Middle and upper abdominal pain
Introduction
Introduction The most common type of recurrent upper abdominal pain is peptic ulcer. Peptic ulcer mainly refers to chronic ulcers occurring in the stomach and duodenum, namely gastric ulcer (GU) and duodenal ulcer (DU). This disease is a common disease in humans and is distributed worldwide. Clinically, DU is more common than GU. The ratio of the two is about 3:1. The duodenal ulcer (DU) is young and young, and the age of gastric ulcer (GU) is later, about ten years later. Moreover, the onset of ulcer disease is seasonal, and the fall of autumn and winter and winter and spring is much more common than in summer. Gastric ulcers and duodenal ulcers are generally referred to as peptic ulcers, sometimes referred to as ulcers.
Cause
Cause
1. Helicobacter pylori infection: This bacterial infection is the main cause of chronic antral sinusitis, and chronic antral sinusitis is closely related to peptic ulcer. Most patients with peptic ulcer have chronic antral sinusitis. The detection rate of Helicobacter pylori in gastric ulcer is 70% to 90%, and the detection rate of Helicobacter pylori in duodenal ulcer is as high as 95% to 100%. Therefore, all ulcers infected with Helicobacter pylori need antibiotics combined treatment, which may cure.
Second, drug abuse: Aspirin, indomethacin, phenylbutazone and corticosteroids such as prednisone, dexamethasone, etc. all cause ulcer disease, especially aspirin.
Third, the mental factors: bad mood, mental stress can increase the secretion of gastric acid through the neuroendocrine system, but also affect the blood supply of the gastrointestinal mucosa, and cause ulcer disease. For example, some young people in the clinic often experience digestive ulcers and even bleeding when they are overworked and are in a state of tension all the time.
Fourth, the diet is irregular: overeating or irregular diet can affect the digestive function of the stomach, causing indigestion and malnutrition, and malnutrition can weaken the barrier function of the gastric mucosa, leading to ulcer disease and affecting the mucosa. repair.
Examine
an examination
Related inspection
Ultrasound examination of gastrointestinal diseases, gastric ultrasound examination, gastrointestinal CT examination, total gastric acidity determination
Clinical manifestation
1, symptoms: upper abdominal pain is the main symptom, can be dull pain, burning pain, pain or severe pain, but sometimes only hunger-like discomfort. Typical cases have persistent pain under mild or moderate xiphoid and can be relieved by antacids and eating. About 2/3 of the duodenal patients have a rhythmic pain: upper abdominal pain begins to appear 1 to 3 hours after breakfast. If they do not take the medicine or eat, they will continue until lunch. 2 to 4 hours after eating, it is painful. It also needs to be eaten to relieve. About half of them have midnight pain, and patients are often awakened. Regular pain can also occur in gastric ulcers, but it occurs earlier after the meal, about half an hour to one hour after the meal, and disappears until the next meal. Midnight pain is not as common as duodenum.
2, signs: ulcers can have a fixed and limited tenderness point under the xiphoid, no obvious signs when relieved.
Diagnosis
Differential diagnosis
Differential diagnosis of upper abdominal pain:
1, right upper abdominal pain: right upper abdominal pain is generally the liver, gallbladder, biliary tract, pancreas, duodenum, right kidney, right segment of the large intestine.
2, left upper abdominal pain: In most cases, there is a corresponding relationship between the abdominal lesions and abdominal pain. Generally, according to the abdominal organ, the abdomen can be centered on the navel, and the painting is divided into four areas: upper right, lower right, upper left, and lower left. According to the site of abdominal pain, it can be divided into left upper abdominal pain, right upper abdominal pain, left lower abdominal pain, right lower abdomen. Pain and abdominal pain in the abdomen. Left upper abdominal pain may be a problem in the stomach, spleen, pancreas, left kidney, and left colon.
3, right lower abdominal pain: abdominal pain is one of the most common clinical symptoms. But because abdominal pain is mostly sporadic, it is often easy for patients to take it lightly. The approximate division of the location of the abdominal organs. Upper right: liver, gallbladder, biliary tract, pancreas, duodenum, right kidney, right segment of the large intestine. Top left: stomach, spleen, pancreas, left kidney, left colon. Bottom right: cecum, appendix, right ovary and fallopian tube, right ureter. Bottom left: sigmoid colon, left ovary and fallopian tube, left ureter. Right lower abdominal pain is a disease of the cecum, appendix, right ovary and fallopian tube, right ureter.
4, lower abdominal pain: lower abdominal pain is a common symptom of women, mostly caused by gynecological diseases. Various gynaecological conditions should be considered based on the nature and characteristics of lower abdominal pain.
5, small abdomen tingling: common symptoms of gynecological diseases in the lower abdomen, which brings great pain to the patient, sometimes it feels painful, and there are many types of abdominal pain, and there are many reasons.
6. Total abdominal pain: Total abdominal pain refers to the lesions of the internal and external organs caused by various reasons, and the pain of the whole abdomen. Total abdominal pain can be divided into acute and chronic. The cause is extremely complex, including inflammation, tumors, bleeding, obstruction, perforation, trauma, and dysfunction.
