What Are Enteric Diseases?

Abdominal pain, referred to as upper abdomen or umbilical pain, is transferred to the right lower abdomen. There is fixed tenderness in the right lower abdomen. After the inflammation spreads to the serosa, there is abdominal muscle tension and rebound pain.

Bowel disease

The intestine is the longest tube in the digestive organs. It includes the duodenum, jejunum, ileum, cecum, colon, and rectum. The total length is about 7m. The jejunum and ileum bend around the center of the abdomen and are surrounded by the colon. . Among intestinal diseases, the incidence of appendicitis is the highest, accounting for about 10% of hospitalized patients. Intestinal obstruction is also a common surgical disease, and intestinal fistula is caused by injury or postoperative complications. Intestinal function: The surface of the small intestinal mucosa is covered with intestinal villi, mainly for the digestion and absorption of food. Various digestive fluids in the small intestine break down the chyme into glucose and amino acids, and after the food is digested and absorbed, the remaining waste forms feces. Stored in the left semicolon and discharged in vitro. Once the intestine is diseased, it can cause digestive and malabsorption problems and a series of related symptoms.

Basic symptoms of bowel disease

Classification of intestinal diseases

Bowel disease acute appendicitis

The appendix is located at the junction of the small intestine and large intestine, and is attached to the posteromedial side of the cecum. It is about 5 to 7 cm long and less than 1 cm in diameter. The end of the appendix cavity is blind, and the proximal end communicates with the cecum. The junction of the two is a half-moon-shaped mucosal corrugated wall called the Gerlach valve. When the mucosa is incompletely closed, food and feces easily enter the cavity and cause inflammation. The cause is caused by lumen obstruction, bacterial infection or neuroreflex spasm. According to the pathological changes of appendicitis, it can be divided into: simple appendicitis, mild inflammation, only serous hyperemia and mucosal bleeding ulcers; suppurative appendicitis, extreme hyperemia of serous layers, and necrosis and suppuration of mucous membranes; gangrenous appendicitis, The layers of the appendix are inflamed, necrotic, dark red, and thin-walled tissues are eroded, making it easy to perforate. Appendicitis is divided into acute and chronic, and the symptoms are similar, but the symptoms are more obvious in acute attacks. Acute emotional appendicitis manifests itself as:

abdominal pain. From the upper abdomen or umbilical pain to the right lower abdomen, there is fixed tenderness in the right lower abdomen, and the inflammation spreads to the serosity and there is abdominal muscle tension and rebound pain.

gastrointestinal symptoms. Symptoms such as nausea, vomiting, diarrhea, or constipation.

fever. Body temperature gradually increased to 37 ~ 38, depending on the severity of inflammation, all patients with acute appendicitis were treated with surgery. If the symptoms are mild and appendicitis is suspected, conservative treatment can be used, such as antibiotics, acupuncture or Chinese medicine.

Etc., but the recurrence rate is higher.

Intestinal obstruction: Intestinal obstruction occurs when the contents of the intestinal tract are impaired.

Intestinal obstruction is divided into:

A mechanical obstruction. Intestinal stenosis due to various reasons, food difficult to pass;

B Dynamic obstruction. People with food retention due to vegetative nerve disorders that cause the intestine to lose normal motility.

C hemodynamic infarction. Intestinal blood flow disorders, mesenteric embolism and so on. According to the obstruction site, it is divided into high obstruction and low obstruction. The former is the jejunum and upper ileum, and the latter is the lower ileum and colon. According to the blood flow, it can be divided into simple obstruction, normal intestinal wall blood supply, and intestinal cavity. Channel obstruction; strangulated obstruction, intestinal lumen passage and blood supply are impaired.

Clinical manifestations of intestinal obstruction:

A Abdominal pain is paroxysmal colic. Intestinal type and dynamic waves can be seen on the abdominal wall. There is gas or water sound during auscultation.

B Vomiting, vomit at the beginning is food, and then depending on the obstruction site, there can be different types of vomit, high obstruction with undigested food, gastric juice, bile, low femoral vomit.

C bloating. Low obstruction is more pronounced, with bulging cymbals and drum sounds in the abdominal cavity.

D Stop defecation and exhaust. If it is low obstruction, stop defecation and exhaust.

When the symptoms of intestinal obstruction are mild and there is no peritonitis, conservative treatment such as gastrointestinal decompression can be given. If recurrent attacks occur, the symptoms are obvious. Especially when peritonitis is complicated, timely surgical treatment is needed.

Bowel disease

There are abnormal voids in the intestinal wall caused by various injuries, and those who intestinal contents overflow are called. The intestinal fistula is divided into an internal fistula and an external fistula. The internal fistula is a perforation of the intestinal wall that communicates with other internal organs in the abdomen and does not lead to the outside of the abdomen. An external fistula is a perforation of the intestinal wall that leads to the outside and intestinal fluid and fecal juice flow out. Intestinal fistula is divided into high fistula and low fistula according to the location. The fistula is a high fistula within 100cm of the duodenum and the upper part of the jejunum, and those below 100cm from the jejunum are low fistulas. This section focuses on high intestinal fistula. Due to improper treatment and treatment of high intestinal fistula, it is a threat to life and should be paid attention to. The clinical manifestation is that once the fistula is formed, a large amount of gastrointestinal fluid, bile, and pancreatic juice can flow out from the fistula every day. These digestive fluids have a strong irritating and corrosive effect. The affected tissues will exhibit erosion to varying degrees The skin around the mouth is more corroded. The patient was weak and wasted. Body temperature rises with the spread of inflammation, and persistent high fever can occur. Imbalances in water and electrolytes soon appear, with symptoms such as dehydration, acidosis, and low potassium. The treatment should first adopt abdominal suction, keep the fistula clean and dry, and strengthen systemic supportive treatment. When the operation is performed again at an appropriate period, the fistula is removed and the intestinal fluid passage of the party is restored.

Bowel disease care

Preoperative preparation for intestinal diseases

For acute diseases of abdominal cavity and intestine, do not use acupuncture agents before diagnosis to prevent concealing symptoms; forbid enema to prevent intestinal perforation; forbid diet and reduce intestinal burden; at the same time, prepare for surgery; do not take laxatives.

Place the gastric tube connected to the gastrointestinal decompressor, and fix it properly, especially for patients with intestinal obstruction. Tell them that the gastric tube cannot be removed randomly, because gastrointestinal decompression is one of the effective measures to treat intestinal obstruction.

If the whole body is weak and the imbalance of water, electrolytes, acids, and bases appears, it should be quickly added and corrected, such as rapid infusion or blood volume. Create conditions for the body to undergo surgery.

Routine preparation.

Postoperative care for intestinal diseases

Understand the operation process, check each tube on the patient, connect and fix them one by one. keep warm. The first blood pressure and pulse were measured and recorded in the care sheet.

Pay attention to the smooth flow of each tube, such as gastric tube or abdominal drainage tube, often check and squeeze, pay attention to observe the color and quantity of drainage fluid within 24 hours after operation to prevent bleeding.

Make a careful record of the amount of output and the amount of input, and do not rely on the numbers reported by the family accompanying guests to avoid deviations.

Observation of vital signs, body temperature was measured every 4 hours within 3 days after operation, blood pressure and pulse were measured every 1/2 to 1 hour within 6 hours after operation, and changes in Shen's condition were observed in time. Those with intestinal infarction should pay attention to abdominal distension. The condition and whether the bowel sounds have recovered, and the appearance of the intestinal fistula and the weakness of the body can indicate that the condition is improving or worsening.

Infusion care. Due to intestinal surgery patients, most patients have gastric tubes and need to fast for many days. Pay attention to three aspects during infusion: the first quality aspect is to increase high energy drugs and colloid input; To supplement the amount with the normal amount required, take a 24-hour continuous infusion if necessary; in the third speed, divide the total amount of infusion 24 hours a day into three 8 hours or calculate the amount of infusion per hour, so that Calculate the drip volume per hour and settle once every 8 hours to meet the infusion volume in the budget. Because, patients with intestinal obstruction and intestinal fistula are all digestive and malabsorption disorders, and the general condition is poor. Intestinal fistula, in addition to the above, there is a large amount of digestive juice outflow every day, most of which can reach 3000 ~ 4000ml, and more attention should be paid to the timely replacement of liquids and electrolytes to prevent metabolic acidosis. Pay attention to blood test reports, such as the determination of K +, Na +, CI-, and changes in CO2, CP, and pH, to provide doctors as a basis for infusion therapy.

Nutrition care. Intestinal fistula patients pay attention to instillation of nutrition from the ostomy fistula; the currently used 24% element diet 1000ml can provide 1800kcal of calories, which can basically meet the daily needs of adults. When starting to use, the concentration and quantity should be halved to prevent vomiting Complications such as diarrhea and diarrhea are gradually added to the normal amount; the elemental diet should be prepared fresh on the day; the excess elemental diet should be prepared and refrigerated at a temperature not exceeding 10 ° C to avoid deterioration; the ostomy tube is kept open; the drip bottle is replaced daily Pay attention to cleaning and disinfection; keep the drip diet warm. If the ordinary high-calorie juice is dripped into the fistula, the perspiration should be filtered with three layers of gauze and then poured into the drip bottle to prevent the pipeline from being blocked.

Wound care. Observe the wound for bleeding within 24 hours after surgery. If there is a small amount of bleeding in the surface cortex, it may be sutured or improper hemostasis. A little pressure should be applied and the abdominal bandage should be used for compression. If there is more bleeding, hemostatic measures should be taken. Generally clean the wound for 2 to 3 days to check and change the dressing. There is no need to change the dressing before removing the thread. For wounds with exudation and drainage, the wound can be cleaned with isotonic saline. Wound care for patients with intestinal fistula: The intestinal fistula exudate should be drained to the outside of the body in time. Double sets of drainage tubes should be placed at the lower part of the fistula and connected with a negative pressure suction device for continuous suction. Protect from digestive juices.

Activity exercise. The postoperative condition is stable, that is, the patient is in a semi-recumbent position, and assists lateral and lateral transposition every 2 hours. The ankle and knee joints often perform flexion, extension, and rotation activities to prevent lower limb swelling and venous embolism. After appendicitis, it can be done after 24 hours Getting up; patients with intestinal obstruction and intestinal fistula, depending on the situation, can get out of bed 48 hours after surgery, walk around the bed, get up early to prevent intestinal adhesions and recurrence of intestinal obstruction; for morning and evening care, order The patient took several deep breaths to expand his lungs well.

Practice sputum. Patients often suffer from wound pain and are afraid of coughing. They can assist and guide the patient. Inhale deeply before coughing. The helper presses with both hands from the left and right sides of the wound to the middle. Cough up.

Oral skin care is performed routinely.

Intestinal diseases

1. Enough calories: Many people think that people with diarrhea should eat less. That's wrong. Because diarrhea causes a significant increase in consumption, the total energy supply is required to increase accordingly. In order to reduce the burden on the gastrointestinal tract, liquid or semi-liquid can be selected.

2. Reasonable protein: Bacterial spoilage is strong in the intestinal tract in the acute phase, and protein intake should be appropriately limited because protein can increase spoilage, but yogurt can be eaten. High-quality proteins such as fish, eggs, milk, lean meat, etc. should be selected as much as possible. At the same time supply a wealth of vegetables, when the condition improves, the appropriate increase in protein supply.

3 Sufficient carbohydrates: The carbohydrate supply should account for 60% -65% of the total energy. It can be given digestible food such as vermicelli and rice porridge, and the stew time should be as long as possible to make it easy to digest and absorb.

4 Limit fats: make full use of fried, fried foods and fat-rich snacks such as fatty meat, pork, and appropriately increase beans, soy products and fresh vegetables.

5. Low dietary fiber: Avoid using fruits and vegetables with a lot of crude fiber. A small amount of raw apple puree can be used because the pectin in apples has an antidiarrheal effect.

6. Abundant water, vitamins and minerals: should pay attention to the full complement of water, can be given to rice soup, fruit juice, etc., vegetables, fruits, etc. can be made into vegetable soup. Patients with acute enteritis due to digestive and absorption dysfunction, so cooking, steaming, cooking, braising, stewing and other methods should be used as much as possible to make the food easy to digest and absorb. In addition, to reduce the burden on the gastrointestinal tract, eat more meals and eat 5-6 daily. Times.

Bowel disease symptoms of bowel disease

Intestinal disorders

The cause may be due to impaired digestion, absorption or motor function of the intestine. However, there are many reasons for the loss of appetite. In addition to gastrointestinal diseases, they can also be caused by mental factors, drug reactions or other organ diseases.

Bowel disease nausea, vomiting

High bowel obstruction or abnormal bowel movement function often causes vomiting. But nausea and vomiting can also occur in many different diseases.

Bowel disease abdominal pain

Intestinal inflammation, intestinal obstruction, bowel perforation, bowel ischemia, etc. can all cause acute abdominal pain. Bowel tumors or chronic inflammatory lesions often have persistent abdominal pain.

Bowel disease diarrhea

Acute diarrhea is usually caused by intestinal bacterial infections, bacterial toxins, or other harmful substances that damage the intestinal mucosa. Chronic diarrhea can be found in diseases such as absorption dysfunction, chronic inflammation, and intestinal tachycardia caused by various reasons. Chronic diarrhea caused by small bowel disease is often accompanied by malabsorption. Diarrhea caused by colon disease is more common in chronic inflammation or colonic hyperkinesia.

Bowel disease constipation

Weak bowel movements, decreased muscle tension in the intestinal wall, or narrowed bowel cavity due to inflammation and tumors in the colon and rectum can cause constipation. Constipation can also be caused by drugs, changes in lifestyle, too little or too much diet, and too little fiber in food. So constipation is not necessarily the manifestation of organic lesions in the intestine.