Bowel disease: conditions requiring emergency care

bowel disease - a very common group of diseases.The reader of this article probably at least once in his life faced with them in person or on the experience of relatives and friends.Part of this group of diseases is acute (eg, infectious diseases - dysentery, salmonellosis), part is characterized by a chronic course (ulcerative colitis, Crohn's disease, chronic enterocolitis).There is a separate group of states - more complications previously described two groups of diseases, time to recognize that it is essential: the failure to provide timely medical care of their outcome can be very sad.In this article, we will introduce the reader to these conditions, describe the clinical signs, diagnostic methods and principles of care for each of them.So ...


  • 1 Rectal (intestinal) bleeding
  • 2 Perforation (perforation) of duodenal ulcer
  • 3 Acute appendicitis
  • 4 Acute intestinal obstruction
  • 5 Infringement haemorrhoid

There are many diseases in which can cause bleeding from the anus

.The most common ones are:

Clinically, this condition is manifested by the presence of impurities of blood in the stool.The volume of blood loss in the intestinal bleeding can be different - from one or two drops at the end of the act of defecation, streaks of blood in the stool to profuse (a massive, continuous stream) bleeding.The most common bleeding is minor, and stops itself clinically solely by the presence of blood in the stool, and the well-being of the patient is not reflected.Less often, it is moderate and heavy - in this case, it is accompanied by characteristic signs of blood loss, the main ones are:

In some cases due to massive blood loss develops hemorrhagic shock - a condition in which the amount of circulating in the body the blood is reduced so much that it becomesinsufficient to maintain the function of vital organs - the heart, kidney and brain.

color of blood in the stool can be different:

When moderate to severe rectal bleeding to diagnose the source of bleeding and provide skilled patient care shows an urgent hospitalization.

establish an accurate diagnosis of experts will help the complaints of patient data history (diagnosed before the disease of the gastrointestinal tract), examination of the patient with emphasis on inspection of the anus, as well as additional methods of research:

in the treatment of intestinal bleeding distinguish several stages:

rectal bleeding mild observed with haemorrhoids or anal fissures are treated mainly through the use of outpatient locally acting drugs (suppositories, gels) or procedures (warm baths).If their inefficiency surgeon will recommend surgery.

One of the serious complications of gastric ulcer and duodenal ulcer perforation is a, t. E. The formation of a defect that penetrates through all layers of the wall of the body, causing the contents of the body enters the abdominal cavity.This condition occurs in 2-3% of patients with chronic peptic ulcer disease, more common in men aged 20-30 years.

perforation of the contributing factors for which there is an increase in abdominal pressure:

Clinically ulcer perforation is always very pronounced: there is a sharp, acute, "knife-like" pain in the stomach, depriving patients of rest;the patient takes a forced position - lying on his back or right side, legs bent at the knees and pressed to dramatically tense abdomen;pain gets worse at the slightest movement.Before the pain attacks may be vomiting.The body temperature of the patient is not increased, the pulse is not speeded up.

Patients should be aware of the fact that approximately 5-6 hours after the onset of pain attack pain is significantly reduced - a state of so-called imaginary well-being that characterizes the beginning of another terrible complications - inflammation of the peritoneum, or peritonitis.So hope for a miracle, and wait for the "self-will" is impossible - it is dangerous for life!At the first sign of perforation of ulcer should immediately call an ambulance.

perforation is diagnosed through fibrogastroduodenoscopy (FEGDS) and diagnostic laparoscopy.

This state - absolute indication for urgent surgical treatment, the amount of which may vary from the closure of the ulcer to resection (removal) of part or all of the stomach, depending on the condition of the particular patient.

acute appendicitis is called inflammation of the appendix - the appendix.This disease is the most common cause of surgery - 30% of them.Every 40 people per 10 000 population suffered acute appendicitis.
etiology of the disease is not fully understood, it is believed that the inflammatory process is caused by nonspecific microflora.By the nature of the inflammatory changes are 4 its forms:

clinically typical cases of acute appendicitis appear the following symptoms:

Diagnosis of the disease is carried out by the surgeon, who suspected appendicitis on the basis of complaints and anamnesis data, update it by examining the objective status of the patient:

From laboratoryresearch methods is informative only common blood test that shows the presence of inflammation in the body (there will be increased white blood cell count - leukocytosis).Instrumental methods of diagnosis is usually not carried out.
If the appendix has an atypical layout (located under the liver in the pelvis, the left half of the abdominal cavity) and his clinical picture is atypical, causing difficulty of diagnosis.It is difficult to diagnose acute appendicitis in children or the elderly.

treatment of this disease extremely surgery - removal of the appendix, followed by antibiotic therapy.

bowel obstruction - this is a condition in which partially or completely disrupted passage of intestinal contents toward the anus.This state is not an independent disease, it is considered to be a complication of a wide variety of chronic diseases:

moment, predisposing to the development of bowel obstruction are congenital or acquired anatomical features of the structure of the intestine (dolichosigma, extra folds of peritoneum, mobile cecum).

leading symptoms of the disease are:

When the above symptoms the patient must immediately seek help from a surgeon who suspected bowel obstruction on the basis of complaints, medical history and life, and then conduct a study of the objective status of the patient.Cheerleaders doctors can:

sure to conduct digital examination of the rectum - frequently this method can detect tumors of the rectum, fecal impaction, traces of blood.

help clarify the diagnosis following research methods:

All patients with suspected acute intestinal obstruction mandatory urgently need to be hospitalized.

obstruction can be of several types, and its treatment may be different - conservative or operative.

Conservative treatment includes:

Surgical treatment depending on the patient's condition can be of different sizes - from local to eliminate obstacles to the resection of the bowel.

This is a fairly common problem that occurs in 3-4 stages of hemorrhoids.The condition can be caused by errors in diet, physical overexertion, lifting heavy weights.This disease may indicate:

diagnosis of this disease difficulties at the doctor does not call.
Treatment should be under the control of the surgeon.

main therapeutic measures are:

can not reduce a disadvantaged nodes yourself!

After calming down signs of acute inflammation is necessary to think of further surgical treatment of hemorrhoids.

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