2020年10月23日星期五

hemorrhoids and anal fissures,Department of Anorectal, Nantong Hospital of Traditional Chinese Medicine-The diagnosis and treatment of blood in the stool should be emphasized

    Blood in the stool is a common clinical symptom. Intermittent blood in the stool is often ignored by patients. In fact, blood in the stool can involve multiple systems or diseases of multiple natures. It should be paid attention to. After gastrointestinal bleeding is discharged through the intestine, the stool will be bloody or Whole blood stools can be bright red, dark red, and tarry in color. The color of blood in the stool depends on the location of the bleeding, the amount of bleeding, and how long the blood stays in the digestive tract. Bleeding from the lower gastrointestinal tract (small intestine, colon, rectum, anus), stools are often bright red or dark red. The upper gastrointestinal tract (esophagus, stomach, duodenum) has bleeding, and stools are often tarry-like. Blood in the stool is generally divided into bloody stools, tarry stools and occult bloody stools. Common diseases include hemorrhoids, anal fissures, polyps, gastrointestinal tumors, ulcers, etc., as described below.

    1 Bloody stools: generally from the lower end of the ileum, colon, rectum, and anus, stools are bright red or dark red in color, and may be mixed with mucus and pus. Common diseases are: hemorrhoids, anal fissure bleeding. Hemorrhoids, hemorrhoids, blood in the stool sprays out during defecation or drips after the stool; anal fissures have less blood in the stool, but the anal pain is more severe. Rectal polyps are bleeding, the amount of blood in the stool is not large, the blood is attached to the surface of the stool, and sometimes the stool becomes thinner or has pressure marks. Dysentery has blood in the stool with pus and blood in the stool, frequent stools, and pain in the left lower abdomen. It is worth mentioning that more than 85% of rectal tumors can be found by simple anorectal examination.

    2 Tar-like stool: Black stool. Upper gastrointestinal bleeding is not vomited, and the blood stays in the intestine for a long time. The hemoglobin in the blood combines with the sulfide in the intestine to form ferrous sulfide, which makes the stool black and shiny, like asphalt. The appearance of tarry stools indicates that the bleeding volume has reached more than 60 ml. But it should be noted that certain foods and drugs can make the stool black, which can be identified by the stool occult blood test.

    3 Occult blood stool: Any small amount of gastrointestinal bleeding does not cause stool color change, and only a positive stool occult blood test during laboratory tests is called occult blood stool. Occult bloody stools can occur in all diseases that cause gastrointestinal bleeding, and gastric ulcers and gastric cancer are common. Endoscope, barium enema and other examinations can help confirm the diagnosis.

    First-aid measures are basically the same as hematemesis. Stay in bed quietly, reduce activity, observe the amount of bleeding, use hemostatic drugs appropriately, and send to the hospital for emergency treatment if syncope or shock occurs. Our recommendations for bleeding symptoms in the anorectal department are: first, a clear diagnosis, and second, timely treatment to avoid future problems.

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