Etiological symptoms
Bloody stool is also called "bloody stool", "bloody stool" and "bloody stool", which is characterized by bloody stool or loose stool. More common in Shang Xiao.
Chemical ulcer bleeding, gastrointestinal polyps, small intestinal bleeding, tumor, perianal disease bleeding, as well as some blood diseases and acute diseases.
Sexually transmitted drugs, parasites, etc The injury here refers to the rectal mucosal injury caused by hemorrhoids, anal fissure and anal sinusitis.
Blood in the stool caused by injury. The stool is soft, shaped or hard, and blood adheres to the surface of the stool. Some have blood before stool, while others have.
After defecation, the blood is mostly bright red, but also dark red and turbid. Blood loss is endless for a long time, and anal pain after defecation.
Intensify.
Traditional Chinese medicine believes that hematochezia is caused by heat accumulation in the intestine (dampness) or spleen-qi deficiency, which can not control blood circulation. It can clear the intestines.
Clearing away heat, stopping bleeding, benefiting qi and enriching blood.
Matters needing attention in self-treatment
(1) Get into the habit of defecating regularly, and the stool should be thin and mushy.
(2) Reduce the posture of increasing abdominal pressure, such as squatting and holding your breath. Avoid sedentary, long standing, long walking and overwork.
(3) Avoid spicy, spicy, greasy, rough and dull food, alcohol, tobacco and coffee.
(4) Eat more raw pear juice, lotus root juice and other foods that have the functions of clearing heat from the intestines, moistening nutritious mucosa, relaxing bowels and stopping bleeding.
Water chestnut juice, reed root juice, celery juice, carrot, white radish (cooked food), bitter gourd, eggplant, cucumber, spinach,
Day lily, cabbage, egg yolk, apple, fig, banana, black sesame, walnut kernel, tremella, etc.
(5) be cheerful, don't be angry and hot. If the mood is not wide, irritability and depression will cause intestinal mucosa to contract and blood circulation will not be smooth.
(6) reduce sexual intercourse. Excessive sexual intercourse will make the intestinal mucosa congested. Aggravate bleeding.
Autonomic therapy
1. TCM self-therapy
(1) Yunnan Baiyao, 0.3g each time, 2-3 times a day. Swallow with warm water.
(2) Piyue Maren Pill, 9g each time, twice a day, swallowed with warm water.
(3) Qinglian Pill, 9g each time, twice a day, swallowed with warm water.
2. Prescription self-treatment
(1) rhubarb charcoal powder, 3-6g each time, twice a day, swallowed with warm water.
(2) Dry the eggplant leaf tile and grind it into powder, 6g each time, twice a day. Swallow rice soup.
(3) 60 grams of Eclipta prostrata, decocted for tea.
(4) Sanguisorba officinalis charcoal 15g, Sophora japonica charcoal 12g, madder charcoal 12g, adzuki bean 30g and windbreak charcoal 10g.
G, rhubarb charcoal 10g, cortex phellodendri 10g, daily 1g, decocted in water twice. Used for heat accumulation and dampness in intestine,
Turbid blood, bitter taste, yellow and thick tongue coating, and poor stool.
(5) 30g of kitchen soil, 0/0g of codonopsis pilosula/kloc-,0/0g of atractylodes macrocephala charcoal, 0/0g of ginger charcoal/kloc-,0/0g of Cimicifuga foetida charcoal/kloc-,
Stir-fry Radix Astragali 12g, Colla Corii Asini 9g (melted separately) and Glycyrrhrizae Radix 6g, 1 paste every day, and fry twice. Used for spleen weakness.
Weak, pale, tired, weak.
3. Diet self-therapy.
(1) 250g pig large intestine, fresh Sophora japonica 15g, cooking and soup.
(2) Eat a few persimmons every day.
(3) Tremella 10g, red dates 15g, and simmer.
(4) 30 grams of day lily, appropriate amount of brown sugar, water decoction.
(5) Ginger and Folium Artemisiae Argyi each 15g. Decoct Folium Artemisiae Argyi and Rhizoma Zingiberis Recens into thick juice, each time 1 cup. Folium Artemisiae Argyi Warming Meridian to Stop Hemorrhage, Ginger
Dispelling cold is used to treat bleeding due to deficiency cold, mainly for bleeding after defecation.
(6) 5 bowls of vinegar and 3 bowls of red beans, cooked and dried into powder, 5g each time. This prescription is mainly used to treat intestinal hemorrhoid bleeding.
4. External treatment and self-treatment
(1) fumigation and washing. Soak colla Corii Asini in vinegar to soften, steaming to melt into paste, taking 30g each time, adding 500g vinegar to melt,
After heating and boiling, smoke first and then wash the anus twice a day. The stock solution can be washed many times. Used for patients with anal fissure and hemorrhoid bleeding.
(2) apply medicine. Cool oil mixed with 2 pieces of xanthium powder is applied inside and outside the anus.
(3) Mud wild wormwood (wormwood cotyledon) and apply it to anus.
(4) Apply egg butter to the anus. (Suitable for dry and ruptured anal mucosa. )
Egg butter method; Take a few cooked egg yolks, stir-fry them in non-ferrous tableware with low fire, and filter until the oil oozes.
5. Other self-therapies
(1) Rub the abdomen. Rub your abdomen twice every morning and evening (after waking up and before going to bed), counterclockwise 100 times.
(2) levator ani. Do anal contraction 2-3 times a day, 30-50 times each time.
Avoid misdiagnosis
In the past, there was no anorectal disease and bloody stool suddenly appeared, or a small amount of dark bloody stool appeared from time to time for a long time; or
There are necrotic and corrupt tissues and sticky secretions in the blood in the stool. Patients should not be negligent and should go to the hospital for examination.
Because of fear of defecation pain, forbearance will cause constipation, endogenous heat toxicity and aggravate defecation.
Shape.
Unmarried young women must pay attention to rest during menstruation and pay attention to the cleanliness of vulva, otherwise it will easily lead to inflammation, rupture and bleeding of anal mucosa.
have/pass blood in one's stool
After gastrointestinal bleeding is discharged through the intestine, the feces contain blood or whole blood stool, which can be bright red, dark red or tar-like. The color of bloody stool depends on the bleeding site, the amount of bleeding and the time that blood stays in the digestive tract. Lower digestive tract (small intestine, colon, rectum, anus) bleeding, stool is often bright red or dark red. Upper digestive tract (esophagus, stomach, duodenum) bleeding, stool is often tar-like.
(1) etiology
Blood in stool is generally divided into bloody stool, tar stool and occult blood stool. Common reasons are described below.
1 bloody stool: it usually comes from the lower end of ileum, colon, rectum and anus, and the stool is bright red or dark red, which can be mixed with mucus and pus. Common diseases are hemorrhoids and anal fissure bleeding. Hemorrhoid hematochezia is ejected during defecation or drops blood after defecation; Anal fissure has less bloody stool, but anal pain is more severe. Rectal polyp bleeding, stool blood volume is not large, blood adheres to the surface of stool, and sometimes stool becomes thin and strip-shaped or imprinted. Dysentery blood is purulent bloody stool with frequent defecation and left lower abdominal pain.
2 Tarky stool: that is, black stool. Upper gastrointestinal bleeding does not vomit, and blood stays in the intestine for a long time. Hemoglobin in the blood combines with sulfide in the intestine to form ferrous sulfide, which makes the stool black and shiny, like asphalt. The appearance of tarry stool indicates that the amount of bleeding has reached more than 60 ml. However, it should be noted that some foods and drugs can make the stool black, which can be identified by fecal occult blood test.
3 occult blood stool: a small amount of gastrointestinal bleeding does not cause stool color change, only when the stool occult blood test is positive, it is called occult blood stool. All diseases that cause gastrointestinal bleeding can cause occult bloody stools, such as gastric ulcer and gastric cancer.
(2) Rescue measures
The rescue measures are basically the same as vomiting blood. Stay in bed quietly, reduce activities, observe the amount of bleeding, use hemostatic drugs appropriately, and send them to the hospital for rescue in case of syncope and shock.
How to register for medical treatment
1. Anorectal surgery: Patients with bright red blood after defecation or bright red bloody stool generally have no severe abdominal pain, so anorectal surgery should be performed.
2. General surgery: Patients with hematochezia, severe abdominal pain or even shock should hang up general surgery.
3. Intestinal outpatient service: Patients with acute onset and purulent bloody stool should be hung up in the intestinal outpatient service.
4. Gastroenterology: Patients with black and dark red bloody stools, or with a history of chronic colitis and frequent discharge of bright red bloody stools should be hung up in Gastroenterology.
5. Hematology: those with hematochezia and systemic bleeding tendency should be further examined in hematology department.
6. Kidney disease: Those with a history of nephritis and bloody stool should contact kidney disease.
7. Infectious Diseases Department: Patients with hematochezia after fever and life history in epidemic areas should be registered in Infectious Diseases Department.
The blood discharged from anus is called blood in stool, which mainly includes blood drop, blood spray or blood in stool. Generally speaking, blood visible to the naked eye often indicates lower gastrointestinal bleeding (especially colon and rectum). The closer the bleeding point is to the anus, the brighter the color.
It is generally believed that hematochezia is caused by hemorrhoids, which is incorrect. Hemorrhoids, especially internal hemorrhoids in the first and second stages, are mainly manifested as blood. Blood in the stool generally occurs during defecation, during defecation and after defecation, blood drips or there is jet bleeding, and blood is not mixed with feces. The amount of bleeding varies from a few milliliters to dozens of milliliters. Repeated bleeding can lead to severe anemia. The diagnosis of hemorrhoids is relatively easy, but it must be pointed out that anorectal diseases with bloody stool, such as rectal adenoma and rectal cancer, are often misdiagnosed as internal hemorrhoids. Therefore, other diseases must be excluded when determining the diagnosis of hemorrhoids. It is necessary to perform finger examination on patients with hematochezia, and routine examination with disposable sigmoidoscopy is a convenient, economical, safe and accurate examination method.
Anal fistula often has purulent secretions and less blood. Because of the recurrence of the disease and the aggravation of the disease, surgical treatment is more reliable at present.
Rectal cancer is a common malignant tumor, and its main clinical manifestations are:
1. bloody stool.
2. Purulent bloody stool and mucus bloody stool.
3. Changes in defecation habits, including constipation, diarrhea or both, and endless defecation.
4. The shape of stool will change.
5. Abdominal pain, abdominal discomfort, abdominal mass, etc.
Routine examination of patients with hematochezia by disposable sigmoidoscopy can detect low resection of rectum and sigmoid colon early, and colonoscopy can be performed if necessary. Early detection, early diagnosis and early treatment must be advocated for colorectal cancer.
Precancerous lesions:
1. Adenoma: It is now recognized that adenoma is a precancerous lesion, and the common symptoms include bloody stool, change of stool habits, tumor protruding from anus, abdominal pain, etc. Disposable sigmoidoscopy is used for early diagnosis and early surgical resection.
2. Chronic ulcerative colitis: The main symptoms are bloody stool, increased defecation times and abdominal pain.
Others:
1. Systemic diseases: such as blood system diseases.
2. Anal injury, etc.
In short, bloody stool should be checked in a regular hospital in time to exclude other diseases, so as not to delay the illness. (
Blood in stool: Blood flows from anus, or comes down with impurities in stool, or is pure blood.
Soul fulcrum The title of "all diseases begin": "post-blood"; Treatise on Febrile Diseases is called "blood"; Synopsis of the Golden Chamber talks about "bleeding", and puts forward the names of "distant blood" and "near blood" according to the order of bleeding and defecation. Zhang Jingyue pointed out: "Blood is far from stool, far from the small intestine or kidneys. ..... If blood comes before defecation, it will come near, and the nearest one is in the intestine or anus. " Later doctors followed the name of turbid blood and established intestinal wind and dirty poison. The key points of syndrome differentiation and treatment says: "bright red serum is intestinal wind, and turbid serum is dirty poison." "Introduction to Medicine" says that "blood arrow" will be very powerful if there is blood in stool, for example, the arrow is far away.
This disease should be differentiated from dysentery and purulent blood. Diarrhea and purulent blood are often accompanied by purulent blood, with obvious abdominal pain, acute diarrhea and severe diarrhea. But this disease is characterized by blood flowing from the stool, no pus, no obvious symptoms such as abdominal pain, acute diarrhea and severe diarrhea.
"common syndrome"
Excess heat in gastrointestinal tract: bloody stool, dry lips, cold drinks, swollen gums, bad breath, bitter taste, sores on mouth and tongue, constipation, burning anus, red tongue with yellow coating and strong pulse.
Damp-heat steaming: blood first, then stool, bright red blood, uncomfortable stool, swollen limbs, anorexia, bitter taste, short and red urine, red tongue, yellow and greasy fur, and rapid pulse.
Deficiency and cold of spleen and stomach: stool with blood first, or blood mixed with stool, or pure blood, purple and dark, or the stool is tar-like, with dull complexion, mental fatigue, abdominal pain, anorexia, thin stool, cold limbs, pale mouth without thirst, pale tongue, white and wet fur and thready pulse.
Yin deficiency of liver: bloody stool, dizziness, blushing, nervous fever, restless night sleep, night sweat due to bone steaming, dreaminess, insomnia, backache, limb fatigue, emaciation, red tongue and rapid pulse.
Hemorrhoid hematochezia: bloody stool, unbearable anal pain, or swelling of hemorrhoid nucleus, or anal fissure, red tongue with yellow coating and rapid pulse.
References:
Abnormal stool color in children with hematochezia
Key points of differential diagnosis of hematochezia:
Possible diagnosis of complications
Blood spray during defecation, or blood drop after defecation, blood and stool are not mixed, and the amount of bleeding varies, accompanied by anal foreign body sensation or sudden pain hemorrhoids.
Fecal blood volume is small, the color is bright red, and it is filiform, covering the feces. There is pain during defecation and anal fissure in different degrees after defecation.
Intermittent bloody stool, usually with a small amount of blood in the stool, is bright red, not mixed with the stool, sometimes the stool becomes thinner, or there is a concave rectal polyp or colon polyp on one side.
With the development of the disease, stool blood volume increases, often accompanied by diarrhea, emaciation, anemia, stool often mixed with thick mucus, rectal cancer with a special fishy smell, more common in middle-aged and elderly people.
Changes in stool habits, diarrhea or constipation, pus-like or mucus-like blood in stool. carcinoma of colon
Sudden onset, accompanied by abdominal pain, diarrhea, nausea and vomiting, less stool, often mixed with feces, frequent stool, bacillary dysentery or amebic dysentery, severe feeling after urgency, abdominal tenderness.
Hemorrhage is often intermittent, with a small amount of blood in the stool, pus or mucus in the stool, and acute diarrhea is often accompanied by abdominal pain, diarrhea and ulcerative colitis.
Blood diseases with less bleeding and bleeding tendency in other parts, such as leukemia, hemophilia, thrombocytopenic purpura and aplastic anemia.
Retardation, often accompanied by hematemesis, is a characteristic symptom of upper gastrointestinal bleeding, such as cirrhosis, portal hypertension, digestive tract ulcer and so on.
There is no change in stool color, only the occult blood test is positive, which is mostly caused by a small amount of bleeding in the digestive tract.
What kinds of diseases should we mainly consider when stool is bloody?
Bloody stool is a special symptom of lower gastrointestinal bleeding, especially colon, rectum and anus, which indicates that there are organic lesions in the intestine, so we must attach great importance to it, make a clear diagnosis in time and pay close attention to treatment. The following diseases should be considered when the stool is bloody:
(1) Anal diseases
① Blood is bright red and painless, which is more common in internal hemorrhoids. Hemorrhoids in stage I are characterized by blood, and they often bleed because of rubbing the hemorrhoids with stool, and the blood keeps dripping, or a line is like an arrow, or only carries blood on toilet paper; Stage Ⅱ hemorrhoids have little or no bleeding in stool, and often flow from anus.
② Hemorrhagic stool in anal fissure is often accompanied by anal pain and typical periodic pain after defecation.
③ The main manifestations of anal canal cancer are bloody stool and pain, and the pain is aggravated before defecation.
(2) Rectal diseases
① The main symptom of rectal polyp is hematochezia, which is intermittent, bright red in color and generally small in quantity. This disease is very common among children.
② The main manifestations of rectal cancer are increased stool frequency, thin stool, mucus and blood, accompanied by acute internal emergency, heavy defecation or endless defecation. The blood in the stool is bright red or dark red in the early stage, and the amount is not much. In the later period, there are often smelly mucus in the stool, and weight loss should be paid great attention to.
③ Radioproctitis can also cause bloody stool, but there should be a history of radiotherapy.
(3) Colonic diseases
① Colonic polyp: A. Juvenile polyposis coli, with an average onset age of 6 years old and no family history, is characterized by blood, often accompanied by malnutrition, anemia, hypoproteinemia and growth retardation, and often accompanied by congenital malformations, such as intestinal malrotation, umbilical hernia and brain edema; B. Familial juvenile polyposis coli: there is a family history, and the common symptoms are bloody stool, rectal prolapse and growth retardation; c .Cronknite？ Kanda's syndrome (CCS) is a hamartomatous polyposis syndrome, which is formed in adults. It is characterized by bloody stool, diarrhea, heavy stool, fat, abdominal pain, anorexia, fatigue, vomiting, loss of libido, and loss of taste. Nails, hair loss and pigmentation almost always change.
② Colon cancer: It is common in left colon cancer. Patients often have intractable constipation, and occasionally the frequency of defecation increases. When the cancer breaks, blood or mucus can be stained on the outside of the fecal mass, and even pus can be discharged.
(3) Chronic nonspecific ulcerative colitis and bacillary dysentery: both of them have bloody stools, and most of them discharge mucus or pus at the same time, accompanied by abdominal pain.
(4) Amebic dysentery: As a result, blood is the main symptom, and its stool is sauce red, sticky and smelly.
(5) Hemorrhagic Escherichia coli enteritis: characterized by acute onset, accompanied by fever and diarrhea, with a history of carrion eating, often in the form of food poisoning.
In addition, children under the age of/kloc-0 should pay attention to intussusception. Some systemic diseases such as leukemia, aplastic anemia and hemophilia. There will also be symptoms of bloody stool.
have/pass blood in one's stool
After gastrointestinal bleeding is discharged through the intestine, the feces contain blood or whole blood stool, which can be bright red, dark red or tar-like. The color of bloody stool depends on the bleeding site, the amount of bleeding and the time that blood stays in the digestive tract. Lower digestive tract (small intestine, colon, rectum, anus) bleeding, stool is often bright red or dark red. Upper digestive tract (esophagus, stomach, duodenum) bleeding, stool is often tar-like.
(1) etiology
Blood in stool is generally divided into bloody stool, tar stool and occult blood stool. Common reasons are described below.
1? Blood usually comes from the lower end of ileum, colon, rectum and anus, and the stool is bright red or dark red, which can be mixed with mucus and pus. Common diseases are hemorrhoids and anal fissure bleeding. Hemorrhoid hematochezia is ejected during defecation or drops blood after defecation; Anal fissure has less bloody stool, but anal pain is more severe. Rectal polyp bleeding, stool blood volume is not large, blood adheres to the surface of stool, and sometimes stool becomes thin and strip-shaped or imprinted. Dysentery blood is purulent bloody stool with frequent defecation and left lower abdominal pain.
2? Tarry stool is black stool. Upper gastrointestinal bleeding does not vomit, and blood stays in the intestine for a long time. Hemoglobin in the blood combines with sulfide in the intestine to form ferrous sulfide, which makes the stool black and shiny, like asphalt. The appearance of tarry stool indicates that the amount of bleeding has reached more than 60 ml. However, it should be noted that some foods and drugs can make the stool black, which can be identified by fecal occult blood test.
3? Concealed blood stool is called occult blood stool only when a small amount of gastrointestinal bleeding does not cause color change of stool. All diseases that cause gastrointestinal bleeding can cause occult bloody stools, such as gastric ulcer and gastric cancer.
(2) Rescue measures
The rescue measures are basically the same as vomiting blood. Stay in bed quietly, reduce activities, observe the amount of bleeding, use hemostatic drugs appropriately, and send them to the hospital for rescue in case of syncope and shock.
Is hematochezia an internal hemorrhoid?
Bloody stool is a typical symptom of internal hemorrhoids, especially early internal hemorrhoids, but it cannot be considered as internal hemorrhoids. Bloody stool is a common symptom, and many diseases can cause bloody stool in clinic.
① Various enteritis: due to inflammation, the integrity of intestinal mucosa is destroyed, and dark purple blood and secretions are mixed in stool, accompanied by various unique symptoms of enteritis.
② Anus papillitis and its hypertrophy: On dental floss, the surface is covered with anal epithelium, with occasional bleeding.
③ Anal fissure: severe pain during defecation and blood dripping after defecation.
④ Rectal cancer: frequent bleeding and many secretions are the most likely to be misdiagnosed and missed. Fingertips can be stained with blood during hand examination, and hard lesions with different shapes, rough surfaces and uneven edges can be touched. Pathological biopsy is needed to confirm the diagnosis. Bleeding from this disease can also lead to anemia.
⑤ Rectal adenoma or choriocarcinoma: The disease often bleeds. Every time I have a bowel movement, there is bloodshot blood in my stool, and occasionally there is a lot of bleeding. However, the tumor is long and pedicled. Anoscopy showed that the tumor was red and pedicled.