enteritis
Introduction
Introduction to enteritis Enteritis is gastroenteritis, enteritis, and colitis caused by bacteria, viruses, fungi, and parasites. Clinical manifestations include nausea, vomiting, abdominal pain, diarrhea, loose water or mucus pus and blood. Some patients may have fever and sensation after urgency, so it is also known as infectious diarrhea. Acute inflammatory changes in the gastrointestinal mucosa caused by eating foods containing pathogens and their toxins, or improper diets, such as excessive amounts of irritating, non-digestible foods. Its pathological manifestations include hyperemia, edema, and mucus secretion in the gastrointestinal mucosa, sometimes accompanied by bleeding and erosion. In China, the incidence rate is higher in summer and autumn, and there is no gender difference. The general incubation period is 12-36 hours. Nausea, vomiting, and diarrhea are the main symptoms of acute gastroenteritis. basic knowledge The proportion of illness: 0.35% Susceptible people: no specific people Mode of infection: non-infectious Complications: rectal polyps anal canal, rectum, colon stenosis anal sinusitis blood in the stool
Cause
Cause of enteritis
Genetic factors (25%):
The incidence of blood relatives in this disease is high. According to European and American literature statistics, about 15-30% of the immediate blood relatives of patients with ulcerative colitis are affected.
Low immunity (20%):
Most scholars believe that this disease is an autoimmune disease. Because the disease is complicated by autoimmune diseases (such as autoimmune hemolytic anemia), improving immunity is also the most important factor in the prevention and treatment of enteritis.
Abuse of antibiotics (20%):
Many people will abuse the antibiotics such as ampicillin and cephalosporin when they encounter diseases. These antibiotics will directly stimulate the intestines, and may also cause intestinal flora imbalance, so that normal E. coli in the intestinal tract can reduce the proliferation of harmful bacteria and cause enteritis.
Inadequate diet (20%):
Including dietary factors such as diarrhea caused by improper diet, food expiration such as milk expiration, and unclean environment, sudden changes in climate, sudden changes in lifestyle can cause diarrhea.
Increased risk of enteritis in women with oral contraceptives (15%):
A cohort study from the United States and the United Kingdom noted that women with oral contraceptives had a 40% increased risk of developing inflammatory bowel disease. Long-term oral contraceptives or high-dose estrogen women have a high risk of enteritis.
Prevention
Enteritis prevention
1. Patients with chronic colitis are mostly weak and have poor resistance. Especially the gastrointestinal tract is easy to be infected. Therefore, it is more important to pay attention to food hygiene, not to eat cold, hard and spoiled food, alcohol and spicy spicy condiments.
2. Patients should usually strengthen their exercise, such as tai chi, to strengthen the waist and strengthen the body.
3. Pay attention to the belly to keep warm.
4. In addition to avoiding cold and controlling emotions, diet is a very important aspect. The disease can not eat beans and soy products, wheat and noodles, as well as garlic, leeks, yam, preserved eggs, cabbage, peanuts, melon seeds and other gas-producing foods during the attack period. Because once the food is eaten, the gas in the gastrointestinal tract is increased, and the gastrointestinal motility is affected, which can induce the disease and even aggravate the symptoms.
5. Persimmon, pomegranate and apple all contain citric acid and pectin components, all of which have astringent and antidiarrheal effects. Chronic colitis can be eaten in moderation.
Complication
Enteritis complications Complications rectal polyps anal canal, rectum, colon narrow anal sinusitis blood in the stool
1, intestinal polyps, colon cancer: proctitis for more than five years, the intestinal ulcer surface is prone to abnormal hyperplasia under the long-term stimulation of inflammation, causing intestinal polyps, more than one centimeter of intestinal polyps cancer rate is extremely high.
2, intestinal stenosis: more common in lesions, the duration of the disease for more than 5-25 years, the location of the rectum, clinically generally asymptomatic, can cause intestinal obstruction in severe cases, in the case of intestinal stenosis, be vigilant Tumors identify benign and malignant.
3, anal sinusitis: proctitis is not treated in time, can be anal sinusitis and other anorectal diseases, and there is a risk of secondary perianal abscess.
4, anal canal inflammation: This is a complication of the disease, often associated with proctitis and called anorectal inflammation, anal canal inflammation for a long time and there is a risk of cancer.
5, blood in the stool: blood in the stool is one of the main clinical manifestations of this disease, the number of blood in the stool is also an indicator to measure the severity of the disease. Long-term chronic bleeding can cause iron deficiency anemia.
Symptom
Symptoms of enteritis Common symptoms Abdominal pain with nausea, vomiting, nausea, watery stool, abdominal pain, diarrhea, nausea, vomiting, feces, pus
Acute inflammatory changes in the gastrointestinal mucosa caused by eating foods containing pathogens and their toxins, or improper diets, such as excessive amounts of irritating, non-digestible foods. Its pathological manifestations include hyperemia, edema, and mucus secretion in the gastrointestinal mucosa, sometimes accompanied by bleeding and erosion. In China, the incidence rate is higher in summer and autumn, and there is no gender difference. The general incubation period is 12-36 hours. Nausea, vomiting, and diarrhea are the main symptoms of acute gastroenteritis.
Clinical manifestations of patients with acute enteritis
Acute enteritis is an acute inflammatory change of the gastrointestinal mucosa caused by eating foods containing pathogenic bacteria and their toxins, or improper diet, such as excessive irritating, non-digestible foods. Its pathological manifestations include hyperemia, edema, and mucus secretion in the gastrointestinal mucosa, sometimes accompanied by bleeding and erosion. In China, the incidence rate is higher in summer and autumn, and there is no gender difference. The general incubation period is 12-36 hours.
Nausea, vomiting, and diarrhea are the main symptoms of acute gastroenteritis. Why does acute gastroenteritis cause vomiting and diarrhea? This is caused by nerve reflex. In acute gastroenteritis, the inflammation of bacteria, toxins or gastrointestinal mucosa stimulates the receptors of the digestive tract, impulses into the vomiting center of the medulla, causing excitement in the vomiting center, and reaching the stomach, diaphragm, and respiratory muscles through the efferent nerves. Abdominal muscles and pharynx, phlegm, epiglottis, etc., cause a series of coordinated movements, and constitute a vomiting action. At the same time, due to the inflammation of the intestinal mucosa, the intestinal contents are increased, and the peristalsis is enhanced directly or reflexively, the absorption function is reduced, and diarrhea occurs.
Because vomiting and diarrhea have certain protective effects on the human body under certain circumstances, clinical measures should be taken according to different situations, such as food poisoning or accidental poisoning. Not only should laxatives be given, but instead, vomiting and diarrhea should be given. Take medicine to promote the discharge of poisons. If vomiting and diarrhea caused by inflammation of the digestive tract, in order to reduce the adverse effects of water and salt metabolism and electrolyte imbalance, the body should be treated with antiemetic and antidiarrheal treatment while actively treating the cause.
Clinical manifestations of patients with chronic enteritis
Chronic enteritis refers to chronic inflammatory diseases of the intestine. The cause of the disease may be microbial infections such as bacteria, mold, viruses, protozoa, etc., and may also be caused by allergies, allergies and the like. The clinical manifestations are long-term chronic or recurrent abdominal pain, diarrhea and dyspepsia. In severe cases, there may be mucus or watery stools.
(1) Digestive tract symptoms: often present intermittent abdominal pain, abdominal distension, abdominal pain, diarrhea is the main manifestation of this disease. In case of cold, oily (oily food) greasy things, or when the mood fluctuates, or after fatigue. The number of stools increased, several times a day or dozens of times, the anus fell, the stool was unhappy. In the acute onset of chronic enteritis, high fever, abdominal cramps, nausea and vomiting, and urges such as water or sticky blood can be seen.
(2) systemic symptoms: chronic consumption symptoms, lack of vitality, lack of energy, lazy words, limb weakness, like temperature and cold. For example, in the acute inflammatory phase, in addition to fever, loss of water, acidosis or shock bleeding can be seen.
(3) physical signs: long-term abdominal discomfort or less abdominal pain, the body can be seen in the abdomen, umbilical or abdomen, with mild tenderness, bowel sounds hyperthyroidism, rectal prolapse.
Examine
Enteritis examination
It varies with the pathogen. Generally judged according to the history of epidemiology and clinical manifestations. Further diagnosis depends on laboratory tests. Bacterial enteritis can be used for vomiting and stool culture, and pathogens can be diagnosed. Some pathogens such as Salmonella infection can be used for blood culture. Viral gastroenteritis can be used to examine viral antigens and antibodies by electron microscopy, immunoelectron microscopy, immunofluorescence, and serological tests such as complement binding assays, enzyme-linked immunosorbent assays, and radioimmunoassays. The virus can also be isolated by tissue culture. Parasitic enteritis can be directly microscopically examined for pathogens and their eggs. Fungal enteritis can be smeared directly from the stool, examined under a microscope for fungal or stool culture.
(1) Radiological tincture examination: In the acute phase, it is generally not suitable for tincture examination. Special attention is given to the possibility of severe ulcerative colitis inducing intestinal dilatation and perforation during barium enema. Under normal circumstances, only symptomatic laxatives should be used in clinical symptoms to avoid acute attacks. Intestinal preparation should be routinely performed during the resting period. Barium enema has important value in the diagnosis and differential diagnosis of this disease. Conventional barium enema X-ray examination can be seen: 1 patients with mild ulcerative colitis, X-ray examination is negative, moderate and severe patients have typical performance. 2 The edge of the colon wall is a small serrated protrusion and a rail-like fold. 3 filling defects, false polyps formation, a small number of cases due to colonic fibrosis and polyp hyperplasia, can cause the intestinal lumen to narrow. 4 The colonic bag disappears or becomes shallow, and the colon shortens and is stiff, even like a water tube. 5 snowflake sign: due to tiny ulcers and erosion, attached to the tincture, sputum spots, gas sputum double angiography such as snowflakes. 6 rows of anomalies. 7 The posterior rectal space increased by more than 2 cm, indicating severe inflammation of the rectum and rectum. 8 should pay attention to the presence or absence of colon cancer.
(2) Endoscopy: Most of the clinical lesions in the rectum and sigmoid colon are valuable for sigmoidoscopy. For patients with chronic or suspected whole colon, fiberoptic colonoscopy should be performed. Generally do not use clean enema, acute acute phase should be listed as taboo to prevent perforation. Endoscopy has the value of diagnosis. By repeating the macroscopic changes and histological changes of the colon under direct vision, it can not only understand the nature and dynamic changes of inflammation, but also detect precancerous lesions early, and accurately collect the diseased tissue under the microscope. And secretions to facilitate the exclusion of specific intestinal infectious diseases.
Diagnosis
Enteritis diagnosis and identification
Diagnose based on
(1) There is a history of overeating or eating unclean and spoiled food.
(2) acute onset, frequent nausea, vomiting, severe abdominal pain, frequent diarrhea, mostly watery stools, may contain undigested food, a small amount of mucus, and even blood.
(3) often have symptoms of fever, headache, general malaise and varying degrees of poisoning.
(4) vomiting, severe diarrhea, may have dehydration, acidosis, and even shock.
(5) Signs are not obvious, there is tenderness in the upper abdomen and umbilical cord, no muscle tension and rebound tenderness, and the bowel sounds are hyperthyroidism.
