Which is best for diagnosis of small intestinal mucosal disease?
Mucosal disease of small intestine : Infection (esp. Giardia, Whipple's disease, tropical sprue), inflammatory diseases (esp. Crohn's disease), radiation enteritis, eosinophilic enteritis, ulcerative jejunitis, mastocytosis, tropical sprue, infiltrative disorders (amyloidosis, scleroderma, lymphoma, collagenous sprue, microscopic colitis), biochemical abnormalities (gluten-sensitive enteropathy, disaccharidase deficiency, hypogammaglobulinemia, abetalipoproteinemia, amino acid transpo deficiencies), endocrine disorders (diabetes mellitus, hypoparathyroidism, adrenal insufficiency, hypehyroidism, Zollinger-Ellison syndrome, carcinoid syndrome) For some small intestinal disorders that are characterized by diarrhea or malabsorption, the biopsy findings may be distinctive and lead to a specific diagnosis. Whipple Disease- -PAS positive inclusions that is Schiff reagent positive inclusion inside the macrophages of lamina propria - Caused by bacteria - Tropheryma whipplei Note Gluten sensitive enteropathy is strongly associated with HLA DQ2 and HLA DQ8
Small bowel Series using barium contrast
Urinary D- xylose test
Small intestinal mucosal biopsy
Breath hydrogen test
Malabsorbtion Syndrome