Diarrhea

Diarrhea is a common symptom, which means that the frequency of bowel movements is significantly higher than the frequency of usual habits, the feces are thin, the water increases, the daily bowel volume exceeds 200g, or it contains undigested food, pus, blood, and mucus. Diarrhea is often accompanied by the urgency to defecate, anal discomfort, incontinence and other symptoms.

1. Acute diarrhea

(1) Infections include viruses (rotavirus, Norwalk virus, Coxsackie virus, Echo and other viruses), bacteria (E. coli, Salmonella, Shigella, Shigella, Vibrio cholerae) or parasites ( Intestinal infection caused by Amoeba histolytica and Piriformis).

(2) Poisoning Food poisoning such as eating undercooked lentils, mushroom poisoning, pufferfish poisoning, heavy metal poisoning, pesticide poisoning, etc.

(3) Drugs: laxatives, cholinergic drugs, digitalis drugs, etc.

(4) Other diseases Acute attacks of ulcerative colitis, acute necrotizing enteritis, food allergies, etc.

2. Chronic diarrhea

The cause of chronic diarrhea is more complicated than acute. Intestinal mucosal disease, excessive bacterial proliferation in the small intestine, defective intestinal transport, insufficient digestion, intestinal motility disorders, and certain endocrine diseases and extraintestinal tumors may all lead to chronic diarrhea. occur. Diseases that can cause chronic diarrhea include:

(1) Intestinal infectious diseases ① Chronic amoebic dysentery; ② Chronic bacterial diseases; ③ Intestinal tuberculosis; ④ Piriformis, schistosomiasis; ⑤ Intestinal candidiasis.

(2) Non-infectious inflammation of the intestinal tract ① Inflammatory bowel disease (Crohn's disease and ulcerative colitis); ② Radiation enteritis; ③ Ischemic colitis; ④ Diverticulitis; ⑤ Uremic enteritis.

(3) Tumors ① Colorectal cancer; ② Colon adenoma (polyps); ③ Small bowel malignant lymphoma; ④ Amine precursor uptake decarboxylase, gastrinoma, carcinoid, intestinal vasoactive intestinal peptide tumor, etc.

(4) Small intestine malabsorption ① Primary small intestine malabsorption; ② Secondary small intestine malabsorption.

(5) Intestinal motility diseases such as irritable bowel syndrome

(6) Stomach and hepatobiliary and pancreatic diseases ①Most gastrectomy-gastrojejunostomy; ②Atrophic gastritis; ③chronic hepatitis; ④hepatic cirrhosis; ⑤chronic pancreatitis; ⑥chronic cholecystitis.

(7) Systemic diseases ① Hyperthyroidism; ② Diabetes; ③ Chronic adrenal hypofunction; ④ Systemic lupus erythematosus; ⑤ Niacin deficiency; ⑥ Food and drug allergy.

Clinical manifestations voice

1. Acute diarrhea

The onset is acute, and the course of the disease is within 2 to 3 weeks. It can be divided into watery diarrhea and dysentery-like diarrhea. The former does not contain blood or pus in the stool, but may not be accompanied by tenesmus, and the abdominal pain is mild; the latter has pus and blood in the stool, often accompanied by tenesmus and dysentery. Abdominal cramps. Infectious diarrhea is often accompanied by abdominal pain, nausea, vomiting and fever, small intestine infection is often watery diarrhea, and large intestine infection often contains bloody stools.

2. Chronic diarrhea

Increased stool frequency, more than 3 bowel movements per day, loose or unshaped stools, stool water content greater than 85%, sometimes accompanied by mucus, pus and blood, lasting for more than two months, or intermittent recurrence within 2 to 4 weeks diarrhea. Patients with lesions located in the rectum and/or sigmoid colon tend to have tenesmus, have a small amount of bowel movement each time, sometimes only a small amount of gas and mucus are discharged, the pink is darker, and they are mostly sticky and can be mixed with blood. Abdominal discomfort is located on both sides of the abdomen or lower abdomen.

Treatment

Etiological treatment and symptomatic treatment are both important. Before the cause is clear, painkillers and antidiarrheal drugs should be used with caution to avoid misdiagnosis and delay of the condition caused by covering up the symptoms.

1. Etiology treatment

(1) Anti-infective treatment According to different causes, choose the corresponding antibiotics.

(2) Others Milk products should not be used for lactose intolerance, and wheat products should fast for adults with celiac disease. Chronic pancreatitis can supplement a variety of digestive enzymes. Drug-related diarrhea should be stopped immediately.

2. Symptomatic treatment

(1) General treatment to correct water, electrolyte, acid-base balance disorders and nutritional imbalances. Supplement liquids as appropriate, supplement vitamins, amino acids, fat emulsions and other nutrients.

(2) Mucosal protective agent Dioctahedral montmorillonite, sucralfate, etc.

(3) Probiotics such as bifidobacteria can regulate intestinal flora.

(4) Antidiarrheal agents Choose corresponding antidiarrheal agents according to specific conditions.

(5) Others 654-2, propylene bromide, atropine, etc. have antispasmodic effects, but patients with glaucoma, prostatic hypertrophy, and severe inflammatory bowel disease should be used with caution.

Reference

Fang Zhaoyin, Xie Huaping, Lu Hongxia, et al. Research on human calicivirus diarrhea in infants and young children in my country from 1999 to 2005. "Journal of Virology", 2007

Zhang Shengsheng, Tang Boxiang, Zhu Peiyi, etc. A multicenter randomized controlled study on the treatment of diarrheal irritable bowel syndrome with traditional Chinese medicine. "CNKI; WanFang", 2010

Ye Xinhua, Jin Yu, Fang Zhaoyin, etc. Study on the etiology of infant viral diarrhea in Lanzhou from 2004 to 2005. "Chinese Journal of Epidemiology", 2006

Jiao Fuyong, Bai Taomin, Lin Jing. New progress in the treatment of pediatric diarrhea. "CNKI; WanFang", 2011

Zhang Jing, Chang Zhaorui, Sun Junling, etc. Current status of norovirus infectious diarrhea in my country and recommendations for prevention and control measures. "Disease Surveillance", 2014

腹泻 腹瀉

腹泻是一种常见症状，俗称“拉肚子”，是指排便次数明显超过平日习惯的频率，粪质稀薄，水分增加，每日排便量超过200g，或含未消化食物或脓血、黏液。腹泻常伴有排便急迫感、肛门不适、失禁等症状。