Achalasia

Introduction

Achalasia (kardiospazam, oesophageal antiperistaltika, megaezofagus) is a nerve disorder of unknown cause that can be confronted with two processes: the rhythmic waves of contraction that push food down the esophagus, called peristalsis, and with the opening of the esophageal sphincter.

Ahalaziju may cause malfunction of the nerves that surround the esophagus and supplies his muscles.

Symptoms and Complications

Achalasia can occur at any age of life, but almost unrecognized usually starts between the ages of 20-40 years and then gradually progresses months and years. The main symptom is difficulty swallowing and solid and liquid food.Pinched lower oesophageal sphincter causes the esophagus above it significantly expanded.

Other symptoms may include chest pain, vomiting facilities extended esophagus and cough at night. Although rarely, chest pain may be caused by swallowing or for some vague cause. About a third of people who have returned ahalaziju undigested food apnea. They can be inhaled into the lungs due to food which may lead to the development of lung abscess, bronchiectasis (enlargement and infections of the respiratory tract) or aspiration pneumonia.Achalasia is a risk factor for esophageal cancer, although such a cancer probably get less than 5% of people with achalasia.

Diagnosis and prognosis

Rtg esophagus made during the time a person swallows barium porridge shows absence of peristalsis. The esophagus is expanded, often of enormous size, while in the lower esophageal sphincter narrowed. Measuring the pressure inside the esophagus (manometry) indicates the absence of contraction, increasing pressures closing lower esophageal sphincter and incomplete opening of the sphincter when a person swallows. Esophagoscopy (of the esophagus through a flexible tube with a video camera observation) indicates expansion, but not narrowing (obstruction).

When esophagoscopy doctor for a biopsy (take tissue samples for examination under a microscope) to make sure the symptoms are not due to cancer in the lower part of the esophagus. Viewing is done and to cut out as the cause of scleroderma, a disease that affects the muscles and can make it difficult to swallow.

Often the cause of achalasia is not serious and does not lead to any serious illness. Prognosis is not so good if gastric contents into lungs because lung complications difficult to treat.

Treatment

The aim of treatment is easier to open the lower esophageal sphincter. The first approach is to expand the sphincter mechanical, eg inflating a balloon inside the sphincter. The results of this procedure in 40% of cases satisfactorily, but may be required and repeated expansion. Nitrates (such as nitroglycerin placed under the tongue before meals) or calcium channel blockers (eg, nifedipine) may delay the need for a second procedure to expand, because they help relax the sphincter. In less than 1% of the esophagus may rupture during the expansion, leading to inflammation of the surrounding tissue (mediastinitis). To close the rift in the wall of the esophagus is required immediate surgical intervention.

As an alternative to mechanical expansion doctor may lower oesophageal sphincter inject venom botulinus. This newer treatment is as effective as mechanical expansion, but long-term effects are not yet known.

If you expand or treating poison botulinus are not successful, surgery is usually performed cutting muscle or the lower esophageal sphincter. The surgery is successful in about

85% of cases. However, in about 15% of people after surgery with occasional return (reflux) acid.

Appendicitis

Appendicitis is the inflammation of the appendix (appendectomy). Appendix is ​​a small tube-shaped fingers that stick out from the colon near the point where it is connected to the small intestine. Appendix could have an immunological role, but not an essential organ. 

Besides catches (inkarceriranih) hernia, appendicitis is the most common cause of sudden, severe abdominal pain and abdominal surgeries in the United States. Appendicitis is most common between the ages of 10-30 years.

The cause of appendicitis is not fully understood. In most cases, the blockage inside the appendix probably starts the process in which the appendix becomes inflamed and infected. If the inflammation continues without treatment, the appendix can kill you. Torn appendix contained full pours intestinal bacteria in the stomach, causing peritonitis, which can lead to life-threatening infections.

Burst (rupture) may cause appendicitis and abscess formation. In women, the infection can lead to ovary and fallopian tube, and fallopian tube blockage that occurs as a result, can cause infertility. Terminate the appendix may allow bacteria to infect the bloodstream, it is a life-threatening condition called septicemia.

Symptoms

Less than half of people with appendicitis have a combination of characteristic symptoms: nausea, vomiting, wrenching pain in the lower abdomen. The pain may begin suddenly in the upper abdomen or around the navel, then you develop nausea and vomiting. After several hours, nausea passes and pain turns into the right lower abdomen.When the doctor pressed the area, it is sensitive, and when tension is released, the pain sharp increases, the symptom is called referred pain. Often a fever of 37.7 ° -38.3 ° C.

The pain can be, especially in small and larger children, to be general and not limited to the right lower abdomen. In elderly people and pregnant women the pain is usually weaker and the area is less sensitive.

If the appendix torn, pain and fever may become severe. Worsening the infection can lead to shock.

Diagnosis and Treatment

Blood tests showed a moderate increase in the number of white blood cells in response to infection. Usually they are in the early stage of appendicitis most tests, including X-ray, CT and TO, essentially useless.

Doctor diagnosis typically based on the findings of the physical examination. To prevent discord appendicitis, abscess formation, or inflammation of the abdominal membrane, doctor-surgeon immediately to make the surgical procedure.

In almost 15% of operations for appendicitis is a normal appendix. However, delaying surgery until a doctor becomes sure what the cause of abdominal pain can be fatal: infected appendix can tear in less than 24 hours after onset of symptoms. Even when appendicitis is not the cause, appendix is ​​usually removed. Then the surgeon search belly and tries to find the real cause of the pain.

With early surgery, the probability of death from appendicitis is very low. A person can usually leave the hospital for 2-3 days, a normal recovery is fast and complete.

When torn appendix, the prognosis is much more serious. Fifty years ago, dissension was often lethal. Antibiotics are lowered mortality to almost zero, but may be required repeated surgery and a long recovery.

Abdominal pain

Introduction

Stomach pain can be caused by digestive system or elsewhere in the abdomen. Such problems include esophageal strife, discord ulcers, irritable bowel syndrome, appendicitis, pancreatitis and gallstones. Some of these diseases are relatively mild, while others can be life-threatening. The doctor must decide if you need immediate treatment or can not wait until a diagnostic test.

 

Diagnosis and Treatment

The key to the diagnosis of the doctor giving the nature of pain and its formation in relation to eating and movement.If other family members have had abdominal disease such as gall stones, the same disorder may have a patient.

An important key may be the appearance of a person, such as jaundice (evident by yellowish discolouration of skin and sclera) indicates liver disease, gallbladder or bile ducts.

Doctor scans the abdomen, examining the sensitivity and any abnormal buildup. When gently pressed the abdominal wall, one feels the pain, and if the pressure suddenly discounts, pain can become even stronger, a symptom called referred pain. This symptom usually indicates inflammation of the peritoneum (the membrane covering the abdominal cavity), called peritonitis.

Diagnostic tests for pain in the abdominal cavity include blood and urine tests, x-ray, ultrasound and CT. When it seems that abdominal pain is due to bowel obstruction, probijenog or the taxation authorities such as the gallbladder, appendix or bowel, or abscess (collection of pus), often for emergency surgery for stomach search.

Celiac Disease

Introduction

Celiac disease (netropska sprue, gluten enteropathy, celiac sprue) is a congenital disease in which the allergic intolerance of gluten protein causes changes in the intestine that result in malabsorption.

Celiac disease has one of the 300 people in southwest Ireland, and one or more than 5,000 in North America. This is a congenital disorder caused by sensitivity to gluten, a protein found in wheat and rye, and to a lesser extent in barley and oats. In this disease part of the gluten molecule combines with antibodies in the small intestine, causing the normal intestinal mucosa, which looks like brushes, becomes flat. As a result, we have a smooth surface that food poorly digested and absorbed. When avoiding foods that contain gluten, it is usually normal Bristle area recover and return to normal bowel function.

Symptoms

Celiac disease can begin at any age. In children, it does not appear any symptoms before they first ate foods containing gluten. Celiac disease often does not cause diarrhea or fatty stools, and a child may have only mild symptoms, which are interpreted as an ordinary stomach disorder. However, some children do not grow normally, suffer from painful swelling in the abdomen and begin to erupt pale, smelly, abundant chair. Iron deficiency anemia occurs. If the level of protein in the blood drops low enough, the child retains fluids and tissues may swell (edema).In some people the symptoms do not occur until adulthood.

Nutritional deficiencies that occur due to poor absorption, celiac disease can cause additional symptoms. These symptoms include weight loss, joint pain, and feel bites nails and needles in hands and feet. Some people who have celiac disease in childhood can have an abnormally bent long bones. Depending on the severity and duration of the disease, a person may have low blood levels of protein, calcium, potassium and sodium. Lack of prothrombin, which is important in blood clotting, leading to the formation of light leak and prolonged bleeding after an injury. Girls with celiac disease can be no menstruation.

Diagnosis

Doctors suspect the celiac pale when they see a child who has a skinny ass and bulging belly, despite adequate nutrition, especially if there is a family history of the disease. Doctor helps in diagnosis results Rtg and laboratory tests. Sometimes it is useful laboratory test in which we measured the absorption of xylose, a simple sugar.

Diagnosis is confirmed by examination of a biopsy specimen showing flat lining of the small intestine, and subsequently fixing the lining after a person stops eating gluten products.

Treatment

Symptoms can cause eating even small amounts of gluten from the diet, and to exclude all gluten. Gluten is so widely used in food products for people with this disease have a detailed list of foods you should avoid and the expert advice of a dietician, as gluten is found in artificial soups, sauces, ice cream and hot dogs.

Sometimes children who are seriously ill at the first diagnosis to be fed intravenously. Adults such a diet is rarely needed.

Some people are poor or do not respond to the elimination of gluten. This may be either because of inaccurate diagnosis, either because the disease has entered the stage where you do not respond. In the case of the other, can be helpful corticosteroids.

Some people with celiac disease, who avoided gluten long time, can not bear reintroduction of gluten in foods. Try to re-introduce gluten may be prudent, but if the symptoms reappear, gluten should be immediately removed from the diet.

Food gluten significantly improves the prognosis for children and adults. However, celiac disease can be fatal, mainly for adults with severe disease. A small percentage of adults can develop lymphoma (a type of cancer) in the intestine. It is not known whether this reduces the risk strict adherence to a gluten-free diet.

Hemorrhagic colitis

Introduction

Hemorrhagic colitis is a type of gastroenteritis in which some strains of Escherichia coli (E. coli) infection colon and produce a poison that causes sudden bloody diarrhea and sometimes severe complications.

In North America, the most common strain of E. coli that causes hemorrhagic colitis is called E. coli 0157: H7. This strain occurs in the intestines of healthy cattle. Outbreaks can occur by eating undercooked beef, especially ground beef, or drinking unpasteurized milk. This disease can also spread from person to person, especially among children in diapers. Hemorrhagic colitis can occur in people of all ages ..

E. coli toxins damage the lining of the colon. If you are absorbed into the bloodstream and can affect other organs, such as kidneys.

Symptoms

Severe abdominal cramps begin suddenly with watery diarrhea that usually within 24 hours becomes bloody. Body temperature is usually normal people, or slightly above normal, but sometimes it can reach more than 38.8 ° C. Diarrhoea usually lasts 1-8 days.

About 50% of people infected with E. coli 0157: H7 obtained hemolytic-uraemic syndrome. Symptoms include anemia caused by the breakdown of red blood cells (hemolytic anemia) and low platelet count (thrombocytopenia) and sudden kidney failure. Some people get it and epileptic convulsions, stroke or other complications of nerve damage or brain. These complications typically develop in the second week of illness, and they may precede temperature elevation. Hemolytic-uraemic syndrome frequently develops in children under 5 and the elderly. Even without these complications in the elderly hemorrhagic colitis can cause death.

Diagnosis and Treatment

Doctor usually suspected hemorrhagic colitis when people say they have bloody diarrhea. For the diagnosis of the doctor giving stool samples to examine E. coli 0157: H7. These samples should be obtained within one week of the onset of symptoms.

Other tests, such as colonoscopy, can be done if the doctor suspects that the cause of bloody diarrhea may be other diseases.

The most important thing in the treatment is to drink plenty of fluids to compensate the loss of fluid and adherence to a bland diet. Antibiotics do not ease the symptoms, do not remove bacteria or prevent complications. People who get complications will likely need intensive care in hospital, including dialysis.

Ulcerative Colitis

Ulcerative colitis is a chronic disease in which the colon is inflamed and full of wounds, leading to episodes of bloody diarrhea, cramps and fever turbuhu.

Ulcerative colitis may start at any age, but usually begin between 15 and 30-years. A small group of people has the first attack between the ages of 50-70 years.

Unlike Crohn's disease, ulcerative colitis usually does not affect the full thickness of the bowel and never affects the small intestine. The disease usually begins in the rectum and sigmoid colon (the lower end of the colon) and eventually spreads partially or completely through the colon. In some people the very early affected the entire colon.

About 10% of people who have ulcerative colitis have only one attack. However, some of these cases may actually be undetected infection before the real ulcerative colitis.

The cause of ulcerative colitis is unknown, but inheritance and overactive immune responses in the intestine could be factors that contribute to the occurrence of the disease.

Symptoms

The attack can be sudden and heavy provoking fierce diarrhea, very high temperature, abdominal pain and peritonitis (inflammation of the inner surface of the abdomen). During such an attack, a person is seriously ill. More often attack begins gradually and the person has a need vacuity chairs, mild cramping in the lower abdomen and visible blood and mucus in the stool.

When the disease is confined to the rectum and sigmoid colon, the stool can be normal or hard and dry, however, comes from the rectum during bowel movements or between the mucus with a large number of red and white blood cells. General symptoms such as fever, were mild or non-existent.

If the disease spreads further along the colon, the stool is fluffy and a person can have 10-20 bowel movements a day. Often a person has severe rectal spasms that accompany the need for emptying the chairs. At night there is no relief. The chair can be watery and contain pus, blood and mucus. Often almost entirely made up of blood and pus.A person may also have a fever and poor appetite and may lose weight.

Complications

Bleeding, the most common complication, often leading to anemia due to iron deficiency. In almost 10% of people with ulcerative colitis, rapidly advancing first attack becomes very serious with massive bleeding, failure and disseminated infections.

In Toxin colitis, particularly dire complications damaged the entire thickness of the intestinal wall. Damage caused by ileus, a condition in which the stop motion intestinal wall and the intestinal contents can not move on their way.Comes to stretching the stomach. As the toxic colitis worsens, the colon loses muscle tension and within days, or even hours, it begins to spread. X-ray abdomen in paralyzed areas of bowel gas shows. When the colon is very stretched, a condition called toxic megacolon. A person is seriously ill and may have a high fever. A person has pain and tenderness in the abdomen and a high number of white blood cells. However, the people who get fast, effective treatment for their symptoms, he died less than 4% of people. If early break hose, there is a risk of death.

Risk of colon cancer is higher in people with long-term extended ulcerative colitis. Risk of colorectal cancer is highest when the entire colon is affected and the person has ulcerative colitis for more than 10 years, regardless of disease activity.

People with a high risk of cancer recommended colonoscopy (colon searches Hose observation) at regular intervals, better during periods without symptoms. During colonoscopy taken tissue samples from the entire colon for microscopic examination. Colorectal cancer each year can get 1 in 100 people with this disease. Most survive if the cancer diagnosis is set in the early stages.

Such as Crohn's disease, ulcerative colitis is associated with diseases that affect other parts of the body. When ulcerative colitis causes outbreak of intestinal symptoms, a person may have inflammation of the joints (arthritis), inflammation of the sclera (episcleritis), inflamed skin nodules (erythema nodozum) and blue-red painful sores on the skin containing pus (pyoderma gangrenozum). When ulcerative colitis does not cause intestinal symptoms, the person may still have inflammation of the spine (ankylosing spondylitis), inflammation of the pelvic joints (sacroiliitis), and inflammation inside the eye (uveitis).

Although people with ulcerative colitis usually have less interference with the functioning of the liver, only about 1% -3% have symptoms of mild to severe liver disease. Severe disease can include inflammation of the liver (chronic active hepatitis), inflammation of the bile ducts (primary sclerosing cholangitis), that it narrows and eventually closes.Inflammation of the bile duct can occur many years before any intestinal symptoms of ulcerative colitis, and this increases the risk of bile duct cancer.

Diagnosis

In establishing a diagnosis anointing the sick with symptoms and searches chairs. Blood tests indicate anemia, increased white blood cell count, low albumin and elevated erythrocyte sedimentation rate. The diagnosis is confirmed by sigmoidoscopy (search sigmoid colon Hose observation) and allows the doctor to directly observe the weight of inflammation. Even during periods without symptoms, bowel rarely looks normal, and take a sample of tissue for microscopic examination indicates chronic inflammation.

X-ray abdomen may indicate the severity and extent of disease. X-ray examination of barium enema and colonoscopy (search entire colon Hose observation) usually does not work before the start of treatment, because there is a risk of leakage, hose when running in the active stages of the disease. However, when the disease is usually calm examines the entire colon to determine the extent of the disease and the exclusion of cancer. To do this, perform a colonoscopy or X-ray after giving barium enema.

Inflammation of the colon has many causes other than ulcerative colitis. The doctor needs to determine whether the inflammation caused by infection by bacteria or parasites. Stool samples that are obtained during sigmoidoscopy are examined under the microscope and work culture of the bacteria. Blood samples were analyzed to determine whether a person has acquired parasitic infections, such as during the trip.

Tissue samples taken from the lining of the rectum and examined microscopically. The doctor checks the STD and rectum, such as gonorrhea, herpes virus or Chlamydia infection, especially if the patient is a male homosexual. In older people with atherosclerosis, inflammation can cause poor blood supply to the colon. Colorectal cancer rarely causes fever or ejection of pus from the rectum, but the doctor has to consider cancer as a possible cause of bloody diarrhea.

Treatment

Treatment helps in controlling inflammation, reducing symptoms and replace lost fluids and nutrients. One should avoid raw fruits and vegetables to reduce physical injury inflamed lining of the colon. Symptoms can be reduced diet without dairy products and ulcers to try. Iron supplements can alleviate anemia caused permanent loss of blood in faeces.

In relatively mild diarrhea taken anticholinergic drugs or low-dose loperimida or diphenoxylate. With stronger diarrhea may require higher doses of tincture of opium or diphenoxylate odorless, loperamide or codeine. In severe cases, the doctor carefully monitors the patient's medication against diarrhea to avoid toxic megacolon.

To decrease the inflammation in ulcerative colitis and for the prevention of the symptoms of his full-scale often used sulfasalazine, mesalamine or olsalazin. These medicines are usually taken by mouth, but can be given as an enema, or as suppositories.

People with moderate to severe disease who are not tied to the bed, commonly used corticosteroids such as prednisone in the mouth. Prednisone in fairly high doses often leads to a dramatic recovery. After prednisone suppress inflammation in ulcerative colitis, sulfasalazine, mesalamine or olsalazin are also often given. Gradually reducing the dose of prednisone and eventually abolish prednisone. Prolonged treatment with corticosteroids almost always cause side effects, although most of them disappear when they stop taking the drug. When mild or moderate ulcerative colitis is limited to the left colon (descending colon) and rectum, can be given enemas with corticosteroids or mesalamine.

If the disease becomes severe, the person is placed in the hospital and given intravenous corticosteroids. People with severe bleeding from the rectum must receive blood transfusions and intravenous fluids.

To maintain the improved condition of patients with ulcerative colitis who would otherwise have had to be on long-term treatment with corticosteroids, used to azathioprine and mercaptopurine. Some people who survived severe attacks, and did not respond to treatment with corticosteroids, cyclosporine is given, but about half of these people eventually need surgical treatment.

Surgical treatment

Toxic colitis is an emergency situation. Immediately as soon as the doctor discovers or suspects threatening toxic megacolon, breaks with all drugs against diarrhea, the patient does not give anything to eat, through the nose slid tube into the stomach or small intestine and attach to occasionally draw, and all the fluids, nutrition and drugs are given intravenously. The patient is closely monitored with regard to indicators of peritonitis or rupture (break) hoses.If these measures are not successful in improving the patient's condition for 24-48 hours, required emergency surgery: it removes almost all or most of the colon.

Once the diagnosis of cancer or in the colon find precancerous changes in the surgical procedure done without urgency. This surgical procedure can be done due to narrowing of the colon or growth retardation in children. The most common reason for surgical treatment was unchanged chronic disease that would otherwise be made by a person disabled or chronically addicted to high doses of corticosteroids.

In rare cases, surgical treatment necessary to do some problems associated with colitis not hose, such as pyoderma gangrenozum.

Full removal of the colon and rectum for good cure ulcerative colitis. Living with a permanent ileostomy (surgically created connection between the lowest part of the small intestine and the opening in the abdominal wall) and ileostomna bags are traditional cost of such treatment. However, there are various other methods, of which the most common procedure called ileo-anal anastomosis. In this procedure removes the colon and rectum most, and of the small intestine makes little rezorvoar and attached to the remaining rectum just above the anus. This process maintains the retention chairs, although some effects can occur, such as the inflammation of the reservoir.

Diarrhea

Diarrhea is an increase in the scope, content and frequency of watery bowel movement.

Persons with diarrhea caused significant medical problem usually has an extremely large volume of chairs, in typical cases, more than a pound a day. People who eat large amounts of plant fibers normally can create more than a pound, but this is a well designed chair and not watery. Normal stool contains 60% -90% of water.Diarrhea usually occurs when exceeds 90%.

Osmotic diarrhea occurs when a substance that can not be absorbed into the bloodstream remain in the intestine. These substances cause to remain in a chair excessive amounts of water, leading to diarrhea. Osmotic diarrhea can cause some foods (such as some fruits and legumes) and hexitol, sorbitol and mannitol (used as substitutes for sugar dijetetičkoj foods, candies and chewing gum). Similarly to osmotic diarrhea may result in a lack of lactase. Lactase is an enzyme that is normally found in the small intestine and that converts milk sugar (lactose) into glucose and galactose so that it can be absorbed into the bloodstream. When people with lactase deficiency drink milk or eat dairy products, lactose is not converted into glucose and galactose. How can accumulate in the intestine, causing osmotic diarrhea. Weight osmotic diarrhea depends on how osmotic substance taken. Diarrhea stops quickly after one such substance ceases to eat or drink. Diarrhoea due to secretion occurs when the small and large intestine secrete salts (especially sodium chloride) and water in the stool. Some toxins, such as a toxin that is produced when infected with cholera and as poisons that occur in other infectious diarrhea can cause such secretion. Diarrhea can be strong, with cholera over a quarter of an hour. Other substances that cause secretion of salt and water are some laxatives such as castor oil and bile acids (which can occur after surgery to remove part of the small intestine). Some rare tumors such as carcinoid, gastrin and vipom, can also cause diarrhea due to excretion. malabsorption syndrome (malabsorption syndromes) may also lead to diarrhea. People with this syndrome can not digest food normally. In general malabsorption of fat left in the colon can cause diarrhea because of malabsorption due to excretion, and carbohydrates can cause osmotic diarrhea. Malabsorption can cause such conditions as netropska sprue, pancreatic insufficiency, surgical removal of part of the intestine, insufficient blood supply to the colon, the lack of certain enzymes in the small intestine and liver disease. exudative diarrhea occurs when the lining of the colon is inflamed, with ulcers or packed so releasing proteins, blood, mucus and other fluids, which increases the volume and the amount of fluid in the stool. This type of diarrhea can cause many diseases including ulcerative colitis, Crohn's disease (regional enteritis), tuberculosis, lymphoma and cancer. When the affected lining of the rectum, the person often feels an urgent need to empty your bowel and has often bowel movements because the inflamed rectum sensitive to stretch chair. Diarrhea can cause damaged intestinal passage. To chair had normal strength has to be a time to keep the colon. See that too left colon is watery, and the chair that stays too hard and dry. Time chair carried in the large intestine can shorten many conditions including excessive activity of the thyroid (hyperthyroidism), surgical removal of part of the small intestine, large intestine or stomach ulcer treatment for which is bisected by the vagus nerve, surgical bypass of the intestines, and medications such as antacids and laxatives containing magnesium, prostaglandins, serotonin and even koefin. Overgrown bacteria (growth of normal intestinal bacteria in abnormally large numbers or growth of bacteria that are not normally found in the intestine) can cause diarrhea. Normal intestinal bacteria play an important role in digestion.Therefore, any disturbance of intestinal bacteria can cause diarrhea. Complications Besides discomfort, embarrassment and disruption of daily activities, severe diarrhea leads to the loss of water (dehydration) and electrolytes such as sodium, potassium, magnesium and chloride. If you have lost large amounts of fluids and electrolytes, blood pressure can be lowered sufficiently to cause loss of consciousness (syncope), heart rhythm abnormalities (arrhythmias) and other dangerous disorders. In particular danger are the very young, the elderly, and people with weakened very severe diarrhea. Chair may also be losing bicarbonate leading to metabolic acidosis, type acid-base imbalances in the blood. Diagnosis Doctor primarily seeks to determine if the diarrhea appeared suddenly in a short time or permanent. The goal is to determine whether the cause of changes in diet, if a person has other symptoms, such as fever, pain and rash, and whether the person has been in contact with others who are in the same condition. Based on the patient's description and tests of stool samples, the doctor and the laboratory staff determines whether solid or watery stool, is there any unusual odor and contains fat, blood, or undigested material. Evaluate the extent of stools in a 24 hour period. When diarrhea is often a steady stool samples must be examined microscopically with regard to cells, mucus, fat and other substances.The chair can be examined and the blood and the substances that can lead to osmotic diarrhea. Uzoci can be tested for infectious organisms, including some bacteria, amoebae and Giardia organisms. If a person is secretly taking a laxative and it can be detected in a stool sample. One can make a sigmoidoscopy (search sigmoid colon) and doctor can view the lining the anus and rectum. Sometimes I do a biopsy (removal of a sample of rectal mucosa for microscopic examination). Treating Diarrhea is a symptom and its treatment depends on the cause.Most people with diarrhea should only remove the cause as dijeteska gum or a drug, to suppress diarrhea until the body just does not heal. Sometimes the cure chronic diarrhea when the person stops drinking coffee or drinks that contain caffeine wheel. To help relieve diarrhea doctor may prescribe a medication such as diphenoxylate, codeine, paregorik (tincture of opium) or loperamide. Sometimes even a thickener which is used in chronic constipation, such as methylcellulose or psilij, helps eliminate diarrhea. Curing chairs helps kaolin, pectin and activated atapulgit. When severe diarrhea causes dehydration, may require hospitalization and intravenous compensation of water and salt. As long as the person does not vomit and feel nauseated, very effectively be drinking liquids that contain a balanced amount of water, sugar and salt. 

Intestinal lymphangiectasis

Introduction 
Intestinal lymphangiectasis's disease in children and young adults at which the increase lymphatic vessels that supply the mucous membrane of the small intestine.
Increase lymphatic vessels may be a flaw at birth or later in life may be caused by inflammation of the pancreas (pancreatitis) or stiffening sack around the heart, the pericardium (constrictive pericarditis), which increases the pressure in the lymphatic system.

Symptoms and diagnosis of
persons with lymphangiectasis has a very fluid retention (edema) because the tissue fluid can not drain effectively through increased but narrowed lymphatic vessels. Island can unequally affect parts of the body depending on which lymphatic vessels affected, eg fluid can accumulate in the abdominal and pleural space.
Can occur nausea, mild diarrhea and abdominal pain. The blood can reduce the number of lymphocytes. Get the protein, because the lifne swollen lymph vessels coming into the intestine, and the chair and the level of protein in the blood decreased. Low levels of protein can cause further tissue swelling. Levels of cholesterol in the blood may be abnormally low because the cholesterol from food is not well absorbed. Some people have oily stools. To help diagnose the disease the doctor may use an intravenous injection of radioactively labeled albumin. If the stools an abnormal amount of a radioactive substance, a person has excessive loss of protein. Biopsy of the small intestine showed that lymphatic vessels increased. Treating Intestinal lymphangiectasis is treated by removing the cause of increasing limfhih vessels, such as the treatment of pericarditis konstriktivnog can relieve pressure on the lymph vessels. Some people recover by taking food with low fat content and taking supplements of some triglycerides, which are absorbed directly into the blood, and not through the lymph vessels. If only a small part of the intestine can be removed by surgery.

Diagnostic methods for diseases of the digestive system

Introduction 
Searches digestive system include endoscopes (endoscopic tube that doctors use to observe the internal structure and to obtain tissue samples from the inside of the body), x-ray, ultrasound, radioactive substances and chemical measurements. These tests can help diagnose, determine the place and sometimes treat disease.Some tests require that the digestive system clean of stool (feces), a 12.8-hour starvation, and the remaining do not require any preparation.
first steps in diagnosing problems are always history and physical examination. However, the symptoms of indigestion are often vague and doctors have difficulty to accurately determine what is wrong. Besides mental disorders such as anxiety and depression can affect the digestive system and contribute to symptoms. A physical examination of a person with digestive symptoms doctors examined the stomach (abdomen), anus and rectum.Stethoscope listening to unusual noises, and look for clusters of enlarged organs, determine whether that area sensitive to pressure, reviewed anus and rectum a finger at who pulled the glove and take a small sample to see the hidden (occult) bleeding. In women, a pelvic examination is often helpful in distinguishing digestive problems from gynecological. doctor recommends appropriate search based on the existing noise and site disturbance. 

REVIEW esophagus Searches barium, in which the patient swallows barium, often carried out in the esophagus. For such a test (called barium swallow porridge), doctors are trying to use fluoroscopy, continuous X-ray technique that allows observation or imaging as barium passes through the esophagus.

Fluoroscopy allows the doctor to see tightening esophagus and any anatomical defect such as narrowing or wounds. Often these views recorded on film or video tape. Besides liquid barium patient can get food-coated barium so that the doctor can determine the location of narrowing or see parts of the esophagus, which normally do not tighten. Both barium preparations taken together may indicate abnormalities such as folds of the esophagus (where the esophagus is partly blocked connective tissue), Zenkerov diverticulum (protrusion esophagus), erosion and early esophagus, esophageal varices (varicose ie varicose veins and izvijugane esophagus) and tumors. manometry is a test in which a tube with manometers along its surface placed in the esophagus. Using these devices (called gauge) doctor can determine whether tightening the esophagus normally expel food. During manometry may make esophageal pH test (test used to measure the acidity in the esophagus).Search is done to determine whether a person has acid reflux (return of stomach acid into the esophagus). One can make one or more measurements. IN Bernstein test (perfusion test acid in the esophagus), the esophagus is put through naso-gastric probe small amount of acid. This search is used to determine whether the chest pain caused by acid stimulation of the esophagus is a good way to detect inflammation of the esophagus (esophagitis).Intubation is the process of pulling a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. This procedure may be used for diagnostic or therapeutic purposes. Although intubation in some patients may cause constipation and nausea, it is not painful. Pipe size is different depending on the purpose.nasogastric intubation (passage tube through the nose into the stomach) can be used to obtain a sample of gastric fluid. Doctors can then determine whether it contains blood or stomach juices can analyze the acidity of the stomach, enzymes and other properties. Samples of gastric fluid poisoned people can be analyzed to identify the poison. In some cases, the tube is left in place so that in the course of a few hours can take more samples.nasogastric intubation can be used to treat some diseases, such as the stomach can enter the cold water to prevent bleeding, poisons can deplete or neutralize Activated carbon, or people who can not swallow can provide liquid food. Sometimes nasogastric intubation is used to permanently remove the contents of the stomach. End of the tube is usually attached to the device for suctioning to remove gases from the stomach (gas) or liquid. This helps ease the pressure when the digestive system and blocked or otherwise not functioning normally. This procedure is used to obtain a sample of intestinal contents, permanently removing fluid or provide feed. Tube with a small device on the end of the tube can be used to perform a biopsy (obtaining a sample of small intestine to search). The tissue can be analyzed with respect to the enzyme activity, examined under a microscope or assessed in other ways. The procedure is not painful, because the stomach and small intestine without sensation of pain. 

Endoscopy 

Endoscopy is an examination of internal tissues through a pipe to observe (fiberendoskopa). When you pass through the mouth, the endoscope can be used to examine the esophagus (esophagoscopy), stomach (gastroscopy) and small intestine (upper gastro-intestinal endoscopy).When you pass through the anus, the endoscope can be used to examine the rectum and lower colon (sigmoidoscopy) and the entire colon (colonoscopy). Endoscopes in the diameter range from about 0.5 cm to 1 cm, and at a distance of about 30, 5 cm to 5 times more. Endoscopic video systems allow endoscopes are flexible and have a light source and a system for viewing. Many have endoscopes equipped with a small clothespin to take tissue samples and electric probe to destroy the abnormal tissue. Doctors can with the help of an endoscope to have a good insight into the surface of the digestive system. I can see the areas of irritation, ulcers (wounds), inflammation and abnormal tissue growth. Usually I take the samples for testing. Endoscopes can be used as therapy. Through a small channel endoscopes doctor can squeeze various types of instruments. Electrocautery can close blood vessels and stop the bleeding or to remove small tumors, a needle can be injected drugs in esophageal varices and stop their bleeding. Before her endoscope passed through the mouth, the person usually not a few hours before taking food. Food in the stomach can interfere with the doctor review, and can be recovered during the proceedings. Before endoscopy rectum and colon person usually takes laxatives and enemas gets to be completely cleared of chairs. complications due to endoscopy are relatively rare. Although endoscopes can injure or even puncture the digestive system, they often cause only irritation of the inner surface of the small intestine and bleeding. 

Laparoscopy

 Laparoscopy is abdominal cavity searches endoscope.Laparoscopy is usually done by the patient under general anesthesia. Once the appropriate area of skin washed with antiseptic, make a small incision, usually in the navel. Then put into the abdominal cavity endoscope. The doctor can look for tumors or other abnormalities, browse virtually every organ in the abdominal cavity, take samples and even work reparative surgical procedure. 

RTG SEARCH To assess digestive problems often used X-ray. Ordinary standard Rtg stomach does not require any preparation of patients. Radiographs are commonly used to show blockage or paralysis of the digestive system or abnormal images of air in the abdominal cavity.Such a standard X-ray and can show an increase and organs such as the liver, kidneys and spleen. barium examination often provides more information. After a person swallows barium, on the X-ray to look white and outlines the digestive system, showing the contours and coating the esophagus, stomach and small intestine.Barium in abnormal areas accumulates showing ulcers (sores), tumors, erosions, and esophageal varices.Radiographs can operate at intervals to determine where the barium is. Can also be used fluoroscope to observe movement of barium through the digestive system. This process can take on a movie for later viewing. Watching the barium passes through the digestive system, doctors can see how the esophagus and stomach, to determine whether their normal shrinkage and say if somewhere in the digestive system, there is a blockade of food.Barium can be given in the bowel wash to show the lower part of the colon. Then Rtg can show polyps, tumors and other structural abnormalities. This process may cause convulsive pains creating light to moderate discomfort. Barium taken by mouth or applied as an enema is finally excreted in the stool making the white chalk. Barium must be quickly removed after the test, because it can cause significant constipation. Some slight laxative can speed up the removal of barium. paracentesis paracentesis is the introduction of a needle into the abdomen and remove the fluid. Normally abdominal cavity outside the digestive system contains only a small amount of liquid. However, in some circumstances, the liquid can accumulate as it is at rupture (rupture) stomach or intestines, liver disease, cancer, or in the event of rupture (break) spleen. To obtain a sample of fluid for analysis or to remove excess weight, the doctor may use a paracentesis. before paracentesis make physical examination, sometimes accompanied by ultrasound to confirm that the abdominal cavity contains the excess liquid. After that, the area of skin, usually below the navel, washed with antiseptic solution and a small amount of anesthetic numbs. The doctor then pierced the skin and muscles of the abdominal wall in the area of accumulated fluid needle to which is attached to the syringe. For laboratory testing involves taking a small amount, and to alleviate stretch the abdominal wall is taken up to several liters. against your abdomen (stomach) with order to produce images of internal organs UZ (ultrasound) uses sound waves. Can show the shape and size of many organs such as the liver and pancreas, and may also indicate abnormal areas in them. TO may also indicate the presence of liquid. However, to examine the lining of the digestive system, it is not a good method and is therefore not used to search for tumors or cause bleeding in the stomach, small intestine or large intestine.

UZ is a painless procedure without any danger. Examiner (doctor or technician), press the small probe to the patient's abdominal wall and moving the transducer directs air waves in different parts of the abdomen. The image is then displayed on a video screen and recorded on videomedia.

REVIEW occult (hidden) BLEEDINGBleeding from the digestive system can be caused by something insignificant, like a small irritation or something serious like cancer. When bleeding heavily, a person may vomit blood, have light red blood in the stool or black, tarry stools (melena). Small amounts of blood that can not see or can not change the look of the chairs can be detected chemically, and the detection of small quantities may be an early indication of the existence of an ulcer (ulcer), cancer or other abnormalities. During rectal examination, the doctor gets a small amount of stool on a finger gloves . This pattern is placed on a piece of filter paper impregnated with chemicals. After the addition of other chemicals, the color of the sample, if there is blood changes. Another possibility is that people put samples from about three different chairs on filter paper which is then sent to the doctor for testing in special containers.If blood is detected, further tests to determine the cause.