulomatous Enteritis

Definition:
Granulomatous enteritis is a condition characterized by the formation of granulomas within the wall of the small intestine, resulting in chronic inflammation and potential damage to the gastrointestinal tract.

Subtypes of Granulomatous Enteritis:
1. Chron’s Disease: A type of granulomatous enteritis in which the inflammation typically affects any part of the digestive tract, most commonly the small intestine, causing symptoms like abdominal pain, diarrhea, weight loss, and fatigue.

2. Tuberculosis Enteritis: A form of granulomatous enteritis caused by Mycobacterium tuberculosis, resulting in granuloma formation primarily in the small intestine, leading to symptoms such as abdominal pain, fever, weight loss, and diarrhea.

3. Sarcoidosis: A systemic disease that can also involve the gastrointestinal tract, leading to granulomatous enteritis characterized by the presence of non-caseating granulomas in the intestinal wall, often causing abdominal pain, nausea, diarrhea, and weight loss.

4. Wegener’s Granulomatosis: An uncommon multisystemic vasculitis that may involve the intestines, causing granulomatous enteritis with symptoms ranging from abdominal pain and diarrhea to more severe complications like bowel perforation.

Clinical Features:
– Abdominal pain or cramping
– Diarrhea or changes in bowel habits
– Weight loss and malnutrition
– Bloody stools or rectal bleeding
– Fatigue and weakness
– Nausea and vomiting (in some cases)
– Fever or elevated body temperature
– Loss of appetite

Diagnostic Approaches:
– Medical history and physical examination
– Blood tests to assess inflammation levels and nutritional status
– Stool tests to check for infections or abnormal components
– Imaging studies (e.g., X-ray, CT scan, MRI) to visualize the gastrointestinal tract and detect abnormalities
– Endoscopic procedures (e.g., colonoscopy, enteroscopy) with biopsies to examine the intestinal tissue and identify granulomas
– Histopathological examination of biopsy samples to confirm the presence of granulomas

Treatment:
The management of granulomatous enteritis depends on the underlying cause and the severity of symptoms. Treatment options may include:

– Medications:
– Anti-inflammatory drugs (e.g., corticosteroids) to reduce inflammation and suppress the immune response
– Immune modulators (e.g., azathioprine, methotrexate) to regulate the immune system
– Antibiotics (in cases of infectious causes) to eradicate the causative organism

– Nutritional Support:
– Dietary modifications to alleviate symptoms and improve nutrient absorption
– Nutritional supplements or enteral nutrition to address malnutrition and weight loss

– Surgery:
– In severe cases or complications (e.g., strictures, bowel obstruction), surgical intervention may be necessary to remove affected segments of the intestine or repair damaged areas.

Prognosis:
The prognosis of granulomatous enteritis depends on various factors, including the underlying cause, disease severity, and response to treatment. While some individuals may experience long-term remission with appropriate management, others may develop chronic symptoms or complications requiring ongoing medical intervention. Regular monitoring and follow-up with healthcare professionals are essential for optimal disease control and quality of life.