The most common cause of gastric perforation is peptic ulcer. Perforation occurs as the ulcer deepens and penetrates the muscular layer, the plasma membrane layer, and finally the wall of the stomach or duodenum. Several different consequences can occur after perforation. For example, before perforation, the bottom of the ulcer has been adhered to the pancreas, liver and other neighboring organs, forming a penetrating ulcer, which is a chronic perforation, and in a few cases, the bottom of the ulcer is adhered to the transverse colon, and a gastrocolic fistula is formed after perforation. Most of the above two cases occur in the stomach, duodenum, posterior wall ulcer perforation, such as ulcer perforation quickly with the greater omentum or nearby organs, adhesion, can be formed around the perforation of pus ulcers.
Symptoms of the disease
1. Abdominal pain
The sudden onset of severe abdominal pain is the first, most frequent and most important symptom of gastric perforation. The pain starts in the upper abdomen or at the site of the perforation, and is often cutting or burning, and is usually persistent, but there are also episodes of aggravation. The pain quickly spreads to the entire abdomen and may spread to the shoulders in a stabbing or aching sensation.
2. Shock symptoms
Perforation of the early stage, patients often have a certain degree of shock symptoms, the development of the disease to bacterial peritonitis and intestinal paralysis, the patient may once again appear toxic shock phenomenon.
3. Nausea and vomiting
About half of the patients have nausea and vomiting, which is not severe, and the vomiting is aggravated by intestinal paralysis, and there are symptoms such as abdominal distension and constipation.
4. Other symptoms
Fever, rapid pulse, increase in white blood cells and other phenomena, but usually appear a few hours after the perforation.1. Emergency response
Due to emotional fluctuations or after overeating, gastric ulcer patients are prone to complicate gastric perforation, and the possibility of gastric perforation should be considered as soon as related symptoms occur. Before the ambulance arrives, you should do the following:
(1) Don't cover your stomach and roll around, you should lie on the left side of the bed. The reason is that most of the perforation sites are located on the right side of the stomach. Lying on the left side of the bed can effectively prevent stomach acid and food from flowing further into the abdominal cavity and exacerbating the condition.
(2) If paramedics can't get there in time, but there is some simple medical equipment at the scene, the patient can insert a gastric tube on his own. Specific method: insert the tube into the nostril, to the throat, and swallow hard while breathing, swallow the tube into the stomach. Then use a syringe to draw out the contents of the stomach, which can reduce the degree of infection in the abdominal cavity, for the patient to win the treatment time, remember that at this time the patient must also be lying on the left side.
2. Disease treatment
The seriousness of gastric perforation lies in the large amount of gastrointestinal fluid that flows into the abdominal cavity after the perforation, causing chemical or bacterial peritonitis as well as toxic shock, which can be life-threatening if not resuscitated in time. Small perforations without peritonitis can be treated conservatively by fasting, placing a nasogastric tube to aspirate gastric contents, giving fluids to replenish water and electrolytes, and applying antimicrobial drugs to prevent secondary infections in the abdominal cavity. Perforation after a full meal, often with diffuse peritonitis, requires emergency surgery within 6 to 12 hours. Chronic perforation, which progresses more slowly and perforates to adjacent organs can cause adhesions and fistulae, also often requiring surgical treatment.
Post-operative care
Avoid stimulation, mainly too spicy food, preferably fluid to adhere to a period of time. Pay attention to the warmth of the abdomen, especially at night; eat more easily digestible food, eat less and more meals.
1. Meals should be taken regularly, can be small and frequent, and avoid rough, too cold, too hot and stimulating diet such as spicy food, strong tea, coffee, and so on.
2. Quit smoking and limit alcohol.
3. Relieve mental tension.
4. Use medication to speed up the healing of ulcers if necessary. Some drugs can reduce the secretion of gastric acid, some drugs will put a layer of protective film such as aluminum salts or proteins on the surface of the ulcer; drugs that can damage the gastric mucosa, such as aspirin, anti-inflammatory pain, pau d'arco and so on, should be banned.
Suggested food and consumption:
1. Spirulina. After consuming spirulina, spirulina can be rapidly decomposed into fine particles, close to the mucous membrane of the stomach and duodenum, forming a protective film, which promotes the regeneration of the mucous membrane, repairing the damaged mucous membrane, so that the stomach feels comfortable.
2. Phospholipids. Phospholipids can promote cell activation, tissue regeneration and repair.
3. High-quality protein. High-quality protein contains comprehensive, rich and balanced essential amino acids, which can be a good solution for stomach nutritional nourishment.
Consumption method:
1. Mild ulcer: daily spirulina 4 capsules, phospholipids 4 capsules, high quality protein 1 packet, consumed every morning, the above food once a consecutive 60 days.
2. Severe ulcers: daily spirulina 5~10 capsules, phospholipids 5~15 capsules, divided into two times a day, the above food once a consecutive consumption of 90~180 days.
How to determine acute gastritis
I. In the past, there is mostly a history of typical gastric problems. That is, regular burning pain in the heart fossa, acid reflux, belching, and the pain can be relieved after eating or taking alkaline medicine. Some of the hospital examination has been diagnosed as ulcer disease, recently mostly due to dietary disorders, cold or nervousness and other reasons to make the stomach disease recurrence.
Two, feel the heart fossa sustained intense knife-like pain, and quickly spread to the right lower abdomen or the whole abdomen.
Three, abdominal pain accompanied by nausea and vomiting, the patient commonly pale, cold limbs, cold sweat, panic and shortness of breath, rapid and weak pulse, blood pressure drop and other manifestations.
Fourth, due to peritoneal irritation, the whole abdomen has pressure pain, the abdomen is hard as a plank, the hand that presses the abdomen is suddenly lifted, the abdominal pain is severe and unbearable. Acute gastric perforation treatment should be based on the patient's age, length of history of ulcer, estimated outflow of digestive fluid is small, may be small perforation, the possibility of closure, can be preceded by non-surgical treatment.
If the patient is old and has a long history of the disease, the perforation is not easy to close, and even if it closes, it is prone to recurrence, or in the case of non-surgical treatment, the condition worsens, and surgical treatment should be carried out.
Disease prevention
1. Eat less fried food: because this kind of food is not easy to digest, it will aggravate the burden on the digestive tract, eating more will cause indigestion, and will also increase blood fat, which is not good for health;
2. Eat less pickled food: these foods contain more salt and some carcinogens, it is not advisable to eat more;
3. Eat less cold and raw food Stimulating food: Cold and stimulating food has a strong stimulating effect on the mucous membrane of the digestive tract, which can easily cause diarrhea or inflammation of the digestive tract;
4. Regular diet: Studies have shown that regular meals, regular meals, can form a conditioned reflex, which can help the secretion of the digestive glands, and is more conducive to digestion;
5. Regular meal times and quantities: We must do the right amount of food at each meal, and have three regular meals per day.
6. Appropriate temperature: the temperature of the diet should be "not hot, not cold" to the degree;
7. Chewing and swallowing: to reduce the burden on the stomach and intestines. The more times you fully chew your food, the more saliva you secrete, which has a protective effect on the gastric mucosa;
8. Drinking water at the right time: the best time to drink water is in the morning on an empty stomach and one hour before each meal, drinking water immediately after a meal will dilute gastric juices, and soaking rice in soup will affect the digestion of food;
9. Avoid stimulation: do not smoke, because smoking makes the stomach vasoconstriction, affecting the blood supply of the stomach wall cells, so that the gastric mucosa resistance is reduced and induce gastric disease. Should drink less alcohol, eat less chili, pepper and other spicy foods;
11. Supplementary vitamin C: vitamin C has a protective effect on the stomach, the gastric fluid to maintain a normal level of vitamin C, can effectively play the function of the stomach, protect the stomach and enhance the stomach's ability to resist disease. Therefore, eat more vitamin C-rich vegetables and fruits.