stomach persimmon stone
Introduction
Introduction of stomach persimmon Gastric persimmon disease is a person who eats persimmons in large quantities on an empty stomach (the persimmon here refers to the kind of persimmons that make persimmons, not tomatoes). Because of the enamel and stomach acid in persimmon, it is easy to form insoluble in water. A block that cannot be digested, that is, a stomach persimmon stone. The stomach persimmon stays in the stomach for a long time, can not be digested, and because the volume is larger than the diameter of the pyloric sphincter when it is relaxed, it cannot be discharged into the intestine, so it will stimulate the gastric mucosa, cause inflammation, erosion, ulcer, and cause Gastric dysfunction, this condition is called gastric persimmon. basic knowledge Sickness ratio: 0.5% Susceptible people: no specific population Mode of infection: non-infectious Complications: gastric ulcer superficial gastritis stomach bleeding
Cause
Gastric persimmon cause
Plant gastroliths are mainly composed of various undigested plant constituents, including tannic acid, cellulose, pectin, colloid and the like. Gastric persimmon disease is the most common plant stone. The incidence of this disease in the persimmon area and persimmon season is higher. Immature persimmons have higher enamel content, so it is more likely to suffer from persimmon stone disease when eating immature persimmons.
Prevention
Stomach persimmon prevention
Avoid eating a large number of persimmons, black dates, etc. on an empty stomach, overcoming the quirks of chewing hair, and actively treating gastrointestinal motility disorders to prevent the re-formation of stomach stones. It is best not to eat hawthorn on an empty stomach, but also to avoid eating milk, sweet potatoes, coffee, seafood, and other foods that are rich in protein and stimulate gastric acid secretion.
Complication
Gastric persimmon complications Complications, gastric ulcer, superficial gastritis, gastric bleeding
Common clinical complications are superficial gastritis and gastric ulcer, the incidence rate is 60% to 70%. Patients with gastritis, gastric ulcer, gastric bleeding or pyloric obstruction may have repeated abdominal pain or hematemesis, vomiting, etc. Corresponding clinical manifestations, occasionally major bleeding, perforation or gastrolithic into the intestine causing intestinal obstruction, its clinical signs and symptoms are more obvious and serious.
Symptom
Gastric persimmon symptoms Common symptoms Upper abdominal pain, bloating, nausea and vomiting, bad breath, vomiting, loss of appetite
Gastrointestinal stones are easy to occur in patients with vagus nerve resection and gastroparesis syndrome, which may be related to gastric dysfunction in this part of patients. Can be divided into acute and chronic two types. The course of the disease is acute within 6 months, and chronic is more than 6 months. It is more common in acute cases. Acute type of eating persimmons, hawthorn, etc. 1 ~ 2h will appear symptoms, more than half of the patients have upper abdominal pain fullness, nausea, vomiting, generally vomiting is not much, may have vomiting brown or bloody substances, and a large number of hematemesis is rare. 30% of the physical examinations touched the upper abdomen glide mass. Due to the stimulation and damage caused by the stomach stone to the local mucosa, it often has gastric ulcer, gastric mucosal erosion, pyloric obstruction, intestinal obstruction, occasional perforation and peritonitis. The clinical symptoms and signs of patients with gastritis are related to the size, shape, nature of the stomach stone and the degree of influence on human digestion and motor function. The patient may have no symptoms at all, or may have upper abdominal discomfort, loss of appetite, bad breath, nausea, vomiting or varying degrees of abdominal distension and abdominal pain. Physical examination often touches the moving mass in the upper abdomen, generally no obvious tenderness.
Examine
Gastric persimmon inspection
Laboratory inspection
Some patients may have small cell hypochromic anemia. Some patients have a positive fecal occult blood test, and persimmon skin samples can be seen at the beginning. Gastric juice analysis showed that the free acid in the stomach was higher than normal.
Other auxiliary inspection
1, X-ray examination X-ray barium meal perspective or gas sputum double contrast, can be found in the stomach to produce shunt phenomenon, and showed floating in the upper layer of the tincture free, agglomerate, round or oval filling defect area, and The gastric mucosa is smooth and the stomach wall is soft. When the sputum in the stomach is empty, there is still a smear, reticular or flaky adhesion on the lumps. There is no obvious tenderness in the shadow of the pressing block, and the contour shape and position can be changed with the force, suggesting that the agglomeration has certain compressibility and migration.
2, fiber endoscopy fiber endoscopy can directly observe the shape and traits of the stones in the stomach. Plant gastroliths may be yellow, brown, brown or green, often round, elliptical, single or multiple free masses due to different agglomerate composition. The tortoise is generally black or tan, and has a "J" shape or a kidney shape, which can fill the stomach or extend into the duodenum. Fiber endoscopy can also be used to understand whether there are other signs such as gastritis and ulcer disease in the stomach. If necessary, the gastric tissue of the agglomerated component or the complication can be clamped for analysis. therefore. Fiberoptic endoscopy should be the preferred diagnostic tool for patients with conditional hospital gastroenteritis.
3, B-ultrasound B-ultrasound is helpful for the diagnosis of gastrolith. Usually, the patient drink 500-1000ml of water, sitting or semi-recumbent examination, it can be seen that there is a clear echo of the image of the echogenic mass in the stomach, floating on the water layer, and can change position with the change of body position or peristalsis of the stomach.
Diagnosis
Diagnosis and differentiation of gastric persimmon
diagnosis
The patient had a history of eating persimmons, hawthorns, and black dates. Shortly after eating, stomach symptoms, including repeated upper abdominal pain, vomiting, and black stools, should be guarded against stomach stones, which can be diagnosed by gastroscopy and X-ray examination.
Differential diagnosis
Chronic gastric persimmon patients, due to long course of disease, symptoms are often similar to chronic gastritis, ulcer disease or gastric cancer, but it is easy to distinguish with the above diseases by X-ray barium angiography or gastroscopy.
