green feces
Introduction
Introduction In the intestinal flora disorder, Pseudomonas aeruginosa infection produces blue-green fluorescein to make the stool green. A healthy person has a wide variety of microorganisms in the gastrointestinal tract. These microorganisms are called intestinal flora. The intestinal flora is combined in a certain proportion, and the bacteria are mutually restricted and interdependent, forming an ecological balance in quality and quantity. Once the environment changes inside and outside the body, it is characterized by long-term application of broad-spectrum antibiotics, and sensitive intestinal bacteria are inhibited. The uninhibited bacteria multiply and multiply, causing the flora to be dysfunctional, and its normal physiological combination is destroyed, resulting in a pathological combination, causing clinical symptoms called the alternation of intestina flora. The incidence of this disease is about 2% to 3%.
Cause
Cause
Causes
(1) Diet: The results of studying the metabolic activity of the flora using the method of measuring bacterial enzymes indicate that the diet can significantly change the fecal flora. Fiber-free foods promote bacterial translocation. The dietary fiber can maintain the normal ecological balance of the intestinal flora, and the end product of the bacterial metabolic fiber has a nutritional effect on the intestinal epithelium, and the fiber can maintain the normal metabolism and cell dynamics of the intestinal mucosa. The low-slag diet with fiber added has a good effect on preserving the structure and function of the intestine. Whether the protective effect of the fiber directly stimulates the intestinal mucosa or induces the release of nutritive gastrointestinal hormone is unclear. Dietary fiber can reduce bacterial translocation, but does not restore barrier function to normal.
(2) Changes in the flora: The composition of the flora may vary from individual to individual, but for the same person, the composition of the flora is very stable over a long period of time. The ecological status of each species is determined by the physiological state of the host, the interaction between bacteria, and the effects of the environment. In equilibrium, all ecological status is occupied. The temporary habitat of bacteria can change the ecological balance.
(3) Metabolism of drugs: Intestinal flora plays an important role in the metabolism of many drugs, including lactulose, sulfasalazine salicylate, levodopa and the like. Any antibiotic can cause a change in the colonic flora, which depends on the antimicrobial spectrum of the drug and its concentration in the intestinal lumen. Clindamycin and ampicillin can cause an ecological vacuum in the large intestine, allowing C. difficile to proliferate. The use of H2-receptor antagonists such as cimetidine can cause drug-induced hypogastric acid and gastric bacterial proliferation.
(4) Age: As the age increases, the balance of intestinal flora can change, the double-tailed bacteria decrease, and the production of Clostridium perfringens increases. The former may weaken the stimulation of immune function, and the latter lead to the increase of toxins, which inhibits immunity. . Older people who are able to maintain the balance of the intestinal flora during youth may be able to improve their immunity.
(5) Gastrointestinal immune dysfunction: The normal immune function of the gastrointestinal tract comes from the plasma cells of the lamina propria. The plasma cells can produce a large amount of immunoglobulin, the secretory IgA, which is the main substance that prevents gastrointestinal invasion. Once the gastrointestinal mucosa synthesizing monomer, or the dimeric IgA, or the function of the synthetic secretory sheet is impaired, resulting in the lack of typing IgA in the gastrointestinal secretions, it can cause excessive proliferation of aerobic and anaerobic bacteria in the small intestine, resulting in The flora is dysfunctional and causes chronic diarrhea. In the case of asymptomatic IgA deficiency, the intestinal flora can also overproduce. The incidence of dysbacteriosis in the neonatal period is high, and may also be related to the immature or imperfect development of the immune system.
Pathogenesis
(1) Excessive bacterial growth: Anatomical and physiological abnormalities of the gastrointestinal tract can lead to the proliferation of colonic plexus in the proximal small intestine, and various metabolic disorders, including steatorrhea, vitamin deficiency and carbohydrate malabsorption. It may be associated with pseudo-obstruction of the small intestine, scleroderma, diabetic autonomic neuropathy, chronic malnutrition, and the like. Bacterial growth in the small intestine, a variety of anaerobic bacteria (mainly Bacteroides, Bifidobacterium, Veillonococcus, Enterococcus and Clostridium) can hydrolyze and bind bile salts, leading to microcapsule formation disorders, liver Hard acid, low acidosis without obvious metabolic disorders, etc. Changes in the colonic flora can lead to D-lactic acidosis due to neurological insufficiency after extensive small bowel resection. The use of broad-spectrum antibiotics, especially clindamycin and ampicillin, can proliferate C. difficile, producing a proteinmycin that causes colonic mucosal necrosis and ulceration, known as pseudomembranous colitis.
(2) Bacterial production of IgA-degrading enzymes: hemolytic streptococcus, green staphylococcus, pneumococcal genus, Haemophilus influenzae, meningococcus, and gonococcus gonorrhoeae can produce proteases that decompose IgA and decompose humans. IgA1 in serum and secretory IgA in colostrum. The first two bacteria are the main strains that constitute the oral flora, and the latter four are the virulence pathogens that adhere to the mucosal surface. Thus, it can be seen that IgA protease is essential for the survival or pathogenesis of these bacteria on the mucosal surface as a resident microorganism.
(3) Intestinal plexus and tuberculosis: The colonic flora produces a variety of metabolically active enzymes that mediate the reaction of some natural products, food preservatives, dyes, additives and pollutants into mutagenic substances. Many bacteria can increase the activity of bacterial enzyme systems due to prolonged exposure to substrates. If the substrate is a procarcinogen, prolonged exposure can increase the production of carcinogens.
Examine
an examination
Related inspection
Fecal color blood electrolyte check blood pressure fecal color blood urea nitrogen (BUN)
Symptoms
This disease is mainly caused by severe diarrhea or chronic diarrhea. In the course of applying antibiotics, such as sudden onset of diarrhea, or the original diarrhea is aggravated, this disease may occur. Most of the diarrhea is a yellowish green watery stool, sometimes like an egg pattern. Fungal infections can be foamy, loose, smelly, pus and bloody; staphylococcal infection can be yellow and green loose, 3 to 20 times a day, accompanied by abdominal distension, abdominal pain is generally not, vomiting and diarrhea can be accompanied by dehydration Electrolyte disorder, blood urea nitrogen and blood pressure drop; Candida albicans infection usually starts from the upper digestive tract and spreads to the small intestine or even the perianal area. Thrush is often the earliest signal of Candida albicans enteritis, such as intestinal mucosal erosion or ulceration. Can cause multiple odorless mucus purulent feces, sometimes with watery diarrhea, accompanied by indigestion, such as treatment is not timely, can spread to the respiratory tract, urinary tract and even brain tissue; Pseudomonas aeruginosa infection can produce blue-green fluorescein Feces are green, but they do not often cause diarrhea. In some cases, there are faeces in the stool. Generally, abdominal pain is mild. A few have nausea, vomiting, water, electrolyte imbalance, and severe shock. Some tourists may have intestinal flora imbalance due to changes in climate and environment. In recent years, due to the widespread use of refrigerators, some households store large amounts of meat and sparse food. Excessive storage deteriorates foods, causing intestinal flora imbalance after eating, causing vomiting, diarrhea, and some mental discomfort. Unconcious.
The types of clinical common intestinal flora disorders are as follows:
(1) Candida albicans: It is the most common type of intestinal flora disorder. More common in patients with thin infants, indigestion, malnutrition, diabetes, malignant tumors, long-term use of antibiotics or hormones.
(B) staphylococcal enteritis: more common in long-term use of antibiotics (tetracyclines, ampicillin, etc.), adrenocortical hormones and elderly patients with intestinal surgery or chronic disease patients.
(3) Clostridium-producing acute necrotic enteritis: The -mycin produced by Clostridium perfringens can cause acute necrotic tumors, wasting diseases, and is most susceptible to infections when antibiotics and corticosteroids are used.
(4) Intestinal infection of Pseudomonas aeruginosa: Pseudomonas aeruginosa is a conditional pathogen, often secondary infection, which is most likely to occur in infants, the elderly, some malignant tumors, wasting diseases, and the use of antibiotics, corticosteroids, etc. infection.
(5) Proteus infection: Proteus can be a conditional pathogen under certain conditions, such as common bacilli, singular bacillus, and Proteus mirabilis can cause food poisoning, and no proteobacteria can cause diarrhea in infants and young children in summer.
(6) Intestinal infection of Klebsiella pneumoniae: When the body's resistance is reduced or other reasons, the pneumoniae that normally parasitizes in the intestine can cause infection, especially severe diarrhea in children.
Diagnosis
Differential diagnosis
The diagnosis should be differentiated from the following symptoms:
1. Infant brown or dark green mucus: The amount of feces is reduced to mucus, dark brown or dark green. It often occurs after indigestion and limited food intake. More milk will be recovered.
2, at the same time need to pay attention to the identification of diarrhea caused by other causes, bacterial culture can identify the type of intestinal pathogenic bacteria.
