General Considerations

Dietetic treatment is not so important in intestinal as in gastric disorder, inasmuch as the common errors of diet produce their effect in the stomach, and the intestine is shielded to some extent. It is more difficult and less exact, because the process of digestion in the small intestine is not fully known. Moreover, we have no direct means of ascertaining the state of the bowel as regards either its secretory or its motor power, and in order to estimate the value of intestinal digestion in any case we must be content with an endeavour to interpret the symptoms and physical signs. Examination of the stools gives some further evidence and it should always be practised. But minute examination is exceedingly difficult, and a rough examination is likely to afford more information as to the state of the colon than as to the digestive power of the small intestine. It is important to realize how completely the bowel is at the mercy of the stomach, and how any impairment of the preparatory and protective functions of the stomach may disturb the action of all parts below. This dependence of the intestine on the stomach is often a serious drawback in prescribing a diet, and an otherwise correct diet must often be modified owing to the coincidence of some gastric failure.