Encyclopedia of Family Medicine

Chapter 43 Prevention of Common Diseases (4)
2. Chronic bronchitis

Various symptoms of chronic bronchitis are usually caused by mucosal congestion, edema, hyperplasia, enlargement, hypersecretion, and increased mucus in the bronchial wall mucosa.Excessive mucus secretion increases the amount of sputum. In the trachea and bronchi, it not only affects the smoothness of the respiratory tract, but also creates favorable conditions for the growth of pyrene by bacteria, so it is easy to cause infection.

While treating chronic bronchitis with medication, attention should be paid to avoid sea fishy, ​​greasy and irritating food, as well as quit smoking and alcohol.Patients with chronic bronchitis should avoid or eat less yellow croaker, octopus, crab, shrimp and fatty meat. Spicy foods such as chili, pepper, garlic, onion, and leek can irritate the respiratory mucosa and aggravate the condition.The seasoning of dishes should not be too sweet or too salty, and should be moderately hot and cold. Smoking is harmful but not beneficial. People suffering from chronic bronchitis should especially smoke.People with chronic lung disease are prone to severe coughing due to the stimulation of alcohol, and may also suffer from sudden syncope and confusion.This phenomenon usually disappears automatically in a few seconds, and is often not taken seriously by patients.Transient mental disorder caused by severe cough, commonly known as "breath-holding", is called cough spine dizziness syndrome in medicine.Severe cough increases the pressure of cerebrospinal fluid and directly compresses the cerebral blood vessels to cause cerebral ischemia. Therefore, patients with chronic bronchitis should drink less alcohol at ordinary times, and it is best not to drink. Some patients, regardless of cough and phlegm, aggravate at night and in the morning, affect sleep. I always like to drink a glass of wine before going to bed, and fall asleep in a daze, thinking that wine has a hypnotic effect. If this happens for a long time, it is very dangerous.The patient already has poor lung function. Drinking alcohol before going to bed will inhibit the respiratory center, causing life-threatening symptoms such as irregular breathing and stop during sleep.Therefore, people with chronic bronchitis and emphysema, especially those who already have pulmonary insufficiency, must not drink alcohol before going to bed.

3. Hyperlipidemia, arteriosclerosis and coronary heart disease

Hyperlipidemia is often an important factor in causing coronary heart disease and atherosclerosis.This is due to the close relationship between diet and hyperlipidemia.Therefore, in terms of dietary taboos, the principles are basically the same, all of which are "five lows", that is, low calorie energy, low satiety, low total fat and fatty acid content, low salt content, and low cholesterol.

The first is to avoid overeating and overeating.The daily calorie intake and consumption should be basically balanced. If the supply exceeds demand, the excess heat energy will be converted into fat and stored in the human body, causing the human body to gain weight and gain weight.Clinically, most of these patients are obese, so controlling heat energy and limiting weight is the key to treatment, especially coronary heart patients should not eat too much, because too much food is difficult to digest, and it can also increase the burden of the heart. Raises the diaphragm, bloating the abdomen and restricting the normal activity of the heart.And because of the need to digest food, the blood of the whole body is mostly concentrated in the gastrointestinal tract, which causes insufficient blood supply to the coronary arteries, aggravates myocardial ischemia and hypoxia, easily induces angina pectoris, and even occurs myocardial infarction, which is life-threatening.Eating a full meal at dinner is even more dangerous.Because blood flow slows down after falling asleep, oversaturation increases blood lipids, which are easily deposited on the blood vessel wall, affecting the elasticity of blood vessels and causing arteriosclerosis.Therefore, diet is forbidden, and diet is the main treatment method.

The second is to eat less meat.Eating too much fatty food for a long time is the main factor causing hyperlipidemia.Clinical data, animal risk and epidemiological examinations all show that dietary saturated fatty acid intake is significantly proportional to the incidence of hypertension and atherosclerosis.In addition to eating less meat, food with high cholesterol, such as animal offal, bone marrow, fish roe, crab roe, dried shrimp, egg yolk, etc., should also be eaten less.

The third is to eat less salt.Salt intake is related to hypertension, and long-term hypertension can easily lead to arteriosclerosis, which in turn develops into coronary heart disease.Therefore, it is best to control the salt intake to less than 5 grams per day.

The last point is to eat less sugar, prohibit alcohol and tobacco, and avoid strong tea.Especially to quit smoking, the risk of myocardial infarction due to coronary heart disease is 2-6 times higher for smokers than for non-smokers. The more you smoke and the longer the time, the higher the incidence of acute myocardial infarction.For example, if a coronary heart disease patient stops smoking after myocardial infarction, although it cannot make the patient recover, it can reduce the number of myocardial infarction attacks.In short, pay attention to eating less salt and sugar, quit smoking, alcohol and strong tea.

4. Acute hepatitis

Acute hepatitis is often caused by viral infection or toxic substances that damage the liver.Viral hepatitis is usually divided into two types, A and B.Hepatitis A can be transmitted by food or water, the incubation period is 18-40 days, and the jaundice is obvious, so it is also called icteric hepatitis.

Hepatitis B is usually transmitted by blood transfusion, vaccination or carrier, and the incubation period is 60-120 days.Some patients are positive for hepatitis B surface antigen without symptoms, and about 5% to 10% of acute hepatitis B can turn into chronic active hepatitis with severe symptoms.Patients with hepatitis have loss of appetite, anorexia, nausea, vomiting, general weakness, diarrhea or constipation.

In terms of diet, no matter what kind of hepatitis, don't eat too much sugar and fat, and you should quit smoking and alcohol.Patients with hepatitis need more nutrition than healthy people in order to maintain the metabolic function in the body and promote the repair of liver cells.It is very necessary for hepatitis patients to supplement a certain amount of glucose, fat and protein every day.However, some people think that the more you eat, the better your hepatitis will get better.Therefore, eating a lot of sugar, fat ducks and geese every day, in fact, this is not only useless, but also harmful.

Excessive glucose will be converted into low-density lipids in the body, which will increase the amount of fats such as triglycerides in the blood.Increased triglycerides in the body can also slow down blood flow, increase blood viscosity, and block small blood vessels.Lead to a series of organic diseases of the cardiovascular system.In addition, patients with hepatitis need a longer period of bed rest, less activity, and excessive sugar and fat supplementation. In addition, glucose metabolism disorders, weight gain gradually, the liver may form fatty changes of varying degrees, from hepatitis to fat Liver, at the same time, too much fat, sweet and savory, or overeating, will cause poor digestion and absorption in the stomach and intestines, abdominal distension and diarrhea, which will affect the absorption of other nutrients.

Therefore, hepatitis patients should not eat a lot of sugar and meat, especially fatty meat should be eaten less.Second, hepatitis patients should stop drinking.The liver is like a multi-functional chemical factory in the human body. Various substances in the diet must be processed by the liver before they can be absorbed and utilized.Various types of hepatitis have different degrees of substantial liver damage. At this time, the metabolism and detoxification functions of the liver to exogenous and endogenous substances are weakened.When patients drink alcohol, more than 90% of alcohol is metabolized by the liver, and both alcohol and its metabolite acetaldehyde have a damaging effect on liver cells, causing degeneration or necrosis of liver cells.Long-term drinking can also lead to fatty liver, and drinking while smoking will make it easier for the nicotine in the smoke to enter the body and increase the destruction of vitamin C.If there are surface antigen positive and asymptomatic people, they should also quit smoking and drinking.

5. Liver cirrhosis

Liver cirrhosis is caused by the gradual development of extensive liver parenchymal degeneration or chronic inflammation of the liver. Most of them are caused by excessive drinking and eating, emotional injury, overwork, or infection with schistosomiasis, etc., which cause dysfunction of the liver, kidneys, and spleen, and eventually lead to The occurrence of liver cirrhosis.Patients with liver cirrhosis should avoid the original taste of fat and sweetness.Quit smoking and alcohol, but also pay attention to eating less or not eating fish.Patients with liver cirrhosis have different degrees of liver function decline. If the diet is not temperate, it will increase the burden on the liver.Some people think that when liver cirrhosis occurs, if there is no unexpected change in the middle, the function of the liver can still metabolize for 40 years.However, if the burden on the liver is often increased.Overload may lead to insufficiency of liver function metabolism, ascites, and hepatic coma.

Normal people drink a small amount of alcohol, the liver can metabolize and detoxify alcohol, and generally it will not cause damage.But for patients with liver cirrhosis, because a considerable part of the liver cells have lost their function, and the activities of various enzymes required for alcohol metabolism are reduced, the secretion is reduced, and the detoxification ability is greatly reduced.Even drinking a small amount of alcohol will increase the burden, affect the recovery of liver function, and even cause liver necrosis, which is life-threatening.Rapid liver failure after drinking alcohol is common in patients with cirrhosis.Therefore, patients with liver cirrhosis must resolutely abstain from alcohol.Patients with advanced liver cirrhosis often have portal hypertension, hypersplenism, esophageal varices, and thrombocytopenia, so upper gastrointestinal bleeding is prone to occur, and it is often difficult to stop.Eventually become a complication and death factor of liver cirrhosis.Some fish, such as sardines, mackerel, saury and tuna, contain unsaturated fatty acid eicosapentaenoic acid, and its metabolites have the effect of yin and yang platelet aggregation.

If you eat more of this kind of fish, it will be difficult to stop the bleeding.So don’t eat this kind of fish, you can eat silk fish, carp, flounder, the content of eicosapentaenoic acid in these fish is relatively small.In addition, patients with liver cirrhosis should also eat less salt, fried, hot and sour and hard food.

6. Typhoid fever

Typhoid fever is an acute intestinal infectious disease caused by typhoid bacillus or paratyphi bacillus, and its main clinical manifestation is persistent high fever (40°C~41°C).The basic requirements of its diet are:

(1) The whole course of typhoid fever should be given a high-protein and high-calorie diet.The general heat supply is 40 to 60 calories per kilogram of body weight per day, which can be increased or decreased according to the specific conditions of the patient.The source of heat energy should be mainly carbohydrates, because carbohydrates are easily digested, absorbed and utilized. At the same time, sufficient carbohydrates can reduce the oxidation of fat and protein in the body, and avoid metabolic acidosis. The supply of protein should be 1 kg per day The body weight is 5 grams to 2 grams, and easily digestible protein foods such as milk, tofu, eggs, and boneless fish can also be selected.

(2) The consumption of inorganic salts, vitamins and water in patients with typhoid fever is also greatly increased. In order to maintain the normal metabolism of the patient's body, promote the excretion of bacterial toxins and restore health, the supply of water, inorganic salts and vitamins also needs to be increased. The daily intake of water should be about 3000 ml; the supply of vitamin B complex and ascorbic acid should be increased more than normal people, and the intake of table salt should be more than 4 grams per day.

(3) During the fever period, patients should adopt a liquid or semi-liquid diet, eat less frequently, and give lotus root starch, rice porridge, milk, steamed eggs, gravy soup, vegetable puree, vegetable soup, fruit juice and other foods.On the third and fourth days of the disease course, the remission period begins, and some bacteria penetrate the intestinal mucosa to invade the lymphoid tissue of the intestinal wall again, causing a strong allergic reaction in the swollen lymphoid tissue, aggravating the necrosis and ulcer of the intestinal wall, and the patient's appetite begins to improve. At this time, special attention should be paid to the appropriate diet, otherwise complications such as intestinal bleeding and intestinal perforation will occur.At this time, it is forbidden to use crude fiber and other foods that stimulate bowel movements and flatulence. A residue-free diet should be used. Vegetables and fruits should be made into puree, vegetable soup and fruit juice. Milk, soy milk, sucrose and other gas-producing foods should not be used.When the patient has intestinal bleeding, intestinal perforation should fast.

(4) During the recovery period after the patient's fever subsided, gradually change to semi-liquid, soft rice with less residue and ordinary rice.

7. Dysentery is the most common acute intestinal infectious disease
According to the different pathogens, it can be divided into amoebic dysentery and bacillary dysentery. Since the pathogen enters the intestinal tract and causes inflammatory changes and ulcers in the intestinal mucosa, its main clinical manifestations include fever, abdominal pain, diarrhea, and bloody stools.Patients often suffer from dyspepsia, fever, diarrhea, nutrient depletion, and dehydration.At the same time, intestinal lesions are particularly sensitive to food stimulation.Therefore, the diet for dysentery should always be rich in nutrition and water, easy to digest, non-irritating, and provide appropriate diet according to the various stages of the disease.

(1) Patients in the acute stage should mainly eat a liquid diet, eat small meals often, and can provide food such as lotus root powder, rice noodle porridge, fruit juice, etc., and add salty soup in an appropriate amount to supplement water and salt.Do not use or use less milk and soy milk, because using milk and soy milk can easily cause flatulence and diarrhea.

(2) Patients in the improvement period can adopt semi-liquid diet, and supply dried noodles, biscuits, steamed cakes, porridge, and oil-free broth.Avoid crumbly foods and harsh condiments.

(3) Patients in the recovery period should avoid eating irritating food with a lot of dregs prematurely, and can eat soft rice with less oil and dregs.Eggs, noodles, milk, tender lean meat, porridge and vegetables with less fiber can also be used.The cooking of soft food should be chopped, boiled and easy to digest.

8. Cholecystitis, cholelithiasis
In recent years, with the continuous improvement of living standards, people's dietary fat intake has also continued to increase, and biliary tract disorders have also been on the rise.Cholecystitis and cholelithiasis often co-exist, and they tend to occur in people over middle age, especially women who are obese and have many children.It often occurs after eating too much greasy food and suddenly feel severe right upper abdominal pain that radiates to the right shoulder.Sometimes the patient rolls on the bed in pain, breaks out in a cold sweat, and is accompanied by nausea, vomiting, high fever, and chills.Cholecystitis and cholelithiasis are closely related to diet. Restricting excessive fat intake is a dietary principle that patients should adhere to for a long time. Generally, when symptoms are relieved, the food is mainly boiled, braised, steamed, and boiled, and frying and oil are prohibited. Fried, because the formation of gallstones is related to high cholesterol in the body, so you should eat less foods with high cholesterol, such as egg yolk, fish roe, liver, waist, brain, fatty meat and other foods.All kinds of alcohol and irritating food, or strong condiments, can also promote the production of cholestin, enhance the contraction of the gallbladder, so that the sphincter of the biliary tract cannot relax and flow out bile in time, and it may also cause acute attacks of cholecystitis and cholelithiasis , so it should be contraindicated.Vegetable oils have a choleretic effect and are not contraindicated during the remission period.During the acute attack of cholecystitis and cholelithiasis, it is best to fast for 1 to 2 days, and rely on infusion to provide nutrition. With the improvement of the disease, the diet should still eat small and frequent meals to avoid excessive stimulation of the diet and affect the gallbladder, and should choose food with less residue , the vegetables must be boiled or pureed.Drink plenty of water and beverages to dilute bile and promote bile outflow.Ensuring smooth bowel movements can relieve symptoms and facilitate recovery.

In short, low-fat diet is one of the key means of prevention and treatment of biliary tract disease, and it should be given enough attention.

The inner wall of the bile duct in patients with gallbladder is often congested and edematous, and is often accompanied by cholelithiasis. The bile duct is often blocked, and it is difficult to expel bile. The pressure in the gallbladder increases, and the patient's pain increases.Therefore, gallbladder patients should not eat fatty meat as well.

9. Gastric and duodenal ulcers

Gastric and duodenal ulcer disease is a common and frequently-occurring disease in clinical, and unreasonable diet is often an important reason for the occurrence and development of ulcer disease.Therefore, attention should be paid to the unfavorable factors in the diet in order to prevent various complications that may occur.Secondly, food taboos should include the following aspects: ulcer disease should avoid overeating and hot and sour cold food, eat less and more meals every day, eat once every 2 to 3 hours during the day, so as not to increase the burden on the stomach, and use The stomach should always keep an appropriate amount of food to neutralize gastric acid and reduce the adverse stimulation of gastric acid to ulcer lesions; food should be fried or fried sparingly or not, so as not to affect digestion; avoid sour, spicy, raw, cold, hard and Food that is too hot.These foods are not only difficult to digest and absorb, but also stimulate the secretion of excessive gastric acid. Too cold food can cause gastric mucosal vasoconstriction, resulting in ischemia and hypoxia, decreased resistance, and can promote gastrointestinal motility, spasm, and aggravate pain symptoms. Foods that are too hot can dilate blood vessels, leading to bleeding.

Therefore, any irritating food, such as chili, coffee, chili oil, pepper, etc., excessive salt, spices, soy sauce, acid aldehydes, sauerkraut, fruit juice, candy, strong tea, wine, and cigarettes can all be harmful to the ulcer surface, stomach, etc. Adverse effects on mucous membranes should also be fasted.Secondly, patients with ulcers should not take baking soda frequently, because most patients have increased gastric acid, often feel a burning sensation under the xiphoid process, and have acid reflux, heating, and increased pain when hungry.At this time, if you eat a few tablets of baking soda, you will feel cool in your stomach and relieve symptoms.Because baking soda can neutralize gastric acid and relieve the irritation of gastric acid on the ulcer surface, but it is very unfavorable if used for a long time.Because baking soda produces carbon dioxide gas when it neutralizes gastric acid, it can stimulate the secretion of gastric acid, which can cause secondary hyperacidity and aggravate the condition.

In addition, carbon dioxide can cause flatulence, stimulate the ulcer surface during gastric expansion, damage blood vessels, and cause gastric bleeding and gastric perforation.Therefore, patients should not take baking soda often, and it is best not to drink too much soda with baking soda.In addition, drugs for the treatment of hyperacidity, such as aluminum hydroxide gel and aluminum sulfate, should not be taken for a long time.Because aluminum hydroxide combines with phosphate in the intestinal tract to form aluminum phosphate, which is excreted in the stool, causing a large loss of phosphoric acid, resulting in osteomalacia.Excessive aluminum buildup can damage the central nervous system and cause dementia.Ulcer patients should also quit smoking.The incidence of duodenal ulcer is relatively high in my country. The main factor is that excessive secretion of gastric acid results in damage to the duodenal mucosa and ulceration.Smoking increases the secretion of gastric acid and gastrin, abnormal blood circulation of gastrointestinal mucosa, and reduces the resistance of gastric mucosa.According to the test, the blood nicotine concentration is directly proportional to the acidity of the duodenal bulb, that is, the more you smoke, the more gastric acid and the longer the duration.Ulcer disease should avoid smoking, smoking immediately after a meal is more harmful.

It is not good for patients with peptic ulcer to drink milk, because milk can stimulate the secretion of gastric acid, and a large amount of gastric acid makes the ulcer surface difficult to heal and aggravates the condition.

Numerous clinical treatment trials have proven this.Therefore, it is best not to drink milk for peptic ulcer patients.

(End of this chapter)