39
H Tiêu hóa
Map 3.3 Các nguyên nhân c a viêm đư ng tiêu hóa
VIÊM RU T TH A
Viêm ru t th a là gì?
Là tình tr ng viêm c a ru t th a v i bi u hi n đau b ng kh i đ u
quanh r n trư c khi khu trú h ch u ph i.
C n lâm sàng
Ch n đoán d a vào lâm sàng:
•
XN máu: T ng phân tích t bào máu, ch c năng th n, CRP
•
Siêu âm
•
Th thai ph n trong đ tu i sinh s n đ lo i tr thai ngoài
t cung
Đi u tr
•
Ph u thu t
Bi n ch ng
•
Viêm phúc m c.
IRRITABLE BOWEL SYNDROME (IBS)
What is IBS?
This is a common functional disorder of
the bowel.
Signs and symptoms
Recurrent abdominal pain, which
improves with defaecation; there is a
change in bowel habit, i.e. increased or
decreased frequency.
GASTRITIS
What is gastritis?
This is inflammation of the stomach lining. Gastritis may be acute or chronic.
•
Acute gastritis, caused by:
○
Stress.
○
Uraemia.
○
Alcohol.
○
NSAIDs.
○
Burns: Curling’s ulcer.
•
Chronic gastritis:
○
Type A:
-
Autoimmune: autoantibodies are present to parietal cells.
-
Presents with pernicious anaemia.
-
Occurs in the fundus or body of the stomach.
○
Type B:
-
Most common.
-
Associated with Helicobacter pylori infection.
Investigate for H. pylori infection:
•
Bloods: anaemia and H. pylori.
•
Urinalysis.
•
Blood test – measures antibodies to H. pylori.
•
Carbon isotope–urea breath test.
•
Endoscopy with biopsy of stomach lining.
•
Stool microscopy and culture – may detect trace amounts of H. pylori.
Treatment
•
Triple therapy to eradicate H. pylori: proton pump inhibitor (PPI), with amoxicillin 1g and
clarithromycin 500 mg or metronidazole 400 mg and clarithromycin 250 mg, taken twice daily.
•
Step-wise approach to treating gastritis:
○
Mild – antacids or H
2
receptor antagonists.
○
Moderate/severe – PPI.
Complications
•
Peptic ulcers, anaemia (from bleeding ulcers), stricture formation, mucosa-associated lymphoid
tissue (MALT) lymphoma.
Investigations
This is a clinical diagnosis.
Treatment
•
Conservative: education and avoidance
of triggering factors, e.g. decrease stress.
•
Medical: depends on symptoms;
antimuscarinics, laxatives, stool
softeners, antispasmodics and
antidepressants may play a role.
Complications
•
Depression and anxiety.
MAP 3.3 Các nguyên nhân c a viêm đư ng tiêu hóa
Xem ti p trang k
B nh viêm đ i tràng (IBS) (Ti p theo )
Chapter_03.indd 39
08/12/14 2:30 PM
