Etiological symptoms
Bloody stool, also known as bloody stool, bloody stool and bloody stool, is characterized by bloody stool or loose stool. More common in Shang Xiao.
Chemical ulcer bleeding, gastrointestinal polyps, small intestine bleeding, tumor, perianal disease bleeding and some blood diseases and acute diseases.
Sexually transmitted drugs, parasites, etc This refers to the injury caused by hemorrhoids, anal fissure and anal sinusitis, and the injury of rectal mucosa.
Blood in the stool caused by injury. Feces are soft, shaped or hard, and blood adheres to the surface of feces. Some have blood first, then stool, while others.
After defecation, the blood is mostly bright red, and some of them are dark red and turbid. Long-term bleeding, anal pain after defecation.
Intensify.
Traditional Chinese medicine believes that hematochezia is caused by heat (dampness) accumulated in the intestine or spleen-qi deficiency, which can not control blood circulation. It can clear the intestines.
Treatment with heat, hemostasis, qi, blood.
Matters needing attention in self-treatment
(1) Get into the habit of defecating regularly, and the stool should be thin and mushy.
(2) Reduce the posture of increasing abdominal pressure, such as squatting and holding your breath. Avoid sedentary, long standing, long walking and overwork.
(3) Avoid spicy, spicy, greasy, rough and dull food, alcohol, tobacco and coffee.
(4) Eat more raw pear juice, lotus root juice and other foods with the functions of clearing heat from the intestines, nourishing the nutritious mucosa, relaxing bowels and stopping bleeding.
Water chestnut juice, reed root juice, celery juice, carrot, white radish (cooked food), bitter gourd, eggplant, cucumber, spinach,
Day lily, cabbage, egg yolk, apple, fig, banana, black sesame, walnut kernel, white fungus, etc.
(5) Be cheerful, don't get angry and get hot. If the mood is not wide, irritability and depression will cause intestinal mucosa to contract and blood circulation will not be smooth.
[6] Reduce sexual intercourse. Excessive sexual intercourse will make the intestinal mucosa congested. Aggravate bleeding.
Autonomic therapy
1. TCM self-therapy
(1) Yunnan Baiyao, 0.3g each time, 2-3 times a day. Swallow with warm water.
(2) Maren Pill with Spleen Rupture, 9g each time, twice a day, swallowed with warm water.
(3) Yanlian Pill, 9g each time, twice a day, swallowed with warm water.
2. Prescription self-treatment
(1) rhubarb charcoal powder, 3-6g each time, twice a day, swallowed with warm water.
(2) Dry the eggplant leaf tile and grind it into powder, 6g each time, twice a day. Swallow rice soup.
(3) 60 grams of Eclipta prostrata, decoction for tea.
(4) Sanguisorba charcoal15g, Sophora japonica charcoal12g, madder charcoal12g, adzuki bean 30g, and Saposhnikovia divaricata charcoal10g.
G, rhubarb charcoal 10g, cortex phellodendri 10g, daily 1g, decocted twice. Used for intestinal heat and dampness,
Turbid blood, bitter taste, yellow and thick tongue coating, and poor stool.
(5) 30g of kitchen soil, 0/0g of codonopsis pilosula/kloc-,0/0g of atractylodes macrocephala charcoal, 0/0g of ginger charcoal/kloc-,0/0g of Cimicifuga foetida charcoal/kloc-,
Stir-fry Radix Astragali 1 2g, Colla Corii Asini 9g (melted separately) and Glycyrrhrizae Radix 6g, and fry with1paste twice a day. Used for spleen weakness.
Weak, pale, tired and weak.
3. Diet self-therapy.
(1) 250g pig large intestine, fresh Sophora japonica15g, used for cooking and soup making.
(2) Eat a few persimmons every day.
(3) auricularia auricula10g, jujube15g, and simmer.
(4) 30 grams of day lily, appropriate amount of brown sugar, decocted.
(5) Ginger and Folium Artemisiae Argyi each 15g. Decoct Folium Artemisiae Argyi with ginger in thick sauce, each time 1 cup. Folium Artemisiae Argyi Warming Meridian to Stop Hemorrhage, Ginger
Dispelling cold is used to treat bleeding due to deficiency cold, mainly for bleeding after defecation.
(6) 5 bowls of vinegar and 3 bowls of red beans, cooked and dried into powder, 5g each time. This prescription is mainly used to treat intestinal hemorrhoid bleeding.
4. External treatment and self-treatment
(1) fumigation and washing. Soak colla Corii Asini in vinegar to soften, steaming to melt into paste, taking 30g each time, adding 500g vinegar to melt,
After heating and boiling, smoke first, and then clean the anus twice a day. The stock solution can be washed many times. Used for patients with anal fissure and hemorrhoid bleeding.
(2) medication. 2 sticks of cool oil mixed with xanthium powder are applied inside and outside the anus.
(3) Mashing wild wormwood (wormwood cotyledon) into mud and applying it to anus.
(4) Apply egg butter to the anus. (Suitable for dry and ruptured anal mucosa. )
Egg butter method; Take a few cooked egg yolks, stir-fry them with non-ferrous tableware over low heat, and filter until the oil oozes.
5. Other self-therapies
(1) Rub the abdomen. Rub your abdomen twice every morning and evening (after waking up and before going to bed), and rub it counterclockwise 100 times.
(2) levator ani muscle. Do anal contraction 2-3 times a day, 30-50 times each time.
Avoid misdiagnosis
There was no anorectal disease in the past, and blood in the stool suddenly appeared, or a small amount of dark and turbid blood in the stool appeared from time to time for a long time; or
There are necrotic and corrupt tissues and thick secretions in the blood in the stool. Patients should not be negligent and should go to the hospital for examination.
Because of fear of defecation pain, forbearing defecation will cause constipation, endogenous heat toxicity and aggravate defecation.
Shape.
Unmarried young women must pay attention to rest during menstruation and pay attention to the cleanliness of vulva, otherwise it will easily lead to inflammation, rupture and bleeding of anal mucosa.
hematochezia
After gastrointestinal bleeding is discharged through the intestine, the feces contain blood or whole blood stool, which can be bright red, dark red and tar-like. The color of bloody stool depends on the location of bleeding, the amount of bleeding and the time that blood stays in the digestive tract. Lower digestive tract (small intestine, colon, rectum, anus) bleeding, stool is often bright red or dark red. Upper digestive tract (esophagus, stomach, duodenum) bleeding, stool is often tar-like.
(1) Etiology
Blood in stool is generally divided into bloody stool, tarry stool and occult blood stool. Common reasons are described below.
1 bloody stool: generally discharged from the lower end of ileum, colon, rectum and anus, the stool is bright red or dark red, and may be mixed with mucus and pus. Common diseases are hemorrhoids and anal fissure bleeding. Hemorrhoid hematochezia is ejected during defecation or drops blood after defecation; Anal fissure stool with less blood, but anal pain is more severe. Rectal polyp bleeding, stool blood volume is not large, blood adheres to the stool surface, and sometimes stool becomes thin and strip-shaped or imprinted. Dysentery blood is purulent bloody stool, frequent defecation, accompanied by left lower abdominal pain.
2 tarry stool: black stool. Upper gastrointestinal bleeding does not vomit, and blood stays in the intestine for a long time. Hemoglobin in the blood combines with sulfide in the intestine to form ferrous sulfide, which makes the feces black and bright, like asphalt. The appearance of tarry stool shows that the amount of bleeding has reached more than 60 ml. However, it should be noted that some foods and drugs will make the stool black, which can be identified by fecal occult blood test.
3 occult blood stool: a small amount of gastrointestinal bleeding does not cause the color change of stool, and it is called occult blood stool only when the stool occult blood test is positive. All diseases that cause gastrointestinal bleeding can cause occult bloody stools, such as gastric ulcer and gastric cancer.
② Rescue measures
Rescue measures are basically the same as hematemesis. Stay in bed quietly, reduce activities, observe the amount of bleeding, and use hemostatic drugs appropriately. Once syncope and shock occur, they should be sent to the hospital immediately for emergency treatment.
How to register for medical treatment
1. Anorectal surgery: The patient has bright red bloody stool after defecation, or accompanied by bright red bloody stool, and generally has no severe abdominal pain, so anorectal surgery should be performed.
2. General surgery: Patients with bloody stools, severe abdominal pain and even shock should hang up general surgery.
3. Intestinal outpatient service: Patients with acute onset and purulent stool should contact the intestinal outpatient service.
4. Gastroenterology: Patients who often discharge bright red bloody stool, dark red bloody stool or have a history of chronic colitis should be hanged in the gastrointestinal department.
5. Hematology: those with hematochezia and systemic bleeding tendency should be examined in hematology for further examination.
6. Nephrology: People with a history of nephritis and bloody stool should contact Nephrology.
7. Infectious Diseases Department: Patients with hematochezia after fever and life history in epidemic areas should be registered in Infectious Diseases Department.
The blood discharged from anus is called blood in stool, which mainly includes dripping blood, spraying blood or stool with blood. Generally speaking, blood visible to the naked eye often indicates lower gastrointestinal bleeding (especially colon and rectum). The closer the bleeding site is to the anus, the brighter the color.
It is generally believed that hematochezia is caused by hemorrhoids, which is incorrect. Hemorrhoids, especially internal hemorrhoids in the first and second stages, are mainly characterized by bloody stools. Bloody stool usually occurs during defecation, during defecation and after defecation, blood drops or there is jet bleeding, and blood is not mixed with feces. The amount of bleeding varies from a few milliliters to dozens of milliliters. Repeated bleeding can lead to severe anemia. The diagnosis of hemorrhoids is relatively easy, but it must be pointed out that anorectal diseases with bloody stool, such as rectal adenoma and rectal cancer, are often misdiagnosed as internal hemorrhoids. Therefore, other diseases must be excluded when determining the diagnosis of hemorrhoids. It is necessary to perform finger examination on patients with hematochezia, and routine examination with disposable sigmoidoscopy is a convenient, economical, safe and accurate examination method.
Anal fistula often has purulent secretion, which is less bloody. Because of the recurrent disease, the condition is aggravated, and the surgical treatment is still relatively reliable at present.
Rectal cancer is a common malignant tumor, and its main clinical manifestations are:
1. Blood in stool.
2. Purulent bloody stool and mucus bloody stool.
3. Changes in defecation habits, including constipation, diarrhea or both, endless defecation, etc.
4. The shape of stool will change.
5. Abdominal pain, abdominal discomfort, abdominal mass, etc.
Routine examination of patients with hematochezia with disposable sigmoidoscopy can detect rectal and low sigmoidectomy early, and colonoscopy can be performed if necessary. For colorectal cancer, early detection, early diagnosis and early treatment must be advocated.
Precancerous lesions:
1. Adenoma: It has been recognized that adenoma is a precancerous lesion, and the common symptoms include bloody stool, change of stool habits, tumor protruding from anus, abdominal pain, etc. One-off sigmoidoscopy should be used for early diagnosis and early surgical resection.
2. Chronic ulcerative colitis: The main symptoms are bloody stool, increased defecation times and abdominal pain.
Others:
1. Systemic diseases: such as blood system diseases.
2. Anal injury, etc.
In short, hematochezia should be checked in a regular hospital in time to exclude other diseases, so as not to delay the illness. (
Blood in stool: blood flows from anus, or goes down with impurities in stool, or is pure blood.
Soul fulcrum The title of "all diseases begin": "post-blood"; Treatise on Febrile Diseases is called "blood"; Synopsis of the Golden Chamber says "bleeding" and puts forward the names of "distant blood" and "near blood" according to the order of bleeding and defecation. Zhang Jingyue pointed out: "The blood comes from far away from feces, and the blood from far away comes from small intestine or kidney. ..... If blood comes before shit, it will come near, and the nearest person will be in the intestine or anus. " Later generations of doctors followed the name of turbidity, and established intestinal wind and dirty poison. The key points of syndrome differentiation and treatment says: "bright red serum is intestinal wind, and turbid serum is dirty poison." Introduction to Medicine calls it "blood arrow". If there is blood in the stool, it will be powerful, for example, if the arrow is far away.
This disease should be differentiated from dysentery and purulent blood. Most people with diarrhea and purulent blood are accompanied by purulent blood. They have obvious abdominal pain, acute diarrhea and severe diarrhea. However, this disease is characterized by blood flowing from feces without pus, and there are no obvious symptoms such as abdominal pain, acute diarrhea and severe diarrhea.
"common syndrome"
Excess heat in gastrointestinal tract: bloody stool, dry lips, cold drinks, swollen gums, bad breath, bitter taste, sore mouth and tongue, constipation, burning anus, red tongue with yellow fur and strong pulse.
Damp-heat steaming: blood comes before stool, blood is bright red, stool is uncomfortable, limbs are swollen, anorexia is bitter, urine is short and red, tongue is red, fur is yellow and greasy, and pulse is rapid.
Deficiency and cold of spleen and stomach: defecation first followed by blood, or blood mixed with stool, or pure blood, dark purple color, or tarry stool, dull complexion, listlessness, abdominal pain, dull stool, cold limbs, pale mouth but not thirsty, pale tongue, white and wet fur and thready pulse.
Yin deficiency of liver: bloody stool, dizziness, flushed cheeks, nervous fever, restless night sleep, bone steaming and night sweats, dreamy insomnia, backache and limb fatigue, emaciation, red tongue and rapid pulse.
Hemorrhoid hematochezia: bloody stool, unbearable anal pain, or swelling of hemorrhoid nucleus, or anal fissure, red tongue with yellow coating and rapid pulse.
References:
Abnormal stool color in children with hematochezia
Key points of differential diagnosis of hematochezia:
Possible diagnosis of complications
Blood is sprayed during defecation, or blood drops after defecation, and the blood is not mixed, and the amount of bleeding varies, accompanied by anal foreign body sensation or sudden pain hemorrhoids.
Fecal blood volume is small, the color is bright red, and it is filiform and covers the feces. There is pain during defecation and anal fissure in different degrees after defecation.
Intermittent bloody stool, usually with a small amount of blood in the stool, is bright red and does not mix with the stool, sometimes the stool becomes thin and thin, or there is a concave rectal polyp or colon polyp on one side.
With the development of the disease, stool blood volume increases, often accompanied by diarrhea, emaciation, anemia, stool often mixed with thick mucus, rectal cancer with a special fishy smell, more common in middle-aged and elderly people.
Changes in stool habits, diarrhea or constipation, purulent stool or mucus-like blood. carcinoma of colon
Sudden onset, accompanied by abdominal pain, diarrhea, nausea and vomiting, less stool volume, frequent stool, bacterial dysentery or amebic dysentery accompanied by acute feeling after urgency and abdominal tenderness.
Hemorrhage is often intermittent, with a small amount of blood in the stool, which contains pus or mucus. Acute diarrhea is often accompanied by abdominal pain, diarrhea and ulcerative colitis.
Blood diseases with less bleeding and bleeding tendency in other parts, such as leukemia, hemophilia, thrombocytopenic purpura and aplastic anemia.
Sluggish, often accompanied by hematemesis, is a characteristic symptom of upper gastrointestinal bleeding, such as cirrhosis, portal hypertension and digestive tract ulcer.
There is no change in stool color, only occult blood test is positive, which is mostly caused by a small amount of bleeding in digestive tract.
What diseases should be mainly considered when stool is bloody?
Bloody stool is a special symptom of lower gastrointestinal bleeding, especially colon, rectum and anal bleeding, which indicates that there are organic lesions in the intestine, so we must attach great importance to it, make a clear diagnosis in time and pay close attention to treatment. The following diseases should be considered when the stool is bloody:
(1) Anal diseases
① Patients with bright red blood and no pain are more common in internal hemorrhoids. Hemorrhoids in stage I are characterized by blood, and they often bleed because of rubbing the hemorrhoids with stool, and the blood keeps dripping, or a line is like an arrow, or only carries blood on toilet paper; Stage Ⅱ hemorrhoids have little or no bleeding in stool, and often flow from anus.
② Hemorrhagic stool in anal fissure is often accompanied by anal pain and typical periodic pain after defecation.
③ The main manifestations of anal canal cancer are bloody stool and pain, and the pain is aggravated before defecation.
② Rectal diseases
① The main symptom of rectal polyp is hematochezia, which is intermittent, bright red in color and generally small in quantity. This disease is very common among children.
② The main manifestations of rectal cancer are increased stool frequency, thinner stool, mucus and blood, accompanied by acute defecation, heavy defecation or endless defecation. The blood in the stool is bright red or dark red in the early stage, and the amount is not much. There is often foul mucus in the stool in the later period, and weight loss should be highly valued.
③ Radioproctitis can also cause bloody stool, but there should be a history of radiotherapy.
③ Colonic diseases
① Colonic polyposis: A. Juvenile polyposis coli, with an average age of 6 years, no family history, is characterized by bloody stool, often accompanied by malnutrition, anemia, hypoproteinemia and growth retardation, and often accompanied by congenital malformations, such as intestinal malrotation, umbilical hernia and brain edema; B familial juvenile polyposis coli: there is a family history, and the common symptoms are hematochezia, rectal prolapse and growth retardation; C. Cronnet? Kanda syndrome (CCS): This is a hamartomatous polyposis syndrome, which appears in adults, accompanied by bloody stool, diarrhea, massive defecation and obesity, as well as abdominal pain, anorexia, fatigue, vomiting, loss of libido and taste. Nails, hair loss and pigmentation almost always change.
② Colon cancer: It is common in left colon cancer. Patients often have intractable constipation, and occasionally the frequency of defecation increases. When the cancer ruptures, blood or mucus can stick to the outside of the fecal mass, and even pus can be discharged.
(3) Chronic nonspecific ulcerative colitis and bacillary dysentery: both of them have bloody stools, and most of them discharge mucus or pus at the same time, accompanied by abdominal pain.
(4) Amebic dysentery: blood is the main symptom, and the stool is sauce red, with a lot of mucus and a bad smell.
(5) Hemorrhagic Escherichia coli enteritis: It is characterized by acute onset, accompanied by fever and diarrhea, and may have a history of eating carrion, often in the form of food poisoning.
In addition, children under/kloc-0 should pay attention to intussusception. Some systemic diseases such as leukemia, aplastic anemia and hemophilia. There will also be symptoms of bloody stool.
hematochezia
After gastrointestinal bleeding is discharged through the intestine, the feces contain blood or whole blood stool, which can be bright red, dark red and tar-like. The color of bloody stool depends on the location of bleeding, the amount of bleeding and the time that blood stays in the digestive tract. Lower digestive tract (small intestine, colon, rectum, anus) bleeding, stool is often bright red or dark red. Upper digestive tract (esophagus, stomach, duodenum) bleeding, stool is often tar-like.
(1) Etiology
Blood in stool is generally divided into bloody stool, tarry stool and occult blood stool. Common reasons are described below.
1? Blood usually comes from the lower end of ileum, colon, rectum and anus, and feces are bright red or dark red, which can be mixed with mucus and pus. Common diseases are hemorrhoids and anal fissure bleeding. Hemorrhoid hematochezia is ejected during defecation or drops blood after defecation; Anal fissure stool with less blood, but anal pain is more severe. Rectal polyp bleeding, stool blood volume is not large, blood adheres to the stool surface, and sometimes stool becomes thin and strip-shaped or imprinted. Dysentery blood is purulent bloody stool, frequent defecation, accompanied by left lower abdominal pain.
2? Tarry stool is black stool. Upper gastrointestinal bleeding does not vomit, and blood stays in the intestine for a long time. Hemoglobin in the blood combines with sulfide in the intestine to form ferrous sulfide, which makes the feces black and bright, like asphalt. The appearance of tarry stool shows that the amount of bleeding has reached more than 60 ml. However, it should be noted that some foods and drugs will make the stool black, which can be identified by fecal occult blood test.
3? If a small amount of gastrointestinal bleeding does not cause the color change of stool, but only appears when the stool occult blood test is positive, it is called occult blood stool. All diseases that cause gastrointestinal bleeding can cause occult bloody stools, such as gastric ulcer and gastric cancer.
② Rescue measures
Rescue measures are basically the same as hematemesis. Stay in bed quietly, reduce activities, observe the amount of bleeding, and use hemostatic drugs appropriately. Once syncope and shock occur, they should be sent to the hospital immediately for emergency treatment.
Is hematochezia an internal hemorrhoid?
Blood in stool is a typical symptom of internal hemorrhoids, especially early internal hemorrhoids, but it cannot be considered as internal hemorrhoids. Blood is a common symptom, and many diseases can cause bloody stool in clinic.
① Various enteritis: due to inflammation, the integrity of intestinal mucosa is destroyed, and dark purple blood and secretions are mixed in stool, accompanied by unique symptoms of various enteritis.
② Anal papillitis and its hypertrophy: On the tooth line, the surface is covered with anal epithelium, with occasional bleeding.
③ Anal fissure: severe pain during defecation and blood dripping after defecation.
④ Rectal cancer: There are often bleeding and a lot of secretions, which are the most likely to be misdiagnosed and missed. During hand examination, the finger cuff can be stained with blood and can touch hard lesions with different shapes, rough surfaces and uneven edges. Pathological biopsy is needed to make a diagnosis. Bleeding from this disease can also lead to anemia.
⑤ Rectal adenoma or choriocarcinoma: This disease often bleeds. Every time I defecate, there is blood on my stool, and occasionally there is a lot of bleeding. However, the tumor is long and pedicled. Anoscopy showed that the tumor was red and could grow with pedicle.