Any blood falling from the stool, or mixed with blood in the stool, or blood before and after the stool, or simply blood, is called hematochezia. It is a common symptom that can occur in many diseases. Some are even signs of serious illness; repeated bleeding can cause anemia; excessive bleeding can cause shock, and even life-threatening. Therefore, blood in the stool cannot be ignored, and the cause should be found out and treated in time.
Clinically, according to the amount of blood in the stool, it is divided into occult blood in the stool and visible blood in the stool. According to the different bleeding sites, the bleeding is upper gastrointestinal bleeding and lower gastrointestinal bleeding. There are many causes of blood in the stool, which can be divided into upper gastrointestinal diseases, lower gastrointestinal diseases, and systemic diseases according to the different primary diseases that cause bleeding.
Traditional Chinese medicine refers to blood in the stool as "blood in the stool", "under blood", "blood purging", "yin knot", etc. Depending on the bleeding site, it is divided into distant blood and near blood. According to the blood color, it is fresh and turbid, and there are intestinal wind and dirty poison. do not. Medical books of the past dynasties have elaborated on the etiology and pathogenesis of hematochezia. The "Internal Classic" points out that its main pathogenesis is the yin formation and damage of the yin collaterals; The Synopsis of the Golden Chamber points out that the differentiation of blood in the stool should be divided into distant blood and near blood. At the same time, different treatment prescriptions are proposed according to their different pathological attributes; "Hou Lun" believes that blood in the stool is injured by the five internal organs, and there is a difference between cold and heat; "Ji Sheng Fang" first divides the blood in the stool into "blood in the stool" and "intestinal wind and visceral toxin". "Danxi Heart Method" proposes that the position of this disease is "in the stomach and the large intestine", "When blood medicine is used, it is not possible to stop it alone. The principle of treatment of "Syndrome and Therapy" is to distinguish between blood in the stool and dysentery with the presence or absence of tensmus; "Introduction to Medicine" divides the blood in the stool into intestinal wind, visceral toxins and vaginal constriction, and believes that the three have different causes and clinical manifestations. "Jingyue Quanshu" also talked about the identification of blood in the stool and intestinal diarrhea (dysentery), and clearly pointed out the parts of distant blood and near blood; "Syndrome and Treatment Huibu" uses pure blood to clear blood and bright red blood as hot, dark color as cold , The color black is silt, which has certain guiding significance for the clinic.
The etiology and pathogenesis of hematochezia are mainly eating carelessly, feeling external evils, emotional imbalance and chronic illness and physical weakness. The main pathogenesis is heat fumigation, impaired gastrointestinal veins, or lack of qi, deficiency and coldness of the spleen and stomach, blood loss and overflow into the intestines, resulting in blood in the stool. The initial illness is more real, but the illness becomes deficient after prolonged illness.
Because dysentery, hematochezia, and hemorrhoids are all manifested as blood in the stool, attention should be paid to distinguish: dysentery so that there is both pus and blood, and abdominal pain, tenesmus, anal burning, etc., hemorrhoids are blood in the stool, often accompanied by anal pain during stool, digital examination It is not difficult to identify. In addition, when the amount of upper gastrointestinal bleeding is heavy, the feces can be dark red or even bright red, which looks like lower gastrointestinal bleeding. On the contrary, the amount of bleeding in the empty and ileum is not much, and it stays in the intestine for a long time, and black feces can appear, just like the upper gastrointestinal tract. Bleeding.
The treatment of hematochezia should first stop the bleeding, but different treatment methods should be implemented according to different diseases. First, distinguish the color and characteristics of blood in the stool, and then distinguish the disease-related cold and heat. Treatment based on syndrome differentiation. Heat accumulation in the stomach, it is appropriate to clear the stomach to purify the fire, remove blood stasis and stop bleeding; liver and stomach stagnation of heat, it is appropriate to clear the liver and heat, cool blood to stop bleeding; Qi stagnation and blood stasis, it is appropriate to promote qi to relieve depression, promote blood circulation; To clear away heat and detoxify, cool blood to stop bleeding; damp-heat accumulates steam, it is appropriate to clear heat and dissipate dampness, cool blood to stop bleeding; if qi is insufficient, it is better to invigorate qi and invigorate the spleen, nourish blood and stop bleeding;
At the same time of treatment, you should pay attention to diet and intake, avoid emotional stimulation, and take appropriate rest. For patients with more blood in the stool, you should closely observe the condition, whether there are heart palpitations, sudden paleness, and pulse count to prevent collapse. The diet should be light and easy to digest, eat small and frequent meals, avoid tobacco, alcohol and spicy thorns