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···· ····   Patient muttering to himself: Oh! Pretty bad diarrhea! I’d better go to the hospital.
  
  患者自言自语:哎哟哟,这拉肚子拉的不对劲儿了,还是赶紧去医院吧。
  
  Doctor: Hi, what’s wrong with you?
  
  医生:你好,请问哪儿不舒服?
  
  Patient: doctor, I’ve been having diarrhea for some time.
  
  患者:大夫,我拉肚子有一段时间了。
  
  Recently, I found blood in the stool and suffered from abdominal pain. So I come here for help.
  
  最近发现大便带血,而且还肚子疼,所以赶紧来看看。
  
  Doctor: Take it easy! Some tests need to be done before diagnosis.
  
  医生:不要着急,咱们再做几项检查,然后才能确诊。
  
  Doctor: According to the results, you’re diagnosed as ulcerative colitis, which is one type of inflammatory bowel disease, IBD for short.
  
  医生:根据你的检查结果,可以确定你得的是溃疡性结肠炎,属于炎症性肠病的一种,炎症性肠病简称IBD。
  
  Patient: Doctor, I’ve never heard of IBD. What kind of disease is this?
  
  患者:大夫,没听说过IBD,请问这是什么病?
  
  Doctor: IBD, also known as inflammatory bowel disease, is a chronic and unspecific inflammatory intestinal conditions, including ulcerative colitis and Crohn’s disease.
  
  医生:IBD,又称炎症性肠病,是一种慢性非特异性肠道炎症性疾病,包括溃疡性结肠炎和克罗恩病。
  
  Ulcerative colitis is prevalent among young and middle-aged population aged between 20-49,
  
  溃疡性结肠炎在20-49岁的中青年人中比较常见。
  
  with clinical features including continual or recurrent diarrhea, mucus or blood in the stool, abdominal pain, tenesmus, and systemic symptoms of variable degrees.
  
  主要表现为持续或反复发生的腹泻、大便带黏液或脓血,还有腹痛、里急后重和不同程度的全身症状。
  
  Some patients may also have extra-intestinal manifestations in the skin mucous membrane, knees, eyes, liver and gallbladder, etc.
  
  部分患者还可有皮肤粘膜、关节痛、眼睛和肝胆等部位的不适表现。
  
  Crohn’s disease can involve the whole digestive tract, with the high incidence in young people aged between 18-35.
  
  克罗恩病可累及整个消化道,18-35岁的年轻人是这种疾病的高发群体。
  
  Diarrhea is not the only trouble IBD brings.
  
  被炎症性肠病“盯上”后的麻烦不止是“闹肚子”。
  
  Take Crohn’s disease for instance, a lot of patients are teenagers, who are prone to develop malnutrition and growth stunting after digestive tract injury and consequent nutrient absorption deficiency.
  
  以克罗恩病为例,不少都发生于十几岁的青少年,由于该病累及全消化道,严重影响患者营养吸收,对于青少年来说容易导致营养不良,阻碍生长发育。
  
  Meanwhile, there’s a risk of developing cancer 8-10 years after the pathogenesis of ulcerative colitis, and the formation of intestinal cancer 15-20 years later.
  
  而溃疡性结肠炎发病8-10年就有癌变风险,15-20年可并发肠癌。
  
  Therefore, young to middle-aged population should go to the gastroenterology department immediately, if diarrhea lasts more than 3 times a day and persists for 6 weeks.
  
  因此,中青年群体如果持续6周腹泻,每天超过3次,应及时到正规医院消化内科就诊。
  
  Patient: doctor, I always eat regular meals. How do I develop this disease?
  
  患者:医生,我平时吃饭都比较规律,为什么会得这个病呢?
  
  Doctor: The pathogenesis of IBD is incompletely understood so far.
  
  医生:IBD的病因目前尚未明确
  
  The medical community believes that genetic and environmental factors such as altered luminal bacteria and enhanced intestinal permeability play a role in the dysfunction of intestinal immunity, leading to gastrointestinal injury.
  
  但医学界认为是遗传与环境共同作用的结果。肠道菌群的改变和肠道通透性的增加,促进了肠道的免疫失调,并最终导致胃肠道损伤。
  
  One or more genes may be responsible for the germination of IBD, and certain environmental factors may lit the fuse that lead to IBD, for example, bacteria or virus.
  
  很有可能是一个或者更多的基因决定了IBD的萌芽,而环境中的一些因素是导致IBD发生的导火索,比如说病毒或者细菌。
  
  Whatever, these factors will influent patients with specific genotypes, in the presence of luminal bacteria, to activate the patients’ immune system to fight against these exogenous substances,
  
  不管具体是什么,这些因素都将作用于特定基因型的患者,并在肠道菌群的参与下,激活患者的免疫系统并且激发它们攻击外来性物质。
  
  in other words, to stimulate the inflammatory reaction.
  
  也就是说它们激发了炎症反应。
  
  Unfortunately, once the balance of intestinal mucosal immune system is destroyed, the constant inflammation would damage the gastrointestinal canal wall, leading to clinical symptoms of IBD.
  
  不幸的是,一旦患者的肠黏膜免疫系统平衡被破坏,炎症反应持续存在,就会损伤胃肠道管壁,从而产生IBD的临床症状。
  
  Patient: It sounds like the disease is caused by gene, so is it incurable?
  
  患者:大夫,听起来这个病病因是遗传基因,那不是就治不好了么?
  
  Doctor:Don’t worry! Although IBD cannot be cured at present, if you follow the doctor’s advice, and receive long-term regular treatment, the symptoms can be well controlled and your quality of life won’t be affected much.
  
  医生:不要害怕,虽然这个病目前没有办法治愈,但只要遵医嘱,通过长期正规治疗可以控制病情,不会特别影响你的生活。
  
  The treatment decisions will be made based on your situation.
  
  来,我们根据你的情况,给你制定你的治疗方案。
  
  Now you’re in the induction period, the aim is to control symptoms. After that, when you enter the maintenance period, we will try to maintain the remission status and prevent recurrence.
  
  现在是治疗期,咱们以控制症状为目标;症状控制好后,进入缓解期,继续维持缓解, 预防复发。
  
  Patient: doctor, I’ll definitely adherent to the treatment.
  
  患者:大夫,我一定会配合治疗。
  
  Doctor: Very good. Besides, IBD is a chronic disease. Due to the constant injury of the intestine by inflammation, there are risks of deriving other intestinal diseases.
  
  医生:非常好。除此以外, IBD是慢性疾病,由于炎症对肠道不断的破坏,控制不好就会有衍生为其他肠道性疾病的风险,
  
  Therefore, regular follow-up is of great importance, and the treatment must be adjusted in case.
  
  因此必须定期随访,根据情况调整方案,马虎不得。
  
  I’ve written the date of return visit on your medical record.
  
  我在你病历本上已经写好了复诊日期。
  
  Before that, you can visit me at any time once you have worsen symptoms of abdominal pain, diarrhea, or bleeding.
  
  但一旦出现腹痛、腹泻、便血加重等症状请随时就诊。
  
  Patient: OK, I see. I’ll return visit on time. Thank you very much.
  
  患者:好的,明白了,我一定会定期随访,按时复诊,谢谢大夫。









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