腹痛 Abdominal Pain (2)

How does IBS(irritable bowel syndrome)cause abdominal pain?肠易激综合症(IBS)是如何引起腹痛的?

As previously mentioned, the discomfort of irritable bowel syndromeis due either to abnormal intestinal muscle contractionsor visceral hypersensitivity.Generally,abnormal muscle contractions and visceralhypersensitivity are much more dificult to diagnose than other diseases orother health conditions,particularlysince there are no typical abnormalities on physical examination or the usualdiagnostic tests.The diagnosis is based on the history (typical symptoms) and the absence of other cause.

如前所述，可证实的鲍氏综合症的不适要么是由于肠道肌肉收缩异常，要么是由于内脏过敏。一般来说，异常肌肉收缩和内脏过敏比其他疾病或健康状况更难诊断，特别是在体检或常规诊断测试中没有典型的异常。诊断依据病史(典型症状)和无其他原因。

Foods,natural remedies,and OTC treatments for certain causes of abdominal pain食物，自然疗法，和非处方药物治疗某些原因的腹痛

If you aren’tsure if you need to seek medical advice for belly pain,contact your doctor orother health care professional before using any home remedies.如果你不确定是否需要寻求治疗腹痛的医疗建议，在使用任何家庭疗法之前，请联系你的医生或其他医疗专业人士。

Common homeremedies andover-the-counter (OTC) medicines include:常见的家庭药物和非处方药物包括:

• Eat less food少吃食物
• Take small amounts of baking soda吃少量小苏打
• Use lemon and/or lime juice使用柠檬和/或酸橙汁
• Start aBRAT diet(banana,rice,applesauce and toast)for a
• day or so for symptom relief. 开始一个BRAT饮食(香蕉、大米、苹果酱和吐司)来缓解症状。
• Don’t smoke or drinkalcohol.不要吸烟或喝酒

Some health care professionals recommend:一些医疗专业人士建议:

• Taking ginger 吃生姜
• Peppermint 薄荷
• Licorice 甘草
• Chamomile tea 洋甘菊茶
• Medications such as bismuth subsalicylate (Pepto-Bismol),
• loperamide (Imodium), ranitidine (Zantac) and other
• over-the-counter substances 药物，如水杨酸铋
• （PeptoBismol）、洛哌胺（Imodium）、雷尼替丁（Zantac）和其他非处方药

Some of these may help reduce symptoms,but if symptoms persist,seek medical care.Beware of"cures"advertised as a single treatment that can cure all causes ofthis problem because no such remedy or cure exists.

其中一些可能有助于减轻症状，但如果症状持续，请寻求医疗护理。当心广告中的“治疗”是一种单一的治疗方法，它可以治愈所有导致这个问题的原因，因为不存在这样的治疗方法。

Taking aspirin or NSAIDs should beavoided until the cause of the pain is diagnosed because the medications couldmake some causes worse(forexample, peptic ulcers, intestinal bleeding).

服用阿司匹林或非甾体类抗炎药应该避免，直到疼痛的原因被诊断出来，因为这些药物会使一些原因变得更严重(例如，消化性溃疡，肠出血)。

Why can diagnosis of the cause of abdominal pain bedificult?为什么腹痛的病因诊断会有困难?

Modern advances in technology have greatly improved the accuracy, speed, and ease of establishing the cause of belly pain, but significant challenges remain. There are manyreasons why diagnosing the cause of it can be dificult.

现代技术的进步极大地提高了确定腹部疼痛原因的准确性、速度和易解性，但仍存在重大挑战。原因有很多，为什么诊断它的原因可能是困难的。

Symptoms may be atypical症状可能不典型

For example, the pain of appendicitis sometimes is located in the right upper abdomen, and of diverticulitis on theright side. Elderly patients and those taking corticosteroids may have little or no pain and tenderness when there is inflammation, forexample, with cholecystitis or diverticulitis. This occurs because cortic osteroids reduce the inflammation.

例如，阑尾炎的疼痛有时位于右上腹部，而憩室炎则位于右侧。老年患者和服用糖皮质激素的患者在出现炎症(如胆囊炎或憩室炎)时可能很少或没有疼痛和压痛。这是因为皮质类固醇可以减少炎症。

Tests are not always abnormal. 检查并不总是异常的。

• Ultrasound examinations can miss gallstones, particularly
• small ones. 超声检查可漏诊胆结石，特别是小结石。
• CT scans may fail to show pancreatic cancer,particularly
• small ones. CT扫描可能无法显示胰腺癌，特别是小的。
• The KUB can miss the signs of intestinal obstruction or stomach perforation. KUB可忽略肠梗阻或胃穿孔的迹象。
• Ultrasounds and CT scans may fail to demonstrate appendicitis
• or even abscesses, particularly if the abscesses are small. 超声波和CT扫描可能无法显示阑尾炎甚至脓肿，尤其是脓肿很小的时候。
• The CBC and other blood tests may be normal despite severe
• infection or inflammation, particularly in individuals receiving
• corticosteroids or other drugs that suppress the immune system. 尽管严重的感染或炎症，CBC和其他血液测试可能是正常的，特别是在接受皮质类固醇或其他抑制免疫系统的药物的个体中。
• Diseases can mimic oneanother. 疾病之间可以是相似的。
• IBS symptoms can mimic bowel obstruction, cancer, ulcer,
• gallbladder attacks, or even appendicitis.

IBS的症状与肠梗阻、癌症、溃疡、胆囊疾病甚至阑尾炎相似

• Crohn's disease can mimic appendicitis. 克罗恩病可与阑尾炎相似。
• Infection of the right kidney can mimic acute cholecystitis.
• 右侧肾脏感染和急性胆囊炎相似。
• A ruptured right ovarian cyst can mimic appendicitis; while a
• ruptured left ovarian cyst can mimic diverticulitis. 右侧膀胱囊破裂，类似阑尾炎;而左侧卵巢破裂可类似憩室炎。
• Kidney stones can mimic appendicitis or diverticulitis. 肾结石可类似阑尾炎或憩室炎。

The characteristics of the pain may change. 疼痛的特征可能会改变。

Examples discussed previously includethe extension of the inflammation of pancreatitis to involve the entire abdomenand the progression of biliary colic to cholecystitis.

前面讨论的例子包括胰腺炎炎症扩展到整个腹部和胆绞痛进展到胆囊炎。

What medications can be used to treat certain causes ofabdominal pain? 什么药物可以用来治疗某些原因的腹痛?

Medications that are used for thetreatment of underlying cause(s) of the pain are the medications of choice. Forexample, medications are not needed for the treatment of simple viral gastroenteritis (stomach flu or stomach bug),whilesurgery and/or chemotherapy may be the bestapproach to treat certain cancers in the abdomen. Other causes may require antispasmodics, antimicrobials,H2 blockers, or even nitratesor ********. The diagnosed cause usually narrows the choice ofmedications. A few causes can only be treated by surgery (for example incarcerated hernia, abdominaladhesions from previous surgeries,and certain abdominalinjuries), although some medications may be used (for example, ********) while the person is waiting to have surgery.

用于治疗潜在疼痛原因的药物是可选择的药物。例如，治疗单纯病毒性肠胃炎（胃流感或胃病）不需要药物，虽然手术和/或血液治疗是治疗腹部某些癌症的最佳方法。其他原因可能需要解痉药、抗菌药、H2阻滞剂，甚至硝酸盐或吗啡。确诊的原因通常会缩小药物的选择范围。少数原因只能通过手术治疗（如嵌顿疝、既往手术腹部粘连，以及某些腹部损伤），尽管在患者等待手术时可能会使用一些药物（例如吗啡）。

What lifestyle choices can I make to prevent abdominalpain?我可以选择什么样的生活方式来预防腹痛?

Lifestylechanges really depend on the cause of the pain.生活方式的改变真的取决于疼痛的原因。

• Eat a healthy diet, exercise, and avoid smoking and excess
• alcohol consumption to reduce the chances that you will
• experience certaincauses.健康饮食、锻炼身体、避免吸烟和过量饮酒，以减少你患上某些疾病的几率。
• Good hygiene, especially hand washing and avoiding materials and foods contaminated with viruses and bacteria will reduce
• your chances of developing illness from many infectious
• causes. 良好的卫生习惯，尤其是洗手，避免接触被病毒和细菌污染的材料和食品，这将减少你因许多传染性疾病而患病的机会。

When should I call my doctor about abdominal pain? 我应该什么时候给我的医生打腹痛电话？

Some doctors suggest that if you have a "less serious" cause of abdominal pain youlikely won’t need to see a doctor if the symptoms resolve in about 24 to 48 hours. For example, if you have viralor bacterial food poisoning, have had discomfort, but aren’t dehydrated.

一些医生建议，如果你有一个“不太严重”的原因，腹痛，你可能不需要看医生，如果症状在24至48小时内解决。例如，如果你有病毒或细菌性食物中毒，有过不适，但没有脱水。

If you have a chronic problem that occasionally causes abdominal discomfort, most doctors suggest you contact the person treating you for the ailment for an appointmentor prescription (refill). However, if you have any of the problems or symptoms listed inthe "serious abdominal pain "section above, you should seek immediatemedical care.

如果你有一个慢性病，偶尔会引起腹部不适，大多数医生建议你联系给你治病的人预约或开处方（补药）。然而，如果你有任何问题或症状列在“严重腹痛”一节，你应该立即寻求医疗照顾。

Tips

As previously mentioned 如前所述

baking soda小苏打

lime juice酸橙汁

applesauce 苹果酱

toast吐司

ginger吃生姜

Peppermint薄荷

Licorice 甘草

Chamomile tea 洋甘菊茶

bismuthsubsalicylate (Pepto-Bismol) 水杨酸铋（Pepto Bismol）

loperamide(Imodium)洛哌胺（Imodium）

ranitidine(Zantac)雷尼替丁（Zantac）

over-the-counter场外交易的，非挂牌的；非处方的

spirin 阿司匹林

NSAIDs 非甾体抗炎药（Non-Steroidal Antiinflammatory Drugs）；非类固醇抗炎药

Modern advances in technology 现代技术的进步

corticosteroids 糖皮质激素

simpleviral gastroenteritis 单纯病毒性肠胃炎

stomach flu 胃流感

stomach bug 胃病

chemotherapy 化疗

antispasmodic 解痉药

antimicrobial 抗菌药

H2blocker H2阻滞剂

nitrate 硝酸盐

******** 吗啡

incarceratedhernia 嵌顿疝

abdominaladhesions from previous surgeries 既往手术腹部粘连

abdominalinjuries 腹部损伤

foodscontaminated with viruses and bacteria 被病毒和细菌污染的食物

have viral or bacterial food poisoning病毒或细菌性食物中毒

dehydrate

vt.使…脱水；使极其口渴；使丧失力量和兴趣等

vi. 脱水；去水

Runnerscan dehydrate very quickly in this heat. 天这样热，赛跑运动员很快会脱水。

thedehydrating effects of alcohol 酒精引起的脱水

ailment 小病；不安

prescription (refill) 处方（补药）

comesand goes 来来去去

menstruation 月经；月经期间；有月经

stabbing or severe pain刺痛还是剧痛

dull ache 隐痛

radiate into your lower back, shoulder, groin, orbuttocks放射到你的下背部、肩膀、腹股沟或臀部

Escherichia coli (E. coli) 大肠杆菌（E.coli）

Listeria 李斯特菌

Microorganism 微生物

stomachcramps, vomiting, diarrhea, nausea, upset stomach胃痉挛、呕吐、腹泻、恶心、胃部不适

Mild food poisoning轻度食物中毒

electrolytes 电解质

rehydrate 补充水分

powder 粉末

life-threatening危及生命的

loperamide(Imodium)洛哌胺（Imodium）

bismuthsubsalicylate (Pepto-Bismol) 水杨酸铋（Pepto Bismol）

carbohydrate 碳水化合物

Lactose intolerance 乳糖不耐受

Fructose 果糖

fig 无花果

apricot 杏子

mango芒果

Celiac disease乳糜泻

gluten 谷蛋白

wheat 小麦

barley 大麦

rye黑麦

osteoporosis骨质疏松