What should I do if I have diarrhea in a hurry? Author: Taylor-Zhang Shengsheng's "When the doctor is sick" famous doctor, chief physician, MD, director of the Department of Gastroenterology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, and postgraduate tutor. He has visited Canada, Switzerland, Germany, France and other countries. At present, he is the leader of the key disciplines of Chinese medicine digestion in state administration of traditional chinese medicine, the leader of the construction unit of the key specialty of spleen and stomach diseases in state administration of traditional chinese medicine, the leader of the key specialty of digestion of integrated traditional Chinese and western medicine in Beijing, the member of the National New Drug Evaluation Committee, the member of the National Natural Fund Evaluation Committee, the evaluation expert of the Ministry of Health, and the member of the Science and Technology Award Evaluation Committee of the Chinese Medicine Association. Undertake 2 national 11th Five-Year Plan supporting projects and 2 Beijing municipal projects. He is good at treating ulcerative colitis, irritable bowel syndrome, dyspepsia, chronic atrophic gastritis and precancerous lesions of stomach, gastroesophageal reflux disease, non-infectious cirrhosis ascites, peptic ulcer, chronic diarrhea, stomachache, abdominal distension, diarrhea, constipation, gastric acid reflux and other diseases. It is difficult to make an appointment with Zhang because he works in the most recognized Chinese medicine hospital in Beijing, which is located in Kuanjie, Dongcheng District. Beijing has produced famous doctors such as Guan Youbo and Zhao Bingnan, and hospitals have always been "time-honored brands" in people's minds. As the current director of gastroenterology, Zhang Shengsheng is definitely a young talent, as evidenced by his academic positions and national projects. Therefore, if you want to see his clinic, you have to queue up at three o'clock the night before. In an afternoon clinic, he has to see more than 60 patients, many of whom are from other places. "When you are in a hurry, you will have diarrhea. "What makes these patients embarrassed is that the car is waiting outside, but it is necessary to solve the' internal emergency' immediately; Friends are very happy at the party. After eating cold dishes, they immediately ask the waiter where the toilet is. Director Zhang said that although most of this kind of "functional diarrhea" only affects the quality of life and is not fatal, "old diarrhea" also ignores the tumor problems covered by diarrhea and even the chronic diseases of other organs because of the "skin" of the disease. In fact, the liver, pancreas, gallbladder, thyroid and so on. It may be the ultimate culprit of diarrhea. Dr. Zhang's experience on various diarrhea problems is worth listening to. 1. What is the "alarm state" of diarrhea? Diarrhea is very common in life, and all kinds of situations can happen: diarrhea can occur when a tumor occurs, ulcerative colitis can also occur, and diarrhea can also occur when intestinal polyps have local inflammation. Some patients suspect that they have a tumor because of long-term diarrhea, and the result is actually hepatitis. However, most cases of diarrhea are good and functional, and its incidence is on the rise, which is mainly related to social development, changes in diet structure and increased psychological pressure. But the nature of many diarrhea can't be judged by yourself. Although the incidence of cancer is still very small, it is 100%, so if you have the following "alarm symptoms", you should pay special attention: 1. Diarrhea used to be light, but it has become more and more serious recently; 2. You have been losing weight recently, and people around you will say that you look pale and ugly; 3. Go to the hospital to find anemia, and then check the stool to find "occult blood". If the above three symptoms appear, it is necessary to check them carefully. Second, people who often have diarrhea, if they go to the hospital for examination, where should they start? When you come to the hospital because of diarrhea, the doctor will ask you "What other symptoms besides diarrhea"? Will ask, "What is diarrhea? Is it watery diarrhea or purulent blood? "If it is a purulent blood sample, one may be colitis and the other may be dysentery. Dysentery includes bacillary dysentery and amebic dysentery. Amebic dysentery is rare in cities, and bacillary dysentery is quite abundant. When the weather gets hot, the food is not clean, and suddenly I have a stomachache, purulent blood and even a fever. It may be bacillary dysentery at this time. The doctor will ask you to do routine stool examination and "stool culture" If "Shigella dysenteriae" is found in the stool, it can be determined that it is dysentery. For chronic diarrhea, you will first check a biochemical index, which is what we often call a blood test, to see if there is any problem with the patient's liver function. Because both hepatitis and pancreatitis can lead to diarrhea, the root cause can be found from the abnormality of biochemical indicators. We also need to check a "B-ultrasound." B-ultrasound is mainly to eliminate the problem of liver and gallbladder. Finally, you can do a colonoscopy if necessary. It may be found that there are many connected ulcers in the intestine, or although there are no ulcers, the intestinal mucosa is rough and bleeds when touched. By doing pathological examination, the tumor can be ruled out and ulcerative colitis can be diagnosed. Ulcerative colitis is not infected with a certain kind of bacteria, but a multi-factor disease related to immunity. If colonoscopy finds polyps, ulcers and other problems, it can not be diagnosed as what we call "functional diseases." In addition, sometimes it is necessary to test thyroid hormone according to symptoms to see if there is hyperthyroidism, because hyperthyroidism can also lead to diarrhea. Generally speaking, "functional" diseases are relatively mild, such as "intestinal dysfunction" and "cardiac neurosis" are all acute diarrhea. If you check, you can't find out what is wrong with the structure of the intestine and heart, just dysfunction, which is generally related to psychological factors. It is more suitable for the treatment of traditional Chinese and western medicine and can be solved as a whole. If the doctor says that there are "organic changes", that is to say, real things can be found through B-ultrasound and X-ray, such as a tumor, the deformation of the second valve of the heart, or the ulcer of the intestine, which are all "organic lesions". Western medicine surgery is good at dealing with this, excision that can be removed and repair that can be repaired. Third, what is the difference between diarrhea caused by hepatobiliary pancreas and thyroid? Diarrhea related to hepatobiliary diseases, in addition to diarrhea, is often accompanied by aggravation after eating greasy food, or loss of appetite, aversion to oil and nausea at the sight of greasy things at the same time, especially for people with a history of hepatitis. Eating greasy food will cause diarrhea, which may be related to the gallbladder. People with cholecystectomy are also prone to this problem. If it is diarrhea caused by pancreatitis, there is often a history of overeating, but overeating is not an absolute concept. Some people get sick after eating only two fried dough sticks or drinking only a little wine. Abdominal pain, diarrhea and vomiting should be considered, especially in young people. If you are an obese person, your blood triglyceride is usually high, and you suddenly have abdominal pain, nausea and vomiting after eating greasy food. You can have a low fever or no fever. You must think about whether it is pancreatitis. Pancreatitis is divided into mild and severe, and the mortality rate of severe pancreatitis is relatively high. Severe pancreatitis has serious symptoms, but it can't be judged from the severity of abdominal pain. Some patients who have no pain are also severe pancreatitis. Young adults, obese people who have eaten greasy food, should have pancreatitis in their hearts and abdominal pain can't be tolerated. Some people may not think that hyperthyroidism can also cause diarrhea, and diarrhea is usually accompanied by hyperthyroidism itself. Hyperthyroidism is a high consumptive disease, which can be manifested as forgetfulness, irritability, sweating, palpitation, diarrhea, overeating and emaciation. If a person with high triglycerides suddenly has a stomachache and a fever after eating greasy meals, must he think of pancreatitis? This is the doctor's experience. Because this kind of person's pancreas is always "busy" dealing with grease, a new greasy meal finally makes the pancreas "overloaded". You know, even now, the mortality rate of "necrotizing" pancreatitis is very high, and it will kill people if it is delayed. Fourth, will ulcerative colitis become cancerous? Patients with ulcerative colitis with a history of more than 10 years should be especially vigilant. Ulcerative colitis used to be rare in China, but it is very common in Europe. In recent years, the incidence rate has increased significantly, which may be related to changes in the environment and diet. The exact cause of the disease is still unclear, but one thing is certain, which is related to immunity. Because of this, ulcerative colitis is a refractory disease, so it is listed as a "major disease" in China's Eleventh Five-Year Plan. Most patients with ulcerative colitis will relapse. Many patients know that they have been taking medicine for at least one and a half years, and as soon as they stop taking it, they will commit crimes. Need to be reminded that ulcerative colitis should be checked regularly. Some patients have repeated attacks for a long time, the mucosa is constantly injured, and the intestine will narrow. Other patients developed intestinal tumors after long-term attacks. Generally speaking, people who have suffered from ulcerative colitis for more than 10 years are more likely to get cancer. Recurrent ulcers can also form polyps, which are also closely related to colorectal cancer. If colonoscopy finds polyps, we suggest resection, which can significantly reduce the incidence of colorectal cancer. At present, colonoscopy can completely remove polyps, which is very simple. Taylor said: once my wife's physical examination found that "triglycerides" were high, but she was not fat. Ask a college student who was the director of internal medicine. She said, nothing, eat less oil, exercise more, and check again. Sure enough, after doing what she said for a few months, it was normal. Compared with high cholesterol, high triglycerides are more likely to be effective through diet and exercise. In other words, most of the high triglycerides are eaten. 5. It was diagnosed as "colitis" during physical examination. Do I need treatment? First, explain what "colitis" is. Before colonoscopy, we should clean the intestines and help them clean up the feces inside. These intestinal lavage drugs will stimulate the intestines. When doing colonoscopy, the doctor will see congestion and edema of intestinal mucosa, and sometimes the doctor may give you the next diagnosis: "colitis". In fact, if there are no other problems, this kind of "colitis" actually doesn't make much sense. More is to provide you with a reference to functional diseases. If he has had acute abdomen before, it may be what we often call "irritable bowel syndrome", which is a typical functional diarrhea. Such patients often show diarrhea and abdominal pain, which often occurs before defecation and is relieved or relieved after defecation. When you are nervous or don't pay attention to your diet, you will have an attack immediately, such as eating something cold and drinking some milk. The car is waiting for you outside, but you have to go to the toilet. Before you get together with your colleagues, you must go to the toilet. If B-ultrasound doesn't find anything, in this case, we can give him a more accurate diagnosis, which should be "irritable bowel syndrome". Many people suffering from this disease are white-collar workers, leaders and people with great pressure. Our epidemiological survey shows that there are more white-collar workers than blue-collar workers, more intellectuals than workers and peasants, and people with relatively complex ideas are also high-risk groups, mainly young people, but there are still few elderly people. This disease used to be called "colonic allergy" or "allergic colitis", "neurocolitis" and "intestinal nerve dysfunction". Many people are hospitalized for this, and everything is fine, but the patient's discomfort is real, and it can be as serious as dehydration and acidosis. I met a patient in the clinic who had severe diarrhea and couldn't work. I think about this every day. I'm afraid of going to dinner and parties. The first thing I want to do is to ask, "Where is the toilet? "He was very depressed and upset, which led to the" irritable bowel syndrome "of anxiety and depression. Psychological stress is very great, which in turn aggravates the problem of diarrhea. In this case, in addition to treating diarrhea itself, anti-anxiety and anti-depression drugs, whether traditional Chinese medicine or western medicine, should be added. Taylor said: Some antidepressants take effect slowly and take two weeks to take effect, which is determined by the characteristics of the drugs. Therefore, if you take antidepressants, you should ask your doctor about it. It is not that the medicine is useless, nor that you are too ill, but that the medicine has not yet taken effect. Six, how to know your condition from the stool? The pus of "purulent bloody stool" often mentioned in stool examination is like snot, and blood is not blood. If it is blood, there is a great possibility of hemorrhoids. The blood in purulent bloody stool is generally dark red, which will appear when ulcerative colitis occurs. There are also differences between cancer hematochezia and hemorrhoid hematochezia. It is difficult for ordinary people without medical knowledge to tell it by themselves. The location of the tumor is different, so is the bleeding. If it grows in the anus, it may bring blood, similar to hemorrhoids, but it is found to be rectal cancer. If the tumor location is relatively high, there is generally no blood in the stool, which can only be found when going to the hospital for routine stool. Moreover, the amount of bleeding in the early stage of tumor is very small, such as 5 ml bleeding, which is invisible to the naked eye. If you can see it with the naked eye, the amount of bleeding will be relatively large. 7. Can berberine still be used now? If it's not bacterial diarrhea, you don't have to take anti-inflammatory drugs! Because there is no inflammation to disappear! Taking anti-inflammatory drugs is not only bad, but also bad. On the one hand, it causes drug resistance. When bacteria are really infected in the future, antibiotics will not work, and it will also destroy the normal operation of the intestine. For example, I went to Shanghai from Beijing on business today, but I didn't eat anything bad and actually had diarrhea. Actually, it's acclimatized. It's best to rest your stomach on an empty stomach. If you eat berberine, the problem is not too big. From now on, "Berberine" has a good protective effect on intestinal mucosa, but its anti-inflammatory effect is very weak, so it is not an anti-inflammatory drug. ‖ Taylor said: Hemorrhage caused by hemorrhoids and rectal cancer is in a relatively low position, and most people can't tell it by themselves. It is blood in the stool. Many people feel that they are "hemorrhoids" because of this, not that "ten people have nine hemorrhoids". In fact, as long as you go to the "gastroenterology department" or "anorectal department" of the hospital and do an "anal finger examination", you can find it. 90% of middle and low rectal cancer looks like hemorrhoids, which can be detected by finger examination. Therefore, the misdiagnosis of rectal cancer is mostly caused by patients' self-diagnosis. Eight, people with chronic diarrhea can use biological fungi drugs? People with chronic diarrhea should take some microecological drugs, namely biological bacteria. Because there are many bacteria in the normal intestine, some are beneficial and some are not. Under normal circumstances, they live in peace. If you take anti-inflammatory drugs all the time, or chronic diarrhea caused by other reasons, it may destroy this balance. Studies have shown that about 70% of chronic diarrhea has intestinal flora imbalance. At this time, taking some "microecological" drugs, such as lactic acid bacteria and "whole intestine", can restore the balance of intestinal flora, and taking microecological drugs can generally stop diarrhea in two or three days. You can also take intestinal mucosal protective agents. Smecta and many traditional Chinese medicines have protective effects on intestinal mucosa. If diarrhea belongs to damp heat, Changweikang and Gegen Qinlian Pills can be used. Can protect intestinal mucosa damaged by diarrhea. At the same time, the diet should be light, drink some rice soup, eat some noodles and the like, and don't overeat at this time. If you are anxious and depressed and have long-term diarrhea, the doctor may diagnose you as "chronic diarrhea with depression". You can add some antidepressants or use traditional Chinese medicine to regulate. Nine, how to eat Chinese patent medicine to treat diarrhea, Chinese medicine generally needs to "soothe the liver" to treat this kind of functional diarrhea and abdominal pain, because "the liver governs the drainage", many patients with emotional tension are considered as "liver depression", which affects the spleen from the liver. Note that this liver and spleen is not the liver and spleen of western medicine, but the viscera of Chinese medicine is actually a combination of functions, including the digestive system here, so the communication between doctors and patients is very good. In addition to Shugan Xiaoyao Pills, there are Shen Ling Baizhu Powder and Sijunzi Pills in pharmacies, all of which strengthen the spleen and are effective for chronic functional diarrhea. If you usually have diarrhea when you eat cold, it will be comfortable to eat a warm stomach. Generally belongs to the cold constitution, you can eat "Fuzi Lizhong Pill". People with heavy moisture generally have thick and greasy tongue coating, and they always feel uncomfortable when defecating, as if they can't wipe their bottoms. This is what Chinese medicine calls "damp heat". People who are often fat and like to eat fat meat can use "Gegen Qinlian Pill". 10. Have you ever taken laxatives that do not produce dependence? Relieving constipation through drugs is only an expedient measure for habitual constipation. Generally speaking, western medicine is still a "soluble laxative", that is, we often say "lactulose" and "polyethylene glycol". This soluble laxative is generally independent, and it increases the volume of stool and promotes defecation. Irritant laxatives are dependent, and both senna and rhubarb are irritant laxatives. If you take a stimulating laxative for a long time, it will lead to blackening of the large intestine. This situation has something to do with cancer. Although it is still uncertain, it is not suitable for single long-term medication, and it should be compatible with other drugs if necessary. Many people are concerned about the treatment of habitual constipation. First of all, the diet should be changed, and you must eat more coarse grains and crude fiber, which is conducive to promoting intestinal movement; Second, drink plenty of water, because stool can't be discharged without water; The third is to exercise. Some people say to exercise once a week. This is not what we call exercise. This "surprise exercise" doesn't work. The correct way is to take a walk and exercise every day. Because of sedentary, the pelvic cavity and intestine are in a state of blood stasis, and regular activities are conducive to defecation; The fourth point is also important. Usually, we should develop the habit of regular defecation and defecate regularly every day. Don't change it at will because time is tight, and habitual constipation will form over time. Umbilical application therapy is to mix Fructus Psoraleae, Radix Aconiti Lateralis Preparata, Semen Myristicae and Fructus Schisandrae Chinensis, grind them into fine powder, make them into paste with vinegar, apply them to umbilical foramen, cover them with gauze and fix them with breathable adhesive tape. Generally, it lasts for 6- 12 hours, and 7 days is a course of treatment, which can be repeated for 2-3 courses. It is especially suitable for abdominal pain and diarrhea with obvious cold and dampness. Skin sensitive person can shorten the time, and those with good skin tolerance can extend it appropriately, but it is best not to exceed 24 hours. People with acute pathological changes, damp heat in the body, navel inflammation or severe skin allergy should not be treated with this method. In addition, it is not advisable to apply Chinese medicine to the navel immediately after an empty stomach or meal.