Pathology of the Digestive system | Pathologies and health.
- Esophageal malformation
- Esophagitis
- The heartburn in pregnancy
- Injury of the esophagus
- Esophageal diverticula
- Achalasia
- Esophageal varices
- Esophageal tumors
- Dyspepsia
- Hyperchlorhydria and achilia
- Acute gastritis
- Chronic gastritis
- Duodenitis
- Peptic ulcer
- Pyloric stenosis
- Stomach tumors
- Chronic constipation
- Diarrhea
- Gastroenteritis
- Crohn's disease
- Meckel diverticulum
- Intussusception
- Volvulus
- Diverticulosis and diverticulitis
ESOPHAGEAL MALFORMATION
What are congenital malformations of oesophagus?The most common is the so-called esofagotracheale fistula, abnormal communication between the esophagus and the trachea, through which, in the newborn, saliva, milk or other ingested substances end up in the lungs, causing an irritation that often degenerates into pneumonia.
Esofagotracheale Fistula is a dangerous?
Yes, if left untreated, is fatal to the baby, because it hinders the respiratory function, due to recurrent infections (aspiration pneumonia).
Should be treated as such a fistula?
Through surgery, which closes the abnormal communication and to correct any defects in the wall that may be associated with the presence of the fistula.This is a risky operation?
Yes; However it should be noted that in the past, when it was not yet possible to apply surgical therapy in this type of malformation, mortality reached 100%.Other congenital malformations of oesophagus?
Yes, you can have the so-called congenital atresia, which consists in the failure to open or occlusion of a canal or orifice, in this case of the esophagus, for which there is no possibility of communication between the upper part of the digestive system and stomach. In some cases this is due to the presence of a membrane or diaphragm, which can also occlude the esophageal lumen thoroughly.That type of intervention requires the incomplete development of the esophagus?
Through an extensive operation, which involves opening the chest, to other suture the two ends of the esophagus respectively above and below the occlusion. If you have not developed the lower half of the esophagus, you must bring the stomach into the chest cavity and suture it to the lower end of the esophagus normally developed (esofagogastrostomia).This should be done with particular timeliness?
Yes, the operations must be carried out as soon as the doctor has diagnosed the existence of such a congenital malformation, as otherwise the newborn is destined to certain death.Which therapy requires the presence of a congenital esophageal diaphragm?
Surgical excision or dilation and subsequent stretching by the doctor. Usually, this is much less complex than the last.•
ESOPHAGITIS
What caused inflammation of the esophagus?
Like any other organ, inflammation (technically called esophagitis) is most frequently secondary to traumatic or infectious factors.In the case of the esophagus, the germs into the lumen is a fairly rare occurrence, which generally provide for other diseases, such as tumors or stagnation of food. Just as rare, and however transient, is that esophagitis follows the accidental ingestion of foreign bodies which, especially if they have sharp mechanical trauma on the wall which subsequently became the seat of an inflammatory reaction. Far more common is the chemical causes esophagitis, which is determined mainly by the acid content of the stomach that, under certain conditions, may flow back into the esophagus.
We speak in this case of reflux esophagitis or peptic. Usually the reflux is associated with a diaphragmatic hernia or a duodenal ulcer. In the first case, being strongly dilated orifice for which the esophagus passes through the diaphragm, a portion of the stomach ends up into the chest cavity; Therefore, the contents of the stomach flows back into the esophagus, causing easily often irritation and, subsequently, inflammation. In the presence of duodenal ulcer, the strongly acidic stomach content tends to rise also in the lower part of the esophagus, causing inflammation.
Peptic esophagitis is a serious disease?
Yes, because it can result in perforation of the esophagus, bleeding, to the formation of a stenosis (narrowing), resulting in difficulty swallowing.How to cure peptic esophagitis?
We must eliminate the root cause of inflammation: if it's a diaphragmatic hernia through a corrective surgery; in the case of duodenal ulcer, with an appropriate medical therapy. Administration of medicines both acts to prevent spasms, both to counteract excessive gastric secretion can be very useful; It takes to this end prokinetic medications, antacids, antisecretory and wall protectors.You can surgically intervene to correct esophageal reflux?
Yes, it is possible the reconstruction of the affected area and it is possible the correction of any related stenosis (endoscopically, by minimally invasive surgery).It is sometimes necessary to surgically remove the esophagus inflamed portion?
Yes, if the esophagitis does not respond to the usual medical treatment under certain conditions is necessary excision of inflamed portion, followed by the two remaining portions suturing, so again the esophageal duct.Partial excision of esophagus is a difficult operation?
Yes, however, exceeded by approximately 90% of patients.What chemicals, in addition to the content, stomach acid can cause esophagitis?
In the overwhelming majority of cases, caustics, e.g. lye or acids. The most frequent victims of similar incidents are unfortunately children, especiallyat an early age, because too often parents do not bother to keep these dangerous substances in places inaccessible to children.
What changes may occur in the esophagus after ingestion of caustic substances?
The consequence of such an accident can be the onset of a severe esophagitis, complicated by scarring.As you adopt in similar cases?
Esophagitis is treated in the same way as other inflammations; If you produce a narrowing of the esophageal lumen scar, you try to delete it with energetic expansion, repeated periodically for months.If this therapy does not bring a sufficient extension of the esophageal lumen excision may be necessary of small portion.
If the scar area is extensive, under certain conditions it is necessary to move the stomach into the chest cavity and connect it with the healthy portion of the esophagus.
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THE HEARTBURN IN PREGNANCY
During pregnancy, half of all women suffer from heartburn stomach. Almost always benign, these symptoms disappear immediately after birth, we discover how to deal with this annoying trouble.To fight the heartburn of pregnancy, it is important to understand why occur without notice.
The stomach of expectant mothers
The heartburn during pregnancy appear for 2 main reasons. First Manager: progesterone. This hormone causes muscle relaxation of the digestive system. This peak reaches hypotonia in quarter 3 of pregnancy. Result? Not only digestion is slower, but the valve which connects the stomach and esophagus is less toned. Closes at moments less opportune or close enough, letting gastric juices to escape.According to Manager: the uterus. Gestation progresses, expands along with the fetus and comes to rest on the stomach that this way is squeezed upward. Under this pressure, the liquid goes into the stomach esophagus, causing acid reflux.
Heartburn: Tips for pregnant women
By following a few tips, you can limit these annoyances. First, adopt a correct posture. If you need to pick up an object, bend your knees. Avoid leaning forward and lie down completely. If you feel the need to lie down, keep a half-sitting position with his back resting on the pillows. You can raise the headboard of approximately 15 cm. Lie on your left side, because the esophagus gets inside the stomach slightly to the right.Try your best to walk outdoors. Exercise is good for digestion and relief. Finally, bring loose clothing to avoid pressure on the abdomen which may result in the opening of the lower esophageal sphincter (the valve that connects the stomach to the esophagus).
Menu for pregnant in sweetness
Avoid fatty foods, spicy, fatty acids and those that ferment. Detect and banish those that cause you discomfort. The list of enemies of your stomach is long: stewed dishes, cheese, flour, chocolate, vinegar, pickles, tomatoes, cabbage, broccoli, as well as tea, coffee and soft drinks. Do you prefer dense foods, such as bananas, rice and egg yolk, and limits. "Beware of false friends like yogurt and white sugar. Give immediate relief, but not particularly digestible and acidify the body in the long run, "says Francine Chénelot, midwife.Used in naturopathy, licorice exerts a protective effect on the intestinal mucosa and an anti-inflammatory. To try, unless you suffer from hypertension. "You can also enjoy an infusion of altea. This grass does it profit to the mucosa, "says midwife.
Divide your usual meals in 5 or 6 minipasti, of which the three most important and two light. And don't forget: chew slowly. Above all, wait an hour after eating to relax while lying down or sitting.
If these are frequent heartburn, do not hesitate to consult with the doctor who follows your pregnancy: you can indicate which therapies do not involve risks.
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INJURY OF THE ESOPHAGUS
How can you produce esophageal sores?
The injuries with rupture of the esophagus may be caused by accidental ingestion of sharp foreign bodies (eg, fish bones accidentally swallowed) that can pierce the wall. Wounds and lacerations can also achieve violent trauma of the chest.What other injuries may occur in the esophagus?
In rare cases, violent fits of vomiting can cause the glass to crack. This is a very rare occurrence, generally of heavy drinkers that the urge to vomit can be expressed in a very violent, that tear the whole thickness of the wall or part of it.How is rupture of the esophagus?
By timely surgery, which closes the opening and draining the thoracic cavity. If the patient's general condition is such as to discourage the operation, we are limited to only chest drain, if needed practicing after surgical correction if the lesion does not spontaneously rimarginasse.•
ESOPHAGEAL DIVERTICULA
What is the esophageal diverticulum?
A dead-end outpouching of mucosa through the muscular wall of the esophagus, whereby in the mucous channel, otherwise smooth, a finger-shaped expansion of glove.Where are located usually diverticula?
In the overwhelming majority of cases, in the first part (neck), but can also be located in the central portion (in the middle of the chest cavity), or in the final stretch of the esophagus (the one located near the diaphragm).Esophageal diverticula cause disorders in General?
Those located in the initial section usually result in the appearance of specific symptoms, because they fill up with fluid ease, expanding, and thus avoid a narrowing of the duct.Liquids or food remains accumulated in the diverticulum may also be entered into the esophageal lumen and cause regurgitation or vomiting. Finally, sometimes from a diverticulum bleeding may occur, or chronic inflammation (diverticulitis).
Diverticula cause all the symptoms?
No, only those located in the initial section or in the terminal portion; localized diverticula in the central part of the esophagus does not usually give rise to no symptoms, but are often linked to inflammation (usually by pulmonary tuberculosis) of the lymph nodes located in the thoracic cavity.What is the most appropriate therapy for Esophageal diverticula?
If it's causing diverticula the appearance of certain symptoms, surgical excision. In this case, if the eversion is located in the initial part of the esophagus, the incision is made in the neck, if the diverticulum is instead located in the terminal portion, this involves opening the ribcage. In individual cases, employed the technique of endoscopic surgery.•
ACHALASIA
What do you mean by cardiospasmo or achalasia?
A disorder, probably due to the lack of certain congenital neural structures of the esophagus, so this is not able to contract and relax in the Terminal; This constant shrinkage leads to spastic an abnormal dilatation of esophageal portion situated above the same shrinkage. Once this disorder was called cardiospasmo, i.e., Cardia contraction term indicates, or outlet orifice of esophagus stomach: Contracting, cardium sphincter closes the esophagus, preventing the reflux of gastric juice and ingested food into the esophagus.What caused the achalasia?
From a congenital malformation characterized by deficiency of the neural structures that coordinate the motility of the wall of the esophagus.At what age is usually affected by this disorder?
Between 30 and 50 years.What are your symptoms?
The most common symptom is an inability to swallow, usually worsen over time, added to this is often a bad breath caused by remnants of food left in the esophagus. Those suffering from this disorder are undernourished, with consequent severe loss of weight, and often afraid to eat for pain and trouble swallowing that are associated with this disease.How to treat achalasia?
The 75% of people with this disorder responds well to therapy based on repeated dilation of the esophagus; in the remaining 25% of cases surgery is required.What is the operation of achalasia?
In the so-called cardiomiotomia: muscle fibers that are located above the affected area are spasm cut longitudinally, this helps to dilate esophageal mucosa where practiced section, preventing the sphincter muscles to contract and cause a spastic esophageal narrowing.It is a serious operation?
Yes, as it involves opening the rib cage; However, it does not have excessive risks.What results are achieved with a similar surgery?
In most cases, a significant improvement; Sometimes, however, as a postoperative complication, occurs a esophagitis.•
ESOPHAGEAL VARICES
From what originated the esophageal varices?
From a stagnation of blood produced in portal vein system, namely in that system of venous vessels that carry the blood to the liver from the intestine.The most common disease that causes stagnation, and then the varices, liver cirrhosis (see later in this chapter).
As a result of the obstacle constituted by cirrhotic liver, blood from the intestines, rather than cross the liver, is rejected and stagnates in the veins causing esophageal dilatation and formation of varices.
What danger the esophageal varices?
The risk of bleeding, due to breakage of varicose veins, to the strong pressure of the blood in them and the progressive decrease of resistance of their walls.How is the diagnosis of esophageal varices?
in Ensuring whether there are) symptoms of cirrhosis of the liver and if there was bleeding from the mouth (hematemesis);b) performing an x-ray of the esophagus, after administration of a meal dull (barium sulfate), and esophagoscopy, i.e. a direct examination of the
the wall of the esophagus by esophagoscope, allowing you to watch the varicose veins.
What can be done to eliminate the esophageal varices?
Cauterize) varicose veins esofagoscopico under control;b) perform ligation of esophageal veins, complex surgery that involves opening the chest and that you run only when hemorrhage occurred so severe as to threaten the patient's life;
c) another surgery that is to connect the portal vein with the inferior vena cava (cava anastomosis-port), or the main vein of the spleen (or splenic vein lienale) with Renal vein (spleno-renal anastomosis).
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ESOPHAGEAL TUMORS
What is the incidence of esophageal tumors?
About 1% of fatal cases caused by Neoplasms consists of esophagus cancer.Benign tumors much more rarely affect the esophagus.
The incidence of these tumors is equal in both sexes?
No; males are affected more often than women.At what age usually arises esophageal cancer?
Between 50 and 70 years.There are environmental factors that can contribute to the development of this cancer?
Yes. Smoking, excessive intake of alcohol and perhaps too hot drinks intake are considered risk factors.What symptoms lead malignant tumors of the esophagus?
swallowing difficulties);b) loss of appetite;
c) weakness and weight loss.
How to treat cancer of the esophagus?
Through surgery or röntgenterapia, or combining both treatments.What results are obtained with these methods?
Röntgenterapia alone is rarely manages to heal an esophageal cancer if it is localized in the final stretch, the surgery to heal in about 20% of cases.Benign tumors of the esophagus can be successfully treated?
Yes; surgical excision of the tumor allows you to reach virtually healing in all cases.What technique follows the surgeon in malignant tumors of the esophagus?
If it is localized tumor in the middle portion or lower (usually forms more successfully operable), the surgeon, after opening the rib cage will remove both the esophageal tumor attached portion is a wide neighboring area healthy again; through an opening in the diaphragm, then move the stomach into the chest cavity to the residual portion of suturing the esophagus.Excision of a tumor of the esophagus is a difficult operation?
Yes, it is one of the most difficult surgeries.•
DYSPEPSIA
What are the most common symptoms of dyspepsia?
Belching, often associated with aerophagia (air intake), acid regurgitation, heartburn, nausea and vomiting.What is heartburn?
A burning sensation in the stomach, which gradually spreads to the esophagus, pharynx and throat, where often there is also a bitter taste.From what originated dyspepsia?
in) by excessive production of juice and gastric acids;b) from the habit of making meals overflowing or eating too fast, chewing little;
c) from eating too much spicy food or incorrectly prepared;
d) from eating foods that you can't tolerate, for example too fat;
and the existence of) other related diseases.
How do we cure it?
Depends on what caused the dyspepsia:in one of the countless) taking medicines that neutralize excess gastric acid production and then the hyperchlorhydria;
b) remaining fast for several hours or even a whole day, if the cause is an abundant meal;
c) observing a light diet;
d) taking a spasmolytic, to calm the violent gastro-duodenal contractions;
and treating related diseases).
There are actually people immune from upset stomach or dyspepsia?
Certain individuals actually have a "more robust" than others; Nevertheless, the undigestible food intake can cause faults or violent reactions even stronger stomach.It is good to try to vomit, when you feel your stomach bothered?
If such an arrangement is not too annoying, cause stomach emptying sometimes proves an effective therapeutic system.How does indigestion?
With nausea, vomiting, cramps to the upper abdomen and inappetence: symptoms usually appear one or two hours after eating something you are not able to digest.How can I tell if it is a simple indigestion or a more serious disease and severe appendicitis, for example, hepatic colic or heart attack?
In many cases it is difficult to determine the true nature of the disorder, especially when there are violent pain in the epigastrium. in such a case, do not waste time and call your doctor.In case of acute dyspepsia or indigestion, it is appropriate to take a laxative?
No, other more suitable therapies may be prescribed by a doctor.If you are suffering from abdominal pains, in which cases you should consult your doctor?
When the pains are unbearable or persist for a long time, or are recurring.There are foods that cause with particular ease stomach?
Yes; more precisely, the battered foods or left for hours on the air when the weather is warm and the food too spicy or fat.Is a bad habit to drink during the meal?
On the contrary, facilitates digestion.When it's hot, you should see a lighter diet?
Yes, when it is hot the calorie requirement is lower.In the evening you should not take heavy meals?
Yes, especially if you suffer from indigestion.It is dangerous to do a big meal just before a swim?
Yes, because in that case the blood flows in greater quantities in the digestive tract and therefore not adequately perfuse the muscular system, that while swimmingneeds instead of maximum blood supply. However, it is not yet proven that eating before a swim causes the onset of cramps and thus endanger the existence of the swimmer.
To what extent the emotions affect dyspepsia?
Substantial extent; abdominal or intestinal symptoms may be linked to an emotional turmoil.Advancing age actually involves a greater tendency to stomach?
Yes.There are foods that you should avoid, when you drink alcohol?
No; the widespread belief that enjoy certain foods in conjunction with alcohol will cause violent stomach upsets, is completely unfounded. Drinking too much alcohol can obviously be damaging to your stomach, but regardless of what you ate.It is dangerous to drink frozen drinks when you're overheated?
No, as long as you do not drink too quickly and too much. It is still damaging the always drinking frozen drinks.•
HYPERCHLORHYDRIA AND ACHILIA
The stomach acids are present?
Yes: the glands in the gastric mucosa in fact secrete hydrochloric acid, which contributes to the digestion of food.The excessive production of hydrochloric acid can cause eating disorders?
Yes; It is believed that hyperchlorhydria, i.e. the abnormal increase of hydrochloric acid in the gastric juice, has a certain role in the formation of duodenal ulcers.Can sometimes also occur in the terminal portion ulcerations of the esophagus.
The, or hyperchlorhydria hyperacidity, can also be associated with heartburn, gastritis or duodenitis (see below).
The lack of hydrochloric acid in the stomach (hypochlorhydria) can cause eating disorders?
Yes; the hydrochloric acid is essential both for the sterilization of any contaminants on food, both for the beginning of the digestive process. In his absence, these are not completed appropriately in the small intestine.In addition, hypochlorhydria is in some cases associated with gastric mucosal diseases that may be causing your symptoms, in addition to those from digestive decreased secretion of hydrochloric acid.
You can live normally without heartburn?
Yes; approximately 10% of individuals suffering from gastric achilia, i.e. low production presents, or even nothing, hydrochloric acid and pepsin (the two components of the gastric juice).From what originates the gastric achilia?
Is secondary to gastric mucosal atrophy which can in turn be due to very different causes, such as a vitamin B 12 deficiency, chronic gastritis, senescence.What are the symptoms of gastric achilia?
This disorder usually has no symptoms, but sometimes an individual realizes that he is suffering from difficulties in digesting protein foods in particular (meat).How to cure gastric achilia?
Usually there is no need for therapy.What caused the hyperchlorhydria?
You do not know the exact cause, but it is known that emotional unstable mind people, and energetic Dynamics tend to a greater production of hydrochloric acid.The mucosa or, better, the gastric glands are stimulated to secrete more acid also strongly spiced foods, alcohol and tobacco, as well as meals to rich in protein.
How can it be determined the content of acid gastric juice?
With the survey, examination carried out by introducing into the stomach through the nose or mouth, and receives a probe and gastric secretions, which are subsequently analyzed.The hyperchlorhydria is a lifelong disorder?
Not necessarily; the factors which constitute the cause (for example, temporary emotional stress) can come to an end, resulting in the normalization of acid gastric juice.Which have effective medicines commonly prescribed against hyperchlorhydria?
The so-called antacids preparations prove very effective in temporarily relieving this ailment, while as therapeutic means are not of any value.Can be detrimental on continue to take antacids for extended periods?
No, but it would be more advisable to consult your doctor in order to establish the real cause of excessive stomach acid. It should also be mentioned that the use of abundant doses of antacids can lead to disorders such as constipation or diarrhea depending on the preparation used.Which therapeutic measures are really effective for combat hyperchlorhydria?
The most effective measure is taking drugs called anti-H 2 (i.e. histamine-receptor blocker 2 type present in the gastric mucosa and largely responsible for acid secretion of the stomach), drugs that, in certain circumstances, prove to be very effective in solving hyperchlorhydria disorders.Beside that, in specific situations, prove useful even antacids and anticholinergics. As a general measure is a good idea to try to lead an emotionally balanced and orderly life and eliminate both smoke and alcohol. Also, it is very important to identify the possibly related pathology.
What role does the hyperchlorhydria in formation of gastric and duodenal ulcers?
The hyperchlorhydria, tissue acidity, is a damaging factor for the gastroduodenal mucosa, which can have numerous mechanisms of Defense and repair. In the chronic stage, hyperchlorhydria is one of several factors that favor the formation of duodenal ulcer, while it considers that it cannot be the cause of stomach ulcers.•
ACUTE GASTRITIS
What is acute gastritis?
An inflammation of the stomach lining, especially related to ingestion of particular drugs (so-called NSAIDS, non-steroidal anti-inflammatory drugs), excessive alcohol and smoking habits, all substances irritating action on the gastric mucosa. More rarely is secondary to viral infection and in this case is frequently associated with a similar inflammation of the first section of the small intestine. Bacteria are the cause of gastritis in only very special conditions, and especially in relation to a decrease in stomach acid secretion, allowing germs present in food to survive and multiply to cause an inflammation of the wall of the organ.What symptoms do you have?
Nausea, vomiting, cramps to the upper abdomen, fever.What's the difference between acute gastritis and acute gastroenteritis?
In gastritis inflammation is limited to the stomach, while in gastroenteritis it also involves the intestines. Looks like gastroenteritis symptoms diarrhea, whichmissing from simple gastritis. (For gastroenteritis, see below, the small intestine and large intestine subchapter).
How to treat acute gastritis?
With:bed rest);
b) appropriate diet;
c) prepare antacids and antispasmodic.
How long will it take to overcome an acute gastritis?
A few days ago. If the symptoms do not resolve, you should satisfy themselves with further investigation if there is a more serious disease.Acute gastritis can be treated with surgery?
No, the trouble is easily solved with medical therapy.•
CHRONIC GASTRITIS
What is chronic gastritis?
A persistent inflammation of the mucosa of the stomach, which can take on very different histological aspects. In particular stand out: gastritissurface) (with interest limited to the mucosa that lines the stomach);
Interstitial b) (with involvement of the deeper portions of the mucosa);
c) and preatrofica, atrophic (with progressive disappearance of gastric glands are replaced by areas of intestinal metaplasia, that is similar to the mucosa that lines the gut);
d) characterized by hypertrophic mucosal edema, hyper-proliferation of mucus-secreting cells (the mucus protects the wall from the detrimental action of hydrochloric acid), decrease of hydrochloric acid-secreting cells and superficial erosions (which can give rise to bleeding).
What causes these changes?
In General, the damage that occurs in the gastric mucosa, as a final result, a decrease in the production of gastric juice.What caused the chronic gastritis?
An important part of responsibility in the genesis of gastritis and ulcers is attributed to ahosted: stomach bacterium Helicobacter pylori. There are also factors that exert an irritating the mucous membrane (such as alcohol, tobacco, drugs, reflux of bile salts from the duodenum, impaired gastric emptying) and that may contribute to the onset of chronic gastritis. It can be supported by psychological factors (stress, tension).
What are the symptoms of chronic gastritis?
Most forms run almost asymptomatic. Other times you have discomfort, sense of fullness and pain in the upper abdomen, loss of appetite, heartburn, weight loss, nausea and vomiting. In the case of the hypertrophied forms, bleeding may also occur, resulting in vomiting blood (hematemesis) or blood in the stool (melena) which appear blackish; in other cases, hypertrophied forms have no symptoms.Based on what the doctor makes the diagnosis of chronic gastritis?
Initially based on the symptoms. Diagnosis is made on the basis of the finding of a histological study done on a mucous fragment taken in course of gastroscopy.What is the best way to prevent chronic gastritis?
Avoid all substances that underpins the onset assumed.How to cure chronic gastritis?
a) in the case where it has been established the presence, in the stomach, Helicobacter pylori, instituting a therapy involving a drug able to inhibit gastric secretion, e.g. omeprazole, and an antibiotic such as clarithromycin and amoxicillin. In 90% of cases you get eradication of bacteria;b) trying to avoid all those irritating factors and affecting on the mucosa (spices, alcohol, coffee, smoking, drugs);
b) using prepared with mucosal protective action, e.g. sucralftato;
c) in the case of altered gastric emptying, using medicines regulators of gastric motility;
d) in cases of bile reflux, using substances that sequester bile salts.
How is determined the presence of Helicobacter pylori in gastric mucosa?
Through the examination of gastric juice collected during gastroscopy; the tests determine the presence of blood specific antibodies; the Urea Breath Test or breath test.Chronic gastritis is capable of healing?
Usually Yes, after appropriate therapy applied for several months; in some cases, while not curing, can be kept under control.Chronic gastritis sometimes requires surgery?
Only in case you experience any bleeding.Chronic gastritis may give rise to other diseases?
Yes, the hypertrophic gastritis can lead, through the overgrowth of mucus-producing cells, a significant loss of proteins. This phenomenon manifests clinically with the emergence, in the most severe forms, subcutaneous edema. Atrophic gastritis instead promotes the onset of peptic ulcer and development of particular types of anemia (anemia and pernicious anemia). In addition, there is a close relationship between the onset of stomach cancer and this type of gastritis.How can it be assessed the progress of chronic gastritis?
Based on histological changes occurring in the stomach mucosa, detectable by gastroscopici examinations, carried out regularly for inspection.•
DUODENITIS
What is the unit?
An inflammation or irritation of the duodenum.What is due?
From hyperchlorhydria and all other factors that lead to the formation of ulcers, particularly from Helicobacter pylori. Stress and the emotional tensions have great importance in determining the duodenitis. Sometimes the cause is a viral infection that, whether it involves the stomach, gives rise to gastroenteritis (see above).What are its symptoms?
Often symptoms of duodenitis are modest, limited to a sense of tension and tenderness in the epigastrium, difficulty to digest and nausea. The disturbances are more accentuated if the unit is associated with a considerable degree of hyperchlorhydria.Depending on what your doctor recognizes the duodenitis?
Mainly based on symptoms. It may sometimes be necessary and a test for gastroduodenoscopy research Helicobacter pylori, or radiographic examination.How you care for duodenitis?
In case of ascertained the presence of Helicobacter, with its therapy (see above) and with a diet free of irritants such as alcohol, coffee, spicy foods. The therapy also makes use of medications that neutralize hyperchlorhydria and spasmolytic drugs which decrease the spastic contraction of the duodenal wall that often accompanies the duodenitis.The unit requires surgery?
No, it can be treated easily with an appropriate medical therapy.If left untreated, duodenitis can heal spontaneously?
Yes; but sometimes it can become chronic.Who suffered of duodenitis, tends to relapse?
Only if you carefully follow the diet that was prescribed, make excessive use of alcoholic beverages and not look the other doctor.•
PEPTIC ULCER
What is a peptic ulcer?
An ulcer is defined as an interruption of the continuity of the mucous membrane of the digestive tract that is exposed to the erosive action of hydrochloric acid and digestive enzymes. Most commonly, the ulcer occurs mucosal of the stomach and duodenum, but can also affect the final part of the esophagus where the lower esophageal sphincter (the pylorus) is incontinent.What changes occur in the presence of gastric or duodenal ulcer?
The mucous membrane that forms the lining is eroded, so that in the wall of the stomach or duodenum remains an inflamed area, without protection, which can be as small as a pinhead or have an extension of several centimeters.What caused the ulcer?
It is believed he is often responsible for the aggressive strain of Helicobacter pylori, a weakening of the protection systems of the gastric mucosa (for example, a decrease in the production of protective mucus), which makes it more susceptible to the action of irritating factors such as:hydrochloric acid), although produced in normal amounts.
b) reflux of pancreatic enzymes and bile from the duodenum to the stomach;
c) delay in gastric emptying;
d) smoking, alcohol, caffeine;
and) drugs, especially anti-inflammatories ingested on an empty stomach or steroid preparations taken for long periods of time;
f) emotional stress that increase stomach acid secretion.
What caused the ulcer?
Duodenal ulcer, as well as esophageal is a hydrochloric acid hypersecretion: coming into contact with the duodenal mucosa in ec amount, routing cannot be neutralized by pancreatic juice and bile, and causes erosion of the mucosa. It should be stressed that even in the genesis of duodenal ulcer is today an important role attributed to Helicobacter pylori.What is the incidence of gastric ulcer and duodenal?
It is believed that, in the course of its existence, about 10% of adults suffering from duodenal ulcer and approximately 1% of gastric ulcer. Gastric ulcer rarely develops before the age of 40 years and the increased incidence is observed between 55 and 65 years with equal frequency in both sexes. Duodenal ulcer, however, is more common in men than women and affects young individuals, generally around 30 years.Which people are at greater risk of ulcer?
Duodenal ulcer is generally more frequent in those individuals energetic, dynamic, highly emotional, that often feel dissatisfied and frustrated, and are still exposed to the stresses of life and society. Often these managers or persons who hold positions of great responsibility. For gastric ulcer there is instead a reference as accurate a particular personality. In contrast to that, it is however duodenal more frequent in lower social classes living standards.Gastroduodenal ulcers are hereditary?
A real disease inheritance has not been proven. However, it is possible to experience a higher incidence of ulcers within a family.The reason is not clear; in the case of duodenal ulcer you give great importance to
psychosocial factors (e.g., stress) that would have an impact on all family members, or to a particular lifestyle.
What steps you can take to prevent, to the extent possible, to be affected by an ulcer?
You must:no smoking);
b) drink alcohol only in moderation;
c) observe a light diet, avoiding spicy foods;
d) strive to live within the limits of their abilities and psychological possibilities;
and) observe precautions when taking NSAIDs (non-steroidal anti-inflammatory drugs, such as aspirin) or prepared corticosteroids.
In particular, it is good to get them fed and always, if it lasts over time, possibly associate with gastroprotective drugs;
f) in the light of the new guidelines on the genesis of infectious ulcer, it is important to follow strict hygiene rules: Helicobacter pylori transmission would indeed for fecal-oral and/or gold-orally.
What are the symptoms of a gastric ulcer or duodenal ulcer?
Symptoms of gastric ulcer and duodenal are very similar and consist of dyspepsia with nausea, vomiting, anorexia, feeling of fullness, epigastric voltage; typical is the tenderness until real epigastric pain of you little crampy, similar to a violent spasm from hunger, and that occurs at different times depending on the type of ulcer. In duodenal ulcer pain occurs between meals and usually disappears for a couple of hours if you eat something. Duodenal ulcer symptoms include a sour taste in the mouth, regurgitation and heartburn: intended to be mitigated if you take antacids preparations. In contrast, gastric ulcer there is no relationship defined with food intake and lacks the acidity (heartburn).What tests are used to diagnose the ulcer?
In most cases, the radiological examination of the stomach and duodenum; the diagnostic certainty, however, can only be obtained with a gastro-duodenoscopy.What consequences can get ulcers?
In addition to the pains and the constant feeling of malaise that afflict ulcer sufferer, you may encounter the following complications:chronic ulcers) may lead to scar formations and narrowing of the pylorus;
b) ulcers can puncture and then cause a peritonitis
c) from ulcers can lead to serious bleeding.
The extension of the ulcer is important?
Not necessarily, because small ulcers can lead to perforation or bleeding almost as easily as larger ones.As a general rule, it can be said, however, that the more the is deep and extensive ulcer, the more healing is long and difficult.
How to cure an ulcer?
People suffering from this disease react positively to a specific medical therapy, which includes:to) if the specific tests reveal the presence of aggressive strains of Helicobacter pylori, eradication of the same by the aforementioned therapy;
b) proper nutrition with elimination of irritants such as smoke, alcohol, caffeine, foods that are too spicy;
c) taking medication, which can be divided into two broad categories: 1. drugs that reduce gastric acidity (cimetidine, ranitidine, FAMOTIDINE): antisecretory and H 2 receptor antagonists of histamine, which mediates the secretion of the stomach; Cholinergic receptor antagonists as well involved in gastric secretion (pirenzepine); Antacid preparations; 2. drugs that increase mucosal defenses, stratifying on it so as to prevent contact with hydrochloric acid (sucralftato, carbenoxolone, bismuth).
Medical therapy should always be continued for many months and suspended only in the opinion of the treating physician. Patients who do not respond to therapy-case today exceptional-they must be subjected to surgery only if:
and pains) the malaise continue, despite all attempts to delete them with medical therapy; in this case, there may be an ulcerated carcinoma and not of a gastric ulcer;
b) has produced a narrowing of pi;
c) ulcer perforates, or there is a risk of perforation;
d) occur repeated, severe bleeding.
Once healed thanks to medical treatment, ulcers may be reformed?
There is a danger in forming a new mucosal lesion and, consequently, a new ulcer.What factors have caused the ulcer relapses?
The inconvenient suspension) of drugs by the patient;b) failure to follow the dietary prescriptions and hygienic conditions and, in particular, of the rule that prohibits smoking and drinking alcohol;
c) the persistence of situations that affect the patient's psyche and emotions and stress.
What happens in the gastric mucosa when the ulcer heals?
The area of the ulcer grows a new layer of the mucosa.What surgeries are performed in ulcer?
The interventions are different, depending on whether gastric or duodenal ulcer. The ulcer is practiced a antrectomia (removal of gastric antrum, i.e. only the terminal portion of the stomach is located immediately before the pylorus) or a subtotal gastrectomy (removal of 3/4 of the stomach). The remaining portion of the stomach is connected to the intestine (gastroenterostomy). The gastroenterostomy you can run residual stomach to catch the duodenum (gastroduodenostomia) or fasting, which is the portion of the small intestine that follows the duodenum.In duodenal ulcer you run a antrectomia (followed by one of two types of gastroenterostomy) but there is associated, namely vagotomy resection of vagus nerve (vagotomy Varicosis). The vagus nerve in fact stimulates the secretion of gastric glands, and eliminates the resection hyperchlorhydria, that the ulcer is linked. More detail is the selective vagotomy, which stops only selectively blurred branches which are distributed to the stomach, the intact nerve branches for the other structures of the alimentary canal.
The outcome of all these operations is too positive?
The surgery is effective but can have significant postoperative sequelae because deleting a more or less extensive portion ofstomach and subsequent anastomosis of gastric stump to a portion of the bowel, radically subvert the anatomical features of this section of the alimentary canal, negatively influencing the digestion and absorption of food. For this the current trend is to reserve the surgery only in very specific cases, and to give priority to interventions still vagotomy-also executable with endoscopicarispetto surgical techniques to those, much more radical, gastrectomy.
Ulcer surgery, therefore, is no longer a common practice?
No. Eradication of Helicobacter pylori and the use of drugs and gastric wall protectors of drugs reduced acidity necessitated surgery only for possible complications like ulcer acute perforation and bleeding.That period of hospital involves the operation of the ulcer?
About two weeks.Ulcer operations are serious interventions?
Yes, but are exceeded by approximately 99% of patients.How long does the ulcer operation?
From 2 to 5 hours, depending on the severity of the case and of the technique.What type of anesthesia is used?
For inhalation narcosis.Which post-operative therapy is needed?
in) the patient may not resume before drinking two or three days and eating before four or five;b) Meanwhile, is fed with infusion made from glucose, amino acids, minerals and vitamins;
c) gastric probes are applied to maintain free or stomach the remaining portion;
d) sometimes also antibiotics are administered, in order to avoid the occurrence of postoperative infection.
After a gastrectomy, which body carries out the function of the stomach or duodenum?
Over the course of a few months, the remaining portion of the stomach expands and forms with the small intestine, with which it was connected, a kind of pocket that performs excellently to the tasks before referred to the stomach.The ulcer may be reformed after being made?
It is a rare phenomenon, which occurs in about 3% of cases.The ulcer operated special precautionary measures should be observed?
Yes, more precisely, should not make meals too generous and must minimize the strongly spiced foods and alcohol for a few months, or at least until you are satisfied that all ulcer symptoms have disappeared.The operated ulcer must limit his activity?
The level of physical activity is closely linked to the General conditions of the subject and should be restricted until it has reached its complete restoration.Gastric resection affects the probable duration of survival?
No.Stomach excision may give rise to anemia?
In some cases, Yes; in such a case, however, it is possible to treat anemia with hematopoietic preparations, that is capable of promoting the formation of the elements that make up the blood, especially red blood cells. A CBC will tell if check the cure achieved.The ulcer operation excludes the possibility of pregnancy?
No.How often you should undergo check-ups, when you've been operated ulcer?
Immediately after surgery you should be followed and visited by a doctor frequently.As time passed and the improvement of the General conditions is simply a visit once a year.
In the case of gastrectomy for ulcer, ulcer is necessarily excised?
No, if its is technically too difficult excision. The healing process is induced by gastric portion removal pro duce, hydrochloric acid from the surgical section of the vagus nerve, which stimulates the production and gastroenterostomy which is completely excluded the duodenum. Thanks to these measures, the ulcer heals by itself.Digestion can take place even without normally hydrochloric acid and with the lack of a portion of the stomach?
Not all food digestion and absorption take place normally.Furthermore, a certain amount of time, which varies from individual to individual, because the residual portion of stomach and intestines are adapted to the new situation.
For this after gastrectomy:
in) patients should make small, light meals and more frequent;
b) can assist in weight loss;
c) may develop an iron deficiency anemia or vitamin B 12;
d) diarrhea may occur.
•
PYLORIC STENOSIS
What is the pyloric stenosis?
The narrowing of the pylorus, a characteristic syndrome of infants.What is due?
From excessive growth (hypertrophy) of the muscles surrounding the pylorus and therefore gives rise to often twitching or abnormal spasm of the valve, which make it difficult to stomach emptying.There are infants affected more than others by pyloric stenosis?
Yes, male infants, who are hit with a rate three times higher than those of females.What is the incidence of pyloric stenosis?
Is found in approximately 1% of newborns.What are its symptoms?
violent Vomiting);b) swelling, tactile and large around as a walnut, usually located in the upper-right part of the abdomen;
c) weight loss, as a result of the repeated fits of vomiting;
d) the x-ray is clear obstruction, which prevents food from passing from the stomach to the duodenum.
Treatment of pyloric stenosis?
In most cases, by surgery; positive results are obtained even with a therapy based on preparations antispasmodics.If the vomiting persists, since you can wait before deciding for surgery?
No more than a week because the vomitting prevents the baby to feed properly.What is the operation?
After practicing in the upper right abdomen, an incision of about 5 cm in length, the surgeon severs the muscle fibres surrounding the area without touching the pyloric mucosa. Surgery can also be done in videolaparoscopy.What results are achieved with this surgery?
Healing, in virtually all cases.This is a dangerous operation?
No; abstracting from unsuspected complications that can occur after all surgeries, always well is exceeded.What type of anesthesia is used?
For inhalation narcosis.How long must remain in the hospital usually baby?
From 5 to 7 days.Special assistance is required?
No.What does it take to heal the wound?
From 7 to 10 days.How long after the operation, you can resume the power supply?
From 24 to 48 hours after surgery.Once, pyloric stenosis can form again?
No.After being operated by pyloric stenosis, the child is destined to grow in an entirely normal?
Yes; If surgery has enabled the healing, the development is not affected at all.Pyloric stenosis can also affect adults?
Yes, but this is a rather rare phenomenon of functional nature, that is caused by a spasm of pyloric sphincter muscles rather than true hypertrophy.•
STOMACH TUMORS
What is stomach cancer?
In most cases, the cause is unknown. However, lesions known as pre-cancerous lesions, which facilitate the onset as atrophic gastritis and intestinal metaplasia (condition in which the mucous membrane of the stomach and takes on the characteristics of the intestinal mucosa). It is also likely that some "external" factors relate to this kind of neoplasia; you feel involved smoking, excess alcohol and the bacterium Helicobacter pylori.All stomach tumors are malignant?
No; Although very rare, there can also be benign tumors that originate from the gastric wall musculature (and are called leiomyomas), adipose tissue (lipomas) or mucosal glands (adenomas). Usually benign tumors do not cause symptoms.Benign tumors of the stomach are curable?
Yes, in forms that give you work with disorders or excision of tumor or only a portion of the stomach.What is the incidence of gastric cancer?
Makes about 1/3 of the different forms that cancer affect men and 1/5 of those that occur in women.At what age it is most affected by this disease?
Average and in old age.Stomach cancer is hereditary or tends to recur in the family?
No.You can prevent it?
The measure "preventative" best is his early diagnosis: if detected in its early stages, theoperable tumor is often successfully. It is also recommended to reduce the risk, healthy life style (abolition of smoking, proper diet).
How is diagnosed with gastric cancer?
Radiological examination, gastroscopy and biopsy. Gastroscopy allows the doctor to see directly the possible tumor formation and tissue samples to be subjected to histological analysis.What are the symptoms of this disease?
Early symptoms of gastric cancer is very small; the persistence of stomach upset, loss of appetite and weight loss or unusual pallor, however, should induce these sufferers to undergo an x-ray of the entire gastrointestinal tract or gastroscopy.How to cure gastric carcinoma?
With a timely gastrectomy.This is a very serious operation?
Yes, but excellently is exceeded more than 90% of cases.How long you need to stay in hospital?
For approximately two weeks unless complications. The time of hospitalization depends in each case the extent of surgical excision.What type of anesthesia is used?
For inhalation narcosis.How long does the intervention of gastrectomy for gastric carcinoma?
From two to five hours, depending on whether it is practiced the partial or total gastric resection; a lot also depends on the extension and carcinoma from technical problems that may arise.Ulcers can sometimes degenerate?
This point is greatly debated. In the presence of a gastric ulcer, therefore, it is always advisable that, making the doctor gastroscopy takes tissue fragments from the ulcer and the surrounding area, for submission to histological examinationAt the time, the surgeon is able to assess if it is an ulcer or cancer?
Generally Yes, because facts examinations prior to surgery (especially on histological levy being gastroscopy) allow a diagnosis of benignity or malignancy of ulcerative lesion.During the gastrectomy, the operand are given blood transfusions?
In some cases, Yes.How do the course and postoperative therapy?
If total removal of the stomach (the most frequent) the patient cannot eat or drink for about 8 days, to avoid complications on visceral sutures, and is nourished with drip.In case of simple resection power resumes after 4-5 days after surgery and is allowed to drink since day one. The average stay is 10-15 days.
•
CHRONIC CONSTIPATION
What is constipation?
We talk about constipation, constipation or constipation, or when you find it difficult to evacuate, or defecation is uneven and too infrequent.What are the most common forms?
functional constipation), due to disabitudine to evacuate regularly, such inappropriate dietary habits, colon irritation or emotional disturbances;b) organic constipation caused by intestinal paralysis or mechanical intestinal occlusion funnel. Among the possible causes of constipation include organic adhesions or intestinal tumors, Cicatricial stenosis of rectum or anus, or inflammatory processes. Paradoxically, even chronic use of laxatives, altering the normal intestinal motility, can lead to chronic constipation.
How often should usually be the evacuation?
This process takes place with a pace different from individual to individual; can take place once or twice a day, or once every two to three days, which no importance if it happens with regularity.There are people more prone to constipation?
Yes. Neurotic individuals and living in a State of continuous tension are susceptible to the onset of spasms of the colon, resulting in constipation.This often affects the chronic, indolent, lazy people who ignore the regularity of habits.
An occasional constipation can cause headaches, moodiness, impatience and other psychological disorders?
If you experience, these disorders are usually caused by an emotional factor, as a constipation so limited in time may not have such effects.What depends on the regularity of bowel movements?
to from being used) from childhood to empty your bowel to fixed hours;b) from the power supply, which must be varied and include copious amounts of fresh fruits and vegetables;
c) General health conditions that allow the regularity of biological rhythms.
Nutrition affects the intestinal activity and evacuation?
Yes.What role does the power to treat constipation?
A role of great importance; a diet that includes fiber-rich foods, such as fresh vegetables and fruits, in fact encourages normal bowel functions, while the foods high in starch and fat, and therefore relatively low in fiber, impede the functionality of the intestines.What caused the infant constipation?
functional disorders), which occur when we don't get used to regular evacuations;b) organic disorders, for example the so-called megacolon or Hirschsprung disease, congenital dilatation of the colon with thickening of the wall;
c) psychic stress.
How to cure constipation?
getting used to the baby) to go body regularly;b) through a varied and rich in fibre;
c) if necessary, giving the child to facilitate evacuation lubricants until bowel functions have not been regularised.
Used to go regularly acquired body in childhood is kept well into adulthood?
Yes, unless you have diseases or psychological stress that constipation.Any change that occurs in the regularity of the evacuation and appearance of stools is a symptom of disease?
Yes, very often, and if a repetition of similar phenomena you should undergo a thorough medical examination, including a check of the intestinal tract.Depending on which items you can distinguish if constipation is functional or whether it is instead determined by organic causes?
The two most important factors that indicate how constipation is due to a disease of the colon, and not a functional phenomenon, are:a) blood or mucus in your stool;
b) produced changes in regularity and evacuation of stool in appearance.
Which abnormalities of intestinal functions make it advisable to visit a doctor?
a) alternating constipation and diarrhea;b) chronic constipation;
c) change in appearance or consistency of stool;
d) blood in the stool and their blackish coloration;
and) presence of mucus in the stool.
When you suffer from abdominal pain, you can take a laxative?
Absolutely not; the measure is dangerous, especially if the symptoms are caused by appendicitis or inflammation of the intestinal tract or by an obstacle to intestinal transit.When is it allowed to take laxatives?
In individual instances, when a period of constipation affect bowel function, otherwise normal.Which laxatives are preferable?
Those very mild; It would be advisable, and much less harmful, fight constipation with dietary measures.Is it harmful to take laxatives for a long time?
Yes, because these preparations affect the regularity and normality of bowel function and in some cases can cause irritation of the intestinal mucosa and, as mentioned above, bring themselves to constipation.Is it harmful to take lubricants, for example Vaseline oil, for a long time?
No, if you really need. Vaseline oil is a laxative and not simply serves to lubricate the feces, and then to facilitate the evacuation.In which cases can use an enema to fight constipation?
Once you have ruled out the organic origin of constipation, and when it's a not very serious constipation, using an enema may be an appropriate measure to temporarily resolve the problem. The enema is free of harmful effects, but does not address the cause of constipation. For this, it would be more appropriate to regulate the diet or the hiring of bran, which is not absorbed and stimulates the intestinal function.How to cure constipation?
a) in the case of functional constipation, the most appropriate measure is dietary habits. You need to take high-fiber foods, like fruits and vegetables fresh or cooked, and possibly integrate the power with bran. In addition to this, it is also very important to accustom the bowel discharge gradually regularly and try to lead an active life;b) in the case of organic constipation, you should delete the pathological cause occlusion, and constipation, surgically or medically appropriate.
Constipation can be cured radically and permanently?
Yes, provided that you comply with the requirements and constantly to doctor's advice.The tendency to constipation increases with advancing age?
Yes, because the abdominal muscles, which play a key role in the evacuation, weaken.What steps you can take to fight constipation in people of a certain age?
in you must first verify) that the cause of the constipation there are diseases of the colon, rectum or anus;b) the patient must observe proper diet and getting used to regular evacuations;
c) if necessary, you can use lubricants or enemas.
The presence of blood in the stool is a major symptom?
Yes, and you should always clarify the cause through a series of tests.What can cause blood in the stool?
excessive Pressure) at the time of the evacuation, especially if you suffer from constipation;b) hemorrhoids or other anal disease;
h) acute colitis (see below), which is manifested by bouts of diarrhea;
d) chronic colitis;
and benign tumor) of the intestine, for example an Octopus;
f) rectal cancer or other intestinal portion.
What is the significance of the blackish coloration of faeces?
It is usually due to a hemorrhage that occurred in the upper part of the digestive system, for example the stomach ulcer, but affection can be caused by the ingestion of certain drugs or foods (such as liver, spinach, etc.) containing iron.What does the presence of mucus in stool?
This phenomenon does not necessarily imply the existence of a disease process; It is found in many people, middle-aged women in particular, in good physical condition. In these cases, however, you should consult your doctor.Is it harmful to exert excessive pressure constantly during bowel movements?
Yes. It is possible the formation of hemorrhoids, especially in predisposed patients.•
DIARRHEA
What is diarrhea?
The emission of liquid or tell, more frequently than normal.What are its most common causes?
Diseases of the small intestine or intestine, in particular diarrhoea may be caused:a) in most cases, a gastroenteritis caused by ingestion of foods containing damaged;
b) often so-called disease such as dysentery diarrheal disease, ulcerative colitis, enteritis, diverticulosis etc.;
c) from infectious diseases, such as typhus or cholera;
d) by ingesting laxatives in high doses;
and often by) functional neurotic and emotionally unstable people;
f) for secretory insufficiency, malabsorption of pancreatic enzymes, bile, or enzymatic deficiency of cells of the small intestine;
g) from food allergies and intolerances.
There are people who are particularly prone to bouts of diarrhea?
Yes, for individuals, hypersensitive, diarrhea is a particularly common way to react in unpleasant situations or stressful.What does chronic diarrhea?
It is generally a symptom of an intestinal disease to chronic character.In which cases it is good to consult your doctor for this disorder?
in) when the diarrhea lasts for more than two days;b) if accompanied by other symptoms, such as high fever, pain in the limbs and generally feeling unwell;
c) when faeces there are traces of blood.
How can you distinguish between functional diarrhea and diarrhea caused by intestinal illness?
In the first case, the noise will disappear spontaneously within a few days; in the second case, it can last for weeks, causing general discomfort and, under certain conditions, the presence of blood in the stool. This examination enables you to determine if the diarrhea is caused by germs or intestinal parasites or by demonstration of undigested material, whether it is related to malabsorption, allergy or food intolerance.What exams you must undergo in the event of persistent diarrhea?
Often the only microscopic examination of stools is sufficient to make a correct diagnosis. Later it may be necessary to continue the investigation with a radiographic examination of the small intestine and/or large intestine or with a rettocolonscopia.How to cure diarrhea?
Depends on the cause: If this is due to the ingestion of infected food or battered diarrheal attacks normally spontaneously cease; If the cause is different, you must take specific measures the disease which caused it.Astringent products are useful to treat diarrhea?
No, simply serve to postpone the most appropriate therapy.Diarrhea and dysentery are the same thing?
No. In common usage the term is often used to indicate dysentery diarrhea.In scientific terminology, dysentery is a particular infectious disease, intestinal localization of which diarrhea is only a symptom.
Antibiotics can cause diarrhea?
Yes, and with two different mechanisms:in) because destroy certain bacteria that normally proliferate in the gut and whose presence is necessary for the organism; This allows other bacteria to be insensitive to the action of antibiotics given to grow in abnormal measures, which often causes intestinal irritation;
b) certain antibiotics may promote, through their action on intestinal germs, a form of enterocolitis, pseudomembranous enterocolitis defined, which is characterized by violent and prolonged diarrheal attacks. For this reason too, therefore, antibiotics should be taken only if prescribed by a doctor.
•
GASTROENTERITIS
What is gastroenteritis?
An acute inflammation of the mucous membrane of the stomach and small intestine.What is due?
By a virus, in almost all cases. Other causes may be:in allergy to certain foods);
b) ingestion of battered foods, which developed germs that infect the intestines;
c) intake of certain medicines;
d) ingestion of toxic substances;
and alcohol abuse);
f) location of the stomach and intestine of infectious diseases notes, such as bacterial dysentery, typhoid, cholera, and many others.
How it manifests acute gastroenteritis?
Suddenly, usually first with anorexia and nausea, then with abdominal cramps, vomiting and diarrhoea attacks, causing a feeling of exhaustion; If the inflammation is infectious in origin, also appears fever.The abdomen also appears taut and swollen in the middle or at the bottom of the small intestine.
How long does it last?
Two or three days.From other diseases such as gastroenteritis should be distinguished?
Especially those that involve surgery, like appendicitis or peritonitis, which cause similar symptoms, but that are much more severe.What are the elements that allow differential diagnosis?
Essentially the status of abdominal wall, which in appendicitis and intestinal perforations is particularly tense and contracted.How to cure acute gastroenteritis?
Depends on the cause. If it is a viral form, as often happens, it is useless to administer antibiotics, which are recommended in the bacterial forms.If there is fever, antipyretics are used; If intestinal pains are intense, antispasmodic drugs can be used, which decrease intestinal motility. It is also appropriate to observe a light diet or even, in the most severe cases, fasting; at the same time, you must replenish fluids and electrolytes lost through vomiting and diarrhea.
Gastroenteritis heals easily?
Yes, provided it is not caused by botulism, a form of acute poisoning caused by ingestion of foods (mainly preserved), where there are toxins from a Bacillus, Clostridium botulinum. A special case is the gastroenteritis in infants.•
CROHN'S DISEASE
What is regional enteritis, or segmental, or Crohn's disease?
Is an inflammation in the predominantly chronic course, that affects bowel localized features (hence the segmental name). The disease can affect any part of the alimentary canal, from the esophagus to the anus, but the most common localization is the ileum, near the ileo-cecal valve.What is due?
You do not know the precise cause. one thinks of the combined action of several factors: congenital defects, environmental, psychological (stress), infectious diseases, immune deficiencies. Today is considered an autoimmune disease.This disease is also called in other way?
Yes; If the symptomatology is circumscribed to the ileum, ileitis Terminal also is called.What are its symptoms?
Pain in the lower abdomen; repeated daily evacuations, with runny stools, loss of appetite, mild fever. These symptoms often disappear after a few days, only to reappear after a few weeks intervals. The disease can lead to bowel obstruction.Regional enteritis is frequently?
No, has an incidence of 1-4 cases per 100,000 people. Is found mostly in people between 20 and 30 years, though all ages can be affected.How is it diagnosed?
Essentially with radiological examination.That has expired?
The course is very different depending on the severity of the shape. In the mild form, can occur one attack that ends after a few days and does not recur; in the most severe form, you have repeated attacks of fever, abdominal pain and runny stools evacuations.Crohn's disease may have complications?
Yes; These consist of:a) Fistula formation, i.e. a pathological communications intestinal loop sick with an adjacent loop, or a portion of the large intestine or bladder, or even with the skin of the abdomen;
b) intestinal abscesses;
c) intestinal obstruction.
How to cure regional enteritis?
read forms), with bed rest, bland diet which excludes spices and alcohol, use of steroids (cortisone), exclusion of emotional tensions;b) if the disease is advanced, can be done surgically with: 1. removal of the inflamed intestinal portion and subsequent anastomosis of healthy portion with the transverse colon (ileo-transverse colostomy); 2. simple healthy intestinal tract anastomosis with the colon, to exclude the inflamed stretch.
Currently, the tendency is to delay as much as possible the surgery and to reserve it to cases that do not respond to medical therapy or who have had complications. In fact, the surgery does not prevent relapses and may itself cause complications, especially the formation of fistulas.
You can prevent regional enteritis?
No, the cause is unknown.There are people who are most prone to this disorder?
It is assumed that they are more easily affected individuals feeling under stress and prone to violent nervous tension, but it is also found in people perfectly balanced.Once gone, regional enteritis is susceptible to relapses?
Yes.You can lead a normal life after surgery?
Yes, the small intestine is about six meters long; less than half is enough to ensure normal bowel function.Regional enteritis is hereditary or applicant under familiar?
No.Once overcome this disease, you must follow a special diet?
Yes, for some months, if not years, to follow a bland diet, free of irritants.•
MECKEL DIVERTICULUM
What is a Meckel's diverticulum?
An appendix of finger-shaped glove which occurs sometimes in the wall of the small intestine, more precisely of the ileum and is an embryonic remnant, i.e. a portion of the intestine that is formed during embryogenesis and that is not reabsorbed during subsequent maturation processes that lead to the final Constitution.Is a common malformation?
No, rather rare.Considerable importance?
Yes, because it can lead to morbid processes, especially in inflammations, quite similar to those of the Appendix.How is the inflammation of Meckel's diverticulum?
Based on the symptoms that arise in those suffering from this malformation (usually in children) and that consist of abdominal pain, pressure sensitivity in the central part of the abdomen, slight fever, and diarrhea.How do we cure it?
As soon as the inflammation was diagnosed with certainty, it is necessary to intervene surgically as soon as possible, to prevent bleeding occurs or inflamed diverticulum perforation. The operation is similar to that of appendicitis and consists of excision of the diverticulum.Is surgery?
Not necessarily; usually well is exceeded without consequences.How long does postoperative convalescence?
The postoperative course is more or less similar to the appendectomy.•
INTUSSUSCEPTION
What is intussusception?
The penetration of a portion of the intestine in the adjacent (usually the lower portion at the top).Those affected more frequently?
May be affected very young children, often between 4 months and year of life; a second tip is observed frequency later in adulthood.What is due?
In the case of children it gives importance to changing food habits tari own occurs between 4 and 12 months; in this period the child passes by a diet mainly consists of liquid foods a gradual introduction of solid foods; These, in contact with the intestinal wall, induce a physiological exaltation of normal peristalsis which can, however, lead to intestinal invagination. In adults, however, is almost always secondary invagination, mainly tumors protruding into the intestinal lumen. Their presence causes the wall to act as if they were present in foods, namely to contract, producing Peristaltic waves. These normally serve to advance the food along the intestine. In the case of a tumor, which is anchored to the wall by a stalk, peristalsis drags itself causing intestinal wall invagination.Where it produces more frequently the intussusception?
At the point where the small intestine connects with Crassus, in accordance the Presidency ileocecal valve.But it can also occur in other locations in relation to the presence of a tumor that protrudes into the intestinal lumen.
What dangers does it entail?
The invaginated segment progression also involves stretching of vessels that provide blood supply. If the stretch is extreme, it stops blood flow resulting in necrosis (i.e. death) of tissues, which must then be surgically excised. In addition, the material contained in the food section of the intestine cannot progress invaginamento and accumulates causing distension of the loops. If you do not act promptly, you may get to break loops peritonitis stretches or hypovolemic shock (determined from blood mass reduction), secondary to the fact that liquids are retained in dilated intestinal portion.How is diagnosed with intussusception?
Based on his symptoms, i.e., abdominal pain, vomiting, bloating, tactile, the bottom right abdomen, as well as the report of characteristic radiological examination.Finally, the often results in diarrhea invagination, with traces of blood in the stool.
How do we cure it?
a) in most cases, by surgery in the abdomen (can laparotomy play), which will return to its original position the intestinal portion invaginata;b) in certain cases, the fault can be corrected surgically, but not by introducing rectally by a barium mixture under pressure. While controlling the intestinal tract x-ray, barium is introduced into the colon up to fill it, you leave then compress the portion of small intestine invaginata until it returns to its original position.
This second technique lets you heal invagination in all cases?
Currently, only a small percentage, while the vast majority of patients surgery is required.The intestinal portion can invaginarsi again?
If the intussusception has been removed surgically, is extremely unlikely.What possibilities of healing has this anomaly?
Great, provided it is diagnosed within the first two days.•
VOLVULUS
What is volvulus?
A twisting, rotating, or an intestinal loop on its axis, in consequence of which the circulation of the bend is blocked, causing tissue necrosis.Where most commonly form a volvulus?
In the colon, more precisely in the terminal portion (sigma).What caused?
Often a colon or scar tissue formed after an inflammation or surgery; in some cases it is recognised the excessive length of the intestine.Who is more susceptible to the formation of a volvulus?
People of a certain age or have undergone a dramatic weight loss due to illness.What are your symptoms?
Acute abdominal pain, nausea and vomiting, bowel obstruction, fever and pressure sensitivity of abdominal region. Radiological examination provides a characteristic, which allows security diagnosis and immediate treatment.How do we cure it?
By timely surgery, intestinal loop position and eliminate the cause of volvulus, i.e. the tumor or adherence.Once corrected surgically, volvulus can reform itself?
If it was deleted, no.Surgery leads to healing?
Yes, in most cases in which the diagnosis was made with sufficient rapidity.If the volvulus is instead discovered at one stage too advanced, gangrenous changes and alterations may occur: peritonitis in similar cases, the chances of recovery are reduced very considerably.
•
DIVERTICULOSIS AND DIVERTICULITIS
What is diverticulosis?
Is the presence of multiple diverticula, i.e. by SAC-like protrusions of the mucosa and submucosa through the muscular tunic of the intestinal wall. In 90% of cases is concerned with the sigma, which is a terminal portion of the large intestine.From what originated?
From an initiating factor, which is the particular anatomy. in the large intestine, in fact, the vessels penetrate in wall thickness and create less resistance zone. On this engages the determining factor, which is made up of an increase in pressure within the intestinal lumen. Increased pressure within the intestine determines to go along a bulging muscular tunic through which mucous is everted and hernia. One of the factors that increase intestinal pressure constipation; habitual constipation sufferers is particularly prone to the development of diverticula.What is the difference between diverticulitis and diverticulosis?
Diverticulitis is nothing but the inflammation of one or more of these diverticula.Diverticulosis is a very common disease?
It is in older people; the 75% of cases of diverticulosis occurs in people over 50 years.The shape is very frequent around 70 years. Most people with diverticulosis, however, is not affected by any disturbance.
As can be discovered a asymptomatic diverticulosis?
Usually after a normal radiological examination, gastrointestinal tract, which provides a framework.Exists, and to what extent, a danger that people with diverticulosis, diverticulitis may be affected?
Diverticulosis is mostly asymptomatic and only 10 percent of those who are suffering an inflammation arises.You can prevent the onset of diverticulitis when you suffer from diverticulosis?
To a certain extent, Yes, observing a slag rich diet, avoiding highly spiced foods and accustomed to regular evacuations.How to cure diverticulitis?
In mild forms, using a simple medical therapy, which includes:bed rest);
b) diet free of irritants;
c) administration of antibiotics to combat inflammation.
This medical therapy gets positive results?
In most cases, Yes. Only 10% of those affected by an attack of diverticulitis is necessary surgery.When diverticulitis need surgery?
in) When the attacks are applicants;b) if there is danger or has already produced inflamed diverticulum perforation, resulting peritonitis;
c) when inflammatory processes took an extension that result in the formation of abscesses or fistulae premises that propagate from the intestine neighboring organs, for example, the gallbladder;
d) when diverticula are caused by repeated violent hemorrhages.
In these cases, such as surgeries are practiced?
to) If you are trained, these abscesses must be drained. In such cases, it is sometimes necessary to practice a colostomy (the colon is made lead outside, through the abdominal wall, and the opening thus created serves as the anus) to divert the intestinal contents from the sick;b) the ideal treatment of a sharply circumscribed diverticulitis is the intestinal portion of escissio sick, followed by the joining of the two remaining suture through healthy parts.