From the Guidelines
Swollen intestinal walls are most commonly caused by inflammatory bowel diseases, such as Crohn's disease, which triggers chronic inflammation in the intestinal lining, as indicated by mural hyperenhancement and wall thickening on computed tomography and magnetic resonance enterography 1. The etiology of swollen intestinal walls can be attributed to various conditions affecting the gastrointestinal tract. Some of the key causes include:
- Inflammatory bowel diseases like Crohn's disease and ulcerative colitis, which trigger chronic inflammation in the intestinal lining
- Infections from bacteria, viruses, or parasites that cause intestinal wall swelling as the body mounts an immune response
- Allergic reactions to foods or medications that lead to intestinal edema through hypersensitivity mechanisms
- Circulatory problems like congestive heart failure, portal hypertension, or mesenteric vascular disease that cause fluid accumulation in intestinal tissues due to increased hydrostatic pressure or decreased oncotic pressure
- Lymphatic obstruction from surgery, radiation, or malignancy that prevents proper drainage of intestinal lymph, resulting in edema
- Intestinal ischemia, whether acute or chronic, that damages the intestinal wall and causes inflammatory swelling
- Protein-losing enteropathies and hypoalbuminemia that reduce oncotic pressure, allowing fluid to leak into intestinal tissues According to the most recent and highest quality study, the diagnosis of swollen intestinal walls can be made using computed tomography and magnetic resonance enterography, which can detect mural hyperenhancement and wall thickening, indicative of inflammation 1. Treatment depends on addressing the underlying cause, which may include anti-inflammatory medications for IBD, antibiotics for bacterial infections, dietary modifications for allergies, or management of cardiac or hepatic conditions for circulatory causes. It is essential to note that the management of swollen intestinal walls should prioritize the reduction of inflammation and the prevention of complications, such as intestinal ischemia and perforation, to improve patient outcomes and quality of life 1. In cases where the underlying cause is not immediately apparent, a thorough diagnostic workup, including imaging studies and endoscopy, may be necessary to determine the etiology of the swollen intestinal walls and guide treatment decisions 1. Ultimately, the goal of treatment is to reduce morbidity, mortality, and improve quality of life for patients with swollen intestinal walls, and this can be achieved through a comprehensive and multidisciplinary approach to diagnosis and management 1.
From the Research
Etiology of Swollen Intestinal Walls
The etiology of swollen intestinal walls can be attributed to various factors, including:
- Environmental factors, genetic factors, and immune responses, which are considered major etiologies of inflammatory bowel disease (IBD) 2
- Inflammatory reactions of the gut wall, which can be caused by excessive and tissue-disruptive immune responses 2
- Neoplastic, inflammatory, infectious, or ischemic conditions, which can cause bowel wall thickening 3
- Modernization, Westernization, and urbanization, which are associated with an increased risk of developing IBD 4
Inflammatory Bowel Disease (IBD)
IBD, which includes ulcerative colitis (UC) and Crohn's disease (CD), is a major cause of swollen intestinal walls. The pathogenesis of IBD is complex and involves:
- Genetic risk factors, intestinal microbiota, and environmental influences 4
- Immune dysfunction and gut injury, which can lead to chronic inflammation and tissue damage 2
- Altered innate and/or acquired/adaptive host immune responses, which can contribute to the development of IBD 4
Risk Factors
Several risk factors have been identified as contributing to the development of swollen intestinal walls, including:
- Western lifestyle and diet, which are associated with an increased risk of developing IBD 4
- Host genetics, which can predispose individuals to developing IBD 4
- Early-life microbiota exposure, which can influence the development of the gut microbiome and increase the risk of IBD 4
- Pollution, changing hygiene status, and socioeconomic status, which can also contribute to the development of IBD 4