

Ren Zheng Xin

About me
General practitioner, currently working at Zhangye People's Hospital affiliated with Hexi University, with 21 years of clinical experience in general medicine.
Proficient in diseases
Specializes in the diagnosis and treatment of common and prevalent diseases in clinical practice such as diabetes, cardiovascular diseases, gastrointestinal diseases, pediatrics, as well as the combination of examination items, comprehensive analysis, and handling of routine physical examinations. The scope of diagnosis and treatment mainly includes: diabetes, coronary heart disease, common gynecological diseases, common pediatric diseases.

Voices

Crohn's disease most commonly affects the area
Crohn's disease commonly occurs in the terminal ileum and the right half of the colon. It is a type of inflammatory bowel disease with unknown causes and can occur in any part of the gastrointestinal tract. Clinically, it mainly presents with symptoms such as diarrhea, abdominal pain, and intestinal obstruction. However, it may also lead to complications like intestinal perforation and bloody stools, and can affect organs like the liver, joints, and skin. The condition tends to relapse frequently and is difficult to cure completely. Current treatments combine medication and surgery. During active phases of the disease, it is important to enhance nutrition, rest in bed, consume high-nutrient, low-fat foods, and utilize supportive therapies. (Please use medication under the guidance of a professional physician.)

How is acute appendicitis treated?
Acute appendicitis treatment primarily involves surgical methods, where the inflamed, suppurative, or perforated appendix is excised during the procedure, and then the base of the appendix is sutured. Moreover, if there is suppuration, it is necessary to irrigate the peritoneal cavity to prevent intra-abdominal infections. After the surgery, fluid therapy should be administered based on the patient's condition. In cases of perforation or suppuration, antibiotics should be used post-operatively. For simple appendicitis, post-operative fluid replenishment is generally sufficient, and antibiotics are not required. (Please use medications under the guidance of a doctor.)

How to stop bleeding from a gastric ulcer?
Gastric ulcer bleeding is a relatively common complication. Treatment methods can be selected based on the endoscopic characteristics of the bleeding lesion. Active bleeding can be treated with acid-suppressing medications such as proton pump inhibitors, combined with endoscopic treatment, and if necessary, vascular interventional treatment or surgery. For those with blood clots, proton pump inhibitors can also be chosen, with endoscopic treatment if necessary. During endoscopy, fibrin glue can be sprayed on the surface of the ulcer, adrenaline can be injected at the bleeding site, and endoscopic hemostatic clip techniques can be used. During treatment, it’s important to adjust the diet. For those with significant bleeding, temporary parenteral nutrition should be chosen, and no food should be consumed to avoid further gastrointestinal irritation. (Please use medications under the guidance of a doctor.)

Acute appendicitis clinical classification
Acute appendicitis can be classified into four types based on the clinical course. The first type is acute simple appendicitis, where the lesions are mostly confined to the mucosa and submucosal layer, with small ulcers and bleeding spots on the mucosal surface. The symptoms and signs are relatively mild. The second type is acute suppurative appendicitis, where the lesion has spread through all the layers of the appendix wall, and pus may accumulate inside, also known as acute cellulitis appendicitis. The third type is gangrenous and perforated appendicitis, which occurs due to pus in the appendix cavity causing increased internal pressure and circulatory disturbances in the appendix wall, leading to mucosal ischemic necrosis and perforation, causing acute diffuse peritonitis. The fourth type is peri-appendiceal abscess, which forms an inflammatory mass encapsulated by the surrounding omentum during suppuration or perforation of acute appendicitis.

Acute appendicitis pain is on that side.
In the initial stages of acute appendicitis, pain can occur in the left side of the abdomen, then gradually move around the navel, and eventually becomes fixed in the lower right abdomen. The typical symptom of appendicitis is migratory pain in the lower right abdomen, which becomes severe upon pressing and intensifies when lifted, a phenomenon known as rebound tenderness. A small number of patients may experience pain in the lumbar and back areas, which could be due to inflammation caused by a retroperitoneal position. Based on the typical symptoms of appendicitis, a diagnosis cannot be confirmed. After confirmation, most cases require an appendectomy.

How often does hemorrhoids cause bleeding?
Internal hemorrhoids can cause rectal bleeding, typically occurring during defecation, ranging from dripping to jet-like bleeding. Rectal bleeding is painless, and prolonged bleeding can lead to anemia characterized by loss of appetite, fatigue, and lack of concentration. It is important to timely apply hemostatic medications or opt for treatments like electrocoagulation, banding, or surgery. Dietary adjustments should be made by increasing the intake of vegetables and fruits and reducing spicy, greasy, and irritating foods. Regular routines should be maintained, avoiding prolonged sitting, and using warm water for sitz baths every evening can effectively relieve the symptoms of hemorrhoidal venous dilatation.

Can appendicitis cause back pain?
Appendicitis located posterior to the peritoneum generally causes back pain, along with gastrointestinal irritation symptoms such as nausea and vomiting. Appendicitis at the cecum location will cause pain in the lower right abdomen, with significant tenderness and rebound pain at McBurney's point. Once appendicitis is diagnosed, it is most often treated surgically. Currently, laparoscopic appendectomy is commonly used. This method involves less bleeding during surgery and a faster recovery thereafter. Postoperative care is important, including regular dressing changes of the surgical incision. The stitches can usually be removed about a week after surgery. Dietary adjustments are necessary after surgery, starting with a semi-liquid diet and gradually transitioning to a normal diet. At least two weeks of rest are recommended postoperatively.

Which is more serious, acute appendicitis or chronic appendicitis?
Acute appendicitis is relatively common in clinical practice with severe symptoms. Compared to chronic appendicitis, acute appendicitis can cause the appendix tube to become purulent and perforate, leading to a widespread peritonitis. Severe peritonitis can cause multi-organ failure and even shock. Chronic appendicitis, on the other hand, mainly manifests as chronic abdominal pain and seldom shows signs of appendix perforation. It primarily leads to an abscess around the appendix, encapsulating the appendix and causing repetitive chronic pain, which is difficult to heal. Both acute and chronic appendicitis should be treated surgically by removing the appendix to achieve a complete cure.

Will there be a scar from appendicitis surgery?
Appendectomy can leave scars, especially more noticeable in people prone to scarring. Currently, there is a minimally invasive treatment that involves the removal of the appendix under laparoscopy. This method only requires three small incisions on the abdomen, resulting in smaller scars and a faster postoperative recovery. The traditional method, which involves making an incision at McBurney's point, leaves a slightly larger scar and has a slower recovery process. After recovery, the application of aloe vera can help reduce scarring. It is important to take good care of the incision, eat plenty of vegetables to prevent constipation, and protect the incision. At least two weeks of rest is necessary after the surgery, during which vigorous exercise should be avoided.

Appendicitis surgery, how many days to discharge?
This is directly related to the surgical method. If it is a laparoscopic appendectomy, this is a minimally invasive treatment, and recovery is quick; patients generally can be discharged from the hospital three days post-surgery, and sutures can be removed at a scheduled follow-up visit. If it is the traditional surgery method through McBurney's point incision, this method also allows for quick recovery, and patients can be discharged after the sutures are removed. Additionally, this also relates to the patient's physique and the severity of their condition. For elderly patients, the hospital stay may be extended. If the appendix has a clear perforation or causes diffuse peritonitis, the use of antibiotics must be intensified post-surgery, hence extending the treatment period. (The use of medications should be conducted under the guidance of a doctor)