Each year, US doctors diagnose about 1200 malignant small intestine tumors. This
is a small number relative to the frequency of tumors in other parts of the GI
It has been proposed that the liquid nature of the small intestinal contents may
be less irritating to the mucosa, the innermost lining of the small bowel.
Rapid transit time in the small bowel may reduce exposure of the intestinal wall
agents found in the intestinal contents.
Other factors that might limit the presence or impact of potential
cancer-inducing agents include the following:
Adenocarcinoma of the small bowel is associated with the following underlying
Crohn disease - An inflammation in the small intestine.
usually occurs in the lower part of the small intestine, called the ileum. The
inflammation extends deep into the lining of the affected organ, causing pain
and making the intestines empty frequently, resulting in diarrhea.
Celiac disease - Gluten intolerance
Familial polyposis syndromes - An inherited
which the large bowel becomes carpeted by polyps of various dimensions during
the second or third decade of life. If untreated, the disease invariably leads
to cancer of the colon or rectum. Celecoxib (Celebrex) has been
Administration (FDA) approved for FAP. After 6 months, celecoxib reduced the
mean number of rectal and colon polyps by 28% compared to placebo (sugar pill)
Cancer is 50
times more common in the large bowel than in the small bowel. Risk factors in
the general population include the following:
Risk factors for developing cancer of the small intestine in
include the following:
Lymphoma of the small intestine is associated with celiac disease but is also
strongly associated with weakened immune systems such as occurs with
The association of small bowel
underlying conditions makes it possible to identify populations at risk and to
develop screening programs.
People with a family history of polyp syndromes, such as Peutz-Jeghers and
Gardner syndrome, may benefit from regular screening using upper GI tract barium
People with celiac disease are at higher risk of developing both adenocarcinoma
and lymphoma of the small bowel. They need to maintain a gluten-free diet.
People with celiac disease who also have new onset weight loss, diarrhea, or
abdominal pain need immediate medical attention, including possible CT scan of
the abdomen and barium study of the small bowel to rule out
People with Crohn disease and small bowel bypass procedures also require
-related adenocarcinoma frequently develops in the lower end of the small bowel,
making colonoscopy a potentially useful screening tool.
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