Patient: Description of the condition (onset time, main symptoms, hospital visited, etc.): 36-year-old male with recurrent pain in the right lower abdomen for 18 years, feeling bloated after a cold, the right lower abdomen is heavy, there is a protruding mass, bloating and pain even when you can not walk upright, need to immediately lie on the left side after the anal vent, usually within 10-30 minutes that is good as normal, normal stool. In winter, he had more episodes, and when he did not have episodes, he sometimes had vague pain in the right lower abdomen when he pressed, without a mass. In 2004, colonoscopy showed: terminal ileal lymphoid follicular hyperplasia. On New Year’s Day 2011, he had a severe attack of pain in the right lower abdomen after a cold, with bulging in the right middle and lower abdomen and normal stools. The abdominal plain film was normal, and the set of gastroscopy, blood picture, biochemistry, amylase, sedimentation, tuberculin test and antinuclear antibody were all normal. Ultrasound: the right lower abdominal intestinal canal was dilated and the peristalsis was obvious. He was discharged from the hospital after treatment with gastrointestinal decompression and no pain and no bulging of the abdomen. On the first day of the first month, there was another attack of pain in the ileocecal region, without antispasmodics just eating liquid and thin rice, the pain has not been relieved, lying down is better, getting up and moving is painful, there is a bulging mass on the right side of the umbilicus towards the upper middle abdomen, there is pressure pain on the right side of the umbilicus, but sometimes the mass will disappear without pressure pain. On February 21, after intestinal preparation for colonoscopy, I saw that the transverse colon was twisted during the process, and the colonoscope could not pass twice. CT showed a large amount of gas accumulation in the intestinal cavity and small intestine obstruction. He was hospitalized for two days for gastrointestinal decompression, with abdominal distension like a drum, no ventilation and no defecation, and severe pain, and the injection of prednisone only lasted for two hours. Intraoperatively, he saw inflammatory abdominal pus, a 20-cm-long segmental dilatation of the middle and lower ileum, about the size of a volleyball, torsion of the ileocecal intestine, poor blood flow in the dark black intestine, and local adhesions, and an increase in local mesenteric lymph node enlargement. The dilated segment of ileum and the ileocecal part (60 cm long in total) were resected, and the ileocecal ascending colon was anastomosed at the opposite end. Intraoperative diagnosis: ileocecal giant cyst, intestinal adhesions, ileocecal torsional necrosis, intestinal obstruction. Postoperative pathology showed: cystic change of ileum with hemorrhage, chronic inflammation of mesenteric lymph nodes with hemorrhage, and torsional necrosis of ileocecal part. The pathology report of Nanjing Military General Department: extensive hemorrhage with necrosis and superficial ulceration in the ileo-intestinal wall, chronic inflammation of mesenteric lymph nodes. It is consistent with intestinal torsion. Now 26 days after surgery, recovery is possible, can eat thin rice, rice, chicken and duck, etc.. He has diarrhea 3-4 times a day, with rotten stools in the morning and evening, and yellow loose stools with thin watery stools at noon, with a large volume of stools each time. After diarrhea, he had pain in the anus and felt weak, and gradually improved after 10 minutes of rest. At 17 days after the operation, he had a strong abdominal “gurgling” sound, bloating, and a lot of anal discharge. I am now taking Azinomide and Bifidobacterium bifidum. 1, Is it short bowel syndrome? 2, What should I do about the diarrhea? Medication? Diet? Patient: Hello Professor Wang, I still have a few questions for you! 1. The post-operative pathology was sent to your hospital for consultation, and inflammatory bowel disease such as Crohn’s disease was basically ruled out, and my stools were always normal before. Is the current diarrhea related to the removal of the ileocecal part? 2. You recommended “intestinal decontamination treatment”, how exactly is it done? Do you use medication? 3. “Supplementary enteral nutrition support treatment”, is it oral enteral nutrition oral solution? On the Internet, I read that when your professor Zhu Weiming answered other patients’ inquiries, he said that enteral nutrition preparations can aggravate diarrhea? Is it possible? I heard that the taste is very unpleasant, may I ask what are the slightly better tasting ones that are commonly used in your clinic? 4. I am in a good state of mind, and I am eating chicken, duck, pigeon and fish soup every day for early recovery. Or can I eat as much as I want according to my taste and just eat appropriately? Thank you! Answer: 1. Diarrhea may be related to the removal of the ileocecal region. 2. About intestinal decontamination treatment is mainly the combined application of antifungal, antibacterial and anti-anaerobic drugs to kill intestinal breeding pathogenic bacteria, and then supplemented with probiotic treatment to regulate the intestinal microenvironment. 3. If you cannot adapt to enteral nutrition may aggravate diarrhea, and some people may have difficulty in absorbing nutrient solution due to lactose intolerance or lack of certain metabolic enzymes, thus causing diarrhea. Enteral nutrition has powder formulas that can be taken orally with good taste, such as Ensure, Nengquansu, etc. 4. Drinking some soup is not a problem, but meat and so on should be eaten as little as possible, and it is better to eat easily digested and absorbed, and noodles or thin rice can be cooked in soup, etc., and supplemented with enteral nutrition support therapy to strengthen nutrition