functional gastrointestinal disease
Introduction
Introduction to functional gastrointestinal disorders Functional gastrointestinal disease refers to a group of diseases with digestive symptoms such as abdominal distension, abdominal pain, diarrhea and constipation, but lacking organic diseases (such as gastritis, enteritis, etc.) or other evidence, the incidence rate in the general population reaches 23.5%. ~74%. In the gastrointestinal clinic, about 42% to 61% of patients with functional gastrointestinal disease have psychological disorders, often manifested as anxiety disorders (panic and generalized anxiety), depression (low mood and bad mood) and somatoform disorders (suspect Disease disorders, etc.), seriously affecting the quality of life of patients. basic knowledge The proportion of illness: 1% Susceptible people: no specific population Mode of infection: non-infectious Complications: viral enteritis
Cause
Cause of functional gastrointestinal disease
Mental factors (35%)
Mental factors are the main causes of this disease, such as emotional stress, anxiety, difficulties in life and work, troubles, accidental misfortunes, etc., can interfere with the normal activities of high-grade nerves, and then cause dysfunction of the gastrointestinal tract. Implications or self-suggestion are important morbid factors, such as the so-called iatrogenic diseases caused by some sloppy diagnosis, inconsistent test results or doctor's behavior and improper expression, and patients with serious diseases such as gastrointestinal tract due to relatives and friends Self-indications caused by cancer of the road can cause this disease.
Dietary factors (24%)
Another pathogenic factor of this disease is the daily dietary factors. If you have frequent eating disorders in your daily life, or you often take laxatives or enema, it can also constitute a bad stimulus and promote the occurrence and development of this disease.
Prevention
Functional gastrointestinal disease prevention
1. Maintaining a good psychological state is broad-minded, emotionally optimistic, cheerful, and open-minded, and is the best measure to prevent this disease.
2. Treatment of psychological disorders Any negative psychological factors that may cause this disease should be avoided as much as possible. Especially for people with fear or cancer, it is necessary for patients to understand that the disease is a functional disease and will never be life-threatening. Eliminate concerns and increase confidence in curing the disease.
3. Treatment of neurological disorders can give sedatives to people with mental stress, such as estazolam (previously known as Shu Le Anding), Baizi Yangxin Pill and oryzanol; for patients with mental depression, amitriptyline and clomipramine can be applied. Etc. For those who are mentally anxious, they can be taken orally and alprazolam (Jia Jing Anding).
4. Treatment of gastrointestinal symptoms for patients with abdominal pain can be used atropine, anisodamine, belladonna, if necessary, with bicycloethylene or papaverine; for diarrhea with compound diphenoxylate (phenethidine), loperamide (easy to stop), etc.; for constipation with bisacodyl (pasta stop), phenolphthalein, Kaisailu, senna and Ma Ren Runchang pills, and eat more vegetables and fruits; for heartburn, acid reflux available Melazodazole (Lossella), nitidine, etc.; domperidone (methodin), cisapride, etc. for bloating; metoclopramide (metazone) and chlorobutanol for nausea and vomiting ( Chlorbutanol); pepsin mixture for indigestion, trypsin, Xiangsha Yangwei pills, etc.
5. Diet regulation Eat less meals, eat foods that are rich in nutrients and easy to digest, avoid eating cold, overheated and irritating foods (ginger, onion, garlic, pepper, mustard, etc.).
6. Chinese medicine treatment to Shugan Liqi, Jianpi Huashi, conditioning spleen and stomach mainly, can be used in Chaihu Shugan San, Sini San, Shenqi Baizhu San and Fuzi Lizhong pills.
Complication
Functional gastrointestinal complications Complications viral enteritis
Generally no complications.
Symptom
Functional Gastrointestinal Symptoms Common Symptoms Anxiety Abdominal Pain Depression Dizziness Bloating diarrhea Stool Color Deep vomiting diarrhea Stool Frequent stool Black green
The clinical manifestations are mainly related symptoms of the gastrointestinal tract (including the pharynx, esophagus, stomach, biliary tract, small intestine, large intestine, anus), which are named differently due to the symptoms. Often accompanied by insomnia, anxiety, depression, dizziness, headache and other functional symptoms, and the background with more mental factors need to be checked to rule out the organic cause can be diagnosed.
Constipation-type functional gastrointestinal disease is mainly characterized by dry stools. When you want to take time, you can't solve it slowly, abdominal swelling and pain, and intestinal cramps. Diarrhea-type functional gastrointestinal disease is characterized by loose stools, more than three times a day of bowel movements, sometimes, you can not control.
Examine
Functional gastrointestinal disease examination
In addition to dyspeptic symptoms such as upper abdominal discomfort, abdominal pain, hernia, nausea, constipation or diarrhea, and patients with autonomic imbalances, such as palpitations, insomnia, etc., especially symptoms often fluctuate with mood changes, suggesting treatment Relieve, suggesting the possibility of this disease. Further gastrointestinal X-ray examination showed that the movement of the entire gastrointestinal tract was accelerated, the colonic pocket was deepened, the tension was enhanced, and sometimes due to colonic spasm, there was a linear shadow below the descending colon. There was no obvious abnormality in colonic mucosa by colonoscopy.
It must be emphasized that the diagnosis of gastrointestinal dysfunction should be very careful, and it is necessary to rule out organic diseases, especially malignant lesions of the gastrointestinal tract, before making a diagnosis. Most of the patients in this disease are emotionally nervous. When they go to the doctor, they complain about a lot of complaints. Some of them complain about the symptoms on paper. The doctor should first patiently listen to and analyze the patient's statement and the situation provided by the patient's relatives and friends, and carefully conduct physical examinations and laboratory tests. X-ray, endoscopy, gastric juice analysis and stool test were taken according to different conditions. Ultrasound, CT, etc. should be performed when necessary to exclude abdominal organs such as liver, gallbladder, and pancreas. For elderly patients with newly diagnosed diseases, careful and careful examination should be carried out in order to prevent other serious organic diseases from being missed. After the initial diagnosis of gastrointestinal dysfunction, close follow-up is required, and the diagnosis can be confirmed after a long period of observation.
Diagnosis
Diagnosis and diagnosis of functional gastrointestinal diseases
The disease should be differentiated from various organic stomach diseases, organic intestinal diseases and various visceral lesions (liver, gallbladder, pancreas).
Neurological vomiting should be differentiated from chronic gastropathy, pregnancy vomiting, uremia, etc., and should also focus on intracranial space-occupying lesions, especially brain tumors; neurological anorexia and gastric cancer, early pregnancy response, pituitary or renal cortical function Decrease the identification. Intestinal irritation syndrome and early ulcerative colitis, Crohn's disease, colon cancer and dysentery, etc., must also be differentiated from hyperthyroidism, malabsorption syndrome.
