Embarrassing medical status
Facing a young life, from falling to the ground, to toddler, to growing up, as a parent, there must be thousands of joys haunting my heart. As Mr. Liang Qichao said: the wisdom of young people is the wisdom of the country, the rich young people make the country rich, and the strong young people make the country strong. Mr. is dead, the words are still in my ears. Indeed, the physical and mental health of a child is related to the hope of the family and the future of the nation.
However, when a pediatrician encounters an immature three-level diagnosis and treatment system, the embarrassing situation of medical treatment has come. Once a child becomes ill, most families seek medical advice and medicine like headless flies, search for famous doctors and hospitals on Baidu, and their brains rush over. As the saying goes: fight tiger brothers, fight father and son soldiers. When a child becomes ill, the whole family must be dispatched. It is based on the principle of "the child is not a small matter, the child is not ill, strict requirements, and high standards".
Seeing the crowds of patients is a good match for the Spring Festival transport, but the most annoying thing is that I didn't find the right doctor, and the medicine might not be effective. How can parents without medical background find the right doctor in the first place? This requires family members to provide disease information as accurately and in detail as possible. In this way, the parents are the child's "first doctor".
How to see a doctor accurately and efficiently
Take blood in the stool for children, the first reaction of many parents with blood in the stool is to get angry. In recent years, "the theory of getting angry" has taken the east wind from the advertisements of major TV stations, spreading across the country, and deeply rooted in the hearts of the people, but the facts are not so simple.
Blood in the stool is not uncommon in childhood. The color of blood in the stool of children is usually bright red, pink, dark red or black stool, and some children have normal stool color, and blood in the stool is found during the stool test. Blood in the stool in children is often not accompanied by other symptoms.
If you find that the stool has the above-mentioned abnormal color, you should seek medical attention in time.
Before seeking medical attention, you should determine whether there is a relationship between the food you eat and the color of stool, such as red food, iron-containing products, etc. At the same time, it is necessary to clarify the time to find blood in the stool, the color, speed, amount of bleeding, bleeding before or after the stool, whether there is mucus or pus, whether it is mixed with stool, whether there is abdominal pain, perianal pain, etc.
It is also necessary to provide a history of past medical conditions, such as oral, nasopharyngeal, bronchial, and lung diseases, to rule out melena caused by bleeding in these areas after being swallowed by children.
I know the disease before it happens
1. Acute intussusception Intussusception is one of the most common acute abdomen in infants. It has a rapid onset and rapid progress. It is easy to be misdiagnosed and cause intestinal necrosis or even death. You should see a doctor as soon as possible. The incidence is mostly children under 11 years old, of which the main population is under 1 year old.
Hematochezia is characterized by jam-like stools, and a sausage-like mass is palpable in the right abdomen or transverse colon. When children under 1 year old have vomiting, paroxysmal crying, or blood in the stool, they should be highly alert to the possibility of intussusception.
Pediatric laparoscopic surgery can be used for intussusception reduction, which has the advantages of small incision, less trauma, and quick recovery, which is more acceptable.
Intestinal volvulus is the kinking of the intestinal tube and obstruction of the intestinal cavity. Most of the disease presents acute intestinal obstruction. In severe cases, it is due to intestinal blood circulation disorder, intestinal ischemic necrosis, bleeding or even death.
This disease mainly manifests as abdominal pain, vomiting, abdominal distension, cessation of defecation, and exhaust.
Intestinal kinks cause congestion and edema of the intestinal wall. At the same time, the permeability of the intestinal wall and capillaries increases. A large amount of bloody exudate penetrates into the intestinal cavity and abdominal cavity. Part of the blood is mixed with the remaining feces and excreted after obstruction, similar to blood in the stool of other diseases.
The mortality of this disease is relatively high, so surgery should be performed immediately after diagnosis to relieve the obstruction and restore the intestinal blood circulation.
3. Rectal polyps
Rectal polyps are a common cause of blood in the stool in children, and juvenile polyps are more common. The polyp grows on the mucosal layer of the intestinal wall. It is a pedunculated pimple, a low-position polyp that can protrude out of the anus during defecation, just like a red "ball of meat." More common in children aged 3-6.
Hematochezia is characterized by the appearance of fresh blood at the end of long-term defecation. The volume is small, not mixed with stool, and generally has no other accompanying symptoms. Blood in the stool caused by colon and proctitis often include abdominal pain, diarrhea, and mucus blood in the stool.
Colonoscopy is the first choice for children with blood in the stool. Colonoscopy can examine the entire large intestine, and its cause is very high. If the child is a single rectal polyp, the polyp can be removed and biopsy by electrocoagulation and biopsy under colonoscopy. If it is multiple polyps, treatment should be divided into several times.
4. Merkel's diverticulum
Merkel's diverticulum is a congenital intestinal malformation. It is a common disease in pediatric surgery and frequently-occurring. It is caused by incomplete degeneration of the yolk tube and unclosed end of the intestine.
The disease has large blood volume in the stool, dark red, painless, recurrent attacks, symptoms of anemia, and shock in severe cases.
Due to the ectopic mucosal tissue in the wall of the diverticula, it is easy to cause complications such as small bowel obstruction, acute gastrointestinal bleeding, and acute diverticulitis. Therefore, no matter whether there are clinical symptoms or not, they should be surgically removed once they are found. With the development of minimally invasive technology, its treatment can be done through laparoscopy.
5. Acute necrotizing enteritis
Acute necrotizing enteritis is an acute hemorrhagic necrotizing inflammation confined to the small intestine, and the lesions are mainly in the jejunum or ileum. This disease usually occurs in summer and autumn, and may have a history of unclean diet.
The disease has a sudden onset and manifests as acute abdominal pain, usually starting from the umbilical or upper middle abdomen. The pain is paroxysmal colic or persistent pain accompanied by paroxysmal aggravation. The bloody stool is like red bean soup or washing meat, which has a fishy smell. Odor, if not treated in time, shock can occur and life-threatening.
6. Infectious diarrhea
Inflammatory diarrhea refers to diarrhea caused by pathogens invading intestinal epithelial cells and causing inflammation.
Feces can be loose stools, watery stools, mucous stools or pus-blooded stools, and may be accompanied by nausea, vomiting, loss of appetite, fever, abdominal pain, and general malaise. Stool microscopic examination can show more red and white blood cells. In severe cases, dehydration, electrolyte disturbance, or even shock due to a large amount of water loss.
Diarrhea in this disease coexists with blood in the stool. Diarrhea is the main cause. Care should be taken to correct the imbalance of water and electrolyte, and the pathogens that cause diarrhea should be treated with corresponding pathogens, or antibacterial or antiviral.
7. Anal fissure
Anal fissure refers to lacerations to the skin and muscles of the anus, which are more common in infants around two years old. The causes of anal fissure include congenital anal stenosis, dry and hard stools, tearing anal and anal skin damage or infection.
Hematochezia is characterized by a little drip of blood in the anus, accompanied by dry and hard stools, painful defecation, and crying and restlessness when the child relieves the stool.
If there is an anal fissure, keep the anus clean (wash with clean water), and apply ointment, such as dragon ball ointment, to promote the healing of the crack.
Many people think that hemorrhoids are a "patent" for adults, but in fact it is not. Hemorrhoids are not age. During the embryonic period, the rectum and anus gradually butt to form an anus. The smooth connection of the two can avoid many anal diseases. However, the "pointing" during the docking process is not so accurate, which easily induces perianal diseases.
Hemorrhoids blood in the stool is a little drip of blood from the anus, with or without a swelling that comes out of the anus, without other discomfort.
For mild hemorrhoids, hemorrhoid cream and other drugs can be used; for severe hemorrhoids, surgery is required.
Medicine is not a panacea, disease prevention is important
The human being is a whole, and various systems influence each other. In addition to the common local gastrointestinal diseases mentioned above, other systemic diseases can also cause blood in the stool. Such as blood in the stool caused by blood diseases, natural bleeding in newborns, thrombocytopenic purpura, allergic purpura, aplastic anemia, leukemia, hemophilia, epistaxis (after swallowing), etc. can appear blood in the stool.
In addition to strict requirements for medical treatment, parents must also strictly require themselves to devote more energy to disease prevention, timely detection of diseases that may cause serious consequences and life-threatening, and prevent the slightest failure.