First, the main points of self-diagnosis of diarrhea
Concurrent syndrome
Possible diagnosis
Acute diarrhea, watery stool, may be accompanied by (or not accompanied by) fever, periumbilical pain, gastroenteritis, mostly caused by eating unclean, spoiled or allergic food.
Acute diarrhea is accompanied by fever and other systemic symptoms, and bacterial dysentery and amebic dysentery with purulent bloody stools can be seen, but ulcerative colitis cannot be ruled out.
Chronic diarrhea with fever is common in chronic dysentery, schistosomiasis, intestinal tuberculosis and colon cancer.
Chronic diarrhea also includes intermittent constipation, colon allergy, rectal or colon polyps, and colon cancer must be ruled out.
Acute amebic dysentery with red feces or blood sample, small pus and blood, large amount and foul smell.
The amount of feces is large, the smell is abnormal, and it is gray and oily, which is generally diarrhea caused by fat digestion and absorption disorder.
Severe diarrhea with severe vomiting, fever and severe dehydration. Feces are like rice swill, and the dangerous situation may be cholera and paracholera.
Etiology and treatment of common diarrhea
Summer is the season of high incidence of bacillary dysentery. At this time, salmonella enteritis and diarrhea caused by rotavirus also reached a peak. Because there are symptoms such as abdominal pain, diarrhea and vomiting in clinic, it is easy to confuse the diagnosis. In addition, bacillary dysentery is different from salmonella enteritis in the use of antibiotics, while rotavirus diarrhea does not need antibiotics. Therefore, it is of great significance to distinguish the three for timely treatment.
Bacillary dysentery is mostly caused by eating unclean food, such as vegetables and fruits, which is rare in children under 65,438+0 years old. The first symptom is diarrhea before vomiting, and abdominal pain, mainly left lower abdominal pain. Diarrhea is characterized by frequent defecation, more than ten times a day, but less stool, mucus or purulent stool, which is obvious after emergency. The visual field of stool is full of white blood cells, and Shigella can be found in ambassador culture. Norfloxacin is the best anti-dysentery drug at present.
Salmonella enteritis is mostly caused by eating unclean food such as milk, eggs, poultry and internal organs, and it is more common in children under 1 year. The first symptom is vomiting first, then diarrhea and frequent vomiting. Periumbilical abdominal pain is the main symptom, and defecation is 3- 10 times a day. The amount of stool is large, and the stool shows watery mucus, which is not obvious after acute diarrhea. Microscopically, the total number of white blood cells in stool is normal. Salmonella can be found in fecal culture. The therapeutic drug is compound neomycin, chloramphenicol, ampicillin or the third generation cephalosporin.
Rotatable disease is the main pathogen of non-bacterial diarrhea in children under 6 years old, and the incidence rate is the highest in children from 6 months to 2 years old. The initial symptoms of rotavirus diarrhea are vomiting and cough. Diarrhea is 3- 10 times a day, and the stool is loose, watery or egg-shaped. There is sour smell, no mucus pus, negative stool microscopic examination and stool culture, and low blood picture. Rotavirus can be isolated by virus detection. If there is no secondary bacterial infection, there is no need for antibacterial drugs.
Grasping "abdominal muscles" to treat diarrhea
Diarrhea caused by catching cold can be treated by grasping "abdominal muscles" Let the patient lie prone on the bed and grab a thick tendon "abdominal tendon" on the inside of the patient's shoulder blades. Grab this tendon, lift it, and then suddenly release it. This will work wonders if you do it left and right several times.
What is diarrhea?
Diarrhea is a common symptom in digestive system diseases, which refers to more defecation times than usual, thin feces, increased water, and sometimes increased fat, undigested substances or purulent blood. Normal people usually defecate 1 time a day, and some people defecate 1 time for 2 ~ 3 days, or 2 ~ 3 times a day, and feces are formed, which should not be called diarrhea. It is worth noting that the elderly and postoperative patients often have rectal constipation. At this time, because feces are embedded in the rectal cavity and stimulate the rectal mucosa, there may be an increase in defecation times, accompanied by a sense of urgency and heaviness, and sometimes mucus will be discharged, which should not be classified as diarrhea. In fact, it is severe constipation. This kind of constipation needs enema or hand digging to help defecate, which is called pseudo-diarrhea in medicine.
How to classify diarrhea?
Diarrhea is a symptom, its pathogenesis is quite complicated, and there are many diseases that cause diarrhea. Therefore, diarrhea can be classified in many ways:
(1) According to the duration of the disease, it can be divided into acute diarrhea and chronic diarrhea.
Acute diarrhea refers to the increase in defecation times, with different degrees of loose stools, often accompanied by abdominal pain caused by intestinal spasm, and the course of disease is within two months; Clinically, if diarrhea lasts or repeats for more than two months, it can be called chronic diarrhea. Of course, this distinction is artificial. Diarrhea with a course of more than two months can be called chronic diarrhea, but those with a course of less than two months are not necessarily acute. Some cases may be the initial stage of chronic diarrhea or the first attack of chronic cases, and there is no obvious clinical manifestation, so it must be cross-referenced with acute diarrhea in actual diagnosis.
(2) According to the characteristics of pathophysiology, it can be divided into:
Exudative diarrhea
Secretory diarrhea
osmotic diarrhea
Malabsorptive diarrhea
E gastrointestinal peristalsis accelerates diarrhea
(3) According to the anatomical site, it can be divided into:
Gastrogenic diarrhea
B enterogenous diarrhea
Chronic pancreatic diarrhea
Diarrhea due to endocrine disorders
Functional diarrhea
Among them, enterogenous diarrhea can be divided into:
A disease-causing infectious diarrhea.
B. Inflammatory non-infectious diarrhea
Tumour diarrhea
Dyspepsia and malabsorption diarrhea
E. Food-borne diarrhea (poisoning, allergy)
Toxic diarrhea caused by drugs or chemicals
Functional diarrhea
What is the basis of diarrhea?
Diarrhea is mainly the result of gastrointestinal secretion, digestion, absorption and motor dysfunction caused by viruses, bacteria, food toxins or chemical poisons, drug effects, intestinal allergies and systemic diseases.
We know that food and other substances ingested by human body are digested and decomposed by gastrointestinal tract, and the useful parts are absorbed, while the useless residues are discharged through feces. Normal people's daily intake of diet and digestive juices and water secreted by various digestive glands (such as salivary glands and pancreas). ) and gastrointestinal epithelial cells to the digestive tract total about 9L, and contain a lot of electrolytes. Generally, within 24 hours, the jejunum absorbs 3 ~ 5L of water, the ileum absorbs 2 ~ 4L, and only about 1 ~ 2L is left in the colon, most of which is absorbed by the colon, and finally only 6544 water is discharged with the feces. Because of the great potential of intestinal absorption of water, the water content of normal human feces is generally stable and will not be affected by the amount of drinking water. In the intestinal cavity of the upper segment of the small intestine, due to the difference of chyme and electrolyte, its osmotic pressure can be in a state of high tension or low tension, and water continuously permeates into the intestinal cavity from the plasma or is absorbed into the plasma from the intestinal cavity, so that the infiltration between the plasma and the intestinal cavity keeps a dynamic balance.
The pathogenesis of diarrhea is based on the dysfunction or disorder of secretion, digestion, absorption and movement of gastrointestinal tract, which leads to increased secretion, incomplete digestion, reduced absorption and/or accelerated motivation, and finally leads to thin feces, which may contain exudates, and increased stool frequency, resulting in diarrhea.
How to infer diseases from diarrhea?
Diarrhea, if combined with the patient's medical history, symptoms, signs and other aspects, is helpful to further speculate the cause of diarrhea.
(1) According to age, children's diarrhea is mainly rotavirus infection, disaccharidase deficiency, congenital chlorine diarrhea, mesenteric lymph node tuberculosis and pancreatic fibrosis. Diarrhea in young adults is mostly functional diarrhea and ulcerative intestinal tuberculosis; Diarrhea in middle-aged and elderly people is often colon cancer.
(2) Gender analysis: Functional diarrhea caused by hyperthyroidism is more common in women, and colonic diverticulum and colon cancer are more common in men.
(3) From the analysis of native place and occupation, farmers and fishermen living in the middle and lower reaches of the Yangtze River are frequently exposed to infected water, and the possibility of schistosomiasis infection should be considered when diarrhea occurs.
(4) From the analysis of onset and course of disease: those with acute onset, short course of disease and frequent diarrhea should consider diarrhea caused by various reasons, such as rotavirus infection, salmonella infection, bacillary dysentery, Vibrio parahaemolyticus infection, staphylococcal enterotoxin food poisoning, amoebiasis, intestinal allergic diseases, drug action and chemical poisoning. If the medical history is more than 2 years, the possibility of colon cancer is small; If the medical history lasts for several years to decades, it is common in functional diarrhea, schistosomiasis, ulcerative colitis and Crohn's disease; If diarrhea is intermittent, it is common in functional diarrhea, malabsorption syndrome and colonic diverticulitis.
(5) Analysis of gastrointestinal symptoms: From the gastrointestinal symptoms presented by patients, especially diarrhea, it can be inferred that the lesion is located in the small intestine or colon. For example, patients defecate frequently, feel heavy after having an acute feeling of defecation, defecate less every time, and sometimes even only some gas or a small amount of mucus is discharged without feces. The feces are dark, thin and sticky, with or without blood visible to the naked eye, and the odor is not heavy, accompanied by persistent pain in the lower abdomen or left lower abdomen. Abdominal pain can be slightly relieved after defecation. This diarrhea is located in the rectum and/or sigmoid colon.
If diarrhea has no symptoms of acute diarrhea, is light in color, has a large amount of feces, is watery, foamy or greasy, has a foul smell, has no blood and pus visible to the naked eye, but contains indigestible food residues, accompanied by intermittent colic around the navel or confined to the right lower abdomen, and hyperactive bowel sounds, then the diarrhea is located in the small intestine.
If the number of defecation in 24 hours is more than 10, or even dozens of times, acute diarrhea is common in secretory diarrhea caused by acute infection, such as cholera, and exudative diarrhea such as bacillary dysentery. Chronic diarrhea with defecation several times a day can be seen in many diseases, such as chronic bacillary dysentery, chronic amoebic enteropathy, schistosomiasis, ulcerative colitis, rectal cancer and colon cancer, irritable bowel syndrome and so on.
If diarrhea and constipation appear alternately, it can be seen in ulcerative intestinal tuberculosis, colon cancer, incomplete intestinal obstruction, colonic diverticulitis and constipation, as well as laxatives and irritable bowel syndrome. When the latter is constipated, the stool is like "cow dung", with mucus and no pus.
If diarrhea is related to eating, it can be stopped after fasting. This kind of diarrhea is common in the increase of osmotic pressure of intestinal contents, abnormal mucosal permeability and accelerated intestinal peristalsis.
If diarrhea occurs in the early morning or after meals, it is common in irritable bowel syndrome; If diarrhea wakes patients from sleep at night, it often suggests that it is caused by organic diseases.
(6) Systemic symptom analysis: If diarrhea is accompanied by fever, we should first consider various causes of intestinal infection, and also exclude ulcerative colitis, Crohn's disease and advanced intestinal cancer. If the patient is obviously emaciated or malnourished, it is common in small intestinal diarrhea, such as pancreatic diarrhea, gastrointestinal short circuit or other absorption defects, and colon diarrhea is rare, but colon cancer can appear cachexia, which should be an exception. If diarrhea is accompanied by insomnia, forgetfulness and inattention. And the symptoms are often temporarily relieved with emotional transfer. This kind of diarrhea is common in irritable bowel syndrome.
(7) Analysis of abdominal signs: Patients with chronic diarrhea, such as palpable abdominal masses, often indicate tumors or inflammatory diseases. If the mass is located in the lower left abdomen, it should be suspected that left colon cancer, sigmoid diverticulitis or cancer caused intestinal stenosis due to fecal accumulation. If the mass is located in the right lower abdomen, right colon cancer, amoeba or schistosomiasis granuloma, intestinal tuberculosis, Crohn's disease and intestinal actinomycosis should be suspected. Colitis and the masses around colitis are softer than cancer, and the tenderness is obvious. Colonic spasm, which can touch the intestinal segment, has disappeared and is uncommon, which can be distinguished from the mass caused by organic lesions. If abdominal tenderness is obvious, it can be seen in Crohn's disease, colonic diverticulitis and pelvic or appendix abscess. If abdominal distension is accompanied by hyperactivity of bowel sounds, it often indicates intestinal obstruction.
(8) Analysis of digital rectal examination: Digital rectal examination is simple and easy, and it can find out whether there are lesions around anus and whether there are strictures, cancers or fecal stones in rectum. Therefore, digital rectal examination is of great value in the direct diagnosis of diarrhea caused by rectal cancer. When the finger touches a hard and immovable nodular mass, there is blood on the finger cuff, which often indicates rectal cancer.
What harm does diarrhea do to human body?
Diarrhea is harmful to human body in many ways:
(1) Diarrhea can lead to malnutrition: As we all know, the gastrointestinal tract is the only way for the human body to absorb nutrients. After the ingested food and other nutrients are digested and decomposed in the gastrointestinal tract, the useful parts are absorbed, and the useless residues are discharged from the feces. When diarrhea occurs, the absorption of nutrients is seriously hindered and the energy supply is insufficient, which makes people feel dizzy, thirsty, weak limbs, flustered and short of breath, and even malnutrition.
(2) Diarrhea can lead to vitamin deficiency: long-term diarrhea can directly affect the body's absorption of vitamins and cause vitamin deficiency. Some people have dry skin and hair after long-term diarrhea, and their hair loses its normal luster and moisture, and occasionally falls off sporadically, leading to premature baldness, which is caused by lack of vitamin A; For another example, some people have glossitis, angular stomatitis and polyneuritis, which is the result of lack of vitamin B.
(3) Diarrhea can cause anemia: due to digestive absorption disorder, the absorption of hematopoietic substances such as protein is reduced, which can cause anemia, such as pale nails, palms, skin, lips, eyelids and conjunctiva, fatigue, dizziness, tinnitus, inattention and other anemia symptoms, and even malnutrition edema.
(4) Diarrhea can reduce the body's resistance: malnutrition, anemia and vitamin deficiency caused by diarrhea can weaken the body's resistance to infectious diseases and various infections, and inflammation is easy to spread. It will also weaken the ability of tissue regeneration and wound healing, and the wound is not easy to heal after injury.
(5) Diarrhea can cause imbalance of water, electrolyte and acid-base: intestinal mucosal lesions can directly affect the absorption of water by the human body. The high osmotic pressure in the intestinal cavity will transfer some water in the blood to the intestinal cavity, and finally it will be discharged from the feces, which will make the body lose a lot of water. When the water loss does not exceed 5% of the body weight, the body can still compensate. Once it exceeds 5%, it cannot be compensated, resulting in a series of water and electrolyte imbalances and acid-base balance disorders.
In the process of diarrhea, the body will not only lose a lot of water and nutrients, but also lose a lot of electrolytes that are very important for the body's functional activities, such as sodium, potassium, calcium and magnesium. If the loss exceeds a certain limit, there will be corresponding body dysfunction. If potassium is deficient, there will be arrhythmia, general weakness, weakened or disappeared reflexes, and even a series of potassium deficiency symptoms such as respiratory muscle paralysis and intestinal paralysis.
Usually, the carbon dioxide produced by metabolism in the body is excreted by breathing, and the rest of the waste needs to be transported by water and excreted by urine through the kidney. During dehydration, due to the loss of water in the body, the amount of urine is reduced, or even there is no urine, which will reduce the amount of waste produced by metabolism in the body and accumulate in the body, causing poisoning symptoms in the body, which is called "acidosis". Its clinical manifestations include respiratory system changes, fatigue, weakness and nervous system symptoms.
Dehydration, electrolyte disorder and acidosis will all cause serious damage to the body. If it is not rescued in time, it will be life-threatening.
Diarrhea is particularly harmful to the elderly. Because of weak resistance, the elderly are more prone to diarrhea than young adults. If you treat diarrhea as a minor illness and don't seek medical attention in time, it will easily lead to serious illness, serious harm to health and even sudden death. This is because acute diarrhea in the elderly is prone to hypoglycemia, cardiovascular and cerebrovascular accidents and other complications. It is routine to eat less when diarrhea occurs. Insufficient intake requires the decomposition of glycogen stored in the body to maintain blood sugar stability, while the elderly do not have enough glycogen storage to convert into sugar. The fasting blood glucose concentration of normal people is 4.4 ~ 6.7 mmol/L. When the blood glucose is lower than 3mmol/L, a series of hypoglycemia symptoms such as weakness, sweating, palpitation, pallor and syncope will appear. Hypoglycemia can also cause deep coma and sudden death.
When diarrhea occurs, a large amount of water is lost, which will make the human body dehydrated, resulting in a decrease in blood volume, an increase in blood viscosity, and slow blood flow, which is easy to form thrombus and block blood vessels. Sodium, potassium, calcium and magnesium can maintain blood acid-base balance, nerve conduction function and heartbeat rhythm. Lack of these cations in diarrhea will cause serious arrhythmia, which is even worse for the elderly with cardiovascular diseases.
Therefore, once the elderly have diarrhea, they should not be taken lightly and should seek medical treatment in time.
Why can't you just use antibiotics to treat diarrhea?
Some people think that diarrhea must be a bacterial infection in the gastrointestinal tract, so once diarrhea occurs, antibiotics are used to treat it, such as berberine, gentamicin, ciprofloxacin and norfloxacin.
It is true that cholera, dysentery and some enteritis caused by Escherichia coli infection are indeed bacterial infections, and antibacterial drugs are often used in treatment. However, diarrhea is not necessarily caused by gastrointestinal bacterial infection, such as: abdominal cold causes accelerated intestinal peristalsis; Allergy to dairy products, fish, shrimp and crabs causes intestinal allergy; Pancreatic exocrine insufficiency, pancreatic cancer, etc. The decrease of bile excretion and the lack of disaccharidase make a large number of undigested solutes in the intestinal cavity, causing hyperosmotic diarrhea; When traveling or moving to other places, some people change the living environment of normal flora in the intestine because of the change of living environment, thus causing symptoms such as anorexia, vomiting, abdominal pain and even diarrhea caused by "flora imbalance"; Some babies have diarrhea because of improper diet and excessive increase in complementary food, and the list is endless. There is no bacterial infection in diarrhea like this. There are also some diarrhea, such as infantile diarrhea in autumn and winter, "epidemic diarrhea" and fungal enteritis of adults and older children in summer, which are generally not called bacterial infection. Among them, infantile diarrhea in autumn and winter and "epidemic diarrhea" in summer are caused by virus infection, while fungal enteritis is caused by a mold with completely different characteristics from all kinds of ordinary bacteria. Due to different pathogens, the treatment methods should not be exactly the same, so the application of antibacterial drugs should be cautious.
Many antibiotics, especially after oral administration, can cause different degrees of gastrointestinal side effects, such as nausea, vomiting, diarrhea or loss of appetite, and even affect liver, kidney and hematopoietic function, among which the gastrointestinal side effects caused by broad-spectrum antibiotics are more serious. In addition to chemical stimulation (chemical stimulation is dose-related), broad-spectrum antibiotics can cause flora imbalance in the body, leading to double infection, which is another important factor.
Double infection, also known as flora imbalance. Under normal circumstances, people are in a huge environment where microorganisms live. A certain number of bacteria are parasitic on human skin and mucosa and cavities communicating with the outside world, such as mouth, nose, pharynx and intestine. These large numbers of bacteria are interdependent and mutually restrictive with human body, which is not only harmless but beneficial to human body. Among them, normal intestinal flora plays an important role in promoting the digestion and absorption of food. Moreover, normal intestinal flora also has a strong inhibitory effect on pathogenic bacteria that endanger human health, which can effectively inhibit their growth and reproduction, which is very important to human body and is called ecological balance in medicine.
The application of antibiotics, especially broad-spectrum antibiotics, often inhibits sensitive bacteria everywhere in the body, making drug-resistant bacteria take the opportunity to multiply and grow in the body, leading to double infection. In other words, antibiotics were originally used to kill pathogenic bacteria, but they were infected with more serious bacteria, among which drug-resistant Staphylococcus aureus and Gram-negative bacilli were the main pathogens of double infection. The main form of double infection caused by drug-resistant Staphylococcus aureus is enteritis. It can be seen that the double infection caused by broad-spectrum antibiotics often aggravates diarrhea.
In addition, the application of broad-spectrum antibiotics inhibits many bacteria in the intestine, and some of these bacteria have the ability to synthesize vitamin B and vitamin K. Therefore, the imbalance of flora may lead to the lack of vitamin B complex, which may lead to gastrointestinal symptoms such as nausea, vomiting and diarrhea.
diarrhea
Diarrhea refers to frequent defecation, increased water, thin stool, or abnormal components such as pus and fat, often accompanied by bowel sounds and abdominal pain.
Acute diarrhea refers to the course of disease within 2 months. Diarrhea is mainly caused by fast intestinal peristalsis, water can not be fully absorbed in the intestine, and some of them are caused by excessive intestinal secretion and digestive absorption disorders.
Acute diarrhea is mostly caused by bacterial infection, such as enteritis and dysentery, and some are simple diarrhea caused by overeating, cold-heat imbalance and indigestion.
(A) the differential diagnosis of acute diarrhea
(1) Diarrhea is accompanied by acute diarrhea, mostly rectal lesions; Paroxysmal pain around navel, watery stool, strong abdominal sound, mostly small intestinal lesions.
(2) Diarrhea with vomiting is more common in gastroenteritis and food poisoning.
(3) Accompanied by fever and abdominal pain, it is seen in acute bacillary dysentery.
(4) Simple diarrhea with dysbacteriosis should be considered in long-term treatment with antibiotics or hormones.
(5) Patients with allergic enteritis have a rash.
(6) Diarrhea with a daily stool volume greater than 1000ml is secretory diarrhea.
(7) Found rice soup-like feces in cholera and paracholera; Purulent blood can be seen in amebic dysentery, bacillary dysentery and colon cancer; Fatty diarrhea, smelly and frothy; Meat washing water sample is acute hemorrhagic enteritis; Egg flower soup is pseudomembranous enteritis.
(2) Rescue measures for acute diarrhea
(1) First consider the relationship between diarrhea and food eaten, and leave food samples to rule out the possibility of food poisoning. Take stool samples for testing in time, and find out the cause before symptomatic treatment.
(2) Fasting temporarily and keeping the abdomen warm. Encourage drinking more light salt water (with a little sugar) to prevent dehydration. When dehydration symptoms such as thirst, oliguria, dry and wrinkled skin, sunken eye socket and so on have appeared, patients with severe vomiting who can't drink water or have been dehydrated should actively carry out intravenous rehydration in addition to oral light salt water.
(3) Diarrhea is contagious, and antibiotics should be taken orally, such as berberine and tetracycline.
(4) Atropine and 654 can be used for abdominal pain. Belladonna tablets were treated and local hot compress was given.
(5) Severe diarrhea can be appropriately given astringent antidiarrheal drugs, tannic acid protein, light tea, burnt steamed bread slices, etc.
(6) Diarrhea caused by indigestion can be treated with drugs such as lactase.
(7) If the above treatment fails, the patient should go to the hospital for treatment as soon as possible.
What is diarrhea, and is it related to anal diseases?
It is generally believed that diarrhea is the most common symptom in large intestine diseases. Its specific performance is the change of defecation frequency and character, such as the increase of defecation frequency, the thinning of stool, the change of shape, color and smell, etc. , containing pus, mucus, undigested food and fat, or yellow water, green and thin, sour and smelly; Abdominal pain, fall, acute diarrhea, anal burning and other symptoms occur during defecation.
Diarrhea is related to many anal diseases:
Such as chronic or long-term diarrhea, can lead to perianal abscess and anal fistula. Diarrhea stimulation can aggravate the pain of anal fissure, diarrhea can form anal congestion, fecal stimulation can make hemorrhoid mucosa edema, and will emerge from anus with feces, forming incarcerated hemorrhoids or inflammatory external hemorrhoids. Long-term diarrhea can also lead to a series of diseases such as rectal prolapse.
In addition, diarrhea can also lead to systemic symptoms of anal diseases, such as anemia, emaciation, fatigue and burnout.
How does western medicine know diarrhea?
Generally speaking, western medicine has the following views on diarrhea:
① Infection: that is, all kinds of bacteria, viruses, fungi, protozoa and peristalsis are parasitized by rotten food. This kind of food enters the digestive tract through the mouth, or the abdomen is stimulated by cold and heat too strongly, which makes the flora in the intestine out of balance and can cause abdominal pain and diarrhea.
② Gastrointestinal tumor and inflammation: Advanced gastric cancer, rectal cancer, chronic gastroenteritis, chronic ulcerative colitis and Crohn's disease can all cause acute and chronic exudative diarrhea.
It can be seen that excrement, mucus and purulent blood are attached to feces, and the number of defecation increases, but no pathogenic bacteria grow in feces culture.
③ Abnormal intestinal movement and excessive peristalsis: Some intestinal diseases, such as appendicitis and diverticulitis, can cause excessive colonic peristalsis and diarrhea; In addition, 5- hydroxytryptamine secreted by carcinoid syndrome, histamine secreted by mastocytosis, gastrin secreted by gastrinoma, prostaglandin, 5- hydroxytryptamine secreted by medullary thyroid cancer and hypocalcemia can increase intestinal peristalsis and cause diarrhea.
Excessive work and study pressure and mental stimulation will cause gastrointestinal dysfunction and diarrhea. In addition, colon allergy can also lead to diarrhea.
Some drugs that inhibit sympathetic nerves and excite parasympathetic nerves can also cause diarrhea.
④ Intestinal malabsorption of fat: This diarrhea stool is yellowish or gray, greasy and pasty, and has a foul smell.
Poisoning: food poisoning, food poisoning caused by bacterial exotoxin, mushroom poisoning, puffer fish poisoning, etc. , causing diarrhea.
Poisoning by chemicals such as arsenic, mercury, alcohol, tetracycline and erythromycin can also cause diarrhea.
People who are allergic to milk, fish, meat, shrimp and crabs will also have diarrhea.
What methods does western medicine treat diarrhea?
Symptomatic treatment is the main means of treating diarrhea in western medicine.
① Antibiotics: Antibiotics should be used in time for those who are definitely diagnosed as bacterial infections.
② astringent and antidiarrheal drugs: sodium hypochlorite, aluminum hydroxide gel or compound camphor tincture were used for symptomatic treatment.
③ Drugs for relieving enterospasm: compound phenylethyl piperidine, atropine, propafenone or tincture of opium were used.
④ Physical therapy: field effect therapeutic apparatus was selected to treat the abdomen. But besides bacterial infection, a definite diagnosis is needed.
⑤ Hot compress: placing a hot water bag in the abdomen is helpful for the treatment of diarrhea.
How to diagnose and differentiate all kinds of diarrhea?
Diagnosis and differential diagnosis should be carried out according to the following items:
① History and symptoms
A medical history: we should know the etiology, pathological process, onset age, sex, diet, commonly used drugs, and the use of antidiarrheal or cathartic drugs. At the same time, understand what diseases and symptoms the patient has, and judge whether it is related to diarrhea and what is the relationship.
B. Symptoms: The nature of diarrhea should be judged by the nature, shape, smell, mucus and other secretions and excretions of feces.
② Physical examination
See a doctor: general situation, rash, mental state, body position, weight, etc.
Palpation: check the abdomen by hand to understand the nature of pain and abdominal mass. At the same time, try to do anal digital diagnosis, except anal diseases.
Auscultation: Understand intestinal peristalsis.
③ Laboratory examination: The pathogenic bacteria were diagnosed by direct microscopic examination and fecal bacterial culture.
④X-ray examination: X-ray plain film was used to examine the intestinal condition, or barium contrast was used to diagnose digestive tract function and organic diseases.