Intestinal Diseases

　　The cause is unknown. The mucosal layer of the small intestine is covered with intestinal villi, which are mainly responsible for the digestion and absorption of food. Various digestive juices in the small intestine decompose the chyme into glucose, amino acids, and make the food digestible and absorbable. The remaining waste forms stool, stored in the left half of the colon, and then excreted out of the body. Once the intestine is sick, it can cause digestive and absorptive disorders, as well as a series of related symptoms.

　　It is often accompanied by symptoms of autonomic nervous imbalance, such as palpitations, shortness of breath, chest tightness, facial redness, insomnia, anxiety, attention deficit, forgetfulness, over-sensitivity of the nervous system, excessive sweating of hands and feet, polyuria, and headache, and so on.

　　Crohn's disease usually starts slowly, with a long history, and the type of manifestation is related to the main lesion site. The main symptoms are diarrhea, abdominal pain, low fever, weight loss, and so on. Occult blood in stool can be positive, and generally there is no blood in stool. Abdominal pain is usually located in the lower right abdomen or around the umbilicus, and is usually spastic pain. It is not severe and often accompanied by slight tenderness. When there is chronic ulcer penetration, intestinal fistula, and adhesion formation, abdominal masses may appear. Some patients may have symptoms of intestinal obstruction, but they are mostly incomplete. Ulcerative colitis may have an acute onset, but most of them start slowly. The course can be persistent or intermittent with remission periods. The main symptoms are diarrhea; during the acute stage or attack, it is manifested as diarrhea, purulent stools, and even massive bleeding. Abdominal pain is not very severe and is usually located in the lower left abdomen. Severe illness or long course may be accompanied by fever, weight loss, anemia, and so on. Acute severe patients may develop acute toxic megacolon or colonic perforation.

　　Gastrointestinal diseases are common and frequent diseases, closely related to people's living environment, including climate, living habits, and lifestyle, and many other factors. Therefore, prevention is the key. How to prevent gastrointestinal diseases, you will know after reading the following content.

　　1. Winter is a high-incidence season for gastrointestinal diseases. Because the gastrointestinal tract is very sensitive to cold stimulation, if protection is not paid attention to, and attention is not paid to diet and life routine, gastrointestinal diseases or recurrence may occur. In addition, with the weather getting colder, appetite increases, and with a large amount of fruits and vegetables on the market, some people overeat, causing the burden on the gastrointestinal tract to increase. Moreover, with a large temperature difference between day and night, it is easy to cause abdominal cold, trigger colonic allergy, and increase intestinal peristalsis, leading to diarrhea.

　　2. Pay close attention to diet. Friends with stomach problems know that when the stomach is sensitive, eating alcohol, smoking, and spicy and heavy foods such as hotpot, barbecue, spicy hotpot, or large amounts of fish and meat can be very uncomfortable. Indeed, because of this, we should adopt a soft policy in protecting the gastrointestinal tract. Porridge, noodles, hot milk, and so on are all good choices. Of course, in addition to this, it is also necessary to choose cooking methods such as steaming, boiling, braising, and stewing as much as possible during the process of food preparation to reduce the stimulation to the gastric mucosa.

　　3. It is also appropriate to supplement some beneficial bacterial factors - inulin to regulate the gastrointestinal tract and promote the balance of the gastrointestinal microecological system.

　　In addition to clinical manifestations, consider x-ray barium meal examination for Crohn's disease, as it may show narrowing of the ileum terminal intestinal lumen, rigidity of the intestinal wall, disappearance of mucosal folds, and linear sign, etc. Ulcerative colitis is most valuable with x-ray barium enema and colonoscopy, but it should be cautious to prevent complications such as colonic perforation during examination in the severe acute attack period. Crohn's disease is sometimes very difficult to differentiate from intestinal tuberculosis; if the lesion is limited to the colon, it needs to be differentiated from ulcerative colitis. Ulcerative colitis should mainly be differentiated from chronic bacterial or amebic dysentery, Crohn's disease, colon cancer, and other diseases. A few Crohn's disease patients have an acute onset or are easily misdiagnosed as acute appendicitis. However, acute appendicitis generally has a history of low fever and diarrhea, localized and fixed tenderness in the lower right abdomen, and a significant increase in white blood cell count.

　　Food that should not be eaten includes greasy foods (fried foods, hamburgers, French fries), and it is advisable to minimize foods that produce gas, such as legumes, sweet potatoes, taros, and foods that change intestinal motility, such as chocolate, desserts (cakes, biscuits), vegetables with a high fiber content (bamboo shoots, celery), and fruits with a lot of skin, seeds, and fibers (bananas, longans, lemons, pineapples). Daily food should be light in taste, and fresh fruit juice, oatmeal, and porridge can be chosen to aid digestion, with small and frequent meals.

　　1. Indications for Crohn's disease surgery include intestinal obstruction, formation of abdominal abscesses, enteric fistulas, or abdominal wall enteric fistulas after chronic intestinal perforation, persistent bleeding, and cases where it is difficult to exclude peritonitis or tuberculosis on diagnosis. Taking the terminal ileum of Crohn's disease as an example, surgery should involve the excision of the lesion site including 3cm of normal intestinal tissue on both sides of the visible lesion, and an end-to-end intestinal anastomosis should be performed. If it is not possible to excise due to severe adhesions or local abscess formation, the normal intestinal tissue can be cut 3cm from the lesion side, the distal end can be inverted and sutured, and the proximal end can be anastomosed with the transverse colon in an end-to-side manner. If there is an abscess, it should be incised and drained, and a decision should be made based on the situation whether to perform a second-stage surgical excision of the lesion—however, it is not advisable to perform a simple短路 surgery of intestinal side-to-side anastomosis near and far from the lesion. If an internal fistula forms with surrounding organs, after excising the Crohn's disease lesion loop, only fistula repair and suture of the surrounding organs are needed, unless there is a simultaneous Crohn's disease lesion. If misdiagnosed as appendicitis and found to be this disease during surgery, if there are no complications such as obstruction or perforation, there is no need for intestinal resection. If the cecum and terminal ileum lesions are obvious, it is easy to develop anastomotic fistula after excising the appendix. The recurrence rate of this disease after surgical treatment can reach over 50%. The recurrence site is often near the intestinal anastomosis.

　　2. Indications for surgery of ulcerative colitis include acute intestinal perforation, uncontrollable massive intestinal bleeding; toxic megacolon; severe patients whose condition continues to deteriorate rapidly under active medical treatment; symptoms recurring repeatedly, difficult to cure, and difficult to maintain a near-normal life; canceration or suspected canceration. The surgery should be determined according to the patient's overall condition and the extent of local lesions, but it is necessary to completely remove the diseased intestinal segments, otherwise the progression of the lesions cannot be controlled; for patients with extensive lesions involving the entire colon and rectum, it is necessary to perform a total colectomy and rectal resection, ileostomy at the end of the ileum, ileal reservoir ileostomy, or end ileal anal canal anastomosis, etc. When the condition is severe and the patient's overall condition is poor, and it is not allowed to undergo radical treatment at one time, staged surgery can be adopted, such as performing a subtotal colectomy, double ileostomy and sigmoidostomy, or simple ileostomy. For patients with acute toxic megacolon, in addition to ileostomy, it is also necessary to perform a transverse colon or sigmoid colon lateral wall ostomy decompression procedure at the same time. After the symptoms subside and the condition stabilizes, a second-stage surgery is performed to remove the remaining diseased intestinal segments. When the lesions only involve the left half of the colon, sigmoid colon, and rectum, a resection of the rectum and left half of the colon, and a transverse colon ostomy can be performed.