The color of self-examination of disease
Director Wang said that there are many factors affecting the formation of stool color. Normal stools should be yellow-brown, because after bile secreted by liver cells enters enterohepatic circulation, after a series of chemical changes, the yellow-green biliflavin in bile becomes yellow-brown, and it is excreted with the stool.
The normal color of stool is: yellowish brown.
Therefore, the normal color of stool is: yellowish brown. If the stool is very dark, there are generally several possibilities. The first is related to food. There is an old saying in Guangzhou: "Eat pig red and black excrement", which means that if you eat pig blood or animal viscera, your stool will turn red and black. If you eat more green vegetables, your stool will be green. The second is related to drugs. Patients with stomach diseases take stomach medicine containing bismuth, patients with iron deficiency anemia often take iron supplements, and their stools will be black. Charcoal and some black Chinese patent medicines will also lead to black stool. This kind of black stool is dull carbon-like black with different shades.
Abnormal colors are related to diseases.
The following is the relationship between abnormal stool color and disease.
Grayish white: If the color of stool is "white clay-like", it may be jaundice or biliary obstruction caused by stones, tumors, ascaris, etc., which leads to the inability of bile flavins to be excreted with stool.
Black: If you don't eat pig blood and drugs that may cause black stool, the stool will be black, usually upper gastrointestinal bleeding. The stomach and duodenum bleed, and the blood passes through several meters of intestines, which undergo various chemical changes and gradually turn black. Therefore, if the amount of bleeding in these places is not very large, the stool should be black. Among the patients with upper gastrointestinal bleeding, about half of them are bleeding due to ulcer, most of which are duodenal ulcer bleeding. In addition to ulcer, gastritis, liver cirrhosis with esophageal or gastric varices rupture and gastric cancer are also common causes of upper gastrointestinal bleeding.
Red: bloody stool, mostly bleeding in the lower digestive tract. The lower digestive tract includes jejunum, ileum, rectum and colon. Because of the short distance and little chemical change, these parts bleed, and the stool should be red. If there is a large amount of bleeding in the upper digestive tract, the blood can't stay in the intestine too much, and the stool is red. However, whether it is bleeding in the upper digestive tract or lower digestive tract, there is a characteristic. Blood and stool are mixed together. If blood is not mixed with stool, it is only attached to the surface of stool or partially deviated, or even drops blood after defecation. This situation is hemorrhoids.
Self-examination of disease and its characteristics
Director Wang said that observing the shape of stool can also keep abreast of some disease information. Normal stools should be cylindrical and soft, and abnormal shapes include: too hard, too rotten or even slimy or watery. The interval should be once a day or once every other day.
The stool is dry because the food residue stays in the large intestine for too long and the water is sucked dry. The rotten stool discharged by diarrhea patients is caused by too fast intestinal peristalsis to absorb the water in food residues. Columnar is found in habitual constipation; Granular sheep manure is found in spastic constipation; Flat banded stool may be caused by tumor compression near anal stenosis or anorectum; Paste is seen after overeating and other dyspepsia; Liquid can be found in food poisoning diarrhea and other acute enteritis; Purulent blood is seen in bacterial dysentery; Sticking and freezing can be seen in chronic colitis or chronic bacillary dysentery.
Sometimes the stool is not necessarily cylindrical, because a section of colon in the large intestine is wrinkled, and the stool will be slightly deformed when passing through these places, which is normal. However, if the stool is always fixed somewhere and there is a depression, it may be a tumor in the intestinal cavity.
Medically speaking, defecation more than four times a week is not constipation; If you defecate no more than three times a day, it is not diarrhea; It is not abnormal if the time of defecation at a time does not exceed 10 minutes. The time, frequency and time of defecation interval can vary from person to person, which is closely related to personal diet and living habits. The intestinal peristalsis of the elderly is not good, and the defecation time and interval will be longer.
Abnormal stool characteristics and frequency are sometimes organic diseases, that is, there is a problem in a certain part of an organ, and sometimes it is a functional problem. Even if you go to the hospital for examination, you can't find anything, so it should be that your function is abnormal and you have irritable bowel syndrome. "Some patients don't believe it and say,' I have a stomachache, how can I not detect it?' In fact, being sick doesn't necessarily hurt, and pain doesn't necessarily hurt. Director Wang said that these diseases are caused by problems in visceral nerve regulation, which are not as harmful as organic diseases and are not fatal.
There is no need to worry too much if there is nothing wrong with it. Some people have diarrhea and constipation alternately, which may be intestinal cancer.
What is the examination for the diagnosis of abnormal stool?
Abnormal stool may be a signal of some kind of disease, and the first check to be made when going to the hospital is:
Routine stool
It mainly includes several items: whether occult blood in the stool is negative or positive, which can detect a very small amount of bleeding in the stool that is invisible to the naked eye. Common diseases with occult blood include tumors, ulcers, inflammatory bowel diseases, bleeding caused by liver cirrhosis and biliary tract diseases, polyps, etc. General patients with colorectal cancer and one third of patients with adenomas will have regular bleeding. High red blood cells also indicate bleeding; High white blood cells indicate inflammation.
Director Wang specifically mentioned that nowadays, no matter whether it is a unit physical examination or an individual physical examination, stool routine is rarely checked, which is a big loophole. She has a patient who spends a lot of money on physical examination every year, but she has never had occult blood in her stool. When she comes here, she finds that she has a cancer. Gastroenterologists attach great importance to occult blood in stool. People with abnormal stools should check occult blood in stool. People over 40 years old should check occult blood every year. The normal practice is to check it three times in a row.
1 day, the amount of gastrointestinal bleeding is more than 5 ml, and the fecal occult blood is positive, but the color can not be seen. When the amount of bleeding reaches 50~70 ml, the feces can be black. If there is black and bright tarry stool or dark red stool, it indicates that the amount of bleeding is about 100~500 ml.
Positive stool occult blood test can find the following diseases: in the early stage of digestive tract cancer, 20% patients can appear occult blood positive, and the positive rate of occult blood in late stage patients is over 90%. The occult blood test of patients with gastrointestinal bleeding and peptic ulcer is mostly positive or intermittent.
Gastroscopy in upper digestive tract and enteroscopy in lower digestive tract
After the routine stool examination finds that there is "hidden feeling", the doctor roughly determines the position of the disease according to the preliminary judgment, and then makes further endoscopic examination.
Diseases of the upper digestive tract and large intestine account for 90%. The diseases are in the upper digestive tract, so it is necessary to do gastroscopy. The diseases from esophagus to duodenum can be observed through gastroscopy. If the diseases are in the large intestine of the lower digestive tract, colonoscopy can be done, and the whole colon and rectum can be observed through anal insertion.
The middle part between the upper digestive tract and the large intestine, that is, the jejunum and ileum in the small intestine, twists and turns about 6 meters, which makes doctors have the biggest headache. Gastroscopy and colonoscopy can't shine at both ends, and the disease in this part accounts for about10% of the whole digestive tract.
Small intestine: several tests to choose from
Director Wang said that with the development of medicine, there are also some examination methods, such as X-ray enterography, capsule endoscopy and enteroscopy in recent two or three years. Capsule endoscopy means that the camera is put into the pill for the patient to swallow, and the pill takes pictures in it during the process of passing through the digestive tract, and the picture is received by the computer, and then analyzed by the doctor. This method may have errors; You can't get the living tissue for examination like a gastrointestinal mirror, and you can only analyze it through computer pictures. In theory, enteroscopy can see 6 meters of small intestine, but it is expensive.
Normal stool, away from gastrointestinal diseases
Director Wang said that the color, character and frequency of defecation are normal, and the time of defecation is short each time, which indicates that the digestive system is in good condition, and the "five-grain cycle" is normal. There are two main points: 1. Don't be partial to food, and eat more crude fiber food, such as vegetables. 2. Exercise, now there are more and more people sitting all day, sitting more, gastrointestinal peristalsis is not good, and it is easy to suffer from various digestive system diseases.
Director Wang specifically mentioned that the incidence of colorectal cancer is increasing year by year. In Shanghai, it has ranked the fourth among cancers, and the incidence rate is high in the west and low in the east in the world, while it is high in the south and low in the north in China. The increase in the incidence of colorectal cancer is related to economic development, the decrease in physical activity, the increase in animal food consumption and the increase in life expectancy. Therefore, it is necessary to establish a reasonable diet structure, eat less animal food and eat more high-fiber food.
The high-risk population of colorectal cancer includes: people over 40 years old with a history of polyps or a family history of colorectal cancer, people with positive cancer-related markers, these high-risk groups and normal people over 50 years old. It is necessary to have regular physical examination, and the necessary items are occult blood in stool and colonoscopy.