foul-smelling stool
Introduction
Introduction The stench is also called stinky fat or stench fat. The fat cramps occur in children who call it celiac disease, and in adults it is called idiopathic steatorrhea. The villus and microvilli of the jejunal mucosa of the patient showed obvious atrophy and the mucosal surface was flat. If the patient's diet does not contain gluten-based foods, the above intestinal mucosal lesions can be recovered.
Cause
Cause
The etiology of this disease may be related to genetically related metabolic abnormalities and immune factors. It is reported that about 80% of patients with this disease carry human leukocyte antigens HLA-B8 and HLA-DW3. When humans eat cereals, the gliadin peptides contained in their gluten require related peptidases when they are hydrolyzed in the intestine. If the intestinal mucosa of the patient lacks this enzyme, the unhydrolyzed gliadin stimulates the intestinal mucosa. Caused the disease.
It is also believed that the disease is gluten sensitive enteropathy, and the allergen is gliadin. Will gliadin.
Examine
an examination
Related inspection
Fecal faeces stool color
The patient was thin, malnourished, diarrhea, and fat. The villus and microvilli of the jejunal mucosa of the patient showed obvious atrophy and the mucosal surface was flat. The mucosal lamina propria is chronically inflammatory, with lymphocytes, plasma cells, and sometimes eosinophil infiltration. If the patient's diet does not contain gluten-based foods, the above intestinal mucosal lesions can be recovered.
Addition to the jejunal mucosa cultured in vitro can be seen to cause T cell proliferation in tissues.
Diagnosis
Differential diagnosis
Common symptoms of bad odor are weight loss, diarrhea, fatty stools, stench, etc., and need to be differentiated from the following symptoms.
1. Foam-like odorous diarrhea: epidemic diarrhea of newborn refers to the outbreak of epidemic diarrhea in the maternity babies or hospital neonatal wards. Due to imperfect immune function and environmental factors, Prone to infection. The pathogens are more commonly spread by bacteria, viruses, and fungal parasites, mainly through the contaminated dairy water in the maternal birth canal, and the adult carriers of the nipple utensils. . Neonatal epidemic diarrhea caused by different pathogens has certain characteristics:
(1) Escherichia coli enteritis: pathogenic Escherichia coli enteritis stool is watery, egg-like soup-like smell of sputum; toxigenic Escherichia coli enteritis stool is a dilute water; invasive Escherichia coli enteritis The stool is mucus pus and bloody, with a stench and a small amount of stool.
(2) Salmonella typhimurium enteritis: stool characteristics are variable, can be watery jelly-like, black-green or gray-white with obvious odor.
(3) Rotavirus enteritis: acute onset, often hot stools, watery, large amount, odor can not be obvious.
(4) Staphylococcus aureus enteritis: stools are mostly yellow-green, dark green, watery, with a stench.
(5) Fungal enteritis: The stool is yellow-green and watery, or tofu-like, with more foam.
2, celiac disease: formerly known as non-tropical sarcolemma (celiac disease), also known as chyluene diarrhea, glucan-induced enteropathy (glutinine enteropathy).
3, dysentery-like stool: bacillary dysentery (bacillary dysentery), is a common acute intestinal infectious disease caused by dysentery bacilli, with colonic suppurative inflammation as the main lesion, systemic poisoning symptoms, abdominal pain, diarrhea, urgency, heavy, pus and blood And other clinical manifestations. Because of the different clinical manifestations and diseases, medical scientists divide dysentery into common dysentery, poisoning dysentery and chronic dysentery. Although there are many types of dysentery, only heavy and poisonous types are threatening to children's lives. Most of the children with poisoning dysentery have sudden onset, high fever, and the intestinal symptoms are often not obvious at the beginning of the disease. Some patients have dysentery-like stools after a day or so. Anal canal or 2% saline enema is helpful for early diagnosis before the discharge of typical dysentery. In the peak season of dysentery, the child suddenly had a high heat and was very weak, and his face was gray.
4, heart palpitations with weight loss, diarrhea: the elderly patients with onychomycosis insidious, and the typical symptoms of young people with hyperthyroidism are not the same, most of them with arrhythmia, high blood pressure, loss of appetite, diarrhea, weight loss and other cardiovascular and gastrointestinal symptoms . Therefore, if a 60-year-old person has palpitations, diarrhea, weight loss, but a good mental state, be alert to the attack.
