2020年10月21日星期三

preparation h hemorrhoids,Common causes of blood in the stool and its diagnosis and treatment

    The special lecture draft of "Healthy Clan" on Zhongshan Radio Station will be broadcast on December 20, 2008 from 2 to 3 pm.

    The radio host asked and Chen Jinquan answered.

    Q: What is blood in the stool?

    Q: How to estimate the location of bleeding based on the color of bleeding?

    Answer: The color of blood in the stool is related to the height of the bleeding location, the amount of bleeding and the speed of blood discharge, the length of time it stays in the digestive tract, and whether it is accompanied by infection. Bleeding in the lower part of the anus and rectum often discharges fresh blood or attaches to the surface of the formed stool; when the upper part of the colon is bleeding, the blood is often mixed in the feces and appears red in sauce. If the blood stays in the intestine for a long time, it can discharge dark black. That is, tarry stool.

    Question: How to estimate the cause of blood in the stool based on the color of the bleeding?

    Answer: The causes of blood in the stool are often seen in hemorrhoids, anal fissures, ulcerative colitis, rectal polyps, rectal cancer, colorectal cancer, vascular diseases and systemic diseases. Its pathogenesis is mainly (1) chemical or physical damage to the anorectal canal; (2) inflammation of the intestinal mucosa caused by various reasons; (3) ulceration or necrosis of benign or malignant tumors; (4) certain systemic Disease or coagulation mechanism disorder: (5) Vascular disease, etc.

    It is worth pointing out that gastrointestinal tumors (regardless of benign or malignant) do not have any symptoms before erosion, ulcers, or bleeding occur in the lesion; that is to say, once gastrointestinal tumors have symptoms of blood in the stool, it means that the tumor has been For a certain period of time, if you want to find tumors and polyps before they are asymptomatic, you can only perform appropriate screenings such as stool occult blood test, digital rectal examination, and electronic colonoscopy for people with early warning signs of colorectal tumors or people around 45 years old. Wait.

    Question: What are the common diseases of bright red blood in the stool?

    Answer: Bright red blood in the stool is common in the following diseases

    Anal canal diseases such as hemorrhoids bleeding, anal fissure bleeding, rectal polyps, acute rectal erosion bleeding, etc.

    Question: What diseases are more common in mucus blood in the stool? .

    Answer: Mucous blood in the stool is more common in ulcerative colitis, bacillary dysentery, amoebic dysentery, tuberculosis of the rectum, ischemic enteritis, radiation enteritis, anal fistula, large polyps of the colon and rectum, rectal cancer, colorectal cancer and other diseases.

    Ask what kind of diseases are tar samples more common in?

    Answer: Tar-like stools or black stools are more common in upper gastrointestinal bleeding such as stomach and duodenum. 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 and ferrous sulfide. Make the stool black and shiny, like tar. It can also be seen in bleeding caused by tumors, inflammation or vascular disease above the ileum or ascending colon. The appearance of tarry stools indicates that the bleeding volume has reached more than 60 ml. However, it should be noted that certain foods such as the blood of pigs and sheep, or certain black drugs such as Ganoderma lucidum powder, laxative tea, etc. can also make the stool black, which can be identified by the stool occult blood test.

    Question: What is occult blood in stool?

    Answer: A small amount of gastrointestinal bleeding does not cause stool color changes, and only those who have a positive stool occult blood test during laboratory tests are called occult blood stools or occult blood stools. Occult bloody stools can occur in all diseases that cause gastrointestinal bleeding. Common causes include gastric ulcer, gastric cancer, colorectal polyps, colorectal cancer, etc.

    Question: Which diseases should be considered for stool bleeding?

    Answer: Blood in stool is a peculiar symptom of lower gastrointestinal bleeding, especially colon, rectum and anal bleeding. It often indicates that there are organic diseases in the intestines, which must be paid attention to. The diagnosis should be made in time and treatment should be done promptly. The following diseases should be considered when hematochezia occurs:

    1. Anal disease

    (1) The biggest characteristic of internal hemorrhoid hemorrhage is that the blood is bright red without pain. Hemorrhoids often bleed due to abrasion of the hemorrhoids in the stool, usually as bleeding, bleeding or ejection after the stool. The first degree internal hemorrhoids only have blood in the stool, and no mass protrudes out of the anus after the defecation. The second degree internal hemorrhoids drips blood or ejects blood after the defecation, and is accompanied by a mass in the anus that protrudes out of the anus after defecation, but can return to the anus by itself after defecation ; Third-degree internal hemorrhoids drip or eject blood after defecation, and the mass in the anus prolapses after defecation and cannot be pushed back into the anus.

    (2) Bleeding from anal fissures and bleeding in stools are often accompanied by typical cyclical pain after stool. As the patient described in a message on my website, "Bleeding occurs every time you have a stool, as if something hard has struck the anus." In Chinese medicine, it is called hook intestinal hemorrhoids. Anal fissure is also one of the most common causes of blood in the stool in children.

    (3) Anal canal cancer mainly manifests as blood in the stool and pain. The pain intensifies before defecation, and the anus is often narrow.

    2. Rectal disease

    (1) Rectal cancer is mainly manifested as increased stool frequency, thinner stools, bloody mucus stools. The biggest characteristic is that the anus has tenesmus or incomplete defecation. The blood in the stool is bright red or dark red in the early stage, and the amount is not large. It is often in the late stool. Foul-smelling mucus, progressive weight loss, rectal cancer is easy to be misdiagnosed as hemorrhoids, the clinical misdiagnosis rate is over 70%, and it should always be taken seriously

    (2) Rectal polyps

    Rectal polyps are more likely to cause bleeding after damage, infection, erosion, or ulcer. Juvenile colon polyps, which are more common in children under 6 years old, have no family history. The main manifestations are frequent blood in the stool, often accompanied by malnutrition, anemia, hypoproteinemia, pale complexion, growth retardation, etc.; familial juvenile colon Polyposis: There is a family history, and the symptoms are bloody stools or bloody sticky stools, abdominal pain, diarrhea, and growth retardation as common features.

    (3) Radiation proctitis, there is a history of radiation therapy for tumors (such as uterine or cervical cancer), stools often have symptoms such as bleeding, anal tightness, and difficulty in defecation.

    3. Colon disease

    (1) Colon cancer: It is common in left colon cancer. Most patients have persistent and progressive constipation, but also occasionally see increased stool frequency, abdominal pain, etc., abdominal mass or incomplete obstruction in the late stage, when the cancer is broken When ulcers, the outside of the stool can be stained with blood or bloody mucus.

    (2) Chronic ulcerative colitis is mostly chronic onset. The main symptoms are purulent mucus and bloody stools, accompanied by abdominal pain, diarrhea, and other symptoms. The number of stools ranges from 1 time to more than 10 times a day or more.

    (3) Bacterial dysentery: mostly acute onset, with history of unclean eating or drinking. The main symptoms are purulent mucous stools, anal tightness, often accompanied by fever and discomfort.

    (4) Amoebic dysentery: so that blood is the main symptom, the stool is red in sauce, mucus is much, and there is a foul smell. The sick often have a history of unclean eating or drinking, such as uncooked chicken. (5) Ischemic enteritis: It is more common in middle-aged and elderly people, and occurs suddenly after a meal or after falling asleep in the middle of the night. The main symptoms are sudden abdominal pain, abdominal pain, diarrhea, and dark red blood in the stool.

    (6) Intussusception usually occurs in children under 1 year old. Sudden abdominal pain is often accompanied by dark red, sticky, bloody stools and fever.

    (7) Systemic diseases such as leukemia, aplastic anemia, hemophilia, etc. may also have symptoms of blood in the stool.

    Question: What is the effect of long-term blood in the stool on the human body?

    Answer: A small amount of bleeding for a long period of time can easily cause chronic anemia in the human body, resulting in pale complexion, yellow hair, and affecting growth and physical fitness. Severe acute massive bleeding can cause hemorrhagic shock, endangering life and safety. Misdiagnosis or missed diagnosis of hemorrhagic malignant tumors will miss precious treatment opportunities, affect the prognosis and quality of life, and lead to serious consequences.

    Question: How to seek medical treatment after blood in the stool

    Answer: If there is a lot of blood in the stool and dizziness, pale complexion, cold sweats, short pulse, etc., it means that the condition is serious or hemorrhagic shock is possible, and you should be sent to the hospital for emergency treatment.

    Usually, if you have bleeding symptoms of unknown cause, you should go to the relevant specialists of the hospital for digital anal examination and anal endoscopy as soon as possible. Electronic colonoscopy is currently the most important diagnosis and treatment equipment for the diagnosis of various colorectal diseases, especially colorectal polyps and colorectal tumors. Unexplained blood in the stool should be checked in time with electronic colonoscopy, and the diagnosis and treatment should be confirmed early.

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