Habitual diarrhea
Introduction
Introduction In the autumn, the gas turns cold and the number of patients with diarrhea increases. According to the statistics of the intestine clinics of major hospitals, diarrhea patients accounted for the majority due to improper diet and cold, and those with repeated diarrhea and chronic diarrhea increased the most. According to the doctor, these patients are "stretched", have abdominal pain, are in a hurry, and frequently have loose stools. However, the laboratory tests for no virus, but it is cured for a long time and is habitual diarrhea.
Cause
Cause
Irritable bowel syndrome (IBS) is common in patients with abdominal cramps, abdominal flatulence, and changes in bowel habits. Some patients have constipation symptoms (difficulty in defecation or reduced bowel movements), others have diarrhea (frequent loose stools, often with emergency discharge of stool), and some people have experienced diarrhea and constipation. Sometimes the patient has abdominal pain and wants to expel stool but cannot discharge it. In the past, there have been many medical names for irritable bowel syndrome, such as mucinous colitis, allergic colitis, colonic fistula, intestinal fistula, and functional bowel disease. Most of these names are not defined accurately. For example, colitis means inflammation of the colon, whereas irritable bowel syndrome does not cause inflammation.
The cause of irritable bowel syndrome is still unclear, and doctors call it a dysfunction because no signs of organic disease are found in the colon examination. The disease can cause great discomfort and pain to the patient, but it does not cause long-lasting colon damage, nor does it cause trouble; the patient may be afraid to participate in social activities, afraid to go out to find a job, or even go out for a short trip. However, some patients with irritable bowel syndrome can control symptoms through diet, nervousness, and medications prescribed by doctors.
Colon sensitivity is too high, because doctors do not find organic lesions, irritable bowel syndrome is usually thought to be caused by emotional conflict or stress. However, studies have shown that although depression, anxiety and stress in life can aggravate the condition, other factors are also important. Studies have found that colonic muscles in patients with irritable bowel syndrome develop paralysis with mild irritation, colon sensitivity and reactivity are higher than normal, and therefore respond to stimuli that most people do not affect.
Medical research has shown that common events such as eating, abdominal flatulence and colonic colon can cause allergic reactions in patients with irritable bowel syndrome. Certain medications or foods may trigger some people with colonic spasms. Sometimes intestinal fistula delays the discharge of feces, leading to constipation. Chocolate, dairy products, or large amounts of ethanol are often the cause. Caffeine can cause many people to loosen, but it is more likely to affect patients with irritable bowel syndrome. Studies have also found that women with irritable bowel syndrome have more severe symptoms during menstruation, suggesting that fluctuating hormone levels can aggravate the symptoms of patients with irritable bowel syndrome.
Examine
an examination
Related inspection
Fecal chlorine coxsackie virus antibody urinary citrulline
It is important to recognize that there is a difference in bowel function between normal people. Normal stools can even be taken three times a day or twice a week, but should be formed without being hard, without blood, and expelling innocent pain and pain. The clinical manifestations of patients with irritable bowel syndrome are non-specific, with long course and repeated attacks. The clinical general classification is diarrhea, constipation, alternating diarrhea and constipation and mucus.
Diarrhea-type patients mainly manifest as diarrhea, many times a day or even more than 10 times, often after repeated bowel movements after breakfast, rarely occur at night and sleep, and mental factors, emotional changes are closely related, mental stress is easy to induce bowel movements; Constipation patients with less fecal volume, difficulty in defecation, 1-2 times a week, occasionally more than 10 days, often accompanied by abdominal pain or bloating, hard stools, or spherical, sometimes slender stools, mucus on the surface; some people constipation And diarrhea can alternate, constipation and diarrhea usually have spastic pain, and sometimes patients with bowel movements with mucus. Irritable bowel syndrome may also have esophageal occlusion, nausea, burning sensation in the sternum, snoring and fullness, and other manifestations of autonomic dysfunction such as palpitation, fatigue, excessive sweating, and insomnia. However, stomach bleeding, fever, weight loss, and persistent abdominal pain are not manifestations of irritable bowel syndrome and may be a sign of other diseases.
Diagnosis
Differential diagnosis
diarrhea:
1) According to the length of the disease, it is divided into acute diarrhea and chronic diarrhea.
2) According to the characteristics of pathophysiology, it can be divided into:
a exudative diarrhea
b secretory diarrhea
c osmotic diarrhea
d malabsorption diarrhea
e Gastrointestinal peristalsis accelerated diarrhea
3) According to the anatomical part can be divided into:
a Gastric diarrhea
b intestinal diarrhea
c pancreatic chronic diarrhea
d endocrine dysfunctional diarrhea
e Functional diarrhea
[associated symptoms]
Diarrhea is not an independent disease, but a common manifestation of many diseases. It can also be accompanied by vomiting, fever, abdominal pain, bloating, mucus, bloody stools and other symptoms. Diarrhea with fever, abdominal pain, vomiting, etc. often indicate acute infection; with stool blood, anemia, weight loss, etc. need to be alert to bowel cancer; with abdominal distension, poor appetite, etc. often need to be alert to liver cancer; with watery stools need to be alert to Vibrio cholerae infection. In addition, diarrhea can directly cause dehydration, malnutrition, etc., which are characterized by dry skin, sunken eyes, dry tongue, and skin wrinkles.
Long-term chronic abdominal pain and diarrhea are common in:
Chronic non-specific ulcerative colitis: diarrhea several times a day to more than 10 times, can be pus and bloody stools, mucus bloody stools or bloody stools. Abdominal pain is light pain, typical of colic, abdominal pain - intention - relief characteristics. The whole body manifests as fever, fatigue, weight loss, often accompanied by the performance of the skin, mucous membranes, joints, liver, kidney, eyes, mouth and other systems. More serious complications are: toxic colon expansion, intestinal perforation, major bleeding, cancer and so on. Treatment is more difficult and complicated, and hospitalization is often required.
Crohn's disease: more names, such as terminal ileitis, localized enteritis, granulomatous enteritis, segmental enteritis. The incidence is mostly in young and middle-aged, male is slightly more than female. Mainly manifested as abdominal pain, diarrhea, fever, nutritional disorders, incomplete intestinal obstruction, abdominal hernia or external hemorrhoids. Severe patients have prolonged unhealed and have a poor prognosis. Treatment: There is no specific treatment for this disease. It should be based on systemic therapy, supplemented with surgery and prevent recurrence.
Intestinal tuberculosis: often coexist with extraintestinal tuberculosis. Generally, the typical clinical manifestations are: dull pain in the abdomen, mostly in the right lower abdomen, or in the umbilical cord or throughout the abdomen. Because the lesion directly affects the digestion and absorption function of the intestine, patients often have weight loss and general weakness. Possible complications include intestinal obstruction, intestinal perforation, and bleeding. Treatment: rest and nutrition are the foundation; anti-tuberculosis drugs; surgery, etc.
It is important to recognize that there is a difference in bowel function between normal people. Normal stools can even be taken three times a day or twice a week, but should be formed without being hard, without blood, and expelling innocent pain and pain. The clinical manifestations of patients with irritable bowel syndrome are non-specific, with long course and repeated attacks. The clinical general classification is diarrhea, constipation, alternating diarrhea and constipation and mucus.
Diarrhea-type patients mainly manifest as diarrhea, many times a day or even more than 10 times, often after repeated bowel movements after breakfast, rarely occur at night and sleep, and mental factors, emotional changes are closely related, mental stress is easy to induce bowel movements; Constipation patients with less fecal volume, difficulty in defecation, 1-2 times a week, occasionally more than 10 days, often accompanied by abdominal pain or bloating, hard stools, or spherical, sometimes slender stools, mucus on the surface; some people constipation And diarrhea can alternate, constipation and diarrhea usually have spastic pain, and sometimes patients with bowel movements with mucus. Irritable bowel syndrome may also have esophageal occlusion, nausea, burning sensation in the sternum, snoring and fullness, and other manifestations of autonomic dysfunction such as palpitation, fatigue, excessive sweating, and insomnia. However, stomach bleeding, fever, weight loss, and persistent abdominal pain are not manifestations of irritable bowel syndrome and may be a sign of other diseases.
