Gastrointestinal fluid retention

　　How is gastrointestinal fluid retention caused? Briefly described as follows:

　　First, etiology

　　The peritoneal effusion is caused by abdominal surgery, or due to diseases such as gastric reflux, where the spleen and stomach are damaged, transportation and transformation are disturbed, leading to the accumulation of water and fluid in the gastrointestinal tract.

　　Second, pathogenesis

　　1. Increased portal vein pressure. Normally, the sinus pressure of the liver is very low (0-2 mmHg), and when portal hypertension occurs, the sinus hydrostatic pressure increases (portal pressure of 10 mmHg is the basic condition for the formation of ascites), a large amount of fluid flows into the Disse space, causing an excessive amount of liver lymph fluid to be produced. Liver cirrhosis patients are often 20 times higher than normal people, and when the thoracic duct cannot drain excessive lymph fluid, it leaks directly into the peritoneal cavity from the liver capsule to form ascites. The increase in sinus pressure can also activate intraliver pressure receptors, through the hepatic-renal reflex, reducing the excretion of sodium by the kidney and exacerbating water and sodium retention.

　　2. Vascular dilatation of visceral arteries. In the early stage of liver cirrhosis, visceral vessels dilate, maintaining effective blood volume within the normal range by increasing cardiac output and heart rate. In the advanced stage of liver cirrhosis, visceral artery dilatation is more pronounced, leading to a significant decrease in effective arterial blood volume, decreased arterial pressure, and subsequently activating the sympathetic nervous system, renin-angiotensin-aldosterone system, and increasing the release of antidiuretic hormone (ADH) to maintain arterial pressure, causing renal vessel constriction and sodium and water retention. The interaction between portal hypertension and visceral vessel dilatation changes the capillary pressure and permeability of the intestines, favoring the accumulation of fluid in the abdominal cavity.

　　3. Decreased plasma colloid osmotic pressure. Liver cirrhosis patients have reduced intake and liver reserve function, decreased ability to synthesize albumin, leading to decreased plasma albumin, and subsequently, decreased plasma colloid osmotic pressure, with a large amount of fluid entering the tissue spaces and forming abdominal effusion.

　　4. Other factors. Relative deficiency of atrial natriuretic peptide in plasma and reduced sensitivity of the body to it, reduced inactivation of estrogen, increased secretion of antidiuretic hormone, lead to dysfunction of diuresis and reduced secretion of prostaglandins, causing renal vessel constriction, decreased renal perfusion, and redistribution of renal blood flow, which are all related to the formation and persistence of abdominal effusion.

　　Patients with peritoneal effusion can produce proteinuria and experience a decrease in urine output. Abdominal effusion patients may also show weakened or absent abdominal respiration, accompanied by other symptoms of abdominal effusion, such as patients with congestive heart failure may have symptoms such as palpitations, shortness of breath, cough, hemoptysis, and systemic edema; tuberculosis peritonitis patients may have symptoms such as fever, fatigue, decreased appetite, discomfort or pain in the entire abdomen, and these symptoms are more common in children and young adults; liver cirrhosis with peritoneal effusion has an insidious onset, a slow course, early liver enlargement, or symptoms such as loss of appetite, nausea and vomiting, discomfort or pain in the liver area, and in the late stage, abdominal wall varices, splenomegaly, and hyperfunction of the spleen may occur, and some patients may also experience pale complexion, emaciation, anemia, spider nevus (a bright red nevus composed of dilated small arteries and their fine branches, resembling a spider, commonly found on the face, neck, upper chest, shoulders, and upper limbs), red palms, and male breast enlargement. The disease may also be complicated by upper gastrointestinal bleeding, infection, and hepatic coma, and it is more common in middle-aged people, with large amounts of ascites and moderate splenic enlargement, and when touching the liver, it is found that the texture has become hard.

　　What are the symptoms of gastrointestinal fluid retention? Briefly described as follows:

　　1, The onset of the disease is slow, with the main symptoms of epigastric and abdominal distension, running water sound in the abdomen, vomiting of water, or with symptoms such as abdominal pain, thirst, poor appetite, palpitations, shortness of breath, dry or loose stools, dizziness and dizziness, fatigue, and gradual thinning of the body.

　　2, Physical examination or visible abdominal distension, tenderness, hydrosonic sound in the upper middle abdomen, hyperactive bowel sounds, and sound of air passing through water can be heard.

　　3, X-ray abdominal film shows liquid plane and gas accumulation in the abdomen.

　　How to prevent gastrointestinal fluid retention? Briefly described as follows: There is currently no effective preventive measure for gastrointestinal fluid retention. Due to the impact of the disease on the patient's daily life and harm to physical health, early detection and early diagnosis are the key to the prevention and treatment of the disease.

　　According to the clinical typical manifestations of gastrointestinal fluid retention, combined with the patient's medical history, and according to the results of auxiliary examinations such as X-ray abdominal films, there is a liquid plane and gas accumulation in the abdomen, and the diagnosis can be made and the treatment plan can be formulated.

　　What should be paid attention to in the diet care of gastrointestinal fluid retention patients? Briefly described as follows:

　　1, Preferable to eat

　　The diet of gastrointestinal fluid retention patients should be light in taste, eat more vegetables and fruits, reasonably match the diet, and pay attention to sufficient nutrition. Nutrition must be comprehensive, and the diet should be high in protein, high in vitamins, low in fat, and low in salt. Eating should be regular and quantitative, and nutrition should be reasonable.

　　2, Avoid eating

　　Avoid smoking and drinking, avoid spicy and greasy foods, avoid cold and raw foods. Try not to eat spicy and stimulating foods, rich in sugar and fat, barbecued, preserved and other foods.

　　How does traditional Chinese medicine differentiate the treatment of gastrointestinal fluid retention? Briefly described as follows:

　　1, Syndrome of retained phlegm and drink in the middle.Distension and fullness in the epigastrium and abdomen, self-induced diarrhea, feeling better after defecation, although diarrhea, the heart continues to be firm and full, there is a sound of running water in the intestines, or dryness of the mouth and tongue, constipation, white greasy or yellow coating, deep and wiry pulse or hidden pulse. The treatment principle is to attack and expel fluid and drink.

　　2, Deficiency of spleen yang.Fullness in the chest and hypochondrium, distension in the epigastrium and abdomen, and a preference for warmth and steam, aversion to cold and backache, vomiting of phlegm or fluid, easy vomiting after drinking water, thirst without desire for drinks, palpitations, shortness of breath, dizziness and dizziness, poor appetite and loose stools, gradual thinning of the body, white slippery coating, wiry and fine pulse. The treatment principle is to warm the spleen and transform fluid.