1. Dai ctfdng
- Chiem 15 - 30% dan so. - Doi ttfdng tre nut/nam = 2.
- Chiing day bung, kho tieu gap trong 80% trUdng hdp. - 3 yeu to" tien trieu: roi loan van dong ruot. Tang nhay
cam dai trang. Roi loan tam than.
2. Chan doan
Trieu chiing: miic do va trieu chiing cd nang da dang doi lap v6i kham lam sang binh thudng va khong co thay doi toan trang chung.
- Dau bung: quan, trtfdng, vung quanh ron, dau tilng cdn, dau hieu cai thien ban g thuoc giam co that va sau khi trung dai tien.
- Roi loan nhu dong: tao bon xen ke ia chay man tinh. - Hinh thai tien trien: bat dau rat lau va tien trien nang
len sau stress.
Tieu chuan chan doan R om e II 1999
- Dau bung hay kho chiu d bun g it nhat trong 3/12 thang - Kem 2 trong 3 trieu ch iin g sau:
+ Bdt sau khi di dai tien + So lan di dai tien thay doi + Thay doi hinh dang phan
- Cac trieu chiing phu: xuat hien ft nhat trong 1/4 so ngay So l&n di dai tien: >3 lan / ngay hay < 3 lan / tuan
Ti'nh chat phan khong binh thudng: phai ran, phan long, cam giac di khong het phan, co nh&y mui
Bung chiidng hay cam giac bung cang
Chan doan loai trit:
- Benh ly thiic the: thay doi tinh trang chung, dung thuoc, ia mau hay phan den, phai thiic day vi dau. - Xet nghiem he thong: cong thiic mau, dien giai, diidng
mau, mau lang, TSH.
- Ky sinh trung phan (amip), xet nghiem phan neu ia chay man ti'nh.
- CD soi dai trang phat hien ton thiidng thiic the va sinh thiet nhieu ndi neu ia chay man ti'nh (viem dai trang vi the):
+ Tien sU gia dinh: ung thii hoac adenome dai triic trang. + Tuoi > 40.
+ Trieu chiing mdi xuat hien hay mdi thay doi ti'nh chat, khong dap ling vdi dieu tri trieu chiing.
+ Co dau hieu bao dong: xuat huyet tieu hoa, bat thiidng khi kham lam sang, g&y sut.
- Chup khung dai trang co baryt, chup doi quang kep neu soi dai trang khong toan bo: hinh anh tang co bop
hoac mat trtfdng luc thanh hinh ong hoac cac dia xep chong len nhau lien tiep (tang chieu cao).
3. Dieu trj
- Lang nghe benh nhan ke va lam yen long benh nhan - Kham tam than.
- H oat dong the thao, tranh rifdu va do uong co gaz. - Che do an khong qua nghiem ngat va rat can doi:
+ Biia an deu dan vao gid co dinh, ngheo xO neu co ia chay.
+ Tranh thiic an len men neu co chvfdng bung.
+ U ong na6c nhieu va che do an co nhieu xd (tang dan tCf 5g tdi 20 - 30g /ngay) neu co tao bon.
- Thuoc:
+ Tao bon hay luan phien ia chay - tao bon: nhuan trang. + Ia chay: Im odium 2 vien /n gay + 1 vien sau moi lan di dai tien long).
+ Dau: giam co that (Spasfon) hay khang C holinergic (visceralgin), nguy cd glaucom e cap va bi tieu tien neu co adenom e tien liet tuyen.
+ Chu6ng bung: than hoat (Carbosylane). + Kho tieu: Prokinetique (M otilium ).
TAO BON
1. D|nh nghTa: tao bon la so' lan dai tien < 3 lan / tuan trong thdi gian > 2 thang. thdi gian > 2 thang.