Frequent diarrhea
Recurrent abdominal pain
Occasional blood in the stool
Presumably, many people have been recruited
But don't underestimate these small signs
It may be a signal given by the "number one strange disease" of the digestive tract
This is not, in the Department of Gastroenterology of the First Affiliated Hospital of Zhejiang University School of Medicine
I received such a mother and daughter
66-year-old Aunt Wang because of this "black hand behind the scenes"
Severe intestinal obstruction occurred
Get away with the innovative technology of experts
The daughter of the 35-year-old "Desperate Three Brides" is also under the "golden eye of fire" of experts
Confirmed Crohn's disease (CD)
I can't eat it in the face of food
Repeated hospitalizations, long-term medications...
Pain we can't imagine
Become the everyday that these patients are experiencing!
How to catch the culprit from the "clues" of something wrong?
The experts have something to say!
Diarrhea more than a dozen times a day, accompanied by blood in the stool, stomach pain... Because of Crohn's disease, the life of the 66-year-old Aunt Li (pseudonym) was completely disrupted, and since 2018, her life has gradually returned to the right track under the diagnosis, treatment and careful follow-up of the gastroenterology expert team of the First Hospital of Zhejiang University. But one day at the end of March 2022, just because she ate a little more soup rice cake at dinner, she began to bloat and abdominal pain, frequent nausea, vomiting until three o'clock in the morning, moaning in bed in pain, and was urgently sent to the emergency department of the First Hospital of Zhejiang University by her daughter who lived with her.
After a series of examinations, Aunt Li was diagnosed with "incomplete intestinal obstruction", and the team of chief physician Ji Feng of the Department of Gastroenterology immediately performed endoscopic balloon dilation formation for Aunt Li, so that her originally narrowed to only one needle gap of the blind valve and rectum could be opened, and the big problem of "blocking" of the digestive tract was solved without surgery, which greatly alleviated her pain.
However, this death escape is just an extremely fierce "exchange of fire" between Aunt Li's mother and daughter and Crohn's disease, and fighting this "green cancer" is a long journey...
Unauthorized discontinuation of drugs, this disease "through the intestines and rotten stomach" is of great harm
Aunt Li is a native of Linping, Hangzhou, and since 2006, her persistent abdominal pain has been punctual like an alarm clock, and every day around 3 p.m. Not only did she have frequent abdominal pain, she also had diarrhea, blood in her stools, and at most, she had to pull a dozen times a day.
Similar to the initial experience of many Crohn's disease patients, at first, she thought it was just gastroenteritis that "ate bad stomach". Because of the abdominal pain, she was suspected of appendicitis, and thought that cutting would be no problem, but she did not expect that after the operation, abdominal pain and diarrhea were still repeated.
"I have diarrhea almost every day, and when I am severe, I pull and throw up. Usually, I planted some food in the field, but once before I could run to the toilet, I couldn't hold back and pulled it directly into my pants. "Aunt Li's weight has lost nearly 30 pounds over the years, and her daughter took her to the community hospital for gastrointestinal endoscopy, but no other problems were found except for proctitis."
In 2018, due to diarrhea and perianal pain, Aunt Li was sent to the Gastroenterology Department of the First Hospital of Zhejiang University for treatment, and after a series of evaluations in the hospital, she was diagnosed with "Crohn's disease" - an autoimmune disease with a prolonged course and difficult to cure. The out-of-control immune system is hostile to me and attacks each other, causing inflammation of the entire digestive tract mucosa from the mouth to the anus, congestion, edema, erosion, ulcers...
After that, Aunt Li reviewed the gastrointestinal endoscopy and small intestine examination every six months, and under the comprehensive treatment of biological immunosuppressants and other drugs, the disease was controlled, "There is no bloody stool, is the disease better?" No need to take medicine? She felt that the symptoms of frequent diarrhea and blood in the stool had been alleviated, and the medication was not so regular, and she thought of eating something and did not eat it when she could not think of it. Although it has been treated, the inflammation has been controlled, but fiber stenosis has emerged.
This time was sent to the emergency department after examination, chief physician Ji Feng of the Department of Gastroenterology did further digestive endoscopy for Aunt Li, the expert team found that her Crohn's disease was stable, but due to repeated episodes of inflammation, Aunt Li's rectum was extremely narrowed and caused obstruction, and the rectum was not dilated first, and the tube of the colonoscopy could not pass through the intestine at all. More seriously, the ileocity valve has been severely damaged under long-term inflammation, forming a needle-sized gap, clinically known as "ileocity valve stenosis".
Before and after the expansion of the ileal blind valve
Magical little balloons! A team of experts solves big problems with endoscopy
In the past, patients with fibrous narrow intestinal obstruction in patients with Crohn's disease first considered surgery, but Aunt Li was suffering from Crohn's patients, and once the intestine was knifed, it was difficult to grow well. Could she solve her obstruction in a less traumatic, easier-to-recover approach?
Zhejiang people do not lack the wisdom and courage to open roads in the mountains and fill bridges in the water.
Under the leadership of Chief Physician Yu Chaohui, Vice President of the First Hospital of Zhejiang University and leader of the Department of Gastroenterology, Chief Physician Ji Feng and his team have fully evaluated that the obstruction site that led to Aunt Li's repeated intestinal obstruction is mainly located in the ileo blind valve, believing that Aunt Li meets the surgical conditions for balloon expansion and can save her from the pain of surgery.
"In order to enter the intestine, we first performed two balloon expansions on the narrow rectum; then we took the endoscope deep into the patient's intestine and found that her ileocecal flap opening was very narrow, coupled with repeated inflammation stimulating multiple polypoid hyperplasia and intestinal adhesions of the ileoclinic valve, the position of the ileal blind valve was very biased, the exposure was difficult, the macerella guide wire could not be inserted, and the intestinal polyps could only be removed with a high-frequency electrocoagulation snare under endoscopy." Chief physician Ji Feng introduced that after the polyps were removed, the surgical team extended the balloon along the guide wire into Aunt Li's narrow ileo blind valve, completing the two expansions of 8 cm and 13 cm. After dilation, the digestive endoscope can freely enter the end of the ileum through the flap opening without any obstruction, and the operation is very successful.
Chief Physician Ji Feng is in surgery
After the dilation, the surgical team once again performed an angiography on Aunt Li's intestines, and the intestinal obstruction was successfully lifted.
Crohn's disease is a long-term chronic inflammatory disease of the intestine. Long-term inflammatory stimulation can cause fibrous narrowing of the intestinal lumen, which can cause recurrent intestinal obstruction. A few days ago, the Department of Gastroenterology and the Digestive Endoscopy Center of the First Hospital of Zhejiang University have normalized the treatment of intestinal stenosis, intestinal obstruction and other diseases caused by Crohn's disease under digestive endoscopy, reducing patient trauma and supporting the life channel.
"Finally I can get something to eat!" On the day of discharge, Aunt Li was already able to eat some semi-liquid food, and this time, she promised the experts that she would follow the doctor's advice, no longer stop the drug without authorization, and review it regularly and on time.
"Crohn's disease is a chronic disease that is prone to recurrence and cannot be stopped without permission." Chen Chunxiao, deputy director of the Department of Gastroenterology, who tailored the treatment plan for Aunt Li, stressed that Crohn's disease is easy to recur, prolonged, and may also have serious complications, such as severe malnutrition, intestinal perforation, intestinal obstruction, intestinal stenosis, intestinal abscess, fistula, etc. The heavy ones need surgery, and even threaten the patient's life, The wider it affects, the more critical the condition, and the early diagnosis and early treatment of Crohn's disease can significantly improve the treatment effect of patients. Insisting on treatment and controlling the disease can allow patients to obtain a relatively high quality of life. ”
These clues suggest that you may have Crohn's disease
In recent years, the incidence of Crohn's disease has been on the rise on the mainland, from a rare disease to a common disease in the digestive system today. The cause of Crohn's disease is not fully understood, and the current medical community generally believes that it is caused by the interaction of various factors triggered by congenital genetics and acquired environment. This disease is complex in diagnosis and treatment, with a long course, repeated attacks, expensive drugs, and difficult to cure, which has become a contemporary digestive medicine problem and a social problem, so it is called "green cancer".
Aunt Li's daughter Meimei, 35 years old this year, a son and a daughter she has been engaged in drug sales, in the gap between taking care of the hospitalized mother, to travel to and from the company to complete the performance, from time to time to ask for leave, the company's leaders criticism and urging made her exhausted, anxious.
During the mother's hospitalization, the careful chief physician Chen Chunxiao saw a different end from Meimei's frequent mouth ulcers, after talking more than two sentences, learned that Meimei said "frequent fire", there will be swelling near the anus, occasionally pus, and there are symptoms such as blood in the stool, dizziness, nausea, etc., experts strongly recommend that she be busy to do a gastrointestinal endoscopy, the results are painful, small intestinal CT shows that Meimei's small intestinal wall segmental thickening with strengthening, in line with the imaging performance of small intestinal Crohn's disease, after colonoscopy and other examinations, She was also diagnosed with Crohn's disease.
Mei Mei was struck by a thunderbolt on a sunny day, and experts advised her that although there is no radical cure at present, under the combined effect of early diagnosis, drug treatment, and close monitoring, the condition of Patients with Crohn's disease can be in a long-term state of remission and does not affect life expectancy.
So, what situations do you need to suspect that you have Crohn's disease?
Chief Physician Chen Chunxiao introduced that the high incidence of Crohn's disease is between 15-35 years old, usually manifested as diarrhea, abdominal pain and blood in the stool, which is also common in general acute gastroenteritis, intestinal tuberculosis and intestinal tumors, easy to confuse, and many patients often delay effective treatment due to misdiagnosis.
If unexplained abdominal pain, recurrent symptoms, or diarrhea occurs, the frequency of stools increases, treatment according to gastroenteritis is ineffective, and Crohn's disease should be vigilant.
In the early stages of Crohn's disease, there may also be repeated mouth ulcers, as well as a variety of rashes, erythema nodosum and other gangrenous pyoderma. Some patients have unexplained fever, weight loss, and delayed development in children and adolescents, or perianal disorders such as perianal fistulas, abscesses, and pain.
In addition, Crohn's disease has a certain hereditary nature, if the immediate family members have Crohn's disease, then the possibility of their own disease will be relatively large. Experts emphasize that once there is repeated abdominal pain and diarrhea that cannot be cured for a long time, we must pay attention to the investigation of inflammatory bowel disease, and it is recommended to go to the gastroenterology department of a regular hospital.
More warm and interesting medical things
Please pay attention to the video number of the First Hospital of Zhejiang University
Expert outpatient table of the First Hospital of Zhejiang University