2011年4月8日星期五

Upper gastrointestinal bleeding

Ulcer disease (including gastric ulcer, duodenal ulcer, anastomotic ulcer) the number of patients in our country about 1 million or more, more common in adults (20 to 50 years). Ulcer disease itself is not fatal, but it is not only high incidence of complications, but also extremely harmful, and sometimes the first symptoms appear, which can easily be neglected or lack of knowledge. Let us know and alert them one by one.

Upper gastrointestinal bleeding

Ranks of upper gastrointestinal bleeding ulcer complications in the first. According to statistics, every 3 to 4 patients had a bleeding occurred. Light were detected only by fecal occult blood test, severe vomiting, blood in the stool up to 1000 ml or more and shock. Upper gastrointestinal bleeding are ulcer disease, especially in the elderly above 60 years old the first cause of death.

Upper gastrointestinal bleeding due to erosion of the stomach ulcers (intestinal) wall the size of the veins or small arteries, if the small arteries, large amount of bleeding, especially dangerous. The blood of patients with vomiting or brown material (such as for the latter prompted large amount of bleeding, severe illness), while with black stools, less blood loss, the stool was brown-black; bleeding is heavy, mostly for dilute tarry stools, more severe, there may be sweating, dry mouth, heart rate, blood pressure and other symptoms of shock. Once the shock, the amount of bleeding that has reached more than 1500 ml, if not up to the amount of discharge, will be there within the intestine, which need to go to hospital emergency room. Another characteristic of this disease is that once bleeding occurs, the original symptoms of abdominal pain but will magically disappear.

Once bleeding occurs, do not even think the hospital immediately.

So dangerous on the gastrointestinal bleeding, ulcer patients must pay attention to prevent it from happening. Note the following general effective prevention can be achieved:

(1) to avoid tension and fatigue, such as violent mood swings, excessive physical or mental work and so on.

(2) prone to bleeding in the autumn, winter and spring when the temperature suddenly changes, special attention should be some preventive treatment at this time.

(3) ulcers in patients unfit for human consumption of ibuprofen, indomethacin, inflammation, and aspirin and other pain Xikang drugs, adrenal corticosteroids such as prednisone, dexamethasone, nor affordable. These drugs are often bleeding incentives.

(4) alcohol: recent research confirms that alcohol is also a factor causing bleeding.

(5) formal, to eradicate the H. pylori can significantly reduce the incidence of bleeding, even after no longer bleeding.

(6) to observe the stool develop the habit of stool color, speed suspicious to see a doctor.

Gastric (or duodenal) perforations

About 5% to 15% of patients perforation may occur, due to duodenal wall is thin, easily perforated ulcer. Recent years due to the application of effective drugs, the incidence of perforation decreased.

The sub-acute chronic perforation. Sudden severe abdominal pain, acute perforation and refused to press; chronic recurrent abdominal pain, perforation, but not as severe acute perforation of the passage of time, while penetrating the gastrointestinal wall, but the opening smaller, often wrapped in tissue inflammation. Others are in sub-acute perforation stage, symptoms range from between acute and chronic.

First found to be regular and complete treatment of ulcers, symptoms of pain must not think that because there is no disease is cured, otherwise planted the seeds. Once the suspected perforation, be sure to fasting, forbidden to drink, avoid stomach contents into the abdominal cavity through the break, cause or aggravate peritonitis.

Ulcer patients should avoid overeating and heavy manual labor (such as lifting, heavy lifting), otherwise it would be increased abdominal pressure, leading to perforation.

Obstruction

Active ulcer - healing scars - ulcer recurrence - a new scar formation - ulcer recurrence ... ... so the cycle repeated, hard scar tissue can form, much like the usual post-traumatic keloid skin left. This is easy to scar contraction of the original narrow pyloric, duodenal blocked the passage of food and liquid can not remain in the stomach, the stomach capacity of more than vomit when they have come to relieve the pressure on the stomach. Over time, because of the lack of stomach or intestinal nutrition and water, the patient will appear thinner, dehydration, malnutrition and electrolyte imbalance, this is a chronic obstruction. Also due to edema caused by acute obstruction, upper abdominal fullness, mobile positioning can be heard the sound of water vapor, such as jitter does not exhaust hot water bottle.

Vomiting is a common symptom, often occurs during or before a meal in the dining, and even spit out the day before the meal, more than a sour smell of vomit. After vomiting, abdominal distension reduced abdominal distension still had not a few days, and vomiting, general medical therapy.

Prevention of obstruction above the basic measures to deal with gastrointestinal bleeding. Before dinner before admission should strictly control the volume. Thorough treatment of the initial attack, can reduce the incidence of obstruction.

Canceration

Cancerous gastric ulcer mainly refers to the current pathology has been observed from ulcers to cancer in multiple stages.

When cancerous ulcer disease, most patients with abdominal pain, bloating, delayed healing of long-term, the recent exacerbations, accompanied by loss of appetite, weight loss, gastrointestinal bleeding may also occur on or sudden obstruction. Therefore, it is a long history of ulcers, those symptoms have increased recently, you must go to the hospital review, without delay autonomy.

Kissing can also be infected gastric ulcer?

Ulcer disease is a common chronic systemic diseases, were divided into gastric and duodenal ulcers, also known as peptic ulcer. It is called a peptic ulcer, because of previous gastric ulcer and duodenal ulcer that was due to gastric acid and pepsin digestion on the formation of mucous membrane itself, in fact, gastric acid and pepsin is only one of the main ulcer formation There are other reasons for the formation of ulcer disease. Gastric ulcer and duodenal ulcer as the etiology and clinical symptoms have many similarities, the doctor is sometimes difficult to distinguish between gastric ulcer or duodenal ulcer, it is often diagnosed as peptic ulcer or gastric ulcer . If you can clear in the stomach or duodenal ulcers, that can be directly diagnosed as gastric ulcer or duodenal ulcer.

Lovers kissing you had better be particularly careful!, MD, and gastritis, gastric ulcer, duodenal ulcer and other gastric diseases are closely related to H. pylori infection will be through the mouth to mouth, H. pylori infection in patients with the best practices to avoid the heat regularly kiss (that is, wet kiss.)

H. pylori is generally one of the most common bacterial infections, H. pylori live in the main body of the gastric and duodenal mucosa; by bacterial culture, but also in a small number of patients with saliva, tartar plaque, feces found H. pylori DNA.

The way H. pylori infection, mainly by the medical community that the "mouth to mouth" and "contaminated food" contagion; for H. pylori in the cold distilled water, saline water and sea water to survive for several days, so whether it is water or food, the best have to eat after cooking.

In the "mouth to mouth" transmission part, the treating physician within the saliva and plaque tartar H. pylori is very small, not too far to avoid kissing; but he suggested that H. pylori in patients with a partner to avoid kissing often as a "French kiss." In addition, some parents like to first put food on the mouth, chew, and then feeding the baby, so that H. pylori infection in children a higher proportion of unhealthy habits such should be avoided.

Drinking too much easy to make ulcer drug failure

Some drugs take effect because of their special way, not only can not drink plenty of water when taking medicine, or even do not drink, otherwise it will reduce the efficacy, loss of its therapeutic effect. For example, some of the treatment of gastric ulcer drug - sucralfate and aluminum hydroxide gel.

Hospital pharmacists explained that the suspension of these medicines are being made into the stomach will not dissolve into a myriad of small particles, the same as the powder covered the damaged gastric mucosa, so that erosion of gastric mucosa to gastric acid from and slowly grow new tissue to fill ulcers and restore its original function.

Taking these drugs, if you drink a lot of water but will dilute the drug, to cover the drug particles in the reduction of gastric mucosal damage, protective film thinning, loss of therapeutic effect. Moreover, services such stomach half an hour and do not drink water, drink plenty of water for a short time, the same will just wash away the protective film formed, so that re-exposure to impaired gastric acid in the corrosive.

Therefore, taking the treatment of gastric ulcer drug, just water delivery service go to the tablets, not more water. Or you can just chew some stomach swallowed without water, the patient medication instructions before you see the mark is used.

With this way of taking the same drugs were also cough, such as cough syrup, brown mixture and so on. These drugs than the thick, the adhesion after taking drugs in the throat, directly on the lesion site, which play a role in inflammation. If you drink too much water, will wash away the active ingredients of drugs throat, so that local drug concentration decreased.

Experts advise patients to take treatment of gastric ulcer, cough, pharyngitis and other drugs, drink as little as possible, these drugs are usually indicated on the instructions, take medicine before you read them carefully. If you want to drink plenty of water should be half an hour after taking the drug, such as membrane stability or to protect the drugs time, the amount of water.

The following are what you need in the stomach before meals or after meals:

1. Need to take in the stomach before meals

Stomachic pediatric powder, gentian rhubarb pieces, stomach Po, gastritis capsules, mainly by means of their bitter taste buds and stimulate peripheral nerves, promote the secretion of saliva and gastric juice should be taken before meals, and taking sugar when you can not join and fruit juices. In addition, sucralfate, colloidal bismuth pectin, bismuth potassium citrate and other gastric mucosal protective agent, or ulcers due to inflammation in the formation of a protective film at, so also need to take before meals.

Gastrointestinal drug motilium (domperidone), metoclopramide (metoclopramide), cisapride (Prepulsid), etc., should be taking 30 minutes before meals. Because they are the gastrointestinal motility drugs, so can not spasmolytic such as belladonna tablets, such as combined anisodamine.

2. The need of the stomach after meals

Zhuxiaohuayao Multienzyme, six Divine Comedy, Lactasin (Table Feiming) and so need to take 15 minutes after meals, it will give the drug and food mixing together, maximizing utility.

Antacids Wei Shuping, famotidine, etc. in the maximum amount of gastric acid secretion after a meal service, fewer ulcers can be stimulated, is conducive to repair ulcers.

Gastric ulcer was caused by spicy food warm

One of the serious consequences of gastric ulcer relapse into cancer. But as long as careful observation, or can find cancer early warning.

Ulcer pain more performance for the upper abdominal pain, was burning like or dull, and with the consumption of the onset of pain, generally in 1 to 2 hours after a meal there, then gradually reduced. If the pain out of these laws, and changes from time to time attack, or a persistent pain, or pain than ever before the nature of significant changes have taken place, and taking anti-ulcer drug treatment as usual for some time, the effect becomes obvious , or ineffective, should be vigilant as a precursor to cancer.

Gastric ulcer patients in the short term loss of appetite, nausea, vomiting, fever and progressive weight loss, or the original does not appear hematemesis and melena in patients in the near future occurrence of hematemesis or tarry stools occur, these phenomena show that gastric ulcer may be into cancer.

One of the serious consequences of gastric ulcer relapse into cancer. But as long as careful observation, or can find cancer early warning.

Ulcer pain more performance for the upper abdominal pain, was burning like or dull, and with the consumption of the onset of pain, generally in 1 to 2 hours after a meal there, then gradually reduced. If the pain out of these laws, and changes from time to time attack, or a persistent pain, or pain than ever before the nature of significant changes have taken place, and taking anti-ulcer drug treatment as usual for some time, the effect becomes obvious , or ineffective, should be vigilant as a precursor to cancer.

Gastric ulcer patients in the short term loss of appetite, nausea, vomiting, fever and progressive weight loss, or the original does not appear hematemesis and melena in patients in the near future occurrence of hematemesis or tarry stools occur, these phenomena show that gastric ulcer may be into cancer.

Chewing gum can cause stomach ulcers

In addition to sweet gum, sweet, fragrant and delicious, there are some special features, such as cleaning the mouth, dental caries prevention, and to promote normal development of children's cheeks, and so on. However, chewing gum for too long will cause adverse health effects, because:

(1) corrosion of the teeth as most are based on sugar-sweetened chewing gum, chewing gum, the sugar will stay a long time in the oral cavity, oral cariogenic bacteria in the use of sucrose would produce acidic substances, corrosive to the teeth, cause tooth decalcification, and induce dental caries.

(2) damage to the mouth of the dental study found that chewing gum can damage the mouth are often used for filling material, that the amalgam is released, causing the blood and urine mercury content exceeded, and thus the brain, central nervous system cause nerve and kidney damage.

(3) children at risk for children of poor self-control, all the gum in your mouth, there may be swallowed or strayed into the trachea, life-threatening. Prolonged chewing gum, chewing muscles is always in a state of tension, it is possible to develop the habit of sleeping molars, thus affecting the child's sleep quality. It is for these reasons, many experts suggest that chewing gum will not take more than 15 minutes. In addition, prolonged chewing gum, it will secrete a lot of acid reflex. Especially in the fasting state, not only nausea, loss of appetite, anti-acidic water and other symptoms, long-term effect may also lead to diseases such as gastric ulcer and gastritis.

◆ laughing and crying are forbidden to talk to chewing gum to prevent the choke into the trachea, causing asphyxia and life-threatening;

◆ make people better not have teeth to chew gum;

◆ Do not chew gum to get into the hands come from the mouth to avoid bacterial contamination.

Gastric ulcer caused by multiple factors

Typical symptoms of ulcer discomfort of hunger, fullness, belching, heartburn, or chronic postprandial epigastric pain, severe melena and hematemesis may have. Chengdu, president of the hospital business, according to Wen Yumin stomach introduced in the winter, leading to high incidence of gastric ulcer reasons: (a), the temperature dropped, the temperature suddenly dropped, the body's resistance has not keep up with, it is easy to stimulate gastric ulcer attack. (B) diet to stimulate the winter cold, the Sichuan people like to eat hot pot, barbecue, drinking, etc., these diets on gastric stimulation very, very easily lead to acute gastric ulcer. (C) drug stimulation, cold winter, many patients, the abuse of cold medicines will cause serious gastric and duodenal mucosal damage, which is currently the main reason for the increase in ulcer disease, the greater the dosage, the longer the age of the patients more large, on gastroduodenal mucosal damage more weight. In addition, bad mood, mental stress, irregular diet and other factors are also induced ulcer disease.

Previously, clinical see most adult patients with gastric ulcer, gastric ulcer patients now have more children, especially school students. The reason is irregular diet, eat puffed food, fried food, irregular sleep, child withdrawn and easy to anger, decreased resistance, easy to damage gastric mucosa of children susceptible to gastric, duodenal ulcer. Children gastric ulcer is characterized by abdominal pain was not typical, not adults, abdominal pain, regularity, periodicity. Often accompanied by vomiting, some children only vomiting without abdominal pain, or pain around the navel. Therefore, some parents mistakenly believe that a child is to indigestion, or there is a roundworm.

Helicobacter pylori induced gastric ulcer

According to Wen Yumin introduced Dean, Helicobacter pylori (referred to as HP) is a major cause of stomach ulcers caused. In 2005, the two found that the bacteria were awarded the Nobel Prize. They found that HP is a cause gastritis, gastric ulcer bacteria. HP is a sojourn in the epithelial mucosa is a Gram-negative bacteria, the bacteria infected about half of the adult world, it is with gastric ulcer, duodenal ulcer, gastritis and other gastrointestinal diseases are of great relationship. The vast majority of infections caused only asymptomatic chronic gastritis, only a few strains produce toxic gastric ulcer or duodenal ulcer. But almost all duodenal ulcers and gastric ulcers are most concerned with Helicobacter pylori. The growth of H. pylori requires a lot of stomach acid, too much stomach acid if there are even more likely to be infected.

In addition, H. pylori is contagious, family members often have a stomach, the other suffering from stomach gradually. Helicobacter pylori infection is mainly through imports. Family shared bowl, chopsticks and dish gastric ulcer in the habit of making easy to cross-infection in family members. When people share dishes meal, the bacteria in saliva can be rice bowls, chopsticks and other utensils with each other cross-infection and spread. Therefore, it is also used to eat with their families who share the dishes ulcer prevalence and incidence of higher.

In this regard, experts suggest that family members shared a meal with their families should be used for Dining System, and not sharing utensils, bowls specifically designed to promote personal chopsticks, this is an effective prevention and control cross-infection of H. pylori is an important measure of gastric ulcer. Behind the health conditions of the patients had been infected in childhood usually, after a long period but without treatment, chronic gastritis, gastric glands gradually shrink and become atrophic gastritis, which in turn related to the formation of gastric cancer, so the better H. pylori that people fear this.

Treatment needs long-term adherence

Wenyuan Zhang said, the general Western medicine treatment of gastric ulcer, the use of inhibition of gastric acid, antibiotics to kill Helicobacter pylori, protecting gastric mucosa. Chengdu stomach Integrative Medicine Hospital is the method used to treat peptic ulcers, in the early stage, to kill Helicobacter pylori, the use of amoxicillin and other antibiotics, coupled with inhibition of gastric acid medicine the hospital to repair gastric mucosa. And Western medicine is different in the treatment of advanced stage without antibiotics, the use of Chinese traditional medicines repair gastric mucosa, gastric mucosa was damaged long to repair from the inside out.

Many young people had not taken seriously after ulcer disease, dead or arbitrary rule, random stopping medication, and even everyday life is still its own way, repeated use of anti-inflammatory drugs and smoking, this behavior can easily lead to recurrent ulcer disease attack. In fact, not a small problem ulcers, or treatment of exacerbations less than once may result in bleeding, gastric perforation, pyloric obstruction, and cancer and other serious consequences. Therefore, young people must be seriously. In general, the treatment of ulcer disease, a course of medicine to take 4-6 weeks, had to consolidate the treatment of pain relief after l-3 months or longer. Therefore, patients must adhere to long-term medication under the guidance of a doctor, do not be a slight improvement in symptoms of withdrawal immediately, or frequent dressing.

Self-care more efficiently

Also do self-care during illness, adjust diet, regular life, so that the treatment of ulcers can play a multiplier effect.

Gastric ulcer during treatment should avoid taking drugs on the gastric mucosa damage, such as aspirin, dexamethasone, prednisone, anti-inflammatory pain. If due to illness must be taken when necessary, should follow the guidance of a doctor, after meals. Do not over-exertion, attention to climate change. Ulcer patients can not be over-fatigue, overwork not only affect the digestion of food, but also impede the healing of ulcers. Ulcer disease episodes and climate change have a certain relationship, so patients must pay attention to climate change, according to solar terms cold, and in time add less clothing. Attention to food hygiene, hunger and eat moderately, excessive consumption of cold drinks cold, or hobbies pepper, tea, coffee, spicy food, is not conducive to the healing of ulcers. Meals should be regular quantitative, slowly, hunger and eat moderate.

Gastric ulcer patients to maintain the spirit of joy. The doctor said, "ulcer disease is a typical psychosomatic illness, influence of psychological factors on a large ulcer." Nervous tension, agitation, or excessive anxiety would have a negative cortical stimulation, causing autonomic dysfunction, is not conducive to food digestion and ulcer healing. Therefore, maintaining a relaxed and happy state of mind is the key to cure ulcer disease.