Wednesday, December 23, 2009

Seemingly chronic colitis in patients with hyperthyroidism

68-year-old Wang Laotai over a year ago began to appear repeatedly diarrhea, vomiting and other symptoms, to a hospital and was diagnosed with "chronic colitis," given antibiotics therapy for six months without significant improvement. 4 months ago, Wang Laotai felt palpitation, sleep well at night, headache, dizziness, again to hospital for examination, was the doctor diagnosed as "neurosis", by Chinese and Western medicine with the symptoms slightly improved after treatment. A few days ago, Wang Laotai again flustered, sometimes with poor swallowing, chest tightness and other symptoms, tiredness, when the symptoms get worse.

This time, accompanied by her daughter, came to the hospital internal medicine clinic, the doctor of their medical examination found that patients with chronic wasting face, mild eyes suddenly, thyroid Ι degree of enlargement, heart rate faster, there is tremor by thyroid function and thyroid color Doppler ultrasound and other tests, the diagnosis of hyperthyroidism (hyperthyroidism). The use of methimazole, propranolol, and to correct conditions such as systemic treatment a month later, Wang Laotai repeated diarrhea, palpitation and other symptoms gradually disappear.

Expert analysis of hyperthyroidism is a common disease, with typical symptoms of hyperthyroidism in patients not difficult to diagnose, but the elderly and the symptoms were more typical for gastrointestinal symptoms, neurological symptoms and cardiac symptoms as the first symptom, so often misdiagnosed.

Hyperthyroidism caused by gastrointestinal symptoms make more use of chronic diarrhea, fatigue, weight loss as the main performance, this is because the thyroid hormone to accelerate gastric peristalsis, emptying accelerated, therefore, often seen in patients with hyperthyroidism stool frequency and more severe cases, may be discharged without The digestion of food. Patients without abdominal pain, diarrhea, and repeated use of antibiotics and drug treatment ineffective. Palpation can be found, except in patients with active bowel sounds, no other abdominal symptoms, and further examination revealed tremor, rapid heart rate, goiter and other signs, blood examination revealed elevated levels of serum thyroxine, hyperthyroidism after treatment with anti-digest tract symptoms will soon disappear.

Experts repeatedly reminded, if unexplained palpitation, diarrhea, and neurosis symptoms should take into account the possibility of hyperthyroidism. A detailed physical examination and relevant laboratory examinations (such as blood T3, T4, etc.) contribute to early diagnosis. In addition, unexplained persistent diarrhea in addition to investigations in patients with thyroid function and blood sugar, but also consider the gastrinomas, somatostatin tumor, vasoactive intestinal peptide tumor, intestinal diseases, diarrhea may be the typical symptoms of these diseases , or even the only symptom.

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