For elderly patients, it depends on whether their physical condition is suitable for surgery, and for those who cannot have surgery, they can take conservative treatment with traditional Chinese medicine. Then how to treat stomach cancer?
How to treat gastric cancer? How to treat to reduce recurrence rate
Surgery is the most effective treatment for early stage of gastric cancer, and the adjuvant treatment with Chinese medicine, such as taking Yuan Neng Oral Liquid, can improve the appetite and mental condition of the patient, which can speed up the recovery of the body after surgery and improve the quality of life of the patient.
How to treat gastric cancer? The following five methods are introduced.
A. Surgical treatment.
This is the first choice and fundamental method to treat gastric cancer. For early and middle stage cases, radical resection is feasible; for advanced cases, palliative resection is feasible. Even if the tumor cannot be removed, a considerable proportion of gastric cancer patients need to receive surgical treatment, such as diversion (shortcut surgery) to relieve obstructive symptoms and improve the quality of life. Therefore, once gastric cancer is diagnosed, it should be treated by surgery as soon as possible.
B. Chemotherapy
Chemotherapy can be used as a bailout treatment after surgery to destroy the remaining cancer cells in the body; it can also be applied before and during surgery to improve the resection rate of surgery and reduce the medical dissemination. In advanced cases, it can be applied as a palliative tool to delay the development of the disease. Therefore, except for a few cases with poor general condition and early gastric cancer, most gastric cancer patients need to receive chemotherapy during the treatment process.
C. Radiotherapy
In the past, radiotherapy was rarely used in the treatment of gastric cancer. In recent years, it is believed that radiotherapy can increase resection rate and improve long-term results for certain gastric cancer patients before or during surgery. In individual cases, radiotherapy can also be used to relieve symptoms.
D. Biological cell immunotherapy
DC-CIK biologic cell immunotherapy can be used for patients with any stage of tumor, and DC-CIK cells can kill and remove very small tumor foci that cannot be removed by surgery or scattered tumor cells in the body, which can delay and prevent tumor metastasis or recurrence. Some patients who are temporarily unsuitable for surgery, interventional or other treatments can also be treated with DC-CIK biologic cell immunotherapy to improve their physical function and quality of life, thus effectively prolonging their life time.
DC-CIK biological cellular immunotherapy is indeed the latest concept in the treatment of cancer in the 21st century. It solves the drawbacks of single conventional treatment means, and it can fundamentally improve patients’ own immunity, which can achieve long-term survival with tumor.
E. Traditional Chinese Medicine
It can not only support the righteousness, but also use its functions of activating blood circulation and removing silt, softening hardness and dispersing nodules to fight cancer, and it can also be used to alleviate the toxic side effects of radiotherapy and chemotherapy.
Outlook of gastric cancer treatment in 2011
In recent years, individualized treatment of gastric cancer has become the most important development, and the best treatment decision is based on various known prognostic factors. The increasing trend toward individualization of gastric cancer treatment, refinement of surgical approaches and rational assessment and short-term evaluation based on the effectiveness of perioperative treatment are likely to be the main challenges in the coming period.
Several major clinical diagnostic tools have their own characteristics
Currently, the main clinical diagnostic tools for gastric cancer include endoscopic biopsy, endoscopic ultrasound (EUS), CT, PET/CT, MR, laparoscopy, etc. The accuracy of CT preoperative staging ranges from 43% to 82%, and the use of multidetector CT and spiral CT can improve the accuracy. The application of CT is quite common in China, and the objective understanding of the value of CT helps the scientific selection of gastric cancer treatment plan. Although EUS is more accurate in judging T-stage, N-stage is limited by detection range, and its clinical value is mainly reflected in T-stage diagnosis and selection of patients for neoadjuvant treatment. In recent years, the application of PET technology (i.e. positron emission tomography) has become more and more common. For gastric cancer, PET scan alone is not recommended because its clinical staging accuracy rate is only 47% and it is difficult to localize. PET/CT, however, can increase the preoperative staging accuracy to 68% through the complementary information of PET and CT. Although it is more expensive, its clinical promotion and application is still necessary.
The mature application of laparoscopic technology has made laparoscopic staging possible, gradually replacing “open exploration”. Studies have shown that about 20% of patients with locally progressive gastric cancer may have abdominal implantation, and laparoscopic exploration is less invasive and can improve the detection rate of abdominal implantation and metastases that cannot be detected by CT, but the detection of lymph node metastases and liver metastases by laparoscopic exploration has certain limitations. In China, many hospitals have carried out laparoscopic procedures, but conventional laparoscopic staging is not yet possible due to economic and other factors, and it can be considered for certain high-risk patients or units with conditions.
The new version of TNM staging is more in line with clinical practice
The staging system of gastric cancer is one of the key bases for individualized treatment selection, and from a certain perspective, it also reflects the characteristics of the biological behavior of a disease, and thus will gradually mature with our deepening understanding of the disease. Although the existing staging system can effectively classify the patient population to a certain extent, it cannot yet include other unknown factors that are important for describing the biological behavior of tumors, which provides a broad prospect for the future development of staging systems. At present, the most authoritative and widely used staging standard for gastric cancer in the world is the TNM staging standard jointly developed by the American Cancer Consortium (AJCC) and the International Union Against Cancer (UICC), and its application value in gastric cancer has been widely confirmed. With the increasing amount of high-level evidence-based medical evidence in recent years, the staging criteria for gastric cancer have been continuously revised, and the 7th edition of the AJCC TNM staging criteria was promulgated in 2010.
The 7th edition of the AJCC TNM staging criteria, which was promulgated in 2010, has made major adjustments in the determination of tumor infiltration (T) and lymph node metastasis (N) (see the table below).
These changes are consistent with the previous experience gained in the treatment of gastric cancer in China. However, whether the adjustment of staging forward for non-distant metastases in the original stage IV is reasonable in this revision remains to be discussed, and the related validation analysis is underway. In addition, the adjustment of treatment strategy corresponding to the change in staging also needs to be further explored because there is still a lack of sufficient data related to individualized treatment. In Japan, the new treatment guidelines and management protocols abolished the anatomical N-stage method and replaced it with a method that determines N-stage based on the number of metastatic lymph nodes.
The changing paradigm of refined surgical treatment is increasingly advantageous
With the progressive understanding of the pattern and biological behavior of lymph node metastasis in early gastric cancer, the treatment paradigm has changed significantly, i.e., surgery with reduced scope of gastrectomy and lymph node dissection is proposed, including transendoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), laparoscopic wedge resection (LWR) and laparoscopic intragastric mucosal resection (IGMR), laparoscopic and laparoscopic radical resection of gastric cancer. A large number of long-term follow-up results show that minimally invasive surgery does not increase the postoperative recurrence rate, and has the advantages of less postoperative pain, faster recovery of gastrointestinal function and less bleeding, as long as the surgical indications are properly mastered. At present, the indications for EMR for early gastric cancer are 2
The currently accepted indications for EMR treatment of early gastric cancer are intra-mucosal carcinoma (cT1a) visible to the naked eye below 2 cm, with differentiated tissue type and without ulcer formation. Since 2000, ESD techniques have also been introduced, but the biggest problem facing EMR or ESD is how to improve the accuracy of preoperative staging. Laparoscopic surgery is still only an investigational treatment for stage IA and IB patients.
Although it is technically perfectly feasible to complete the same D2 lymph node dissection as open surgery for strictly selected gastric cancer patients, no clinical studies with large samples and designed in accordance with the principles of evidence-based medicine have been published, and further exploration of laparoscopic gastric cancer surgery is still needed. Minimally invasive procedures that preserve function, such as PPG and LAVSSG, are effective in improving postoperative GI function and reducing the incidence of gallstones and diarrhea, mainly by preserving the hepatic and abdominal branches of the pyloric vagus nerve, thus improving patients’ postoperative quality of life, but their application in conventional treatment is not common due to the overlap of their indications with endoscopic surgery. However, it may also be re-evaluated in the future along with advances in diagnostic techniques (e.g., anterior lymph node detection techniques) and changes in standard procedures.
D2 surgery containing lymph nodes around named vessels of the abdominal trunk branches has become the standard
Over the years, the issue of lymph node dissection for gastric cancer has been thoroughly analyzed by scholars from the East and West, and D2 lymph node dissection including perivascular lymph nodes of the abdominal trunk has become the standard of care. A retrospective analysis of 1,377 resected gastric cancer data in the US SEER database showed that for patients with progressive gastric cancer, patients with more than 15 N2 lymph nodes or more than 20 N3 lymph nodes detected had the longest survival. However, the Japanese JCOG9501 trial confirmed by a randomized controlled study of D2 lymph node dissection versus D2+ paraaortic lymph node dissection (PAND) that D2+PAND dissection should not be routinely used for curable gastric cancer.Ilfet
Songun et al. performed an in-depth analysis of the 15-year follow-up results of the Dutch D1D2 study, and the results were published in this year’s Lancet
Oncology, also found a trend toward higher survival rates after D2 surgery and significantly lower gastric cancer-related mortality in the D2 group than in the D1 group (37% vs.
48%, P=0.01), while the high perioperative mortality due to combined splenectomy or pancreatectomy may be the main reason for the previous bias in survival outcomes. The Italian Gastric Cancer Study Group reported the results of D2 lymph node dissection with preservation of the pancreas, confirming that perioperative complications and mortality with D2 surgery were similar to those with D1 surgery. a subgroup analysis of the controversial INT0116 study by Enzinger et al. also found a trend toward improved patient survival with D1 or D2 surgery in centers with a high number of patients admitted with gastric cancer.
Therefore, compared to previous versions, the 2010 US NCCN guidelines specifically state that “in larger oncology centers, ‘modified’ D2 surgery (without combined pancreatectomy or splenectomy) performed by experienced surgeons does result in lower mortality and survival benefits “Therefore, “radical gastric cancer surgery should be performed by experienced surgeons in large oncology centers and should include regional lymph node – perigastric lymph node dissection (D1), as well as lymph nodes accompanying named vessels of the abdominal trunk (D2), with the aim of at least 15 or more lymph nodes” were examined.
Only a preliminary consensus has been reached on upper progressive gastric cancer
For upper progressive gastric cancer, there has been a debate whether a combined splenectomy should be performed for complete clearance of the No.10,11d group of lymph nodes, especially in the West, where combined splenectomy for gastric cancer is considered a high-risk surgical procedure. In recent years, it has been found that most of the metastases from splenic lymph nodes occur in the cardia region of the fundus of the stomach, with an incidence of 9.8% to 14%, and mainly occur in advanced tumors that have infiltrated into the plasma membrane (T3) or outside the plasma membrane (T4). Clinically, direct infiltration of gastric cancer into the spleen is rare, and the efficacy of prophylactic splenectomy is not superior to that of splenoprotection, so it is generally not recommended to perform this operation routinely.
It is currently being explored in several clinical studies, including the Japanese JCOG0110 trial. However, at least, the preliminary consensus is that stage IIIB and IV carcinomas in the cardia region of the gastric fundus or the greater curvature side of the gastric body region with direct tumor infiltration of the spleen or bloodstream metastases to the spleen and metastases to the splenic hilar lymph nodes should be treated with splenectomy.
Perioperative chemotherapy improves survival of progressive gastric cancer
The most representative clinical study on perioperative chemotherapy is still the MAGIC study. In this study, three cycles of ECF (epirubicin combined with cisplatin and 5-FU) were given preoperatively and postoperatively. The results showed that perioperative chemotherapy improved the long-term survival of patients with progressive gastric cancer, with neoadjuvant chemotherapy for locally progressive gastric cancer reducing T and N stages and increasing the rate of surgical cure. Another representative study is the FFCD conducted by Boige et al.
9703 study. The results showed that the preoperative chemotherapy group significantly increased the R0 resection rate (84% vs.
73%, P=0.04), and again there was no significant difference between the two groups in terms of surgery-related mortality. The chemotherapy group had a significant advantage in 5-year overall survival and disease-free survival (disease-free survival: 34% vs.
21%, P=0.003; overall survival: 38% vs. 24%, P=0.02). The results of these clinical studies confirm that perioperative chemotherapy improves the survival benefit of patients with progressive gastric cancer.
The currently accepted principles for the application of neoadjuvant chemotherapy for gastric cancer are: for localized progressive cancer with possible radical resection, the aim is to control microscopic metastases in people with a higher risk of recurrence. In Europe and the United States, there are results from phase III clinical trials indicating the effectiveness of radiotherapy for gastroesophageal junction cancer. In addition, there is a lack of high-level clinical evidence to support this, although there are reports of high rates of conversion with potent chemotherapy in patients with positive abdominal free cells.
Recommended adjuvant therapy protocols differ between the United Kingdom, the United States, and Japan
For postoperative adjuvant therapy, the INT0116 trial in the US and the MAGIC study in the UK demonstrated the effectiveness of postoperative 5FU/LV combined radiotherapy and ECF regimens for pre/postoperative adjuvant chemotherapy, respectively, but the efficacy of both was lower than the overall efficacy reported in Japan. For the standard chemotherapy regimen for patients with primary gastric cancer, S-1+CDDP is recommended in Japan, and the ACTS-GC study published in 2007 confirmed that adjuvant chemotherapy with S-1 after D2 surgery in gastric cancer patients reduced the risk of death, but only 3 years of follow-up was available at that time. At the 2010 ESMO meeting, Japanese scholars presented the 5-year follow-up results of this study, and similar to the 3-year results, postoperative use of S-1 single-agent adjuvant chemotherapy was effective in improving patient survival (71.7%
vs.
61.1%) and a decrease in the risk of recurrent metastasis by approximately 35% (HR=0.653), further confirming the effectiveness of S1 in adjuvant chemotherapy for gastric cancer. In contrast, the recommended treatment regimen in the West is still the traditional ECF regimen.
Targeted agents may become more important in non-surgical treatment
Since 2009, NCCN guidelines have added paclitaxel-based chemotherapy regimens to systemic chemotherapy for gastric cancer (Level 2B evidence), while starting to mention the value of targeted drugs such as sorafenib in combination with conventional chemotherapy. And last year, with the publication of ToGA study results, the therapeutic value of chemotherapy combined with trastuzumab for patients with HER2-positive progressive gastric cancer was confirmed by scholars from various countries, thus becoming one of the standard treatments for metastatic or locally progressive gastric cancer (level 2A evidence). Looking at the trend of clinical research related to gastric cancer in recent years, targeted drugs may occupy an increasingly important position in the non-surgical treatment of gastric cancer.
How to treat advanced gastric cancer?
Advanced gastric cancer often has widespread metastasis and is often combined with pyloric obstruction, cancer perforation, bleeding, ascites and other conditions, which have lost the chance of radical surgery. Such patients account for 10%-15% of the total number of gastric cancer. With the improvement of modern treatment technology, people have gradually realized that the treatment of advanced gastric cancer should adopt the new concept of active treatment instead of the old consciousness of passive waiting. From the perspective of comprehensive surgical treatment, the main elements include: (1) Never give up the opportunity of surgical treatment for advanced stage patients easily. Currently, cytoreductive surgery is highly recommended.
(1) Never give up the opportunity of surgery for advanced stage patients easily, which emphasizes that if the primary tumor can be removed actively, it can significantly reduce some complications related to advanced tumor and create conditions for other comprehensive treatment. (2) For patients without surgical indications, non-surgical or minimally invasive treatments should be adopted as far as possible to alleviate complications and improve patients’ quality of life. (3)Actively carry out terminal
care, such as analgesia, sedation, diet regulation, nutritional supplementation, spiritual and psychological care, etc., so as to minimize the suffering of the terminally ill. Although there is no significant progress in this field, some new technologies can be applied to improve symptoms and enhance the quality of life of patients.
Treatment of pyloric stenosis or obstruction due to advanced gastric cancer
Gastro-jejunal diversion is a traditional palliative treatment. However, patients with advanced cancer often suffer from severe malnutrition, anemia and immunosuppression, and the operative mortality rate is high, and the surgery has problems such as accelerated local spread of tumor and slow wound healing. It has been reported that gastro-jejunal diversion does not help to improve patient survival and quality of life. Given that various advanced diagnostic techniques such as endoscopic ultrasound, spiral CT and laparoscopy can provide more accurate preoperative staging for patients with progressive gastric cancer, unnecessary laparoscopic exploration should be avoided as much as possible for advanced patients who are clearly unresectable. In recent years, the development of various intracavitary instruments and endoscopic techniques have provided new treatment means for such patients. The most reported is the application of self-expandable metal stents (self-expandable
men tallic
stent (SEMS), i.e., the placement of a self-expandable endoluminal stent after balloon dilation of the pyloric stenosis after local anesthesia guided by fiberoptic endoscopy to relieve the symptoms of obstruction, has gradually replaced the traditional gastro-jejunal diversion in recent years. This method is simple, safe, less painful, and has a high success rate. The successful placement can immediately relieve the symptoms of obstruction, and most patients can resume eating semi-liquid or even solid food from inability to eat, which improves the nutritional status of patients and thus the quality of life to a certain extent. In cases of severe pyloric stenosis, pediatric gastroscopy guidance can be used, and it can also treat advanced penetrating carcinoma complicated by GI-airway fistula. Recently, there have been many innovations and improvements in technology and materials, and new materials such as memory metal alloys, polysilicone-coated malleable stents and new stents with, for example, anti-reflux devices have emerged. The recent complications of this method are acute perforation and bleeding, and the late complications are food retention, tumor overgrowth and catheterization.
overgrowth) and catheter migration.
For very advanced cases of proximal gastric tumor obstruction where stent placement is difficult, percuta ne ous endoscopic guided gastrostomy (PEG) can be used.
gastrostomy (PEG), but this method has the potential to lead to tumor implantation in the abdominal wall. In cases of end-stage gastric cancer causing severe obstruction in multiple parts of the digestive tract, percutaneous transesophageal gastric tube placement has been reported to drain digestive juices and save patients from long-term nasogastric tube placement, supplemented with intravenous nutrition and analgesia to help relieve symptoms and improve quality of life. For patients with obstruction of GI input collaterals and severe obstructive jaundice caused by recurrence of gastric cancer, percutaneous transhepatic duodenal drainage (percutaneous transhepatic duodenal drainage) can be used.
transhepatic duo denal
drainage (PTDD) method. Other methods, such as palliative treatment with bipolar electrocoagulation needles under direct endoscopic view, cryotherapy with liquid nitrogen and other cryotherapy and endoscopically guided laser treatment, and endoscopic palliative argon gas electrocoagulation, are not yet available, but the exact efficacy and clinical application are uncertain.
Treatment of advanced carcinoma combined with ascites
Ascites arising from cancerous dissemination in advanced gastric cancer is a difficult problem in the management of patients with end-stage cancer. Chemotherapy is still the main treatment method for this type of ascites. It can be used as long as the patient’s condition allows, and the route of administration can be via vein or artery. For intractable ascites, direct intraperitoneal administration is mostly used. It has been reported that low-dose cisplatin plus intraperitoneal infusion of concentrated ascites filtrate, together with intravenous 5-FU, can significantly improve ascites symptoms, and most patients in the treatment group have decreased serum CA125 levels and improved quality of life. There are also recent animal experiments in which anti-gastrin antibodies supplemented with cytotoxic drugs were successfully used to treat a mouse model of human gastric cancer ascites, but clinical practice is still being explored.
Neoadjuvant chemotherapy has also become a common treatment for this group of patients in recent years, which can reduce ascites, relieve symptoms, and have a clinical downstaging effect on the tumor. The commonly used regimens are CDDP, 5’DFUR, etc., but there are no clinical reports of complete remission (CR), mostly partial remission (PR). The reported results vary, but neoadjuvant chemotherapy has undoubtedly become a major component of the comprehensive treatment regimen for this group of patients.
Treatment of advanced gastric cancer combined with upper gastrointestinal bleeding and perforation
With few new advances, upper gastrointestinal bleeding is often difficult to control in this group of patients. When the patient’s general condition does not allow surgical hemostasis, minimally invasive endoluminal techniques such as endoscopic spraying of hemostatic drugs and gelatin, endoscopic laser and freezing techniques can be used to stop bleeding, but the efficacy is not definite and there is a possibility of rebleeding. Advanced gastric cancer combined with perforation is often accompanied by diffuse peritonitis. As long as the systemic conditions permit, abdominal dissection should be performed, and if the primary cancer foci can still be palliatively removed, it should be strived for. Repair of the perforation alone is often futile, but a concomitant gastrostomy and nutritional jejunostomy may provide symptomatic relief and ultimately help the patient survive the end stage.
Home treatment of the end-stage patient
For most patients with advanced disease, quality of life is often more important than prolonging survival. Many end-stage patients prefer to be treated and cared for at home. Home
care) is gaining importance. The duration of home care ranges from a few days to several months. The main focus of home care is to relieve symptoms, improve nutritional status and analgesia. The application of a small amount of hormones, the emergence of various new technologies and home care devices have also made home care possible for patients with end-stage cancer. Some treatments that used to be carried out in hospitals, such as gastrointestinal decompression, total parenteral nutrition, spray inhalation, etc., can now be carried out at home, which can provide mental and psychological comfort and shorten hospitalization time, and to a certain extent, reduce treatment costs and expenses.
Can malignant gastric mesenchymal tumor be treated?
For malignant gastric mesenchymal tumor, some people feel very scary or even fearful, in fact, the treatment of malignant gastric mesenchymal tumor is not difficult, the key is to start from the correct choice of treatment methods and the regulation of their own body.
The first treatment and complete removal of the tumor is found to be extremely important for the first treatment of mesenchymal tumor. If the first treatment of malignant gastric mesenchymal tumor is reasonable, the efficacy is significantly improved, and the 5-year survival rate reaches 54%. In contrast, the 5-year survival rate for other recurrent cases is only 10%. Therefore, it is crucial to pursue the success of the first treatment, rather than the endless passive treatment for future recurrence, which is very ineffective.
2. Tumor-free operation and intraoperative prevention of tumor rupture Mesenchymal tumor’s envelope is very easy to rupture, which is obviously different from general gastrointestinal cancer. Especially for small intestine mesenchymal tumor, it often hangs on the intestinal wall and mesentery, so it cannot be clamped and treated if it breaks down slightly. In addition to traditional treatments, bioimmunotherapy can also be chosen for the treatment of malignant gastric mesenchymal tumor, which can effectively reduce the side effects caused by radiotherapy, prolong the life cycle, and effectively improve the quality of life of patients.
The best method is bioimmunotherapy. If we say that using single radiotherapy or surgery will have a lot of side effects, and they have to endure a lot of suffering during the treatment process, but bioimmunotherapy is different, he is stimulating the body’s own immune system through various effective methods to achieve the inhibition or killing of tumor cells. Biological immunotherapy can effectively prevent the recurrence and metastasis of malignant gastric mesenchymal tumor. If you are not suitable for surgery or radiotherapy, biological immunotherapy is the preferred method to improve the immunity of the body without any toxic side effects. You should also pay attention to your diet and stay optimistic, which will help you recover from the disease. Believe that one day you can overcome the disease and get well soon!
Three preferences and three contraindications for the diet of intestinal obstruction
Intestinal obstruction is a physical or functional obstruction of the intestinal cavity, and the site of onset is mainly the small intestine. Mechanical obstruction of the small intestine lumen or irreversible changes in the normal physiological position of the small intestine (intussusception, intussusception and torsion, etc.) occur. Small intestine obstruction not only makes the intestinal lumen mechanically inaccessible, but also accompanies severe local blood circulation disorders, resulting in severe abdominal pain in animals. Vomiting or shock and other changes, the disease occurs rapidly. The course of the disease develops rapidly, the prognosis is cautious, such as untimely treatment of high mortality.
So what should be noted in the daily diet of patients with intestinal obstruction? What are the contraindications?
Intestinal obstruction diet three appropriate
1, it is appropriate to eat light and nutritious, liquid food, such as rice soup, vegetable soup, lotus root powder, egg flower soup, noodles, etc.;
2, easy to digest food to promote defecation. Such as vegetables: seaweed, pig’s blood, carrots and other fruits: hawthorn, pineapple, papaya, etc.; eat more fiber-rich foods, such as various vegetables, fruits, brown rice, whole grains and beans, can help defecate, prevent constipation, stabilize blood sugar and lower blood cholesterol.
3, it is advisable to eat foods rich in protein and iron, such as lean meat, fish and shrimp, animal blood, animal liver and kidney, egg yolk, soybean products, as well as dates, green leafy vegetables, sesame paste, etc.;
Three contraindications to the diet of intestinal obstruction
1, avoid coarse food: 3 to 4 days after surgery, after the anal exhaust, suggesting that the intestinal function began to recover, at this time can be given a small amount of fluid, 5 to 6 days later can be changed to a semi-liquid diet with less residue. Avoid eating chicken, ham, pigeon meat and various vegetable soups. This material, even if cooked very badly, can not be manipulated too quickly.
2, forbidden greasy food: even to the 10th day, the organism can bear soft rice, greasy food can not be eaten early, such as hen soup, broth, mutton, fatty meat, pork ribs soup, turtle, etc..
3, avoid eating hairy food: even after the removal of lines, should be prohibited to eat dog meat, mutton, bird meat, bird eggs, dried bamboo shoots, scallions, pumpkin, beef, cilantro, smoked fish, bacon, chili, leek, garlic, light vegetables, etc. (Responsible Editor: Seeking Home)
Tips: teach you how to stay away from intestinal obstruction!
A. Avoid strenuous exercise
Effective prevention of intestinal obstruction, then, people should pay attention to do not do strenuous exercise after a full stomach, in order to prevent the occurrence of intestinal torsion.
Second, pay attention to dietary hygiene
Experts believe that the prevention of intestinal obstruction to pay attention to dietary hygiene, unclean diet will not only cause acute gastroenteritis, will also cause intestinal obstruction. If acute gastroenteritis is serious, repeated diarrhea will cause “paralytic intestinal obstruction”.
Three, eat less undigested food
Eat too much peanuts, melon seeds, eat a lot of persimmons, prunes, hawthorn, etc. on an empty stomach will lead to intestinal obstruction. For people who have had intestinal obstruction or have a history of abdominal surgery, be especially alert! Hemorrhoids hide these deadly diseases behind
When it comes to the causes of hemorrhoids, many friends can name a whole lot of them, such as sedentary, smoking and drinking, unhealthy diet …… In fact, hemorrhoids are a result, but the reasons that can produce this result are not just a bad lifestyle, there are many hidden very deep, easy to be ignored by us situation.
Be alert! Behind hemorrhoids may be hidden rectal cancer (file photo)
Hemorrhoids are a common and frequent disease that causes a lot of harm to the human body and brings a lot of inconvenience to work and life. If hemorrhoids are not very serious, they are easily treatable. Internal hemorrhoids are particularly prone to iron deficiency anemia, and external hemorrhoids can easily form anal fistulas. The more serious hemorrhoids can lead to or induce cardiovascular disease, especially in elderly patients, such as suffering from hemorrhoids produce psychological pressure, afraid to go to the toilet, and this will aggravate constipation, when defecation occurs with difficulty, the patient force to hold his breath, which can make the heartbeat accelerate causing cerebral vascular rupture, causing cerebral hemorrhage or cerebral embolism; if there is internal hemorrhoids embedded, pain can also induce angina attack; if there is thrombosis, can trigger pulmonary embolism! Due to the recurrence of hemorrhoids, the repeated stimulation of the anorectum by inflammation makes the local tissue inflammatory hyperplasia, causing the incidence of rectal cancer to rise 5 to 10 times in people suffering from hemorrhoids.
Be alert! Hemorrhoids hide these deadly diseases behind
Hemorrhoids – I never thought it was rectal cancer
Three years ago, he was found to have hemorrhoids and often had blood in his stool, but it did not hurt. He didn’t pay much attention to it until recently, when he lost weight day by day, blood in his stool increased, and his whole body was obviously weak. The company has been advised to go to the hospital for examination, only to discover that he has rectal cancer. ”Hemorrhoids are not confusing: rectal cancer and hemorrhoids have similar symptoms, such as blood in stool or bleeding after stool, anal pain and itching.
More than 90% of rectal cancers will be mistaken as hemorrhoids by themselves or doctors in the early stage. Distinguishing hemorrhoids from rectal cancer can be achieved clinically with some simple examinations, such as anal finger examination, anoscopy and Olympus colonoscopy. If it can be detected early, the treatment effect of rectal cancer is very good.
Hemorrhoids – not expected to be an enlarged prostate
Immediately after finding blood in the stool, you went to the hospital. During the doctor’s detailed inquiry, he also recently had thinning and weakening urine. The actual fact is that you can find a lot of people who are not able to get a good deal on this.
”The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The prostate hypertrophy will cause difficulty in urination, and it is inevitable that you will often hold your breath with force, prompting a rise in abdominal pressure, and the occurrence of blood return obstruction of the rectal veins stasis expansion, causing or aggravating the occurrence of hemorrhoids and prolapse.
Hemorrhoids – I never thought it was because of calcium deficiency
I never thought I would get hemorrhoids, he will have 30 minutes of exercise each morning and evening, and usually love to eat vegetables and fruits. The hemorrhoids written on the physical examination form puzzled him, and the doctor said that his hemorrhoids might be caused by a lack of calcium.
”Hemorrhoids” is not confusing: Hemorrhoids occur for no other reason than poor blood circulation in the anus or bleeding injury caused by the pressure of defecation. When there is enough calcium in the body to make good blood circulation, the chances of hemorrhoids occurring will be much less. Smoking and drinking are the culprits of calcium deficiency. Even if you have more exercise and eat more fruit, if you don’t change the two bad habits of smoking and drinking, it will directly affect the absorption of calcium.
Acute gastroenteritis dietary problems
Acute gastroenteritis disease is often characterized by an obvious history of improper diet, sudden onset and quick recovery, often manifested as nausea and vomiting, abdominal pain, diarrhea, etc. Summer is the high incidence of acute gastroenteritis, so how to pay attention to the diet of acute gastroenteritis?
In the prevention, in addition to paying attention to the dietary hygiene of acute gastroenteritis and washing hands regularly, it is also important to disinfect household items. The actual disinfection of utensils, towels, and clothing, of course, should be strictly disinfected, as well as the toilet bowl and faucet switch, which should not be neglected. This is because the toilet compartment is easily contaminated by splashing out bacterial secretions when the patient defecates, and the faucet switch is also easily contaminated when the patient washes his hands after defecating.
Fasting period: the acute phase of the disease is heavy, at this time should be fasted, so that the gastrointestinal tract to rest completely, rely on intravenous fluids to replenish water and electrolytes. Patients with milder conditions can drink sugar saline to replenish water and salt and correct disorders of water and salt metabolism.
Liquid diet period: During the recovery period after remission, first try a liquid diet, with 6~7 meals per day. A small amount of rice soup, lotus root powder, almond cream, etc. can be given at first. When the symptoms are relieved and the number of bowel movements is reduced, the diet can be changed to full liquid, such as adding steamed egg custard, salted egg yolk rice paste, lotus seed rice paste, thick rice soup dumping egg flower, carrot rice paste and other foods. After the smooth transition of liquid diet, it can be changed to low-fat, less residue semi-liquid diet, still should be small and frequent meals.
Semi-liquid diet period: the amount of consumption can be determined according to the patient’s condition. If the condition keeps improving, the transition to semi-liquid diet can be made in time.
Acute gastroenteritis mostly develops within 1~24 hours of eating. Symptoms may include nausea, vomiting, abdominal pain, diarrhea, loss of appetite, etc., and usually improves in 1~2 days. Therefore, it is important to pay more attention to the diet of acute gastroenteritis, and once this happens, you should seek medical attention in a timely manner.
Preventive measures for acute enteritis
The diagnosis of acute enteritis can cause the occurrence of symptoms in various parts of the body and is not difficult. Patients mostly have a sudden onset in summer and autumn, and patients mostly show nausea and vomiting first, followed by diarrhea many times, watery stools, dark yellow or greenish, malodorous, and can be accompanied by abdominal cramps, fever, generalized aches and pains, and other symptoms. how to develop measures to prevent acute enteritis.
Measures to prevent acute enteritis I: The prognosis for this disease is generally good. Because of the acute enteritis of Salmonella spp. infection of the gastrointestinal tract reaction violent intestinal pathogenic bacteria are rapidly expelled from the body, therefore, the symptoms of toxemia are generally mild, and patients mostly recover on their own in a short period of time. Some patients have poor body resistance, or suffer from some chronic diseases or receive adrenocorticosteroids, immunosuppressants and other treatments, resulting in a decrease in body resistance, then the germs can invade the blood from the intestinal wall to cause bacteremia, resulting in a larger infection process. For those with acute diarrhea, timely rehydration and attention to correct the electrolyte acid-base balance, otherwise there will be adverse consequences, especially for the elderly and infants should pay attention.
Measures to prevent acute enteritis II: actively carry out health education work, do not eat meat and offal of sick and dead livestock. Meat, poultry, eggs, etc. should be cooked before consumption. Strengthen food hygiene management, spoiled and salmonella-contaminated food is not allowed to be sold. Improve the sanitation of the canteen, establish a sanitation management system, pay careful attention to food production hygiene, and prevent food from being contaminated. Do a good job of water protection, drinking water management and disinfection.
Measures to prevent acute enteritis three: strengthen exercise, enhance physical fitness, so that the spleen is not easily affected by evil. The mood is relaxed to maintain a balanced gastrointestinal function. Diet to facilitate the absorption function of the spleen and stomach. The spirit is cured by careful living and avoiding wind and cold is yinping yang dense.
What factors can cause acute enteritis?
The cause of acute enteritis is caused by microbial infections such as bacteria and viruses, and is a common and frequent disease. Therefore, we should pay attention to dietary hygiene in our daily lives, especially in summer, and should avoid mistakenly eating unclean food, what are the causes of acute enteritis manifested in?
1, improper diet
It is often due to overeating, eating too much high-fat and high-protein food, drinking alcohol, drinking too many cold drinks, or after getting cold. Or eating corrupt, contaminated food, such as overnight food not heated and disinfected, smelly fish and shrimp, not fresh crabs, seafood, long stored in the refrigerator meat food, fermented and spoiled milk and milk products. It is mainly caused by irritating, raw, cold and corrupt contaminated food.
2.Intestinal infection
Such as common Salmonella, Salmonella, Escherichia coli, Aspergillus and Staphylococcus infections.
3, systemic infection
Such as typhoid fever, paratyphoid fever, hepatitis and sepsis, etc.
4.Drug-induced
Such as salicylic acid preparations, arsenic, mercury and laxatives, etc.
5.Individual patients have allergic reactions to food.
Acute enteritis is more frequent in the summer season, related to the hot weather and easy decay of food.
In summary, the five aspects of the causes of acute enteritis, people should avoid the above in life, so as to prevent the triggering of acute enteritis.
This is a good way to prevent acute enteritis from three aspects
Now there are many people think that only summer acute enteritis will appear, this idea is wrong. The reason why summer is prone to acute enteritis is because of the prevalence of cold night snacks and seafood. However, the fact is that even if the weather becomes colder, you should not take it lightly and pay attention to the prevention of acute enteritis.
It is easy to delay the condition without timely medical attention
Experts point out that the risk of cancer will increase exponentially if acute enteritis is not treated thoroughly. Many scholars have also mentioned in academic reports that ulcerative colitis in adolescents is prone to bowel cancer after middle age.
Anti-inflammatory drugs as a meal is not advisable
According to experts, antibiotic-associated enteritis is a kind of enteritis caused by the long-term use or abuse of antibiotics. If long-term use of antibiotics, antibiotics will kill certain pathogenic bacteria while also inhibiting or killing the normal flora, so that it loses its inhibitory effect on pathogenic bacteria, resulting in the proliferation of pathogenic bacteria (such as antibiotic-insensitive staphylococci, Candida albicans, etc.), leading to the occurrence of intestinal flora dysbiosis.
Western medicine may not be better than Chinese medicine
In the treatment and prevention of acute enteritis, Chinese medicine still has a unique approach. The whole body is in harmony with the internal organs, especially the application of topical patches, which is slightly better.
Warm tips: Prevention of acute enteritis should pay attention to diet. In addition to active treatment for the cause of the disease, but also to arrange a good diet. Low fat, less fiber, avoid alcohol and spicy stimulants. Small and frequent meals for more than 3 months.
Clinical manifestations of ectopic acute appendicitis and precautions before treatment
What is heterotopic acute appendicitis?
In the sixth week of embryonic life, a conical blind sac, the original base of the cecum and appendix, appears on the distal branch of the midgut against the mesenteric margin. The tip of the appendix grows into the appendix. In the tenth week, the midgut in the umbilical cord returns to the abdominal cavity and begins to rotate counterclockwise. By the time of birth, a total of 270° of rotation occurs, and the original lower left cecum and appendix rotate to the right iliac region. If the midgut does not rotate or rotates incompletely, the cecum and appendix are located in the lower left abdomen in the original position or somewhere on the way to transposition, forming an ectopic appendix. Another cause of ectopic appendix is incomplete fixation of the midgut, resulting in a free cecum and appendix. There are several types of ectopic appendix: (1) non-translocation deformity: the small intestine is on the right side, the colon is on the left side, and the cecum and appendix are ectopic in the lower left abdomen; (2) incomplete rotation: the cecum and appendix are ectopic in a part on the way of rotation, such as the left upper abdomen or under the liver, the latter is also called high appendix; (3) incomplete fixation of the ascending colon: incomplete fixation of the cecum and ascending colon causes the appendix to change position; (4) reverse transposition: very rare. The midgut is rotated in a clockwise direction so that the small intestine is located on the left side, the ascending colon is located on the right side, and in a few cases, the cecum and appendix are located in the neutral position. Another condition seen in ectopic appendix is that the appendix is located posteriorly to the cecum outside the peritoneum, due to the turning of the appendix to the posterior cecum outside the peritoneum during the elongation and descent of the cecum.
What to consider before treatment of ectopic acute appendicitis?
Ectopic acute appendicitis is not easily diagnosed and is often misdiagnosed as an inflammatory disease of the organ in which the ectopic site is located, such as subhepatic or high acute appendicitis is often misdiagnosed as acute cholecystitis, and acute appendicitis deep in the female pelvis is misdiagnosed as an inflammatory disease of the pelvic organs. When the heterotaxy is located in the left lower abdomen, it is usually difficult to confirm the diagnosis before surgery, except when the midgut is known to have a nonrotational deformity or is associated with a right-sided heart. Therefore, in cases of pain and fixed pressure pain located outside the right lower abdomen, a thorough physical examination with careful history is necessary to consider the possibility of ectopic appendicitis.
The principles of treatment for ectopic appendicitis are the same as those for general appendicitis.
Daily precautions for appendicitis
1. Prohibit the consumption of alcohol and avoid eating raw, cold and spicy foods. The first thing you should do is to eat less fried and indigestible food.
2, avoid overeating, to eat less and more meals.
3, to prevent excessive fatigue. Because overwork will make the body’s ability to resist disease and lead to a sudden aggravation of the disease.
4. Drink a moderate amount of water. It can neutralize the stomach acid and reduce the irritation of the ulcer surface by gastric juice, and it can also supplement the mild dehydration of the body caused by diarrhea.
5, careful use of drugs, especially some antipyretic analgesics and anti-inflammatory drugs, gastrointestinal stimulation is large, and in serious cases can cause gastrointestinal bleeding or even perforation, it is best not to use or use less.
6, adjust the diet structure, eat more vegetarian, less meat; eat more soft, less hard. Appropriate supplementation, strengthen physical exercise.