Caecum Health Dictionary

A term applied to the appendages of several hollow organs: for example, the larynx has two pouches called appendices, and the epiploic appendices are the tags of fat that hang from the exterior part of the large intestine. The commonest application, however, is to the vermiform appendix of the large intestine. This is a short, slim, blind-ended tube up to 10 cm long attached to the caecum (a pouch at the start of the large intestine). Its function is unknown, though it may once have had one in ancestral humans. It is, however, prone to in?ammation and infection (see APPENDICITIS).... appendix

All the alimentary canal beyond below the stomach. In it, most DIGESTION is carried on, and through its walls all the food material is absorbed into the blood and lymph streams. The length of the intestine in humans is about 8·5–9 metres (28–30 feet), and it takes the form of one continuous tube suspended in loops in the abdominal cavity.

Divisions The intestine is divided into small intestine and large intestine. The former extends from the stomach onwards for 6·5 metres (22 feet) or thereabouts. The large intestine is the second part of the tube, and though shorter (about 1·8 metres [6 feet] long) is much wider than the small intestine. The latter is divided rather arbitrarily into three parts: the duodenum, consisting of the ?rst 25–30 cm (10–12 inches), into which the ducts of the liver and pancreas open; the jejunum, comprising the next 2·4–2·7 metres (8–9 feet); and ?nally the ileum, which at its lower end opens into the large intestine.

The large intestine begins in the lower part of the abdomen on the right side. The ?rst part is known as the caecum, and into this opens the appendix vermiformis. The appendix is a small tube, closed at one end and about the thickness of a pencil, anything from 2 to 20 cm (average 9 cm) in length, which has much the same structure as the rest of the intestine. (See APPENDICITIS.) The caecum continues into the colon. This is subdivided into: the ascending colon which ascends through the right ?ank to beneath the liver; the transverse colon which crosses the upper part of the abdomen to the left side; and the descending colon which bends downwards through the left ?ank into the pelvis where it becomes the sigmoid colon. The last part of the large intestine is known as the rectum, which passes straight down through the back part of the pelvis, to open to the exterior through the anus.

Structure The intestine, both small and large, consists of four coats, which vary slightly in structure and arrangement at di?erent points but are broadly the same throughout the entire length of the bowel. On the inner surface there is a mucous membrane; outside this is a loose submucous coat, in which blood vessels run; next comes a muscular coat in two layers; and ?nally a tough, thin peritoneal membrane. MUCOUS COAT The interior of the bowel is completely lined by a single layer of pillar-like cells placed side by side. The surface is increased by countless ridges with deep furrows thickly studded with short hair-like processes called villi. As blood and lymph vessels run up to the end of these villi, the digested food passing slowly down the intestine is brought into close relation with the blood circulation. Between the bases of the villi are little openings, each of which leads into a simple, tubular gland which produces a digestive ?uid. In the small and large intestines, many cells are devoted to the production of mucus for lubricating the passage of the food. A large number of minute masses, called lymph follicles, similar in structure to the tonsils are scattered over the inner surface of the intestine. The large intestine is bare both of ridges and of villi. SUBMUCOUS COAT Loose connective tissue which allows the mucous membrane to play freely over the muscular coat. The blood vessels and lymphatic vessels which absorb the food in the villi pour their contents into a network of large vessels lying in this coat. MUSCULAR COAT The muscle in the small intestine is arranged in two layers, in the outer of which all the ?bres run lengthwise with the bowel, whilst in the inner they pass circularly round it. PERITONEAL COAT This forms the outer covering for almost the whole intestine except parts of the duodenum and of the large intestine. It is a tough, ?brous membrane, covered upon its outer surface with a smooth layer of cells.... intestine

The group of organs responsible for digestion. It consists of the digestive tract (also known as the alimentary tract or canal) and various associated organs. The digestive tract consists of the mouth, pharynx, oesophagus, stomach, intestines, and the anus. The intestines are the small intestine (comprising the duodenum, jejunum, and ileum) and the large intestine (comprising the caecum, colon, and rectum). The associated organs, such as the salivary glands, liver, and pancreas, secrete digestive juices that break down food as it goes through the tract.

Food and the products of digestion are moved from the throat to the rectum by peristalsis (waves of muscular contractions of the intestinal wall).

Food is broken down into simpler substances before being absorbed into the bloodstream.Physical breakdown is performed by the teeth, which cut and chew, and the stomach, which churns the food. The chemical breakdown of food is performed by the action of enzymes, acids, and salts.

Carbohydrates are broken down into simple sugars. Proteins are broken down into polypeptides, peptides, and amino acids. Fats are broken down into glycerol, glycerides, and fatty acids.

In the mouth, saliva lubricates food and contains enzymes that begin to break down carbohydrates. The tongue moulds food into balls (called boli) for easy swallowing. The food then passes into the pharynx. From here, it is pushed into the oesophagus and squeezed down into the stomach, where it is mixed with hydrochloric acid and pepsin. Produced by the stomach lining, these substances help break down proteins. When the food has been converted to a semi-liquid consistency, it passes into the duodenum where bile salts and acids (produced by the liver) help to break down fats. Digestive juices released by the pancreas into the duodenum contain enzymes that further break down food. Breakdown ends in the small intestine, carried out by enzymes produced by glands in the intestinal lining. Nutrients are absorbed in the small intestine. The residue enters the large intestine, where water is absorbed. Undigested matter is expelled via the rectum and anus as faeces.... digestive system

n. a rare manifestation of chronic or partially treated amoebic *dysentery leading to the development of a nonmalignant inflammatory mass in the bowel. It can occur in the caecum, appendix, and *rectosigmoid area in descending order of frequency. Amoebomas can cause symptoms of *intestinal obstruction, weight loss, and low-grade fever. Colonic amoeboma with multiple amoebic liver abscesses can masquerade as colorectal carcinoma and liver metastases; imaging with ultrasound and CT scan is used to differentiate between these.... amoeboma

Arises from premalignant adenoma. About one in ten adenomatous polyps develop into a carcinoma. Simple excision of polyps with in situ carcinoma sometimes leads to complete cure.

Symptoms: bleeding, with alteration of bowel habit. Common in diverticular disease where large polyps may be undetected. Early detection by flexible sigmoidoscopy at hospital is essential to accurate diagnosis. Sudden episodes of unexplained diarrhoea and constipation.

The term refers to cancers of the ascending colon, caecum, transverse colon, hepatic flexure, descending colon, splenic flexure, sigmoid colon and rectum. The large bowel tumours are almost wholly adeno-carcinoma.

Common causes: ulcerative colitis, Crohn’s disease, necrotic changes in polyps. The colon is at risk from cancer on a diet high in protein, fat and alcohol and which is low in fibre. An exception is the average diet in Finland where a high fat intake is present with a low incidence of cancer. Strong evidence advanced, includes the heavy consumption of yoghurt (acidophylus lacto bacillus) by the population.

A study of 8006 Japanese men living in Hawaii revealed the close relationship between cancer of the rectum and alcohol consumption. A family history of pernicious anaemia predisposes.

A 19-year prospective study of middle-aged men employed by a Chicago electric company reveals a strong correlation between colorectal cancer and Vitamin D and calcium deficiency. Results “support the suggestion that Vitamin D and calcium may reduce the risk of colorectal cancer”. (Lancet, 1985, Feb 9, i, 307)

Patients with ulcerative colitis of more than 10 years standing carry the increased risk of developing colorectal cancer. There is evidence that malignancy in the bowel may be reduced by saponins. Alternatives of possible value. Inoperable lesions may respond to: Bayberry, Goldenseal, Echinacea, Wild Yam, Stone root, Black root, Mistletoe, Clivers, Marshmallow root, Violet leaves, Chickweed, Red Clover, Thuja.

Tea. Equal parts: Red Clover, Gotu Kola, Violet leaves. 2-3 teaspoons to each cup boiling water; infuse 15 minutes. Freely, as tolerated.

Tablets/capsules. Echinacea, Goldenseal, Wild Yam.

Formula. Echinacea 2; Bayberry 1; Wild Yam 1; Stone root 1; Goldenseal half; Liquorice quarter. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily and at bedtime.

Mistletoe: Injections of fresh plant (Iscador). (Dr Rudolph Steiner Institute, Switzerland)

Violet leaves: Daily irrigations of strong infusion.

Chickweed: Bathe rectum with strong infusion. Follow with Chickweed ointment.

Chinese Herbalism. (1) Tea – Pan-chih-lien (Scutellaria barbarta), 2 liang. (2) Tea. Feng-wei ts’ao (Pteris multifida) 1 liang, and po-chi (water chestnut) 2 liang. (3) Concoction of suitable amount of ts’ang-erh ts’ao, for bathing affected area. (Barefoot Doctor’s Manual)

Diagnosis. Exploration of proctosigmoidoscope to confirm.

Diet. Special emphasis on yoghurt which is conducive to bowel health; orally and by enema. A vegan uncooked raw food diet has been shown to reduce the body’s production of toxins linked with colon cancer. A switch from conventional Western cooked diet to an uncooked vegan diet reduced harmful enzymes produced by gut bacteria. (Journal of Nutrition)

A substance has been found in fish oil believed to prevent cancer of the colon. Mackerel, herring and sardines are among fish with this ingredient. Bowel cancer and additives. See: CROHN’S DISEASE (Note).

Preventive care. All 55-year-olds with this predisposing condition should be screened by sigmoidoscopy. Regular faecal occult blood tests advised.

Regular exercise helps prevent development of bowel cancer. (Nottingham University researchers) Treatment by general medical practitioner or oncologist. ... cancer-colorectal

The final, longest, and narrowest section of the small intestine. It is joined at its upper end to the jejunum and at its lower end to the large intestine (comprising the caecum, colon, and rectum). The function of the ileum is to absorb nutrients from food that has been digested in the stomach and the first 2 sections of the small intestine (the duodenum and the jejunum).

Occasionally the ileum becomes obstructed, for example by pushing through a weakness in the abdominal wall (see hernia) or by becoming caught up with scar tissue following abdominal surgery

(see adhesion). Other disorders of the ileum include Meckel’s diverticulum and diseases in which absorption of nutrients is impaired, such as Crohn’s disease, coeliac disease, tropical sprue, and lymphoma.... ileum

n. an abnormal collection of small blood vessels found in the mucosa of the gastrointestinal tract, which are thought to be due to degeneration of previously healthy blood vessels. Angiodysplasia may be isolated lesions or found in clusters; they are located predominately in the caecum or ascending colon and they may bleed or contribute to iron-deficiency anaemia. Angiodysplasia may be diagnosed at endoscopy or angiography. Treatment includes endoscopic coagulation with *diathermy, *argon plasma coagulation, *embolization at angiography, or surgical resection in cases not responding to other treatments.... angiodysplasia

the small area of the *retina of the eye where the nerve fibres from the light-sensitive cells (see cone; rod) lead into the optic nerve. There are no rods or cones in this area and hence it does not register light. Anatomical name: punctum caecum.... blind spot

n. the creation of an artificial *stoma that serves as a bridge between the caecum and the anterior abdominal wall. Its function is to facilitate lavage in patients with refractory constipation or to decompress the intestine, usually when the colon is obstructed or injured. This may be performed surgically or endoscopically (percutaneous endoscopic caecostomy, PEC).... caecostomy

(ileo-) combining form denoting the ileum. Examples: ileocaecal (relating to the ileum and caecum); ileocolic (relating to the ileum and colon).... ile

a valve at the junction of the small and large intestines consisting of two membranous folds that close to prevent the backflow of food from the colon and caecum to the ileum.... ileocaecal valve

a radiological technique used to diagnose conditions of the large bowel using the combination of X-ray imaging and radiopaque contrast (barium sulphate). Prior bowel cleansing is usually required with a colonic cleansing preparation. A large-bore tube with a balloon is inserted into the rectum and through this the barium is delivered to the caecum. The balloon is inflated in the rectum to prevent leakage of barium outside. In *double contrast studies, air is passed through the catheter to distend the colon. A series of radiographs are taken after barium has coated the colon, and the patient may be asked to change position to ensure that the whole bowel is delineated. Barium enema is used to identify colonic polyps, colorectal cancer, and diverticular disease. However, its role has been largely taken over by *colonoscopy which enables additional mucosal sampling and therapeutic intervention.... barium enema

n. an invasive endoscopic procedure for examining the interior of the colon and the terminal ileum. A colonoscope is a flexible, steerable telescopic instrument that houses a high-definition digital video camera to allow direct visualization of the colonic mucosa. It is inserted into the anus and guided around the loops of the large bowel to the caecum and terminal ileum. Its progress may be aided by using an external *3-D magnetic imager (e.g. ScopeGuide). It is possible to obtain biopsies for microscopic examination using flexible forceps passed through the colonoscope (diagnostic colonoscopy) and to remove polyps, dilate strictures with endoscopic balloons, or insert self-expandable metal stents (SEMS) into benign or malignant strictures (therapeutic colonoscopy).... colonoscopy

n. an operation to enlarge the capacity of and to decrease the pressure within the bladder by incorporating a segment of bowel. In a clam cystoplasty, the bladder is cut across transversely from one side of the neck to the other side through the dome (fundus) of the bladder and a length of the ileum, jejunum, or colon is inserted as a patch. In the operation of ileocaecocystoplasty, the dome is removed by cutting across the bladder transversely or sagittally above the openings of the ureters; it is replaced by an isolated segment of caecum and terminal ileum. In ileocystoplasty the bladder is enlarged by an opened-out portion of small intestine. The bladder may be totally replaced by a reservoir constructed from either small or large intestine (see cystectomy).... cystoplasty

combining form denoting 1. large size, or abnormal enlargement or distension. Example: megacaecum (of the caecum). 2. a million. Example: megavolt (a million volts).... mega

n. Archaic. inflammation of the tissues around the caecum.... perityphlitis

(barium follow-through) a technique for examining the small bowel, often used when small-bowel enema is not tolerated. The patient swallows dilute *barium sulphate suspension and then a series of abdominal radiographs are taken. A complete examination occurs when contrast reaches the first part of the large bowel (caecum). This technique is particularly useful for investigating small-bowel *Crohn’s disease.... small-bowel meal