What Is the Relationship Between Stress and the Digestive System?

Medical history is very important in the diagnosis of digestive diseases. Some digestive diseases have prominent symptoms and insignificant signs, and the diagnosis is determined to a large extent by the analysis of medical history. Treatment of medical history should first focus on analyzing the patient's current symptoms.

Diseases of the digestive system

In addition to the symptoms and signs of the digestive system, the clinical manifestations of digestive system diseases are often accompanied by other systemic or systemic symptoms, and some digestive system symptoms are not as prominent as those of other systems. Therefore, careful collection of clinical data, including medical history, signs, routine tests and other related auxiliary examination results, and comprehensive analysis and synthesis can be used to obtain a correct diagnosis.

History of digestive diseases

Signs of digestive system disease

A comprehensive and systematic examination is extremely important. First of all, pay attention to the general situation of the patient, whether jaundice and spider moles, whether the lymph nodes on the collarbone are swollen, whether there are varicose veins and blood flow direction in the chest and abdomen wall, and whether the heart and lungs are abnormal . Abdominal examination should be more in-depth and detailed, with or without abdominal swelling, peristaltic waves, mobile dullness, tenderness, rebound pain, rigidity of abdominal muscles, tremors, bowel sounds; if a mass is found, you should know its location, depth, size, Shape, hardness, surface condition, presence or absence of mobility, tenderness, pulsation, etc. Liver and spleen examinations are important. Pay attention to size, hardness, edges, surface, and presence of tenderness. Be careful not to mistake lumps in the sigmoid colon, the filling bladder, the lordotic spine, the abdominal aorta, the kidneys, or the pregnant uterus as a mass. In addition, in those who are deficient in subcutaneous fat, veins can appear on the abdominal wall and portal hypertension should not be mistaken; those with weak and loose abdominal walls can see bowel peristaltic waves and should not be regarded as intestinal obstruction. Digestive intestinal diseases and anal finger examination in elderly patients should be listed as routine and cannot be ignored.

Laboratory of digestive diseases and other tests

Digestive system diseases (a) laboratory tests

Fecal occult blood test and urinary triple gall test are both simple and valuable tests. Gastric fluid analysis and duodenal drainage can provide a basis for diagnosis of gastric and biliary diseases. There are many liver function tests with different meanings and should be selected appropriately. Cytological examination is very helpful for the diagnosis of esophagus, stomach and colon cancer. Examination of tumor markers, such as AFP, CEA, and CA19-9, has some value. Autoantibody tests, such as anti-mitochondrial antibodies, are helpful to the diagnosis of digestive autoimmune diseases.

Digestive System Diseases (B) Ultrasound Examination

It can show the size and outline of liver, spleen, and gallbladder, which is helpful to distinguish liver cancer and liver abscess. It can also show gallbladder stones, internal diameter of splenic portal vein, bile duct dilatation, liver, pancreatic cyst, and other masses in the abdomen. Easy to do and helpful for diagnosis.

Digestive System Diseases (3) Endoscopy

The lesions can be directly observed. Due to the large brightness, clear field of vision, fewer blind spots, convenient operation, and increasingly expanding use. Fiber gastroscopy is very helpful for the early diagnosis of gastric cancer. Due to the application of gastroscopy, more than 30% of gastric cancer may be diagnosed at an early stage (those who have not invaded the muscle layer). ERCP is of great help in the diagnosis of liver, gallbladder and pancreatic diseases. Fiber colonoscopy can be inserted into the ileum, while fiber laparoscopy can help diagnose liver and pancreas and intra-abdominal masses to determine the cause of ascites.

X Digestive system diseases (4) X-ray examination

Gastrointestinal barium meal and barium enema examination are helpful to understand the dynamic state of the gastrointestinal tract, and have certain help in the diagnosis of tumors, ulcers, and diverticulum. The recent application of gas-barium double contrast has increased the positive rate. Biliary cholecystography is helpful to understand the gallbladder condensing function and judge the presence or absence of stones. Percutaneous hepatic cholangiography can distinguish the cause of obstructive jaundice. Selective abdominal angiography has diagnostic value for liver and other tumors and gastrointestinal bleeding. CT and MRI have been used to diagnose intra-abdominal tumors, and patients are happy to accept them. Hepatic vein and inferior vena cava manometry and angiography, blood flow and oxygen consumption measurement are helpful for the diagnosis of Bai Yicha syndrome and liver cancer.

Digestive system diseases (5) Radionuclide examination

There are more and more items, and liver scanning has been used for a long time. R-camera and ECT can provide diagnosis basis for space-occupying lesions such as liver cancer. Recently, some people have developed anti-tumor monoclonal antibody-labeled nuclides for imaging diagnosis, which can help diagnose liver and pancreatic tumors. In addition, the application of radioimmunoassay (RIA) can also detect tumor markers or gastrointestinal hormones, which is of great value for the diagnosis of some tumors and diseases of the digestive system.

Digestive system diseases (6) esophageal stress and vitality

And biliary pressure measurement

Measuring the pressure in the lower cavity of the esophagus is very valuable for the diagnosis of reflux esophagitis. Understanding the vitality of various segments of the esophagus is very helpful for the diagnosis and differentiation of esophageal sports diseases such as esophageal and achalasia. Endoscopic intubation of biliary tract manometry can help diagnose biliary insufficiency obstruction, sclerosing cholangitis, biliary atresia, and papillary sphincter dysfunction.

Digestive System Diseases (7) Biopsy

Liver biopsy is one of the most valuable methods for the definitive diagnosis of chronic liver disease. At present, fine needle aspiration is mostly used, which rarely causes the risk of bleeding. Small intestine biopsy, the small intestine biopsy is sent to the jejunum or ileum (can be guided through the endoscope through the pylorus) through the mouth, and mucosal tissues are used for pathological examination, which is of diagnostic value for diarrhea and small bowel malabsorption Indications should be strictly controlled during inspections. In addition, pathological diagnosis can be made by endoscopic biopsy, fine-needle percutaneous biopsy of histological cytology, and surgical biopsy under the guidance of B-mode ultrasound.

Research direction of prevention and treatment of digestive system diseases

Internal medicine In the past two or three decades, due to unprecedented advances in cell biology, molecular biology, biochemistry, endocrinology, immunology, and enzymology, as well as the establishment of many new and sophisticated techniques, the pathology, etiology, Great achievements have been made in pathogenesis, diagnosis, prevention and treatment. Gastroenterology is now an increasingly complete branch of internal medicine.

Digestive diseases are closely related to systemic diseases. Gastrointestinal diseases can have other systems or systemic manifestations outside the digestive tract, and even cover the basic symptoms of the system for a certain period of time. On the other hand, systemic diseases often take digestive symptoms as the main manifestation or the digestive tract disease is only a systemic disease. An integral part. Therefore, a digestive professional must have a solid general clinical foundation. Focusing on the patient as a whole, diagnosis and treatment are combined with the whole and the part.

Examples of digestive diseases

There are many new diagnostic and therapeutic technologies that have greatly promoted the development of gastroenterology. For example, the widespread use of gastrointestinal fiber endoscopy since the 1970s has greatly improved the diagnostic level of upper and lower gastrointestinal diseases. With the development and promotion of new endoscopes such as electronic gastroscopy and ultrasound gastroscopy, it will further Play its diagnostic role. In recent years, endoscopy has not only been widely used for diagnosis, but also has made new progress in treatment, such as electrocoagulation of gastrointestinal polyps, duodenal papillary surgery and choledocholithotomy, and drainage of common bile duct obstruction. , Esophageal varicose vein sclerosing and ligation therapy, electrocoagulation of hemorrhage of digestive tract, photocoagulation to stop bleeding, laser treatment of peptic ulcer, laser hematoporphyrin treatment of cardia cancer, etc. have played or will play a very good role.

Liver and gall diseases are also common diseases of our people. Liver function tests remain an important means of diagnosing diffuse liver disease. Due to the poor specificity of some old liver function tests, poor sensitivity, or other reasons that need to be eliminated, new liver function tests should be established. For example, sodium sulfobromophthalide has been replaced by indigo green because of its easy to induce systemic allergic reactions. The detection of new enzymes and their isoenzymes, such as 5 / -nucleotide phosphodiesterase and its isoenzyme, transaminase isoenzyme, alkaline phosphatase and its isoenzyme, etc. is constantly being explored for diagnostic value.

Imaging diagnosis is a subject that has developed rapidly in recent years. It will significantly improve the correct diagnosis rate of localized space-occupying diseases of the liver. For example, the ultrasound imaging diagnosis technology of the liver, because it can distinguish and significantly improve the liver tissue, and is easy to operate without harming the human body, the application is more and more widely used, and the function is more and more important. The new generation of computer tomography has been rapidly promoted in the diagnosis of liver disease, and will certainly become one of the important diagnostic methods. Computer tomography is another major new diagnostic technology. Magnetic resonance has no radiation effect on the human body, and it can be clearly contrasted without the need for contrast agents. Some biochemical differences in the human body can sometimes resonate from nuclear nucleus. It is reflected in the density contrast on the image and may therefore be superior to CT. Of course, the diagnostic role of magnetic resonance in liver, gallbladder, and pancreatic diseases needs further research to make a comprehensive evaluation.

The radioimmunoassay was developed in the 1970s and can be used to determine trace amounts of substances in the human body, such as hormones, antigens, antibodies, biological drugs, and drugs, which greatly promote digestive diseases. Diagnostic and pathophysiology studies, such as the determination of gastrin, intestinal vasoactive peptides, glucagon and somatostatin, have played a good role in the clinical significance of these hormones and the diagnosis of hormone tumors. In China in the 1970s, radioimmunoassay and rocket electrophoresis were used to detect alpha-fetoprotein census of liver cancer, and a number of small liver cancers and subclinical liver cancer cases were found. Early surgery was obtained and good results were obtained. Radioimmunoassay will be applied to the detection of other tumor-associated antigens. Radioimmunoassay is used to determine the surface, core, e and delta antigens and antibodies of hepatitis B. It has also been obtained in the pathogenesis of hepatitis, cirrhosis and liver cancer. Some valuable information. The biotin-avidin enzyme-linked immunoassay is being researched and developed, and its sensitivity is comparable to that of radioimmunoassay, and it may be popularized instead of the latter.

Genetic recombination, molecular hybridization, and probe technologies developed on the basis of molecular biology have been used to detect hepatitis B virus DNA polymerase and oncogenes in animal tumors. If the human gastrointestinal cancer also has oncogenes and can be successfully isolated, this new examination will soon be transferred to clinical applications and will further improve the diagnostic level and theoretical understanding of certain digestive diseases.

Information on digestive diseases

Peptic ulcer is a common disease. Although there have been many developments in its research over the years, its pathogenesis is still not well understood. In recent years, the pathogenesis of gastrointestinal hormones such as prostaglandin and gastric mucosa protection, gastrin, somatostatin, genetic factors, stress and Helicobacter pylori has been further explored, and the prevention and treatment of peptic ulcer will be improved.

In recent years, although some achievements have been made in the prevention and treatment of gastric cancer, in order to take preventive measures against gastric cancer, it is necessary to carry out in-depth research on the cause, pathogenesis and strengthening of gastric cancer. To further prove the nitrate-reducing bacteria, fungi and N-nitroso compounds cause gastric cancer. In addition, the isolation of gastric cancer-related or specific antigens, the preparation of human monoclonal antibodies directed against the corresponding antigens, etc. may be helpful in the prevention and treatment of gastric cancer.

Attach importance to and strengthen research on bowel disease. Intestinal diseases, especially small bowel examination methods are not yet perfect. In addition to the new examination method, intestinal endoscopy and blind small intestine biopsy have been carried out, intestinal immune response, small intestinal bacteria reproduction and intestinal absorption pathophysiology are the topics to be studied in the future.

The treatment of digestive diseases depends on both medicines and general measures, including proper rest and a balanced and nutritious diet. In the rehabilitation phase, you should arrange your life reasonably and gradually do some physical exercises to strengthen your physique. It is necessary to grasp the indications, side effects and contraindications of various medications. Choose medicines with high efficacy, few side effects, cheap prices, and convenient taking. Don't abuse drugs, you must realize that drugs always have side effects, and some drugs are more serious, which can increase liver metabolic load. Be familiar with the properties of various drugs that can cause side effects of digestive diseases and avoid or use them with caution.

Some new drugs or therapies developed in recent years, such as new H2 receptor antagonists and proton pump inhibitors, are used to treat peptic ulcers, deoxyselenic acid and ursolic acid are used to treat gallstones, and the application of intravenous hypertrophic therapy has enriched digestive diseases. Treatment methods, certain diseases of the digestive system or their complications often require surgical treatment, and the close cooperation of physicians and surgeons is often the key to effective treatment.

The "spleen and stomach" of traditional Chinese medicine is similar to the digestive system in modern medicine in terms of its physiological functions and clinical manifestations. For some digestive system diseases, traditional Chinese medicine treatment or integrated traditional Chinese and western medicine treatment is often better than western medicine alone. It should be actively used, such as Qingyi Decoction is effective in treating acute pancreatitis and Paishi Decoction in treating bile duct stones.

Although the above lists some aspects, it is not enough to summarize the entire content of the research on the prevention and treatment of digestive diseases. Digestive system diseases have a high incidence in China and should be paid attention to. Malignant tumors of the digestive system, stomach cancer, esophagus cancer, liver cancer and colorectal cancer, etc., there are still many difficulties in their early detection. Chronic hepatitis B and C related to the onset of liver cancer are not satisfactory enough for its prevention and treatment so far. These diseases No doubt it should be one of the key research and problem solving.

Surgical treatment of digestive diseases

Surgical treatment of the digestive system consists of two parts: the digestive tube and the digestive gland. The digestive tract is a long muscular tube that extends from the mouth to the pharynx, esophagus, stomach, small intestine, large intestine, and finally anus, and includes the oral cavity, pharynx, esophagus, stomach, small intestine (duodenum, jejunum, ileum) and Large intestine (cecum, colon, rectum) and other parts. There are two types of digestive glands: small digestive glands and large digestive glands. The small digestive glands are scattered in the wall of each part of the digestive tract, and the large digestive glands have three pairs of salivary glands (parotid gland, submandibular gland, sublingual gland), liver, and pancreas. They all use the catheter to discharge secretions into the digestive tract. The basic function of the digestive system is the digestion and absorption of food, the substances and energy required by the body, and the nutrients in food except vitamins, water and inorganic salts can be directly absorbed and utilized. Proteins, fats and sugars can not be used. It is directly absorbed and used by the body, and needs to be decomposed into small molecular substances with simple structure in the digestive tract to be absorbed and utilized. The process by which food is broken down into small molecules that can be absorbed in the digestive tract is called digestion. This small molecule is absorbed through the digestive tract mucosal epithelial cells into the blood and lymph fluid. For the unabsorbed residue, the digestive tract is excreted in the form of feces through the large intestine. There are two forms of mechanical and chemical digestion in the digestive process. The food is chewed by the mouth, the teeth are ground, the tongue is stirred, swallowed, and the gastrointestinal muscles are moved. The large pieces of food are reduced to small pieces, the digestive juice is fully mixed with the food, and the bolus or chyme is pushed. Moving from the mouth to the anus, this digestive process is called mechanical digestion, or physical digestion. Chemical digestion refers to the chemical decomposition of food by the digestive juice secreted by the digestive glands. The digestive juice secreted by the digestive glands breaks down complex nutrients into simple compounds that can be absorbed by the intestinal wall, such as sugars into monosaccharides, proteins into amino acids, and lipids into glycerol and fatty acids. These decomposed nutrients are then absorbed into the body by the small intestine (mainly the jejunum), into the blood and lymph fluid. This process of digestion is called chemical digestion. Mechanical digestion and chemical digestion are performed simultaneously to complete the digestive process.

Gastrointestinal emergency

Some gastrointestinal disorders can be fatal and sometimes require urgent surgery. These diseases include: gastrointestinal bleeding, mechanical obstruction of the digestive tract, paralytic intestinal obstruction (a temporary cessation of the normal contraction of the bowel), appendicitis and peritonitis (inflammation of the inner surface layer of the abdominal cavity).

Digestive system

Gastrointestinal bleeding

Bleeding may occur anywhere in the entire digestive tract from the oral cavity to the anus, and can manifest as blood in stool or vomit or occult blood that can only be detected by laboratory methods. Bleeding in any part of the digestive tract can be exacerbated by another bleeding disorder.

Symptoms: Possible symptoms include vomiting blood (vomiting blood), solution of black tar-like stools, and visible blood from the rectum (blood in the stool). Usually, black tar-like stools come from the upper gastrointestinal tract, such as the stomach and duodenum; the black color is caused by the blood being exposed to the effects of gastric acids and bacteria before being excreted from the body. About 60ml of blood can produce tar-like stools. A severe bleeding can produce tar-like stools for up to a week, so continued tar-like stool does not necessarily mean continued bleeding.

Digestive system disease arteriovenous malformation bleeding

Arteriovenous malformations are caused by abnormal rupture of the blood vessels connecting the arteries and veins.

The cause of arteriovenous malformations on the inner gastrointestinal surface is unclear. However, this disease is known to be common in patients with heart valve disease, kidney or liver disease, patients with connective tissue disease, and patients with bowel radiation therapy. The diameter of these malformed blood vessels can range from a fishing line to the thickness of a human's pinky finger, and is prone to bleeding, sometimes severe bleeding, especially in the elderly.

Gastrointestinal disorders

Diseases of the digestive tract or other organs in the abdominal cavity can cause abdominal pain, such as esophageal rupture, perforation of ulcers, irritable bowel syndrome, appendicitis, pancreatitis and gallstones. Some diseases are relatively mild, while others can be fatal. The doctor must decide whether to take treatment immediately or to be able to wait for the test results to come out before making a decision.

Digestive system disease mechanical intestinal obstruction

Mechanical intestinal obstruction is a disease that completely obstructs the intestine or seriously affects the passage of intestinal contents.

Obstruction can occur anywhere in the intestine. When the obstruction occurs, the intestinal segment above the obstruction site is still functional. When the intestinal lumen is filled with food, fluids, digestive fluids and gases, the intestine swells like a hose.

In newborns and infants, common causes of intestinal obstruction are birth defects, hard faeces in the intestine (meconium), or torsion of the intestine itself (intestinal torsion).

In adults, duodenal obstruction can be caused by pancreatic cancer, ulcer scars, previous surgery, Crohn's disease, or fibrous bands of connective tissue entanglement in the intestine. Intestinal obstruction can also occur when a part of the intestine passes through a potential opening in the abdomen (hernia), such as when the abdominal wall muscles bulge and become incarcerated. In rare cases, gallstones, undigested food clumps, or large groups of roundworms can also cause intestinal obstruction.

In the large intestine, cancer is a common cause of intestinal obstruction. Bowel loops or large stools (fecal impaction) can also cause bowel obstruction.

If the obstruction blocks blood supply to the intestine, this condition is called intestinal strangulation. Intestinal strangulation occurs in approximately 25% of cases of small bowel obstruction. Common causes of intestinal strangulation are: part of the small intestine is incarcerated at a latent opening in the abdomen (strangulation hernia), the bowel is twisted, and the bowel is trapped in another bowel (intussusception). Intestinal strangulation occurs only 6 hours, and intestinal gangrene, intestinal wall necrosis can occur, often causing perforation, which in turn causes inflammation (peritonitis) and infection of the inner lining of the abdominal cavity. If left untreated, patients often die as a result.

Even if intestinal strangulation does not occur, the intestinal segment above the obstruction site becomes swollen and swollen, and the intestinal mucosa swells and inflammation occurs. If left untreated, the intestinal tract may be perforated and the contents of the intestine leak into the abdominal cavity causing inflammation and infection of the abdominal cavity.

Gastrointestinal obstruction

Paralytic intestinal obstruction (dynamic intestinal obstruction) is a type of intestinal obstruction caused by the temporary cessation of normal intestinal contraction.

Like mechanical intestinal obstruction, paralytic intestinal obstruction also stops the movement of intestinal contents in the intestine. However, unlike mechanical intestinal obstruction, paralytic intestinal obstruction rarely causes bowel perforation.

The causes of paralytic intestinal obstruction are infection, or the formation of blood clots in the abdominal blood vessels to block intestinal blood supply, and atherosclerosis or intestinal arterial or venous damage to the intestinal blood supply. Paraintestinal obstruction can also be caused by diseases outside the bowel, such as renal failure or abnormalities in blood electrolytes, such as hypocalcemia or hypercalcemia. Other causes include certain medications and hypothyroidism. 24 to 72 hours after abdominal surgery, there are often varying degrees of intestinal paralysis.

Digestive System Diseases

Appendicitis is inflammation of the appendix.

The appendix is a small, finger-like tubular protrusion located near the large intestine that connects the small intestine. The appendix has some immune functions, but it is no longer an important organ. In the United States, in addition to incarcerated hernias, appendicitis is the most common cause of acute abdominal pain and requires surgery. The most common age for appendicitis is 10 to 30 years.

The cause of appendicitis is not fully understood. In most cases, it is likely that an obstruction in the appendix cavity caused inflammation and infection of the appendix. If untreated, appendicitis continues to develop, and the appendix will perforate, allowing intestinal contents containing a large number of bacteria to enter the abdominal cavity, causing peritonitis and lethal intraperitoneal infection. Appendiceal perforation can also cause the formation of abscesses in the abdominal cavity. In female patients, infections can occur in the ovaries and fallopian tubes, which can cause tubal obstruction and infertility. An appendix rupture can also allow bacteria to enter the bloodstream and cause a fatal disease called sepsis.

Diseases of the digestive system peritonitis

Peritonitis is an inflammation of the inner lining (peritoneum) of the abdominal cavity, usually caused by an infection.

The peritoneum is a thin, smooth layer that normally covers all the organs of the abdomen and the inner surface of the abdominal wall. Peritonitis is usually caused by the spread of infection in an organ in the abdominal cavity. A common cause is perforation of the stomach, intestine, gallbladder, or appendix. The peritoneum has a strong resistance to infection. Unless the pollution persists, peritonitis generally does not occur, and the peritoneum itself has the function of healing and healing.

In women who have sex, pelvic inflammatory disease is a common cause of peritonitis. Uterine and fallopian tube infections can spread to the peritoneal cavity, including bacterial and chlamydial infections that cause gonorrhea. In patients with liver and heart failure, fluid (ascites) can accumulate in the abdominal cavity and infection can occur.

There are several causes of peritonitis after surgery. Damage to the gallbladder, uterus, bladder or intestine during surgery can cause bacteria to spill into the peritoneal cavity and cause infection. During intestinal segment anastomosis, leakage of intestinal contents can also occur and enter the peritoneal cavity to cause infection.

Peritoneal dialysis (a method of treating renal failure) often causes peritonitis. The common cause is an infection caused by a fluid drainage tube through the abdominal cavity.

In the absence of infection, peritonitis can also be caused by certain irritation. For example, inflammation of the pancreas (acute pancreatitis) can cause peritonitis. Similarly, talc or starch on surgeons' gloves during surgery can cause peritonitis without infection.