Former Central Hospital of Chengdu China Railway Second Bureau, Sichuan
Now Chengdu Anorectal Hospital
Post Code: 610031
Methods: Over the past 16 years, more than 1,500 patients with intractable constipation have been examined by sigmoidoscopy, X-ray defecography + barium enema, and various structural variations and pathological changes of the colon and rectum have been understood at one time. With the colon transport test, it can Make a clear diagnosis for intractable constipation. Suspension sclerosing atrophy therapy, rectal valve suture, transrectal intersacral adhesion, selective partial colectomy, etc. are used to treat patients. And use this idea to treat hemorrhoids.
Results: After these minimally invasive surgical treatments for all rectal constipation, the patient’s rectal obstruction was eliminated and cured, and the recurrence rate of hemorrhoid patients was greatly reduced. Nearly 200 cases of colonic constipation were cured after open surgery, and none of them had intractable diarrhea. And other complications.
Conclusion: 1: Refractory constipation is an independent surgical disease, and its essence is chronic incomplete intestinal obstruction.
2: The narrow effective passage area of the rectum is the main cause of rectal constipation.
3: Variation in colon structure is the main cause of colonic constipation.
4: To treat hemorrhoids, the passage must be treated first, and the probability of recurrence will be greatly reduced when the bowel obstruction is eliminated.
5: Irritable bowel syndrome is the compensatory period of intractable constipation.
[Text] Intractable constipation, as a worldwide problem, has attracted wide attention from medical circles at home and abroad. However, after more than a hundred years of exploration, people still consider it to be a symptom of many diseases. All kinds of textbooks, papers, standards, guidelines. Various treatments have had little effect, and various constipation drugs have been advertised overwhelmingly.
My colleagues and I started in 1989 to explore the causes of recurrence of hemorrhoids after surgery. 16 years of research on refractory constipation have cured more than 1,480 cases of refractory constipation and preserved complete X-ray data. . Among them, nearly 200 cases underwent laparotomy. It was found that intractable constipation should be a kind of independent surgical "disease". It is not functional, but colon and rectal lesions with obvious organic changes. It is related to functional The definition of constipation should conform to the "Rome II" standard, that is, the time limit. It is a type of "disease" that cannot be cured by non-surgical treatment. Various laxatives, motility drugs and laxatives can only temporarily relieve symptoms, but long-term use will cause greater damage to the intestines, and even loss of part of the colon and the entire colon. We have confirmed this through nearly 200 cases of pathological sections of intestinal resection. The essence of intractable constipation is chronic incomplete intestinal obstruction, and the cause can be completely identified and cured. We can classify the obstruction into colonic, rectal, and mixed types according to different parts of the obstruction, and continue to treat them as symptoms. In fact, we have given up effective treatment, delayed and aggravated the patient's condition.
In the process of diagnosis and treatment of intractable constipation, we have made the following discoveries and theoretical innovations.
1. The stenosis of the effective inner diameter of the rectum is the main cause of obstruction and constipation of the rectal outlet, and the stenosis of the effective inner diameter is caused by the variation of the congenital development of the rectal valve. It is clinically found that the rectal valve is wide, large in number, too close, and even rectal. Annulus. This is rectal constipation is the main initial cause, and other reasons include congenital anal stenosis, congenital anal extension, internal sphincter achalasia, etc. Due to the narrowing of the inner diameter of the rectum, greater resistance to the discharge tract and friction of the contralateral intestinal mucosa can be formed, which can be secondary to rectal mucosal prolapse, rectal protrusion, rectal pocket formation, rectal flexion, rectal intussusception, sacral rectum Separation, and even full-thickness prolapse of the rectum. In terms of treatment, we have uniquely created rectal valve sutures, suspension sclerotherapy, transrectal sacral adhesions and other therapeutic methods to expand the effective passage area of the rectum, reset and fix the prolapsed mucosa, through this minimally invasive, painless, and bloodless Surgery achieves the goal of complete cure. And invented the deep ligature, which has won the national utility model patent. The cure rate of rectal constipation has reached 100%.
2. Variation of colon structure is the main cause of colonic constipation. We combine X-ray barium enema with X-ray defecography, and a one-time examination of the patient can basically confirm the diagnosis. A variety of structural variations of the colon were found, such as lengthy sigmoid colon, sigmoid coil, descending colon coil, left hemicolon duplication deformity, transverse colon lengthy, colon to the right, etc. These structural variations can cause the intestine to form angles in many places in the abdominal cavity, and the feces will have many times of "climbing" during the intestinal movement, and the abdominal pressure of defecation is a vertical pressure, which is much stronger than the motility of the intestine. The pressure in the tube is blocked and the stool cannot go down. Over time, the upper intestine gradually develops fatigue injury, degeneration of intestinal muscles, disappearance of enteric ganglia, and irreversible loss of intestinal function. Timely detection and removal of the lengthy intestinal segment is actually a protective measure for the upper intestine.
3. Re-understanding of the theory of hemorrhoid formation. There have been many theories about the formation of hemorrhoids in the past, and there is no final conclusion yet, and it is believed that hemorrhoids cannot be cured. We found that almost every patient with hemorrhoids has defecation disorders, that is, time-consuming and laborious defecation or long-term diarrhea. As the hemorrhoids increase, the prolapse of the mucous membrane becomes more serious. The true initial cause is still the effective inner diameter stenosis formed by the rectum, the lower valve is too wide or the valve is too much. Due to defecation resistance, the supporting tissue of the lower part of the large rectum, which is the "flexor muscle" between the congested cushion and the internal rectal sphincter, is broken, and the hemorrhoids also protrude outside the anus. When the resting pressure and diastolic pressure of the anal sphincter are both high in the initial stage of hemorrhoids, congested hemorrhoids are prone to squeeze bleeding in the neck of the anal canal. When the sphincter is relaxed, the hemorrhoids will protrude outside the anus at the beginning of defecation. Not easy to bleed. This is due to the prolapse of hemorrhoids, the loose rectal mucosa is stretched and straightened, which enlarges the effective inner diameter of the rectum. The bowel movement is better. Therefore, the modern treatment theory of hemorrhoids states that if hemorrhoids that are asymptomatic are not treated, if they do not continue to bleed, they can receive it by themselves after prolapse and do not prolapse and affect work and life. There is no need for surgical treatment, and treatment should be done. Change past treatment thinking. Therefore, we propose that the treatment of hemorrhoids must first treat the channel, and the resistance to defecation is reduced, and the chance of recurrence of hemorrhoids is greatly reduced. In our more than ten years of clinical practice based on this line of thinking, we have successfully cured thousands of hemorrhoids patients with almost no recurrence. Due to the chaos in the treatment theory, many patients have repeated operations, resulting in scars and strictures, resulting in more serious defecation disorders. The author has seen several cases of anal stenosis and stiffness due to random treatments and it is very sad to have an abdominal fistula. Case. Moreover, when the cause and pathology have not been fully understood, various treatments, including all high-tech treatments, are used to treat hemorrhoids such as microwave, radio frequency, infrared, high frequency, freezing, plasma, etc. Is it normal? Of all the diseases in the world, there are the most treatments, and the only odds are hemorrhoids.
Here I try to use a philosophical point of view to conduct a retrospective philosophical reflection on our work and previous theories. It is for the reference of colleagues, and sincerely hopes to cause controversy, and welcome criticism.
Physiological normal defecation and defecation disorders are the pros and cons of people's defecation function. Normal defecation requires a variety of factors to complete. There are many discussions in defecation physiology, and there is no need to repeat them. And defecation disorders are commonly known as "constipation." All previous data are considered to be a type of symptoms caused by multiple diseases, and dozens of diseases can be listed at once. Except for constipation caused by tumors and adhesions, most of them are called "functional constipation." If a patient with stubborn constipation comes, we have to screen one by one like a large net, and screen one by one. This patient may run out of funds and cannot find out why. There is actually a philosophical principle hidden here, the universality of contradictions. And particularity. That is, inevitability and contingency. Our research for more than ten years found that only three patients with more than 1,480 constipation had no obstructive factors (two of them were elderly patients with pulmonary pulmonary pulmonary heart disease without abdominal pressure, and one was Parkinson's syndrome). Then the obstruction should be universal and inevitable. Dialectics believes that inevitability is caused by the essence of things, and is something with regularity, which determines the direction of the development of things. Of course we are not denying contingency. We also accidentally discovered that during the visit of a 13-year-old girl, the rectal valve was too wide, which affected the descending of the stool. After the electrotomy, the child had a bowel movement from once in the past 7-10 days to once a day. Followed by detailed observation, it was found that almost every case of rectal constipation, including hemorrhoids, had different degrees of rectal valves that were too wide and too dense, and there were a large number of them, even full-thickness intussusception and capsular formation were formed. Therefore, the dialectical point of view, necessity exists in contingency, contingency expresses inevitability, we must be good at grasping inevitability from contingency.
Being good at catching chance is totally different from taking chance. If we do not have the habit of performing sigmoidoscopy in every anorectal patient, we may have lost this opportunity for discovery.
The task of scientific research is to show the essence of things through the phenomenon. The essence and the phenomenon are different. It is the unity of opposites. Take rectal constipation as an example. Past data believe that rectal mucosal prolapse, rectal protrusion, Rectal flexure, perineal descent syndrome, isolated ulcer syndrome, sacral-rectal separation, pelvic floor spasm syndrome, puborectalis syndrome, etc., are various causes of rectal constipation, that is, outlet obstructive constipation. But are these phenomena found through microscopy and X-ray examination the cause of the disease, that is, is it the essence?
Dialectics believes that some things are different on the surface, but the essence may be exactly the same. So what is the difference between the phenomenon and the essence? First, the phenomenon is exposed and can be directly perceived by human senses, and the essence is hidden deep inside things. It may be invisible or intangible, or it may be that people see it according to a fixed mode of thinking and think it is normal. Second, essence is the common thing in similar phenomena; phenomenon is the concrete manifestation of essence in various aspects. Third, the phenomenon is changeable, but the essence is relatively stable. The essence is determined by the fundamental contradiction within a thing. As long as this fundamental contradiction is not resolved, the essence of the thing will not change. So in rectal constipation, what is the essence of causing outlet obstruction? In fact, we also have a process of gradually deepening our understanding. First of all, we can observe rectal mucosal prolapse, rectal protrusion, solitary ulcer, perineal descent, rectal flexion, sacral and rectal separation. Are they phenomenon or essence, we must trace the root cause, why there is rectal mucosal prolapse, Why is there no rectal mucosal prolapse in normal people with barrier-free defecation? The rectal column shape is clearly visible after rectal microscopy. We can infer that rectal mucosal prolapse must be caused by high defecation resistance and large lateral friction. The mucosa and rectal muscles are separated. Pathological diagnosis has confirmed that the flexor muscle that connects the fixed mucosa is broken. These are all phenomena. The root cause of rectal mucosal prolapse is the stenosis of the effective passage area of the rectum, which is caused by congenital variation, too wide, too small spacing, a large number of rectal valves and even annulus. This is the essence of things.
Protrusion of the rectum, the previous data all say that the anterior wall of the rectum is weak in women, and it is regarded as an independent disease for various repairs and reinforcements. Ignorance of this has taken the phenomenon as the essence. In the large number of female constipation patients with rectal protrusion that we treated, we found that they have the same stenosis of the effective area of the rectum like men. X-ray examinations often have mucosal phases. The mucosa is inverted umbrella-like intussusception, and some prolapse is so serious that the loose mucosa of the posterior wall has moved to the lower end of the front protrusion. Moreover, due to the bony nature of the sacrococcygeal region and the anal-coccygeal ligament, there is no place to retreat on the back wall, and the neck of the anal canal is blocked by the loose mucous membrane. It does not rush forward wherever it is. Formation of acquired giant rectum The acquired giant rectum we have seen, the diameter of the rectum reaches 15 cm. So can only the anterior rectal wall reinforcement solve the problem? Therefore, we assert that rectal protrusion is a unique X-ray symptom of female outlet obstruction and constipation. It is the phenomenon rather than the essence. And there are statistics due to the sacrococcygeal curve. The descending stool itself has an impact on the anterior wall of the rectum. 70% of women without constipation also have a rectal protrusion. How can this be explained?
Perineal descent syndrome, taking the perineal descent found in X-ray measurement as an independent disease, has no real clinical significance. Long-term excessive defecation will inevitably lead to the relaxation of the levator ani muscle. It is a problem for all patients with severe constipation. A consequence, without any characteristics of the cause.
Isolated ulcer syndrome is a superficial ulcer formed by ischemia and hypoxia due to prolapsed mucosa being squeezed by dry and hard stool for a long time. It is not the essence of the disease.
The more special ones are puborectalis syndrome and pelvic floor spasm syndrome. Strictly speaking, they also belong to the stenosis of the effective passage area of the rectum. Both diseases also have congenital factors, which are due to the congenital length of the rectal anal canal and the internal sphincter. Hypertrophy, congenital anal canal stenosis or may be puborectalis hypertrophy. As we all know, the puborectalis muscle is the striated muscle, also called skeletal muscle. It is the main muscle that maintains the anal self-control. Someone has tested that people can contract the anus continuously for no more than 50 seconds, so it is common in clinical practice that such patients often two or three hours Unable to pass stool, even the thin barium during defecography. Can muscles continue to contract for so long? It was found that these patients still have rectal mucosal prolapse and rectal valve variation. Through moderate anus expansion, suspension hardening and atrophy injection treatment, after rectal valve suture, the patient's defecation obstacle is eliminated. We haven't cut a case of puborectalis muscle in 16 years and the patient has recovered, which itself proves the mistake of the past theory.
Things have the same identity and their particularity. Through long-term anorectal practice, we have found that every patient with hemorrhoids also has rectal mucosal prolapse and congenital variation such as wide rectal valve. This is the same as rectal constipation. Sexual issues. But the problem is not here. Many rectal constipation do not have hemorrhoids. This is a phenomenon that is worth studying. People with very smooth stools are not easy to get hemorrhoids. This is common knowledge, but intractable constipation does not have hemorrhoids. If explained by the same nature, it will fall into the misunderstanding of mechanical materialism. After our observation, we found that the effective area of the rectum The level of the narrow plane determines the occurrence of hemorrhoids,The narrow plane of hemorrhoids is low, and the prolapse of hemorrhoids is actually due to defecation disorder. The patient must work hard to turn the anus out of the anus, and the rectal mucosa can be excreted only when the rectal mucosa is relatively stretched and straight. Therefore, we propose this understanding that hemorrhoids are due to congenital rectal anatomy Structural variation leads to relatively narrow rectal and anal canal. Excessive defecation resistance causes a phenomenon in which the rectal and anal canal tissue loses support and slides down. Internal hemorrhoids are mucous membranes or cushions that move down, and external hemorrhoids are anal canal valgus, and both are accompanied by long-term The tortuous and dilated blood vessels caused by increased venous pressure. This is the particularity of contradiction. In addition, there is a puzzling phenomenon in the past. The internal hemorrhoids are easy to bleed in the early stage, but the hemorrhoids are not easy to stop bleeding in the second and third stages. The traditional theory of varicose veins and the theory of pads cannot be explained well. This is another contradiction. In the early stage of internal hemorrhoids, the resting pressure and diastolic pressure of the anal canal are higher. The bleeding of hemorrhoids is the squeezing bleeding formed in the neck of the anal canal. When the hemorrhoids can protrude outside the anus, the resting pressure and diastolic pressure of the anal canal All have been lowered, the anal canal can no longer form a binding force on the hemorrhoids, and the hemorrhoids have already protruded outside the anus at the initial stage of defecation, and there is no squeeze.
The world can be known, and people are also capable of knowing the world. Feuerbach said: "Nature is a big book that does not hide itself. As long as we read it, we can know it. Humans have an understanding of the objective world. Reflection is a dialectical process full of contradictions from not knowing to knowing, from not knowing much to knowing more, from phenomenon to essence." Someone once asserted that hemorrhoids is a health-preserving disease and cannot be completely cured, but can only improve symptoms; almost all data believe that intractable constipation is a symptom; irritable bowel syndrome is an unexplained digestive tract Since the disease is only a symptom and the cause cannot be identified, it can only be treated symptomatically, which actually falls into the agnosticism of idealism. The history of scientific development is a process in which people continue to understand the unknown world. If we stay in agnosticism and give up the exploration of the objective world, how can we have today's technological progress?
We oppose the skepticism that denies the world knows, but we do not mean that there is no need for doubt in scientific exploration. From the perspective of our research on colonic constipation, the surgical treatment of intractable constipation in our country started in the late 1980s. In the 1990s, the Chinese Medical Association formulated the "Constipation Diagnostic and Treatment Standards" for provisional purposes. At the beginning, we performed defecation according to the standards. For contrast, the amount of barium perfusion is 250-300ml. Since we have a habit that the X-ray examination doctor of every patient has to go to the radiology department to watch and do it in front of the TV monitor screen, I found that most patients cannot exhaust the barium, only the rectum is discharged, but the sigmoid colon barium cannot. Discharge, because the rectum is fixed on three sides in front of the sacrum and cannot move, while the sigmoid colon is free. During defecation, most patients with a long sigmoid colon cannot discharge the barium in the sigmoid colon. In fact, there is a sigmoid angle, the greater the abdominal pressure The smaller the sigmoid angle, the pressure in the sigmoid cavity cannot enter the rectum, and sometimes the sigmoid colon has already dropped to the pelvic floor. There is indeed a problem of not being able to overcome the mountain. Therefore, after the twelfth case of defecation angiography, we were stubborn for nearly 40 years. Patients with sexual constipation underwent sigmoid colon resection, and the postoperative effect was very good. Next, we performed more than 10 consecutive sigmoid resections. The problem came out. Some patients still had constipation after the operation. We realized that it might be caused by incomplete examination. As a result, the examination showed that the transverse colon was lengthy, and the patient was cured by a second operation. Since the 1990s, we have combined X-ray defecography with barium enema. The results are amazing. Over time, we found a large number of structural changes in the colon. The transverse colon drooped to the pelvic cavity and then moved up to the splenic flexure. Some splenic flexures even reached the eighth intercostal space, forming a huge gap between them. The colon ligament is fixed and forms an acute angle with almost zero angle. There are also spiraling descending colon, repeated malformations of the left hemicolon, spiraling colon to the right, and sigmoid colon. Even a few cases of congenital colon knots are found. Obviously, the one-sidedness of the examination covers the essence of things. This also shows that things are knowable. Unknowable may be the wrong way of understanding the world.
Almost all textbooks and references believe that colonic constipation is caused by enteric neuron dysfunction and decreased vasoactive peptides. Is it primary or secondary? If it is primary, why are many patients? Onset after puberty, if the congenital ganglion is absent, there should be intractable constipation at birth, like Hirschsprung's disease. Then it must be secondary. Due to the discovery of numerous colon mutations, the colon is lengthy in the abdominal cavity, with multiple angles and twists, which can completely form incomplete intestinal obstruction.In order to push the stool downward, the intestine above the obstruction is bound to strengthen peristalsis. Over time, fatigue damage occurs. Intestinal dilatation, intestinal muscle degeneration, and ganglion are reduced. Severe colonic constipation can even cause small intestinal dysfunction and even small intestine. Colonization, this should be a logical explanation. This is not just a question of who is first and who is second, but it is a major issue in determining our treatment principles. What is our purpose in treating intractable constipation? It is to improve people's quality of life (of course, the harm of intractable constipation has been discussed a lot). According to the traditional view, subtotal colonectomy for so-called slow transit patients is a standard surgical procedure, and many physiologically functional intestinal segments may be cut off to correct the intractable constipation in the past and turn it into intractable. Diarrhea, another one-sidedness.
The previous surgical indication for "slow transit constipation" is the colonic transit test. In our practice, it is still one-sided, because most patients with constipation have mixed constipation, that is, they have both colon problems and Rectal problems, even an anal stenosis, can cause the markers of colonic transit to not be excreted for several days. Just like the accidental vehicle appears on a one-way street and does not move away, the vehicles behind it will accumulate more and more, and even paralyze the road. Therefore, after we understand the patient’s entire situation, we must first distinguish the colon or rectal obstruction which is the main contradiction. For particularly severe colonic obstruction, laparotomy can be performed first without a transportation test. In general, the most common situation is to deal with the rectal obstruction first. If the patient's constipation is relieved, colon surgery can be ignored. If the patient still has constipation, then the colon transport test can be performed to truly understand the transport function of the colon. The number of bowel tubes to be removed is instructive and can be quantified. Of course, we also need to observe more changes in the intestinal pouch, the disappearance of the colon pouch, or even a sausage-like change in a certain intestinal segment, indicating that the intestinal segment has lost its peristaltic function. Merely eliminating constipation is not our goal. The goal is to improve the quality of life. If we make mistakes in judgment or theoretical guidance, it will bring greater harm to the patient's body and mind.
Truth and fallacy are a pair of enemy brothers born in the process of human cognition. They exist in comparison and develop through struggle. Like the development of objective things themselves, they follow a tortuous and complicated road full of struggles between truth and fallacy. Looking back on our 16-year scientific research process, we are also in success → failure → resuming → success again. Even if we find some rules that may be correct, they are summed up in failure. The electric resection we used in the initial stage to cut the rectal valve has many successful cases, but there is also a failure to cut through the rectum of one patient. Later, I concluded that rectal valve thread-hanging therapy is a relatively safe method that is unlikely to occur intestinal perforation, but there are still risks, and secondary bleeding may occur when the sutures fall off. We have a few cases of simple sigmoid colectomy that does not work well, and the patient has to undergo a second operation for left hemicolectomy or subtotal resection to solve the problem. Therefore, a scientist must constantly improve himself.
Quantitative change can cause qualitative change is one of the basic laws of materialist dialectics. The quality mentioned here, in philosophical terms, refers to the inherent prescriptiveness of things, and the particularity that distinguishes one thing from other things. But things have not only qualitative regulations, but also quantitative regulations. The so-called quantity refers to the size of things, the speed of movement, the speed of movement, the number of things, and so on. Occasional constipation can be called a symptom. Some constipation caused by changes in living habits and sudden mental stimulation can be a function. Sexual, constipation caused by certain drugs is better called "idiopathic constipation". Of course, contradictions can also be transformed -12. However, long-term constipation that is completely dependent on external forces such as laxatives and motility drugs is still classified as a type of symptom, which may limit the way of thinking of medical staff. For patients, it is delaying the correct, effective and completely cured treatment. Didn’t Rome II also set a time limit?
Chronic constipation and irritable bowel syndrome constipation have most of the same symptomology, and its particularity is that irritable bowel syndrome has abdominal pain before the stool and relieves the symptoms after the stool. Some people may not have noticed two details. One is that irritable bowel syndrome does not occur at night, and the other is that almost no one suffers from irritable bowel syndrome in old age. In our work for more than 10 years, we have actually diagnosed and treated chronic constipation and irritable bowel syndrome according to the same theory, and basically achieved the goal of curing. What should be used to explain these two details? The patient is lying on his back at night, lying on his side, and the intestines are not always sagging like during the day. The angulation is relieved and the stool can pass. In the later years of chronic constipation, due to the pressure of long-term dry and hard stools, the intestinal motor and sensory functions have been impaired. It is understandable that abdominal pain is not easy to appear, but the absence of abdominal pain does not mean that the condition has been relieved, but it has worsened . Moreover, when we performed X-ray examinations for patients with irritable bowel syndrome, all cases were not found to have obstructive factors, so we have this inference that the constipation type of irritable bowel syndrome should not be independent, but only intractable constipation. The compensation period. And put forward the academic view of early treatment. This is actually a process from quantity to quality.
The dialectical relationship between the diarrhea type of irritable bowel syndrome and hemorrhoids is the hardest and most inconceivable hard bone in the obstruction theory.
It is understandable that constipation causes hemorrhoids, and long-term diarrhea can form hemorrhoids is also a common clinical phenomenon, but the defects of the previous treatment methods have caused the essential problems between them to fail to be revealed. There is a common saying that hemorrhoid surgery is "the first pain in the world." , Anorectal (surgery) doctors have hemorrhoids and do not dare to treat them. It is often said that bleeding on their buttocks to treat hemorrhoids to others reflects the shortcomings of traditional treatment methods. Because of our improvement in surgical technology, we must first treat hemorrhoids. , Fully achieved tension-free surgery, the current hemorrhoid surgery has basically achieved minimally invasive, painless, bloodless, and relatively safe. Only in this way can we dare to treat the kind of hemorrhoids caused by diarrhea (Note: In the past textbooks, diarrhea is a hemorrhoid surgery (Contraindications) and accidental long-term diarrhea after hemorrhoid surgery is the most brilliant glimmer of light we have seen. Science is to explore the details. Several cases of irritable bowel syndrome with hemorrhoids have been operated on. The patient’s months The sudden cessation of diarrhea for several years and ten years caused us a high degree of excitement, because we found that these patients had severe rectal obstruction, severe rectal mucosal prolapse, and rectal valve width. Since then, each of our IBS diarrhea patients has X-ray examinations found that there are various symptoms of obstruction of the colon and rectum. In this way, we try to treat patients who are not mainly hemorrhoids. We also use the same method to treat patients who have suffered from diarrhea for many years due to minor trauma from the operation. Happy to make such an attempt. We contacted the Department of Gastroenterology and transferred IBS diarrhea patients to the anorectal department. According to our thinking, the results of treatment are shocking. Every patient is effective. The current cure rate of ten patients has reached 90%, and the number of stool formations has returned to daily 1 to 2 times, a patient with diarrhea in the past 30 years had a long intestinal hernia due to the descending of the transverse colon to the pelvic sigmoid colon. The only treatment was that the rectal valve was too wide and the formation of multiple sacs. There were several days of stool after the operation and more than 10 times a day. Reduced 2 times, and the stool piled up and formed, and then recovered about 5 times a day, but the amount of defecation was less than before, and the first stool was also piled up, and the clinic was also improved. We asked her to insist on daily knee and chest exercises with TDP treatment and try to use doxepin to block her stubborn conditioned reflex. I will continue to follow up.
Intestinal overcompensation caused by obstruction is a bold hypothesis for the cause of irritable bowel syndrome diarrhea. It is the mechanism of its production. What way the human body mediates to produce symptoms requires more scientific research. We treat What is the mechanism and why the patient's diarrhea ceased after the obstruction was eliminated. There is a metaphor here that if a movie theater only opens one door, it will inevitably cause crowded people and open a few more doors and everyone will not be crowded. I went to the Hukou Waterfall on the Yellow River not long ago. Before the Yellow River entered the Hukou, the river was 300 meters wide and the Hukou was only 50 meters. Why is it impossible for the Yellow River to silt the Hukou for thousands of years, because it is a necessity of the Yellow River The passage accelerates and rushes past, and the strong current washes the valley and bottom of the Yellow River. The surrounding riverbeds are made of hard yellow river stones. The principle of Hukou may give us an inspiration. The principle of peak storage and sand regulation in Xiaolangdi is also the principle. With the magical workmanship of nature and the discovery and invention of science and technology, the Yellow River - our mother river may have been silted up long ago.
Marx once said: A history of science is a history replaced by "new and declining absurdity." It is obviously more to treat history-the process of human understanding and transforming the world as absurd substitution. The absurd course should be said to be a great contribution of Marx. It is like a manifesto that solemnly declares that any ideology is only a historical category. It must be constantly supplemented, revised, and perfected with the development of history. There is no absolute thing at all, and it must be an evergreen tree of mankind. Enduring, only through-practice. We are willing to continue groping forward silently, and it is our lifelong goal to relieve the patient's pain.