Peritonitis

Peritonitis is an inflammation of the peritoneum covering from within an abdominal cavity with the organs located in its limits.  Inopportune treatment of the disease often causes a lethal outcome.

Inflammatory process in a peritoneum arises at a bacterial infection or under the influence of noninfectious irritants – blood, bile, gastric juice, urine. Usually peritonitis develops at destruction of abdominal organs (acute pancreatitis, intestinal obstruction, appendicitis). Fecal masses and pus get to abdominal cavity from damaged organs.

More infrequent cause of peritonitis is penetrating wound of stomach with infection entering from outside. Sometimes peritonitis arises because of diffusion of infection with blood.

The clinical picture of peritonitis develops acutely and quickly. Sharp abdominal pain, expressed nausea, sometimes vomiting, fast temperature rise, and loss of weight are the symptoms of peritonitis. Stomach is painful and hard. Arterial pressure may drop. Leucocytes content in blood is considerably increased. In case of hollow abdominal organ rupture gas accumulates under the diaphragm.

Pain at peritonitis cannot be removed with spasmolytic. At the slightest symptoms of the disease it is necessary immediately apply to the doctor. Opportune treatment of peritonitis has a crucial role in rescue of patient’s life. Peritonitis differs in severity and fast development.

Treatment needs to be carried out within the first 12 hours from the beginning of the disease. In most cases the urgent surgical intervention is necessary. Almost always antibiotics prescribed. After operation the patient is treated at the intensive care unit.

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Acute cholecystitis

Acute cholecystitis is an inflammation in gall bladder. As a rule, the disease arises in the patients having cholelithiasis, in case of getting the stone into the general cystic duct and its occlusions. Bile stands too long, the infection joins that causes gall bladder mucous edema and its inflammation.

Symptoms of gall bladder acute inflammation are: persistent pain on the right at the top of the stomach, with extension to the right arm, neck and breast; body temperature raise, dyspepsia phenomena, bitter taste in the mouth, not giving relief to the patient vomiting; icterus of skin, eyes and mucosa. Emergence of pain is preceded often by an attack of biliary colic.

The disease is dangerous by its complications – a purulent inflammation and rupture of gall bladder, development of inflammation of peritoneum, developing of acute pancreatitis.

It is necessary to call the ambulance urgently. It is forbidden to put one stomach more anything hot, to accept laxative, to wash out a stomach. The bed rest is necessary for the patient, it is necessary to place ice to the place of a projection to abdominal wall of gall bladder but so that there was no frostbite of skin.

The acute cholecystitis is treated at surgical hospital. During the first hours a dropper is put to the patient. Spasmolytic medicines, antibiotics, carry out de-intoxication is prescribed. When cholecystitis implications weaken patient is prepared for operation and the gall bladder is completely removed. If the attack of a cholecystitis proceeds, it is necessary to carry out an urgent operation.

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Acute pancreatitis

Acute pancreatitis in fact, is a self-digestion of the pancreas filled with digestive enzymes which are developed in it. In norm they are activated, only coming to intestine lumen but if activation comes earlier, consequences are very serious. Trypsin splits protein, ruins gland tissues, gets into blood and damages the next organs. The patient has blue-black maculae on back and stomach surface – traces of destructive effect of enzyme. Illness proceeds very hard, the lethal outcome is possible.

Disturbance of outflow of pancreatic juice, which is generated in quantity of one and a half liters, can provoke acute pancreatitis. It occurs at a muscular spasm of cells of a of the gland duct papilla combined with biliary. For example, tannins of cognac cause muscles spasms, and the fat snack stimulates production of pancreas juice. Therefore, most often patients with acute pancreatitis come to hospitals on days off and holidays.

The main symptom of acute pancreatitis is extremely severe pain at the top of stomach (in epigastria, subcostal area), with the encircling character. It cannot be removed with spasmolytic and analgesic, strong narcotic opiates, like morphine. Vomiting, diarrhea, weakness becomes perceptible.

Often the cholecystitis, infection with development of purulent complications joins acute pancreatitis. Intra-abdominal bleeding, peritonitis can develop.

After having an acute pancreatitis most of patients have a chronic form of disease. Its exacerbations are provoked by the irritating nutrition, alcohol. As a result of destruction insulin – generating cells diabetes mellitus can develop.

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Acute gastritis

Gastritis is a stomach mucosa inflammation. Acute gastritis arises at short influence of strong stimuli, proceeds hard, being followed by formation of erosions (destructions of mucosa) of stomach, bleeding. The exacerbation of chronic differs from initially acute gastritis.

Excessive alcohol intake, the casual or deliberate use of acids, alkalis, poisons, some drugs – high doses of Aspirin can become the cause. Gastritis arises at a stress after a myocardial infarction or stroke, injuries, burns, operations, at renal and liver failure.

The patient with acute gastritis has eructation, heaviness in stomach, severe sharp pain in the pit of the stomach, giddiness, nausea, vomiting. Sometimes there is a vomiting with blood or blood impurity which is already semi-digested (brown color). The stool is liquefied in couple of days. Usually the patient had no gastritis before.

At first it is necessary to find the cause of acute injury of stomach, and if it is possible, to eliminate it. Sometimes the gastric lavage is required. For the first days of a disease it is recommended not to eat any food. Further at acute gastritis it is necessary to keep a diet – to use slimy soups, berry jelly. The diet has to be chemically and mechanically sparing for stomach.

In case of bleeding the drugs weakening production of the hydrochloric acid are injected intravenously. Medicines promoting healing of erosions by means of formation on their surface of protective film are applied.

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Colitis

The colitis is not colic in stomach. Colon in Greek and Latin is a large intestine. Its inflammation (of its internal mucosa) is called colitis.

The fresh acute colitis proceeds violently, chronic – slowly and listlessly. The inflammation of large intestine is often combined with inflammation small intestine (enteritis) or stomach (gastritis).

Colitis may be infectious, ulcerative, ischemic (when the blood is badly supplied to intestine), medicinal, radiative. Long taking of antibiotics, purgatives, neuroleptics, excess of animal and flour nutrition in ration, the use of spicy food, alcohol, and dreary diet can be the reason. Sometimes the colitis is caused by worms, poisoning (arsenic, lead).

The colitis caused by intestinal infection proceeds violently. Bacteria damage mucosa. The wall of the intestine swells, secretion of slime and its contraction (peristalsis) is broken. There are painful urges to defecate, diarrhea, sometimes with blood, abdominal pains disturb.

Pains – the first sign of a colitis, they can be followed by rumbling, abdominal distention. The person is flaccid, weak, in severe cases temperature increases. The acute colitis lasts for some days, chronic for weeks and even years.

Treatment of colitis begins with a diet. Further therapy depends on a cause of illness. If it is an intestinal infection, antibiotics are prescribed. At the colitis caused by prolonged use of drugs they should be canceled. A chronic colitis treats spasmolytic, anti-diarrheal agents, anti-inflammatory, in the most severe cases glucocorticoid hormones are prescribed.

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Intestinal Obstruction

Intestinal obstruction is a disturbance or complete stop of food movement in the intestine. It is provided with contractions of intestinal wall (peristalsis). Disturbance of peristalsis arises because of muscles relaxation (paralytic obstruction) or with long contraction (spastic obstruction). Both forms belong to dynamic obstruction. It develops after surgeries on abdominal organs, complicates appendicitis, cholecystitis and pancreatitis.

Other type of intestinal obstruction is mechanical. It arises at presence of an obstacle, connected with volvulus, infringement of bowel. It happens at long starvation and subsequent plentiful meal (strangulated obstruction). At mechanical occlusion of intestine lumen occlusion obstruction develops, its causes are: adhesions, tumors, foreign matters, gallstones, hernias.

Severe pain in stomach disturbs the patient. At first it is felt only in the disease center then all stomach hurts. The patient feels rapid contractions of intestine. There can be a vomiting and bloody diarrhea. A delay of gases and stool is an important symptom of the intestinal obstruction.

The state quickly worsens; the person turns pale, breaks through cold sweat; stomach is asymmetrically blown up. Usually treatment of the obstruction requires urgent operation.

In the first 6 hours the intestinal obstruction is treated conservatively: stomach is washed out with a probe, clysters are done, and dropper is put. When the state doesn’t improve start the operation. More often portion of the intestine is removed. Operation isn’t required if the obstruction is caused by abrupt weakening of intestine contractions. It is possible to cope with it by means of medicines.

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Gallstone Disease

Gallstone disease is a disease proceeding with formation of stones in bilious ducts. Bile stagnation and growth of salts concentration are guilty in it.

Overeating or starvation, irregular nutrition, obesity, sedentary work and lifestyle, hormonal contraceptives, pregnancy, biliary dyskinesia can provoke a gallstone disease.

Stones are formed at sedimentation of bile particles. They consist of calcium salts, bile pigment (bilirubin), and cholesterol.

At overeating or harsh riding the stone can pass in bile duct orifice, having corked it (biliary colic). Bile outflow is broken; walls of gallbladder are overstretched and the patient feels severe pain under a costal arch or at the top of stomach on the right side. Pain at biliary colic attack may extend in back and right arm. There is a bitter taste in a mouth, vomiting which does not bring a relief.

If the small stone could pass ducts and drop out in intestine – the attack of colic stops, the stone comes outside. Otherwise there is an occlusion of biliary ducts; there is a danger of an acute cholecystitis.

Treatment is begun with a diet. Prescribe split meals, fat, fried, spicy, carbonated drinks, chocolate, smoked products, the irritating seasonings, alcohol are excluded. The vegetable nutrition, dairy products are recommended.

In the presence of small single cholesterol stones the method of their dissolution in a gall bladder is applied. The course of treatment lasts one and a half year. In many patients stones are formed again. Crushing of stones with ultrasound or classical surgery is more effective.

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Biliary dyskinesia

Bile is generated in the liver. Before getting into intestine it passes a long way on bile-excreting ducts. The largest bile duct falls into a duodenum. It has muscular cells, contractions and relaxation of which doses a bile flow.

Biliary dyskinesia is a disease at which normal contractions of a gall bladder and bile-excreting ducts are disturbed.

More often women have the dyskinesia. Improper feeding provokes development of the disease (fat, spicy, with long breaks), illnesses of digestive organs (peptic ulcer, gastritis, and pancreatitis), climax, hormonal disturbances, lesion with worms, nervous experiences and stresses.

There are two kinds of biliary dyskinesia – hyperkinetic and hypokinetic. In case of hyperkinetic a tonus of a gall bladder is high, contractions happen quickly and strongly. Muscular “gates” of bile ducts open insufficiently that causes a sharp pain under the right costal arch. Painful attacks are short-term seldom proceed more than an hour. Usually they are provoked with disorders, nervous overloads, negative emotions. Exacerbations are connected with menses during which the tonus of a gall bladder raises. The hyperkinetic form of a dyskinesia is met more often at the young age.

The hypokinetic form on the contrary, strikes elderly people more often. The gall bladder contractions are insufficient. It also causes pain in right subcostal area. But pain is mild, long term, has blunt, arching character.

Biliary dyskinesia periodically becomes aggravated. There is an inflammation or formation of gallstones in bile ducts and gall bladder begins.

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Dysentery

Dysentery is widespread intestinal infection, especially frequent during a hot season. Infection occurs from the sick person, at non-compliance with rules of hygiene. It is possible to catch dysentery through dirty arms, dirty water which was used for washing up fruit and vegetables, badly thermally processed products.

Bacteria cause an inflammation of large intestine walls. The main symptom is a frequent liquid stool, not too plentiful, dark green color, containing slime, pus, blood. There are false urges to defecation (tenesmus). Overall health worsens, the patient is excruciated by nausea and vomiting, appetite strongly decreases, there is a headache. Dehydration is possible.

Dysentery is treated at a hospital. Two problems should be solved at treatment: destroy a microbe originator with antibiotics and recoup liquid loss with plentiful drink, if necessary intravenous injections of special solutions.

If the patient has a good immunity, illness is completely cured in a week, but sometimes gains relapsing wavy character (happens in people who have not carried out the prescribed treatment completely), it threatens with emergence of a chronic form.

During illness it is necessary to control thoroughly possible complications: rupture of intestine, dehydration. Damage of intestinal wall integrity requires an urgent surgical intervention.

In people who had the disease, unstable immunity develops, and repeated infection sometimes happens.

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Hepatitis B

This form of viral hepatitis is transmitted through the infected blood at injections by reusable syringes, sexually, to a fetus from mother, at donor blood transfusion. Virus of hepatitis B cannot be transferred with mother’s milk. Danger is in acupuncture, drawing tattoos, dental surgery.

Before emergence of icterus hepatitis B reminds flu. Temperature increases, there is a head ache, and pain in the body is felt. Symptoms accrue gradually, temperature slowly rises. Also the virus is shown by eruption on integuments and joint pain.

In some days appetite vanishes; there are nausea and vomiting, pain in the right subcostal area disturbs, urine darkens, and feces become light. After emergence of icterus there comes improvement. Within several weeks symptoms decrease.

At the normal immune response of organism the acute hepatitis B comes to the end with convalescence. At the asymptomatic course of the disease, owing to the insufficient immune response, chronic hepatitis develops. It represents the greatest danger. Chronic hepatitis is shown by malaise, fatigability. Sometimes there is a pain at the top of a stomach, joints and muscles, nausea. At far gone chronic viral hepatitis there are an icterus, a skin itch, urine darkening, weight loss, a gingival hemorrhage.

The diet limiting fatty, spicy, fried, salty and marinated food is recommended. Alcohol is completely excluded. At an acute hepatitis the maintenance therapy without special antiviral medicines is prescribed. At chronic hepatitis individual treatment with antiviral medicines is carried out. It is necessary to be treated for half a year, sometimes for some years.

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