Abdominal distension

　　The disease, commonly known as 'twisted fetus', is characterized by occasional vomiting, coughing, or lying on one side and stretching, yet still retaining a little urine. Pregnant women, postpartum women, and those who have fallen from a height may suffer from this condition. The etiology of this disease is diverse, with the most common cause being ascites due to liver cirrhosis, followed by cardiac and renal dysfunction, which can also lead to ascites. Additionally, kidney disease with a large amount of protein excreted in the urine can also cause ascites.

　　1. Gastroenterology Department:Patients with abdominal distension accompanied by belching, acid regurgitation, exacerbation after eating, or diarrhea should go to the gastroenterology department.

　　2. General Surgery Department:Patients with sudden abdominal distension and abdominal pain, accompanied by vomiting or no排气, no defecation, should go to the general surgery department. Chronic abdominal distension accompanied by upper right abdominal pain and exacerbation after eating greasy food should also go to the general surgery department.

　　3. Gynecology Department:Patients with frequent abdominal distension accompanied by backache and excessive leukorrhea should go to the gynecology department.

　　4. Hepatitis Department:Patients with abdominal distension accompanied by dislike of oil and jaundice should go to the hepatitis department.

　　5. Tuberculosis Department:Patients with frequent abdominal distension accompanied by low fever should go to the tuberculosis department.

　　6. Cardiology Department:Patients with a history of heart disease and frequent abdominal distension should go to the cardiology department.

　　7. Neurology Department:Patients with lower limb paralysis often have abdominal distension and should go to the neurology department for treatment.

　　The main symptoms include abdominal distension, thin and tight skin, difficulty in urination, pain in the flanks. Most patients have a yellowish complexion, or accompanied by jaundice, and sometimes red spots (spider veins) can be seen on the body. This is due to liver depression and spleen injury, liver failure to vent, spleen failure to transform, and water toxicity accumulation. At the same time, this disease is mainly caused by liver disease, so the clinical symptoms are mainly those of liver disease, and fatigue and weakness are one of the early symptoms, which is related to the degree of liver disease activity. The cause of easy fatigue and weakness is related to poor appetite, insufficient intake of calories, and intermediate metabolism disorders such as sugars, proteins, and fats, resulting in insufficient energy production. In addition, when the liver is damaged or bile excretion is not smooth, the reduction in blood cholinesterase affects the normal physiological function of the neuromuscular system and the reduction in the conversion of lactic acid to glycogen in the liver, resulting in excessive accumulation of lactic acid after muscle activity; weight loss is also a common symptom, mainly due to decreased appetite, gastrointestinal digestion and absorption disorders, and reduced synthesis of albumin in the body; the cause of low fever may be liver cell necrosis, inflammatory activity, or endotoxins produced by intestinal bacteria entering the systemic circulation through collateral circulation without being inactivated by the liver. In addition, the liver cannot inactivate heat-producing hormones such as reduced urinary testosterone, etc., which can also be found.

　　1. Regular physical examination: in order to achieve early detection, early diagnosis, and early treatment.

　　2. Good follow-up: prevent the deterioration of the disease.

　　3. Infection is the main cause of abdominal distension, so it is necessary to strengthen prenatal care and prevent various infectious diseases during pregnancy, especially infections such as hepatitis B virus, cytomegalovirus, rubella virus, herpes simplex virus, and congenital syphilis, in order to avoid liver damage in infants and the occurrence of this disease.

　　4. Strengthen physical fitness and improve immunity: Pay attention to the combination of work and rest, participate in physical exercise more often, and eat more fresh fruits and vegetables rich in vitamins.

　　5. At the same time, reasonable feeding, balanced diet, good postpartum vaccination, good hygiene habits, and prevention of various chronic inflammatory bowel diseases should be done.

　　1, Blood routine

　　A decrease in the serum bilirubin, ALT, and prothrombin time can be normal in the compensatory phase of liver cirrhosis. A slight decrease in the level of serum albumin is an early sign of liver dysfunction.

　　Elevated serum alkaline phosphatase, cholesterol, and phospholipids; moderate or mild elevation of ALT; while decreased albumin, increased globulin, and an inverted albumin/globulin ratio are laboratory abnormalities indicating active lesions in liver cirrhosis.

　　2, Ultrasound examination

　　Doppler ultrasound examination shows the formation of collateral vessels around the portal vein, which is a sign of extrahepatic portal vein obstruction. Normally, respiration has a regulatory effect on portal vein blood flow. If this sign disappears, it suggests portal hypertension. However, the presence of this sign cannot absolutely exclude portal hypertension.

　　3, Esophageal X-ray barium contrast

　　In adults, the sensitivity of barium esophagography for detecting esophageal varices is about 70%. In recent years, due to the wide application of endoscopy, this technique has been rarely used for the examination of esophageal varices, and its value in detecting active upper gastrointestinal bleeding is extremely limited.

　　4, Gastroscopy

　　Gastroscopy can directly observe the presence and degree of esophageal varices.

　　For children with upper gastrointestinal bleeding, once the condition is stable, a gastroscopy should be performed immediately to determine the bleeding site, the nature of the lesion, and to perform endoscopic hemostasis treatment as soon as possible.

　　Gastroscopy can also be performed in children without symptoms or in stable periods to predict the risk of variceal bleeding and select the timing for prophylactic sclerotherapy.

　　5, Selective mesenteric artery angiography

　　After inserting a catheter through the femoral artery, selective mesenteric artery angiography is performed. Under normal circumstances, the portal vein can be visualized within 10 to 20 seconds. In patients with cavernous angioma-like variation, there are many small collateral vessels around the occluded portal vein.

　　1, 30 grams of watermelon rind (dried), 30 grams of red bean, 30 grams of winter melon rind, and 30 grams of corn silk are decocted in water, taken twice a day.

　　2, The treatment of liver cirrhosis and ascites with garlic watermelon juice requires one watermelon, a small hole is dug, 60 to 100 grams of peeled garlic is placed inside, and then the small hole is covered and steamed to extract the juice for drinking. It has the effects of diuresis, swelling, and detoxification. It can treat edema, acute and chronic nephritis, and liver cirrhosis and ascites.

　　3, Eat fresh plums after washing them. For the treatment of liver cirrhosis and ascites, take 4 to 6 plums, twice a day.

　　4, Shred 1000 grams of winter melon and cook until soft. Filter the juice through gauze to remove the residue, and for the treatment of liver cirrhosis and ascites, take 60 milliliters each time, three times a day, which can alleviate symptoms.

　　5, Young leaves of sweet potato, young leaves of water spinach, and an appropriate amount of brown sugar are mashed and applied to the navel. After one or two hours, abdominal fluid can be defecated, and the abdominal fluid can be cured when it is completely defecated. It is used to treat abdominal swelling and ascites due to liver cirrhosis.

　　6, Fresh crucian carp, about 500 grams, cleaned, and 500 grams of red bean are placed in a pot. For the treatment of liver cirrhosis and ascites, 2 to 3 kilograms of water should be added and cooked until the fish is cooked and the beans are soft. Remove the fish head, scales, and bones, and eat the fish, beans, and soup in turns (no salt).

　　7. Huangqi 80 grams, Yiyiren 100 grams, fresh duck meat 500 grams. Preparation: Clean and chop the duck meat, then cook it with Huangqi and Yiyiren together with water until the meat is tender. No salt or other seasonings should be added. Administration: Take twice a day, about 250 milliliters each time, for 10 consecutive days. Effect: The Yiqi Yiren Duck Soup can nourish the Yin of the five internal organs, clear the heat of emaciation, and invigorate the blood and promote urination.

　　8. Dahuang 10 grams, Xingmi 80 grams. Preparation: First, clean the Dahuang, decoct the water, remove the dregs, and then add Xingmi to cook porridge.

　　Liver cirrhosis is caused by the disorder of tissue structure, leading to liver dysfunction. At present, there is no radical cure. The main approach is to detect early and prevent the progression of the disease, extend life, and maintain work capacity.

　　First, compensatory stage:After the diagnosis of liver cirrhosis is confirmed, attention should be paid to the combination of work and rest, reasonable treatment and diet, and high-calorie, high-protein, and easily digestible foods rich in vitamins should be preferred. Alcohol should be strictly prohibited. Avoid using drugs that cause liver damage. Generally, light work can be performed. Regular follow-up is recommended.

　　Second, decompensated stage:In general, patients with severe conditions need rest or hospital treatment.

　　1. Diet:Diet should be easy to digest and nutritious, with moderate high protein intake at 1.0-1.5g/(kg·d), appropriate high sugar and low-fat content, with fat approximately equal to one-third of calories. The total calorie intake should be about 8000-10000J per day. In the presence of hepatic encephalopathy, protein intake should be restricted to 0.5-1.0g/(kg·d) per day. To prevent esophageal varices from bursting and bleeding, avoid using irritant and hard foods. When there is ascites and edema, limit the intake of sodium and water. Maintain fluid volume based on 24-hour urine output and insensible loss, or aim for less than 1500ml per day.

　　2. Vitamin supplementation:Manifestations of vitamin deficiency occur during liver cirrhosis, so it is appropriate to supplement vitamins B1, B2, C, B6, niacin, folic acid, B12, A, D, and K.

　　3. When there is active chronic hepatitis, hepatitis should be controlled, and antiviral and immunomodulatory therapy such as interferon and arabinosylcytidine should be administered when necessary. Strong prednisone and other treatments may be used when necessary.

　　4. Antifibrotic liver drugs:Antifibrotic drugs can prevent liver fibrosis in animal experiments, but their clinical use is still rare. There are often side effects that affect their application.