<div id="pf1" class="pf w0 h0" data-page-no="1"><div class="pc pc1 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/b2059c16-b174-46e7-8e10-adbf30b5d20d/bg1.png"><div class="c x0 y1 w0 h2"><div class="t m0 x1 h3 y2 ff1 fs0 fc0 sc0 ls3 ws0">Esôfago</div><div class="t m0 x2 h4 y3 ff2 fs1 fc0 sc0 ls3 ws3">SINAIS E SINT<span class="_0 blank"></span>OMAS CARACTERÍSTICOS </div><div class="t m0 x2 h5 y4 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3 v1">PIROSE: <span class="_1 blank"> </span>é <span class="_1 blank"> </span>a <span class="_1 blank"> </span>sensação <span class="_1 blank"> </span>de <span class="_1 blank"> </span>dor <span class="_1 blank"> </span>em <span class="_1 blank"> </span>queimação <span class="_1 blank"> </span>na <span class="_1 blank"> </span>região <span class="_1 blank"> </span>retroesternal, <span class="_1 blank"> </span>podendo <span class="_1 blank"> </span>irradiar-</span></div><div class="t m0 x3 h6 y5 ff3 fs3 fc0 sc0 ls1 ws3">se para abdômen superior <span class="_1 blank"> </span>e orofaringe, sendo frequentemente <span class="_1 blank"> </span>relatada como \u201cazia" (no </div><div class="t m0 x3 h6 y6 ff3 fs3 fc0 sc0 ls3 ws3">epigástrio. A<span class="_2 blank"></span> <span class="_3 blank"> </span>pirose <span class="_3 blank"> </span>ocorre <span class="_3 blank"> </span>frequentemente <span class="_3 blank"> </span>após <span class="_3 blank"> </span>refeições <span class="_3 blank"> </span>gordurosas. <span class="_3 blank"> </span>Os <span class="_3 blank"> </span>mecanismos </div><div class="t m0 x3 h6 y7 ff3 fs3 fc0 sc0 ls1 ws3">fisiopatológicos <span class="_4 blank"> </span>da <span class="_4 blank"> </span>pirose <span class="_4 blank"> </span>são: <span class="_4 blank"> </span>agressão <span class="_4 blank"> </span>da <span class="_4 blank"> </span>mucosa <span class="_4 blank"> </span>esofagiana <span class="_4 blank"> </span>por <span class="_4 blank"> </span>conteúdo <span class="_4 blank"> </span>ácido </div><div class="t m0 x3 h6 y8 ff3 fs3 fc0 sc0 ls1 ws3">refluído do estômago ou espasmo da musculatura esofagiana em resposta ao HCl. </div><div class="t m0 x2 h5 y9 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3 v1">REGURGIT<span class="_2 blank"></span>AÇÃO: é o retorno do conteúdo gástrico e/ou esofágico à cavidade oral, não </span></div><div class="t m0 x3 h6 ya ff3 fs3 fc0 sc0 ls1 ws3">acompanhada <span class="_3 blank"> </span>de <span class="_3 blank"> </span>náusea, <span class="_3 blank"> </span>vômito <span class="_3 blank"> </span>ou <span class="_3 blank"> </span>contração <span class="_3 blank"> </span>abdominal. <span class="_3 blank"> </span>Gosto <span class="_1 blank"> </span>amargo <span class="_3 blank"> </span>(associado <span class="_3 blank"> </span>a </div><div class="t m0 x3 h6 yb ff3 fs3 fc0 sc0 ls1 ws3">secreção <span class="_5 blank"> </span>bilio-pancreática), <span class="_5 blank"> </span>gosto <span class="_5 blank"> </span>ácido <span class="_5 blank"> </span>(origem <span class="_5 blank"> </span>gástrica) <span class="_5 blank"> </span>e <span class="_5 blank"> </span>gosto <span class="_5 blank"> </span>putrefeito <span class="_5 blank"> </span>(material </div><div class="t m0 x3 h6 yc ff3 fs3 fc0 sc0 ls1 ws3">proveniente da estase esofágica prolongada. </div><div class="t m0 x2 h5 yd ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">DOR T<span class="_0 blank"></span>ORÁCICA: dor retroesternal, em aperto, de forte intensidade com irradiação para </span></div><div class="t m0 x3 h6 ye ff3 fs3 fc0 sc0 ls1 ws3">MMSS, <span class="_1 blank"> </span>anterolaterais <span class="_3 blank"> </span>do <span class="_3 blank"> </span>tórax, <span class="_3 blank"> </span>dorso <span class="_1 blank"> </span>e <span class="_3 blank"> </span>mandíbula. Associada <span class="_1 blank"> </span>ao <span class="_3 blank"> </span>espasmo <span class="_3 blank"> </span>esofagiano. </div><div class="t m0 x3 h6 yf ff3 fs3 fc0 sc0 ls1 ws3">A<span class="_2 blank"></span> <span class="_4 blank"> </span>invervação <span class="_5 blank"> </span>é <span class="_4 blank"> </span>comum <span class="_5 blank"> </span>ao <span class="_4 blank"> </span>coração, <span class="_6 blank"> </span>permitindo <span class="_6 blank"> </span>que <span class="_6 blank"> </span>desordens <span class="_6 blank"> </span>esofagianas <span class="_6 blank"> </span>simulem </div><div class="t m0 x3 h6 y10 ff3 fs3 fc0 sc0 ls1 ws3">uma <span class="_7 blank"> </span>doença <span class="_7 blank"> </span>cardíaca, <span class="_7 blank"> </span>como <span class="_7 blank"> </span>insuficiência <span class="_7 blank"> </span>coronariana <span class="_7 blank"> </span>(dor <span class="_7 blank"> </span>anginosa <span class="_7 blank"> </span>cardíaca). <span class="_7 blank"> </span>O </div><div class="t m0 x3 h6 y11 ff3 fs3 fc0 sc0 ls1 ws3">primeiro passo na abordagem desses pacientes é excluir uma doença cardíaca. </div><div class="t m0 x2 h5 y12 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">BOCA<span class="_2 blank"></span> <span class="_6 blank"> </span>AMARGA/HALIT<span class="_0 blank"></span>OSE: <span class="_8 blank"> </span>apesar <span class="_8 blank"> </span>de <span class="_8 blank"> </span>serem <span class="_8 blank"> </span>queixas <span class="_8 blank"> </span>frequentes, <span class="_8 blank"> </span>raramente <span class="_8 blank"> </span>estão </span></div><div class="t m0 x3 h6 y13 ff3 fs3 fc0 sc0 ls1 ws3">associadas <span class="_3 blank"> </span>à <span class="_9 blank"> </span>doenças <span class="_3 blank"> </span>gastroesofágicas. <span class="_9 blank"> </span>Normalmente <span class="_3 blank"> </span>relaciona-se <span class="_9 blank"> </span>com <span class="_3 blank"> </span>problemas <span class="_9 blank"> </span>da </div><div class="t m0 x3 h6 y14 ff3 fs3 fc0 sc0 ls1 ws3">orofaringe ou psicogênicos. </div><div class="t m0 x2 h5 y15 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">SIALORREIA: é <span class="_1 blank"> </span>uma produção <span class="_1 blank"> </span>exagerada de <span class="_1 blank"> </span>saliva ou <span class="_1 blank"> </span>dificuldade de <span class="_1 blank"> </span>deglutição devido </span></div><div class="t m0 x3 h6 y16 ff3 fs3 fc0 sc0 ls3 ws3">à estenose (estreitamento) de porção inicial do TGI. </div><div class="t m0 x2 h5 y17 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">NÁUSEAS/VÔMITOS: <span class="_9 blank"> </span>qu<span class="_1 blank"> </span>ando <span class="_a blank"> </span>associados <span class="_a blank"> </span>à <span class="_a blank"> </span>estenose <span class="_a blank"> </span>esofágica <span class="_a blank"> </span>resultam <span class="_a blank"> </span>em <span class="_5 blank"> </span>vômitos </span></div><div class="t m0 x3 h6 y18 ff3 fs3 fc0 sc0 ls1 ws3">alimentares precoces, não digeridos. </div><div class="t m0 x2 h5 y19 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3 v1">DISF<span class="_2 blank"></span>AGIA: é a dificuldade para deglutir<span class="_2 blank"></span>, pode ser classificada em: </span></div></div><div class="c x1 y1a w2 h7"><div class="t m0 x4 h8 y1b ff3 fs4 fc1 sc0 ls2 ws3">Gabriela Reis Viol</div></div><div class="c x5 y1c w3 h9"><div class="t m0 x3 ha y1d ff1 fs5 fc0 sc0 ls3 ws3">T<span class="_b blank"></span>r<span class="_2 blank"></span>ato ga<span class="ff4">!</span><span class="ws1">r<span class="_2 blank"></span>oint<span class="ff4 ws2">"</span>tinal</span></div></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf2" class="pf w0 h0" data-page-no="2"><div class="pc pc2 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/b2059c16-b174-46e7-8e10-adbf30b5d20d/bg2.png"><div class="c x6 y1e w4 hb"><div class="t m0 x4 h6 y1f ff3 fs3 fc0 sc0 ls1 ws4">1. <span class="ls4 ws5">FUNCIONAL<span class="ls3 ws3">: <span class="_c blank"> </span>distúrbi<span class="_1 blank"> </span>os <span class="_c blank"> </span>neuromot<span class="_1 blank"> </span>ores <span class="_c blank"> </span>(múscu<span class="_1 blank"> </span>los <span class="_c blank"> </span>da <span class="_c blank"> </span>degluti<span class="_1 blank"> </span>ção <span class="_c blank"> </span>e <span class="_c blank"> </span>peristal<span class="_1 blank"> </span>tismo </span></span></div><div class="t m0 x7 h6 y20 ff3 fs3 fc0 sc0 ls3 ws3">e<span class="_1 blank"> </span>s<span class="_1 blank"> </span>o<span class="_3 blank"> </span>f<span class="_1 blank"> </span>á<span class="_3 blank"> </span>g<span class="_1 blank"> </span>i<span class="_3 blank"> </span>c<span class="_1 blank"> </span>o <span class="_d blank"> </span>c<span class="_1 blank"> </span>o<span class="_1 blank"> </span>m<span class="_3 blank"> </span>p<span class="_1 blank"> </span>r<span class="_3 blank"> </span>o<span class="_1 blank"> </span>m<span class="_3 blank"> </span>e<span class="_1 blank"> </span>t<span class="_3 blank"> </span>i<span class="_1 blank"> </span>d<span class="_1 blank"> </span>o<span class="_3 blank"> </span>s<span class="_1 blank"> </span>)<span class="_3 blank"> </span>. <span class="_c blank"> </span>R<span class="_3 blank"> </span>e<span class="_1 blank"> </span>p<span class="_3 blank"> </span>r<span class="_1 blank"> </span>e<span class="_3 blank"> </span>s<span class="_1 blank"> </span>e<span class="_1 blank"> </span>n<span class="_3 blank"> </span>t<span class="_1 blank"> </span>a<span class="_3 blank"> </span>m <span class="_c blank"> </span>d<span class="_3 blank"> </span>i<span class="_1 blank"> </span>f<span class="_3 blank"> </span>i<span class="_1 blank"> </span>c<span class="_3 blank"> </span>u<span class="_1 blank"> </span>l<span class="_1 blank"> </span>d<span class="_3 blank"> </span>a<span class="_1 blank"> </span>d<span class="_3 blank"> </span>e <span class="_c blank"> </span>p<span class="_3 blank"> </span>a<span class="_1 blank"> </span>r<span class="_3 blank"> </span>a <span class="_c blank"> </span>d<span class="_3 blank"> </span>e<span class="_1 blank"> </span>g<span class="_3 blank"> </span>l<span class="_1 blank"> </span>u<span class="_3 blank"> </span>t<span class="_1 blank"> </span>i<span class="_1 blank"> </span>r <span class="_d blank"> </span>q<span class="_1 blank"> </span>u<span class="_3 blank"> </span>a<span class="_1 blank"> </span>l<span class="_3 blank"> </span>q<span class="_1 blank"> </span>u<span class="_3 blank"> </span>e<span class="_1 blank"> </span>r </div><div class="t m0 x7 h6 y21 ff3 fs3 fc0 sc0 ls1 ws3">substância, <span class="_e blank"> </span>especialmente <span class="_e blank"> </span>líquidos <span class="_e blank"> </span>(são <span class="_e blank"> </span>mais <span class="_e blank"> </span>leves <span class="_e blank"> </span>e <span class="_e blank"> </span>sofrem <span class="_e blank"> </span>menor <span class="_e blank"> </span>ação <span class="_e blank"> </span>da </div><div class="t m0 x7 h6 y22 ff3 fs3 fc0 sc0 ls1 ws3">gravidade) </div><div class="t m0 x4 h6 y23 ff3 fs3 fc0 sc0 ls1 ws4">2. <span class="ls5 ws6">ORGÂNICA<span class="ls6 ws3">:<span class="_0 blank"></span> <span class="_e blank"> </span>estreitamento<span class="_0 blank"></span> <span class="_e blank"> </span>mecânica<span class="_0 blank"></span> <span class="_e blank"> </span>do<span class="_0 blank"></span> <span class="_e blank"> </span>tubo<span class="_0 blank"></span> <span class="_e blank"> </span>(musculatura<span class="_0 blank"></span> <span class="_e blank"> </span>e <span class="_e blank"> </span>peristaltismo<span class="_0 blank"></span> <span class="_2 blank"></span></span></span></div><div class="t m0 x7 h6 y24 ff3 fs3 fc0 sc0 ls3 ws3">p<span class="_9 blank"> </span>r<span class="_9 blank"> </span>e<span class="_9 blank"> </span>s<span class="_9 blank"> </span>e<span class="_9 blank"> </span>r<span class="_9 blank"> </span>v<span class="_9 blank"> </span>a<span class="_9 blank"> </span>d<span class="_a blank"> </span>o<span class="_9 blank"> </span>s<span class="_9 blank"> </span>, <span class="_d blank"> </span>p<span class="_9 blank"> </span>o<span class="_9 blank"> </span>r<span class="_9 blank"> </span>é<span class="_9 blank"> </span>m <span class="_f blank"> </span>t<span class="_9 blank"> </span>u<span class="_9 blank"> </span>d<span class="_9 blank"> </span>o <span class="_f blank"> </span>e<span class="_9 blank"> </span>s<span class="_9 blank"> </span>t<span class="_9 blank"> </span>á <span class="_d blank"> </span>e<span class="_9 blank"> </span>s<span class="_9 blank"> </span>t<span class="_a blank"> </span>r<span class="_9 blank"> </span>e<span class="_9 blank"> </span>i<span class="_9 blank"> </span>t<span class="_9 blank"> </span>a<span class="_9 blank"> </span>d<span class="_9 blank"> </span>o<span class="_9 blank"> </span>) <span class="_d blank"> </span>g<span class="_9 blank"> </span>e<span class="_a blank"> </span>r<span class="_9 blank"> </span>a<span class="_9 blank"> </span>n<span class="_9 blank"> </span>d<span class="_9 blank"> </span>o <span class="_d blank"> </span>u<span class="_9 blank"> </span>m<span class="_9 blank"> </span>a <span class="_f blank"> </span>o<span class="_9 blank"> </span>b<span class="_9 blank"> </span>s<span class="_9 blank"> </span>t<span class="_9 blank"> </span>r<span class="_9 blank"> </span>u<span class="_9 blank"> </span>ç<span class="_9 blank"> </span>ã<span class="_9 blank"> </span>o <span class="_f blank"> </span>e </div><div class="t m0 x7 h6 y25 ff3 fs3 fc0 sc0 ls1 ws3">consequentemente, <span class="_6 blank"> </span>dificultando <span class="_6 blank"> </span>a <span class="_4 blank"> </span>passagem <span class="_6 blank"> </span>de <span class="_4 blank"> </span>alimento. <span class="_6 blank"> </span>Pode <span class="_4 blank"> </span>ser <span class="_6 blank"> </span>progressiva <span class="_4 blank"> </span>de </div><div class="t m0 x7 h6 y26 ff3 fs3 fc0 sc0 ls1 ws3">sólidos para líquidos, comum nos casos de neoplasias. </div><div class="t m0 x4 h6 y27 ff3 fs3 fc0 sc0 ls1 ws4">3. <span class="ls3 ws7">MIST<span class="_2 blank"></span>A<span class="ls7 ws3">. </span></span></div><div class="t m0 x4 h5 y28 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3 v1">ODINOF<span class="_2 blank"></span>AGIA: <span class="_1 blank"> </span>é a <span class="_1 blank"> </span>dor <span class="_1 blank"> </span>ao <span class="_1 blank"> </span>deglutir<span class="_2 blank"></span>, <span class="_1 blank"> </span>resultando, na <span class="_1 blank"> </span>maioria <span class="_1 blank"> </span>das vezes, <span class="_1 blank"> </span>do <span class="_1 blank"> </span>contato <span class="_1 blank"> </span>do bolo </span></div><div class="t m0 x8 h6 y29 ff3 fs3 fc0 sc0 ls1 ws3">alimentar com a área lesada da mucosa esofágica. </div><div class="t m0 x4 h5 y2a ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">SOLUÇO: <span class="_e blank"> </span>contração <span class="_c blank"> </span>rápida <span class="_c blank"> </span>e <span class="_e blank"> </span>involuntária <span class="_c blank"> </span>do <span class="_e blank"> </span>diafragma <span class="_c blank"> </span>que <span class="_e blank"> </span>produz <span class="_c blank"> </span>inspiração </span></div><div class="t m0 x8 h6 y2b ff3 fs3 fc0 sc0 ls1 ws3">interrompida pelo fechamento <span class="_8 blank"> </span>da glote com emissão de som <span class="_8 blank"> </span>agudo característico. </div><div class="t m0 x8 h6 y2c ff3 fs3 fc0 sc0 ls1 ws3">Ocorre por estímulo do SNC ou local do nervo frênico (como em doenças esofagianas). </div><div class="t m0 x4 h5 y2d ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">HEMA<span class="_2 blank"></span>TÊMESE: <span class="_a blank"> </span>é <span class="_a blank"> </span>o <span class="_a blank"> </span>vômito <span class="_a blank"> </span>com <span class="_a blank"> </span>sangue, <span class="_a blank"> </span>a <span class="_a blank"> </span>origem <span class="_a blank"> </span>é <span class="_a blank"> </span>sempre <span class="_a blank"> </span>de <span class="_a blank"> </span>uma <span class="_a blank"> </span>lesão <span class="_a blank"> </span>acima <span class="_a blank"> </span>do </span></div><div class="t m0 x8 h6 y2e ff3 fs3 fc0 sc0 ls1 ws3">ângulo de T<span class="_2 blank"></span>reitz - junção jejunoduodenal. </div><div class="t m0 x4 h5 y2f ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">MELENA: <span class="_1 blank"> </span>eliminação <span class="_3 blank"> </span>fecal <span class="_3 blank"> </span>de <span class="_3 blank"> </span>sangue <span class="_3 blank"> </span>digerido, <span class="_3 blank"> </span>ou <span class="_1 blank"> </span>seja, <span class="_3 blank"> </span>fezes <span class="_3 blank"> </span>com <span class="_3 blank"> </span>sangue <span class="_3 blank"> </span>que <span class="_3 blank"> </span>passou </span></div><div class="t m0 x8 h6 y30 ff3 fs3 fc0 sc0 ls1 ws3">pelo <span class="_10 blank"> </span>estômago <span class="_10 blank"> </span>e <span class="_10 blank"> </span>intestino. <span class="_7 blank"> </span>As <span class="_10 blank"> </span>fezes <span class="_10 blank"> </span>possuem <span class="_10 blank"> </span>aspecto <span class="_10 blank"> </span>enegrecido <span class="_10 blank"> </span>e <span class="_10 blank"> </span>odor <span class="_10 blank"> </span>fétido </div><div class="t m0 x8 h6 y31 ff3 fs3 fc0 sc0 ls3 ws3">característico. </div><div class="t m0 x4 h5 y32 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">COMPROMETIMENTO <span class="_9 blank"> </span>NUTRICIONAL: <span class="_9 blank"> </span>doenças <span class="_9 blank"> </span>esofagianas <span class="_9 blank"> </span>podem <span class="_9 blank"> </span>fazer <span class="_9 blank"> </span>com <span class="_a blank"> </span>que <span class="_9 blank"> </span>o </span></div><div class="t m0 x8 h6 y33 ff3 fs3 fc0 sc0 ls1 ws3">paciente evite a deglutição por receio a odinofagia e disfagia. </div><div class="t m0 x4 h4 y34 ff2 fs1 fc0 sc0 ls3 ws3">DOENÇAS ESOF<span class="_2 blank"></span>AGIANAS </div><div class="t m0 x4 h5 y35 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">DOENÇA<span class="_2 blank"></span> <span class="_5 blank"> </span>DO <span class="_6 blank"> </span>REFLUXO <span class="_5 blank"> </span>GASTROESOFÁGICO <span class="_5 blank"> </span>(DRGE): <span class="_5 blank"> </span>é <span class="_6 blank"> </span>a <span class="_5 blank"> </span>principal <span class="_5 blank"> </span>patologia <span class="_6 blank"> </span>que </span></div><div class="t m0 x8 h6 y36 ff3 fs3 fc0 sc0 ls1 ws3">acomete <span class="_e blank"> </span>o <span class="_11 blank"> </span>esôfago, <span class="_11 blank"> </span>caracterizada, <span class="_e blank"> </span>principalmente, <span class="_11 blank"> </span>pelo <span class="_e blank"> </span>refluxo <span class="_11 blank"> </span>do <span class="_e blank"> </span>conteúdo <span class="_11 blank"> </span>do </div><div class="t m0 x8 h6 y37 ff3 fs3 fc0 sc0 ls1 ws3">estômago. É <span class="_1 blank"> </span>uma doença <span class="_1 blank"> </span>com múltiplas <span class="_1 blank"> </span>causas, sendo <span class="_1 blank"> </span>a principal <span class="_1 blank"> </span>delas, o <span class="_1 blank"> </span>relaxamento </div><div class="t m0 x8 h6 y38 ff3 fs3 fc0 sc0 ls1 ws3">anormal do <span class="_1 blank"> </span>esfíncter <span class="_1 blank"> </span>inferior <span class="_1 blank"> </span>do <span class="_1 blank"> </span>esôfago, ou <span class="_1 blank"> </span>seja, <span class="_1 blank"> </span>a <span class="_1 blank"> </span>abertura <span class="_1 blank"> </span>do esfíncter <span class="_1 blank"> </span>não <span class="_1 blank"> </span>associada </div><div class="t m0 x8 h6 y39 ff3 fs3 fc0 sc0 ls1 ws3">ao <span class="_a blank"> </span>momento <span class="_5 blank"> </span>da <span class="_a blank"> </span>deglutição, <span class="_5 blank"> </span>provocando <span class="_a blank"> </span>o <span class="_5 blank"> </span>refluxo <span class="_a blank"> </span>gástrico. <span class="_5 blank"> </span>É <span class="_a blank"> </span>uma <span class="_a blank"> </span>doença <span class="_5 blank"> </span>genética <span class="_a blank"> </span>e </div><div class="t m0 x8 h6 y3a ff3 fs3 fc0 sc0 ls1 ws3">relacionada <span class="_1 blank"> </span>aos <span class="_1 blank"> </span>hábitos <span class="_1 blank"> </span>alimentares. <span class="_1 blank"> </span>Cursa <span class="_1 blank"> </span>com <span class="_1 blank"> </span>pirose <span class="_1 blank"> </span>(principlamente <span class="_1 blank"> </span>no <span class="_1 blank"> </span>período <span class="_1 blank"> </span>pós-</div><div class="t m0 x8 h6 y3b ff3 fs3 fc0 sc0 ls1 ws3">prandial), <span class="_5 blank"> </span>regurgitação, <span class="_a blank"> </span>dor <span class="_5 blank"> </span>torácica <span class="_5 blank"> </span>e <span class="_5 blank"> </span>sintomas <span class="_a blank"> </span>extraesofágicos <span class="_5 blank"> </span>(da <span class="_5 blank"> </span>via <span class="_5 blank"> </span>áerea: <span class="_a blank"> </span>tosse, </div><div class="t m0 x8 h6 y3c ff3 fs3 fc0 sc0 ls1 ws3">pigarro, rouquidão). </div><div class="t m0 x4 h5 y3d ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3 v1">NEOPLASIA: <span class="_e blank"> </span>relacionada <span class="_e blank"> </span>à <span class="_c blank"> </span>fatores <span class="_e blank"> </span>ambientais <span class="_e blank"> </span>e <span class="_e blank"> </span>habituais, <span class="_e blank"> </span>como <span class="_c blank"> </span>o <span class="_e blank"> </span>tabagismo, </span></div><div class="t m0 x8 h6 y3e ff3 fs3 fc0 sc0 ls1 ws3">alcoolismo e <span class="_1 blank"> </span>ingestão de <span class="_1 blank"> </span>bebidas quentes. <span class="_1 blank"> </span>Os principais <span class="_1 blank"> </span>sintomas <span class="_1 blank"> </span>incluem: sintomas <span class="_1 blank"> </span>da </div><div class="t m0 x8 h6 y3f ff3 fs3 fc0 sc0 ls1 ws3">DRGE, <span class="_7 blank"> </span>disfagia orgânica <span class="_7 blank"> </span>e <span class="_12 blank"> </span>progressiva <span class="_12 blank"> </span>(redução <span class="_12 blank"> </span>do <span class="_12 blank"> </span>lúmen <span class="_12 blank"> </span>esofágico), <span class="_12 blank"> </span>odinofagia, </div><div class="t m0 x8 h6 y40 ff3 fs3 fc0 sc0 ls1 ws3">hematêmese e melena e comprometimento nutricional. </div></div><div class="c x1 y1a w2 h7"><div class="t m0 x4 h8 y1b ff3 fs4 fc1 sc0 ls2 ws3">Gabriela Reis Viol</div></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf3" class="pf w0 h0" data-page-no="3"><div class="pc pc3 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/b2059c16-b174-46e7-8e10-adbf30b5d20d/bg3.png"><div class="c x0 y41 w0 hc"><div class="t m0 x2 h5 y42 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">ACALÁSIA: pode <span class="_1 blank"> </span>ser <span class="_1 blank"> </span>consequência <span class="_1 blank"> </span>da <span class="_1 blank"> </span>doença <span class="_1 blank"> </span>de <span class="_1 blank"> </span>Chagas <span class="_1 blank"> </span>ou idiopática. <span class="_1 blank"> </span>Cursa <span class="_1 blank"> </span>com <span class="_1 blank"> </span>um </span></div><div class="t m0 x3 h6 y43 ff3 fs3 fc0 sc0 ls1 ws3">dano <span class="_10 blank"> </span>neuromuscular <span class="_7 blank"> </span>fazendo <span class="_10 blank"> </span>com <span class="_10 blank"> </span>que <span class="_7 blank"> </span>haja <span class="_10 blank"> </span>perda <span class="_10 blank"> </span>da <span class="_7 blank"> </span>peristalse <span class="_10 blank"> </span>do <span class="_10 blank"> </span>esôfago. <span class="_7 blank"> </span>Os </div><div class="t m0 x3 h6 y44 ff3 fs3 fc0 sc0 ls1 ws3">principais <span class="_c blank"> </span>sintomas <span class="_e blank"> </span>são: <span class="_c blank"> </span>disfagia <span class="_c blank"> </span>funcional <span class="_e blank"> </span>e <span class="_c blank"> </span>uma <span class="_c blank"> </span>disfagia <span class="_c blank"> </span>orgânica <span class="_e blank"> </span>associada, </div><div class="t m0 x3 h6 y45 ff3 fs3 fc0 sc0 ls1 ws3">regurgitação do alimento em estase esofágica. </div><div class="t m0 x9 h3 y46 ff1 fs0 fc0 sc0 ls3 ws0">E<span class="ff4">!</span><span class="ws3">ômago e Duo<span class="_0 blank"></span>deno</span></div><div class="t m0 x2 h4 y47 ff2 fs1 fc0 sc0 ls3 ws3">SINAIS E SINT<span class="_0 blank"></span>OMAS CARACTERÍSTICOS </div><div class="t m0 x2 h5 y48 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3 v1">DOR <span class="_5 blank"> </span>EPIGÁSTRICA: <span class="_5 blank"> </span>dor <span class="_5 blank"> </span>em <span class="_5 blank"> </span>queimação, <span class="_6 blank"> </span>na <span class="_5 blank"> </span>linha <span class="_5 blank"> </span>mediana <span class="_5 blank"> </span>da <span class="_6 blank"> </span>região <span class="_5 blank"> </span>epigástrico <span class="_5 blank"> </span>do </span></div><div class="t m0 x3 h6 y49 ff3 fs3 fc0 sc0 ls1 ws3">abdômen, <span class="_a blank"> </span>cíclicas, <span class="_a blank"> </span>agravada <span class="_a blank"> </span>por <span class="_a blank"> </span>jejum <span class="_a blank"> </span>prolongado <span class="_a blank"> </span>(mais <span class="_a blank"> </span>ácido) <span class="_a blank"> </span>e <span class="_a blank"> </span>ingesta <span class="_a blank"> </span>de <span class="_a blank"> </span>agentes </div><div class="t m0 x3 h6 y4a ff3 fs3 fc0 sc0 ls1 ws3">irritantes <span class="_1 blank"> </span>(drogas <span class="_1 blank"> </span>e <span class="_3 blank"> </span>alimentos) <span class="_1 blank"> </span>e <span class="_3 blank"> </span>aliviada <span class="_1 blank"> </span>por <span class="_3 blank"> </span>substâncias <span class="_1 blank"> </span>que <span class="_3 blank"> </span>alcalinizam <span class="_1 blank"> </span>o <span class="_3 blank"> </span>pH <span class="_1 blank"> </span>gástrico. </div><div class="t m0 x3 h6 y4b ff3 fs3 fc0 sc0 ls3 ws3">Pode acordar o paciente a noite (clocking) em casos mais graves. </div><div class="t m0 x2 h5 y4c ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3 v1">NÁUSEA/VÔMITO<span class="_0 blank"></span>: <span class="_5 blank"> </span>desejo <span class="_5 blank"> </span>iminente <span class="_6 blank"> </span>de <span class="_5 blank"> </span>vomitar<span class="_2 blank"></span>, <span class="_6 blank"> </span>resulta <span class="_5 blank"> </span>de <span class="_5 blank"> </span>atividade <span class="_5 blank"> </span>desordenada <span class="_6 blank"> </span>do </span></div><div class="t m0 x3 h6 y4d ff3 fs3 fc0 sc0 ls1 ws3">trato <span class="_a blank"> </span>digestivo <span class="_a blank"> </span>superior <span class="_a blank"> </span>e <span class="_9 blank"> </span>antiperistalse <span class="_a blank"> </span>do <span class="_a blank"> </span>duodeno. <span class="_a blank"> </span>Pode <span class="_a blank"> </span>associar-se <span class="_a blank"> </span>à <span class="_a blank"> </span>distúrbios <span class="_a blank"> </span>da </div><div class="t m0 x3 h6 y4e ff3 fs3 fc0 sc0 ls1 ws3">atividade autonômica. </div><div class="t m0 x2 h5 y4f ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">PLENITUDE <span class="_a blank"> </span>PÓS-PRANDIAL: <span class="_9 blank"> </span>sensação <span class="_a blank"> </span>desagradável <span class="_9 blank"> </span>e <span class="_a blank"> </span>incomodativa <span class="_9 blank"> </span>de <span class="_a blank"> </span>enchimento </span></div><div class="t m0 x3 h6 y50 ff3 fs3 fc0 sc0 ls1 ws3">excessivo <span class="_3 blank"> </span>do <span class="_3 blank"> </span>abdômen <span class="_3 blank"> </span>após <span class="_3 blank"> </span>refeições. <span class="_3 blank"> </span>Referida <span class="_3 blank"> </span>pelo <span class="_3 blank"> </span>paciente <span class="_3 blank"> </span>como <span class="_3 blank"> </span>uma <span class="_3 blank"> </span>má <span class="_3 blank"> </span>digestão, </div><div class="t m0 x3 h6 y51 ff3 fs3 fc0 sc0 ls1 ws3">empaixamento, <span class="_12 blank"> </span>distensão <span class="_12 blank"> </span>abdominal. <span class="_7 blank"> </span>Está <span class="_12 blank"> </span>associada <span class="_7 blank"> </span>à <span class="_12 blank"> </span>doenças <span class="_12 blank"> </span>que <span class="_7 blank"> </span>cursam <span class="_12 blank"> </span>com </div><div class="t m0 x3 h6 y52 ff3 fs3 fc0 sc0 ls3 ws3">di<span class="_1 blank"> </span>fi<span class="_1 blank"> </span>c<span class="_1 blank"> </span>ul<span class="_1 blank"> </span>da<span class="_1 blank"> </span>d<span class="_1 blank"> </span>e <span class="_c blank"> </span>de <span class="_c blank"> </span>e<span class="_1 blank"> </span>s<span class="_1 blank"> </span>va<span class="_1 blank"> </span>zi<span class="_1 blank"> </span>a<span class="_1 blank"> </span>me<span class="_1 blank"> </span>nt<span class="_1 blank"> </span>o <span class="_c blank"> </span>d<span class="_1 blank"> </span>a <span class="_c blank"> </span>câ<span class="_1 blank"> </span>m<span class="_1 blank"> </span>ar<span class="_1 blank"> </span>a <span class="_c blank"> </span>gá<span class="_1 blank"> </span>s<span class="_1 blank"> </span>tr<span class="_1 blank"> </span>ic<span class="_1 blank"> </span>a <span class="_c blank"> </span>p<span class="_1 blank"> </span>or <span class="_c blank"> </span>o<span class="_1 blank"> </span>b<span class="_1 blank"> </span>st<span class="_1 blank"> </span>ru<span class="_1 blank"> </span>ç<span class="_1 blank"> </span>ão <span class="_c blank"> </span>m<span class="_1 blank"> </span>ec<span class="_1 blank"> </span>â<span class="_1 blank"> </span>ni<span class="_1 blank"> </span>ca <span class="_d blank"> </span>ou </div><div class="t m0 x3 h6 y53 ff3 fs3 fc0 sc0 ls1 ws3">acometimento da peristalse. </div><div class="t m0 x2 h5 y54 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">HEMA<span class="_2 blank"></span>TÊMESE E <span class="_8 blank"> </span>MELENA: a hemorragia digestiva alta é definida como qualquer </span></div><div class="t m0 x3 h6 y55 ff3 fs3 fc0 sc0 ls1 ws3">sangramento <span class="_a blank"> </span>proximal <span class="_5 blank"> </span>à <span class="_a blank"> </span>junção <span class="_5 blank"> </span>duodenojejunal, <span class="_a blank"> </span>podendo <span class="_5 blank"> </span>se <span class="_a blank"> </span>exteriorizar <span class="_5 blank"> </span>na <span class="_a blank"> </span>forma <span class="_5 blank"> </span>de </div><div class="t m0 x3 h6 y56 ff3 fs3 fc0 sc0 ls1 ws3">hematêmese, <span class="_6 blank"> </span>melena, <span class="_6 blank"> </span>hematoquezia <span class="_6 blank"> </span>ou <span class="_4 blank"> </span>sangue <span class="_6 blank"> </span>oculto <span class="_6 blank"> </span>nas <span class="_6 blank"> </span>fezes. <span class="_4 blank"> </span>Hematêmese <span class="_6 blank"> </span>é <span class="_6 blank"> </span>o </div><div class="t m0 x3 h6 y57 ff3 fs3 fc0 sc0 ls1 ws3">vômito <span class="_1 blank"> </span>de <span class="_3 blank"> </span>sangue, <span class="_3 blank"> </span>podendo <span class="_3 blank"> </span>ser <span class="_3 blank"> </span>vermelho <span class="_3 blank"> </span>ou <span class="_3 blank"> </span>escuro. <span class="_3 blank"> </span>Melena <span class="_3 blank"> </span>se <span class="_1 blank"> </span>refere <span class="_3 blank"> </span>à <span class="_3 blank"> </span>evacuação <span class="_3 blank"> </span>de </div><div class="t m0 x3 h6 y58 ff3 fs3 fc0 sc0 ls1 ws3">fezes <span class="_12 blank"> </span>escuras <span class="_12 blank"> </span>contendo <span class="_12 blank"> </span>sangue <span class="_12 blank"> </span>digerido. <span class="_12 blank"> </span>Hematoquezia <span class="_12 blank"> </span>é <span class="_12 blank"> </span>a <span class="_12 blank"> </span>presença <span class="_12 blank"> </span>de <span class="_12 blank"> </span>sangue </div><div class="t m0 x3 h6 y59 ff3 fs3 fc0 sc0 ls1 ws3">vermelho <span class="_9 blank"> </span>vivo <span class="_9 blank"> </span>nas <span class="_9 blank"> </span>fezes. As <span class="_9 blank"> </span>principais <span class="_9 blank"> </span>causas <span class="_9 blank"> </span>de <span class="_9 blank"> </span>hemorragia <span class="_9 blank"> </span>digestiva <span class="_3 blank"> </span>alta <span class="_9 blank"> </span>são <span class="_9 blank"> </span>úlcera </div><div class="t m0 x3 h6 y5a ff3 fs3 fc0 sc0 ls1 ws3">péptica, <span class="_11 blank"> </span>lesão <span class="_11 blank"> </span>aguda <span class="_e blank"> </span>da <span class="_11 blank"> </span>mucosa, <span class="_11 blank"> </span>varizes <span class="_e blank"> </span>esofagianas, <span class="_11 blank"> </span>neoplasias, <span class="_11 blank"> </span>esofagites <span class="_e blank"> </span>e </div><div class="t m0 x3 h6 y5b ff3 fs3 fc0 sc0 ls1 ws3">duodenite. </div><div class="t m0 x2 h4 y5c ff2 fs1 fc0 sc0 ls3 ws3">DOENÇAS DO ESTÔMAGO/DUODENO </div><div class="t m0 x2 h5 y5d ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3 v1">ÚLCERA<span class="_2 blank"></span> <span class="_4 blank"> </span>PÉPTICA: <span class="_8 blank"> </span>consiste <span class="_4 blank"> </span>numa <span class="_8 blank"> </span>lesão <span class="_4 blank"> </span>resultando <span class="_8 blank"> </span>da <span class="_4 blank"> </span>ruptura <span class="_8 blank"> </span>do <span class="_4 blank"> </span>balanço <span class="_8 blank"> </span>entre <span class="_4 blank"> </span>a </span></div><div class="t m0 x3 h6 y5e ff3 fs3 fc0 sc0 ls1 ws3">agressão <span class="_a blank"> </span>à <span class="_9 blank"> </span>mucosa <span class="_a blank"> </span>gástrica/duodenal <span class="_a blank"> </span>representada <span class="_a blank"> </span>pela <span class="_9 blank"> </span>secreção <span class="_a blank"> </span>ácido <span class="_a blank"> </span>péptica <span class="_a blank"> </span>e <span class="_9 blank"> </span>os </div></div><div class="c x1 y1a w2 h7"><div class="t m0 x4 h8 y1b ff3 fs4 fc1 sc0 ls2 ws3">Gabriela Reis Viol</div></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf4" class="pf w0 h0" data-page-no="4"><div class="pc pc4 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/b2059c16-b174-46e7-8e10-adbf30b5d20d/bg4.png"><div class="c x0 y5f w0 hd"><div class="t m0 x3 h6 y60 ff3 fs3 fc0 sc0 ls3 ws3">mecanismos <span class="_1 blank"> </span>de <span class="_3 blank"> </span>defesa <span class="_3 blank"> </span>dessa <span class="_1 blank"> </span>mucosa. <span class="_3 blank"> </span>Pode <span class="_3 blank"> </span>ser <span class="_3 blank"> </span>causada <span class="_1 blank"> </span>por <span class="_3 blank"> </span><span class="ff5 ls1">Helicobacter <span class="_3 blank"> </span>pylori</span> <span class="_1 blank"> </span>e <span class="_3 blank"> </span>uso </div><div class="t m0 x3 h6 y61 ff3 fs3 fc0 sc0 ls3 ws3">de <span class="_e blank"> </span>AINE<span class="_1 blank"> </span>\u2019s. <span class="_c blank"> </span>Os <span class="_c blank"> </span>pri<span class="_1 blank"> </span>nci<span class="_1 blank"> </span>pai<span class="_1 blank"> </span>s <span class="_c blank"> </span>sin<span class="_1 blank"> </span>toma<span class="_1 blank"> </span>s <span class="_c blank"> </span>são<span class="_1 blank"> </span>: <span class="_c blank"> </span>dor <span class="_c blank"> </span>e<span class="_1 blank"> </span>pig<span class="_1 blank"> </span>ást<span class="_1 blank"> </span>ric<span class="_1 blank"> </span>a <span class="_c blank"> </span>int<span class="_1 blank"> </span>ensa<span class="_1 blank"> </span>, <span class="_c blank"> </span>ali<span class="_1 blank"> </span>via<span class="_1 blank"> </span>da <span class="_c blank"> </span>co<span class="_1 blank"> </span>m </div><div class="t m0 x3 h6 y62 ff3 fs3 fc0 sc0 ls1 ws3">alimentação <span class="_3 blank"> </span>e <span class="_9 blank"> </span>piora <span class="_9 blank"> </span>com <span class="_3 blank"> </span>jejum <span class="_9 blank"> </span>prolongado, <span class="_3 blank"> </span>possui <span class="_9 blank"> </span>uma <span class="_3 blank"> </span>periodicidade <span class="_9 blank"> </span>(dor <span class="_3 blank"> </span>surgindo <span class="_9 blank"> </span>ou </div><div class="t m0 x3 h6 y63 ff3 fs3 fc0 sc0 ls1 ws3">se <span class="_6 blank"> </span>intensificando <span class="_4 blank"> </span>no <span class="_4 blank"> </span>período <span class="_4 blank"> </span>pós-prandial <span class="_6 blank"> </span>tardio <span class="_4 blank"> </span>e <span class="_4 blank"> </span>aliviando <span class="_4 blank"> </span>no <span class="_4 blank"> </span>período <span class="_6 blank"> </span>pós-prandial </div><div class="t m0 x3 h6 y64 ff3 fs3 fc0 sc0 ls1 ws3">precoce). Náuseas e vômito, plenitude, comprometimento nutricional. </div><div class="t m0 x2 h5 y65 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">DISPEPSIA<span class="_2 blank"></span> <span class="_5 blank"> </span>FUNCIONAL: <span class="_6 blank"> </span>caracterizada <span class="_5 blank"> </span>por <span class="_6 blank"> </span>dor <span class="_5 blank"> </span>epigástrica <span class="_6 blank"> </span>e <span class="_5 blank"> </span>plenitude <span class="_6 blank"> </span>pós-prandial, </span></div><div class="t m0 x3 h6 y66 ff3 fs3 fc0 sc0 ls1 ws3">porém, <span class="_6 blank"> </span>esse <span class="_6 blank"> </span>quadro <span class="_6 blank"> </span>não <span class="_4 blank"> </span>apresenta <span class="_6 blank"> </span>lesão <span class="_6 blank"> </span>orgânica <span class="_6 blank"> </span>e <span class="_4 blank"> </span>está <span class="_6 blank"> </span>mais <span class="_6 blank"> </span>associada <span class="_6 blank"> </span>à <span class="_4 blank"> </span>fatores </div><div class="t m0 x3 h6 y67 ff3 fs3 fc0 sc0 ls3 ws3">genéticos e psicossociais. </div><div class="t m0 x2 h5 y68 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">CÂNCER <span class="_a blank"> </span>GÁSTRICO: <span class="_5 blank"> </span>os <span class="_a blank"> </span>fatores <span class="_5 blank"> </span>de <span class="_a blank"> </span>risco <span class="_5 blank"> </span>são <span class="_a blank"> </span>a <span class="_a blank"> </span>genética, <span class="_5 blank"> </span>infecção <span class="_a blank"> </span>pelo <span class="_5 blank"> </span><span class="ff5 ls1">Helicobacter </span></span></div><div class="t m0 x3 h6 y69 ff5 fs3 fc0 sc0 ls3 ws7">pylori<span class="ff3 ws3">, <span class="_6 blank"> </span>tabagismo, <span class="_6 blank"> </span>alcoolismo, <span class="_6 blank"> </span>gastrectomia <span class="_6 blank"> </span>parcial. <span class="_6 blank"> </span>Os <span class="_6 blank"> </span>sintomas <span class="_6 blank"> </span>são <span class="_6 blank"> </span>muito <span class="_6 blank"> </span>varáveis, </span></div><div class="t m0 x3 h6 y6a ff3 fs3 fc0 sc0 ls1 ws3">podendo <span class="_10 blank"> </span>ocorrer: <span class="_10 blank"> </span>dispepsia, <span class="_10 blank"> </span>plenitude, <span class="_10 blank"> </span>dor <span class="_10 blank"> </span>epigástrica, <span class="_10 blank"> </span>vômitos, <span class="_10 blank"> </span>comprometimento </div><div class="t m0 x3 h6 y6b ff3 fs3 fc0 sc0 ls1 ws3">nutricional (dificuldade de absorção), anemia (perda sanguínea). </div><div class="t m0 xa h3 y6c ff1 fs0 fc0 sc0 ls3 ws0">Int<span class="ff4 ws8">"</span><span class="ws3">tino delgado</span></div><div class="t m0 x2 h4 y6d ff2 fs1 fc0 sc0 ls3 ws3">SINAIS E SINT<span class="_0 blank"></span>OMAS CARACTERÍSTICOS </div><div class="t m0 x2 h5 y6e ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">DOR <span class="_9 blank"> </span>ABDOMINAL: <span class="_5 blank"> </span>em <span class="_5 blank"> </span>cólica, <span class="_5 blank"> </span>de <span class="_5 blank"> </span>início <span class="_5 blank"> </span>abrupto <span class="_5 blank"> </span>atingindo <span class="_a blank"> </span>rapidamente <span class="_5 blank"> </span>a <span class="_5 blank"> </span>intensidade </span></div><div class="t m0 x3 h6 y6f ff3 fs3 fc0 sc0 ls3 ws3">máxima, <span class="_9 blank"> </span>em <span class="_9 blank"> </span>torsão <span class="_a blank"> </span>e <span class="_9 blank"> </span>intermitente, <span class="_9 blank"> </span>de <span class="_9 blank"> </span>localização <span class="_a blank"> </span>imprecisa <span class="_9 blank"> </span>(visceral <span class="_9 blank"> </span>- <span class="_9 blank"> </span>usualmente <span class="_a blank"> </span>em </div><div class="t m0 x3 h6 y70 ff3 fs3 fc0 sc0 ls1 ws3">mesogástrio), <span class="_1 blank"> </span>acompanhada <span class="_1 blank"> </span>de <span class="_1 blank"> </span>borborigmos <span class="_3 blank"> </span>(sons), <span class="_1 blank"> </span>alívio <span class="_1 blank"> </span>por <span class="_3 blank"> </span>compressão <span class="_1 blank"> </span>e <span class="_1 blank"> </span>desejo <span class="_1 blank"> </span>de </div><div class="t m0 x3 h6 y71 ff3 fs3 fc0 sc0 ls3 ws3">evacuar<span class="_2 blank"></span>. <span class="_2 blank"></span>Aliviada por compressão. </div><div class="t m0 x2 h5 y72 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">AL<span class="_2 blank"></span>TERAÇÃO <span class="_5 blank"> </span>DO <span class="_5 blank"> </span>HÁBITO <span class="_5 blank"> </span>INTESTINAL: <span class="_5 blank"> </span>diarreia <span class="_6 blank"> </span>(aumento <span class="_5 blank"> </span>do <span class="_5 blank"> </span>volume <span class="_6 blank"> </span>do <span class="_5 blank"> </span>bolo <span class="_6 blank"> </span>fecal, <span class="_13 blank"></span> </span></div><div class="t m0 x3 h6 y73 ff3 fs3 fc0 sc0 ls1 ws3">aumento <span class="_12 blank"> </span>da frequência <span class="_12 blank"> </span>de <span class="_12 blank"> </span>evacuações, <span class="_12 blank"> </span>diminuição <span class="_12 blank"> </span>da consistência <span class="_12 blank"> </span>das <span class="_12 blank"> </span>fezes) <span class="_12 blank"> </span>ou </div><div class="t m0 x3 h6 y74 ff3 fs3 fc0 sc0 ls1 ws3">constipação por obstrução intestinal. </div><div class="t m0 x2 h5 y75 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">PRODUTOS <span class="_1 blank"> </span>P<span class="_2 blank"></span>A<span class="_2 blank"></span>T<span class="_0 blank"></span>OLÓGICOS: <span class="_1 blank"> </span>fezes <span class="_3 blank"> </span>pastosas, <span class="_3 blank"> </span>brilhosas, <span class="_9 blank"> </span>que <span class="_1 blank"> </span>flutuam <span class="_3 blank"> </span>na <span class="_3 blank"> </span>água <span class="_3 blank"> </span>de<span class="_1 blank"> </span>vido <span class="_3 blank"> </span>à </span></div><div class="t m0 x3 h6 y76 ff3 fs3 fc0 sc0 ls1 ws3">presença <span class="_12 blank"> </span>de <span class="_12 blank"> </span>material <span class="_12 blank"> </span>gorduroso (esteatorreia), <span class="_12 blank"> </span>restos <span class="_12 blank"> </span>alimentares <span class="_12 blank"> </span>(má <span class="_12 blank"> </span>digestão) <span class="_12 blank"> </span>e </div><div class="t m0 x3 h6 y77 ff3 fs3 fc0 sc0 ls3 ws3">parasitas. </div><div class="t m0 x2 h5 y78 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">DISTENSÃO: <span class="_10 blank"> </span>distensão <span class="_14 blank"> </span>gasosa <span class="_10 blank"> </span>de <span class="_14 blank"> </span>alças <span class="_10 blank"> </span>de <span class="_14 blank"> </span>delgado <span class="_14 blank"> </span>com <span class="_10 blank"> </span>eventual <span class="_14 blank"> </span>aumento <span class="_10 blank"> </span>da </span></div><div class="t m0 x3 h6 y79 ff3 fs3 fc0 sc0 ls1 ws3">circunferência abdominal, timpanismo <span class="_8 blank"> </span>à percussão, com RHA<span class="_2 blank"></span> aumentados <span class="_8 blank"> </span>na fase </div><div class="t m0 x3 h6 y7a ff3 fs3 fc0 sc0 ls1 ws3">inicial <span class="_9 blank"> </span>de <span class="_9 blank"> </span>processos <span class="_9 blank"> </span>obstrutivos <span class="_9 blank"> </span>ou <span class="_9 blank"> </span>diminuídos <span class="_9 blank"> </span>em <span class="_9 blank"> </span>fase <span class="_9 blank"> </span>tardia <span class="_9 blank"> </span>da <span class="_9 blank"> </span>obstrução <span class="_9 blank"> </span>e <span class="_9 blank"> </span>em <span class="_9 blank"> </span>íleos </div><div class="t m0 x3 h6 y7b ff3 fs3 fc0 sc0 ls3 ws3">paralíticos (redução de peristalse sem fator obstrutivo). </div></div><div class="c x1 y1a w2 h7"><div class="t m0 x4 h8 y1b ff3 fs4 fc1 sc0 ls2 ws3">Gabriela Reis Viol</div></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf5" class="pf w0 h0" data-page-no="5"><div class="pc pc5 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/b2059c16-b174-46e7-8e10-adbf30b5d20d/bg5.png"><div class="c x0 y5f w0 hd"><div class="t m0 x2 h5 y60 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">COMPROMETIMENTO <span class="_a blank"> </span>NUTRICIONAL: <span class="_5 blank"> </span>a <span class="_5 blank"> </span>perda <span class="_5 blank"> </span>de <span class="_5 blank"> </span>nutrientes <span class="_5 blank"> </span>por <span class="_5 blank"> </span>má <span class="_5 blank"> </span>absorção <span class="_5 blank"> </span>gera </span></div><div class="t m0 x3 h6 y61 ff3 fs3 fc0 sc0 ls1 ws3">manifestações <span class="_e blank"> </span>sistêmicas, <span class="_c blank"> </span>emagrecimento, <span class="_e blank"> </span>anemia, <span class="_e blank"> </span>edema, <span class="_c blank"> </span>diátese <span class="_e blank"> </span>hemorrágica, </div><div class="t m0 x3 h6 y62 ff3 fs3 fc0 sc0 ls3 ws3">raquitismo, entre outras. </div><div class="t m0 x2 h5 y7c ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">MELENA<span class="_2 blank"></span> <span class="_3 blank"> </span>E <span class="_9 blank"> </span>ENTERORRAGIA: <span class="_3 blank"> </span>o <span class="_3 blank"> </span>melena <span class="_9 blank"> </span>é <span class="_3 blank"> </span>menos <span class="_3 blank"> </span>frequente <span class="_9 blank"> </span>(está <span class="_3 blank"> </span>mais <span class="_3 blank"> </span>associado <span class="_9 blank"> </span>com </span></div><div class="t m0 x3 h6 y64 ff3 fs3 fc0 sc0 ls1 ws3">lesões <span class="_4 blank"> </span>no <span class="_4 blank"> </span>esôfago <span class="_8 blank"> </span>e <span class="_4 blank"> </span>estômago), <span class="_4 blank"> </span>há <span class="_4 blank"> </span>a <span class="_8 blank"> </span>enterorragia <span class="_4 blank"> </span>(eliminação <span class="_4 blank"> </span>de <span class="_4 blank"> </span>sangue <span class="_8 blank"> </span>vivo <span class="_4 blank"> </span>nas </div><div class="t m0 x3 h6 y65 ff3 fs3 fc0 sc0 ls3 ws3">fezes) é mais comum - sinal de hemorragia digestiva. </div><div class="t m0 x2 h4 y7d ff2 fs1 fc0 sc0 ls3 ws3">DOENÇAS DO INTESTINO DELGADO </div><div class="t m0 x2 h5 y7e ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">P<span class="_2 blank"></span>ARASIT<span class="_0 blank"></span>OSE: <span class="_10 blank"> </span>cursa <span class="_10 blank"> </span>com <span class="_10 blank"> </span>alteração <span class="_14 blank"> </span>de <span class="_10 blank"> </span>hábito <span class="_10 blank"> </span>intestino, <span class="_14 blank"> </span>dor <span class="_10 blank"> </span>abdominal, <span class="_10 blank"> </span>produtos </span></div><div class="t m0 x3 h6 y7f ff3 fs3 fc0 sc0 ls1 ws3">patológicos nas fezes, comprometimento nutricional (anemia, astenia, PICA). </div><div class="t m0 x2 h5 y80 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">DIARREIA<span class="_2 blank"></span> <span class="_3 blank"> </span>AGUDA: <span class="_a blank"> </span>causada <span class="_9 blank"> </span>por <span class="_a blank"> </span>intoxicação <span class="_9 blank"> </span>e <span class="_a blank"> </span>infecções <span class="_9 blank"> </span>(enteroviroses <span class="_a blank"> </span>e <span class="_9 blank"> </span>bacteriana), </span></div><div class="t m0 x3 h6 y81 ff3 fs3 fc0 sc0 ls1 ws3">cursa <span class="_14 blank"> </span>com <span class="_14 blank"> </span>alteração <span class="_14 blank"> </span>do <span class="_14 blank"> </span>hábito <span class="_10 blank"> </span>intestinal, <span class="_14 blank"> </span>dor <span class="_14 blank"> </span>abdominal <span class="_14 blank"> </span>(cólica) <span class="_14 blank"> </span>com <span class="_14 blank"> </span>distensão, </div><div class="t m0 x3 h6 y82 ff3 fs3 fc0 sc0 ls1 ws3">desidratação (que pode levar a hipotensão em casos graves). </div><div class="t m0 x2 h5 y83 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">DOENÇA<span class="_2 blank"></span> <span class="_8 blank"> </span>OBSTRUTIV<span class="_2 blank"></span>A: <span class="_8 blank"> </span>obstrução <span class="_8 blank"> </span>do <span class="_8 blank"> </span>tubo <span class="_8 blank"> </span>intestino <span class="_8 blank"> </span>devido <span class="_8 blank"> </span>à <span class="_8 blank"> </span>cirurgias <span class="_8 blank"> </span>abdominais </span></div><div class="t m0 x3 h6 y84 ff3 fs3 fc0 sc0 ls1 ws3">prévias <span class="_a blank"> </span>ou <span class="_5 blank"> </span>por <span class="_a blank"> </span>\u201cbolo" <span class="_5 blank"> </span>de <span class="_9 blank"> </span>Ascaris. <span class="_a blank"> </span>Os <span class="_a blank"> </span>sintomas <span class="_5 blank"> </span>são: <span class="_a blank"> </span>dor <span class="_5 blank"> </span>abdominal <span class="_a blank"> </span>intensa <span class="_a blank"> </span>(peristalse </div><div class="t m0 x3 h6 y85 ff3 fs3 fc0 sc0 ls1 ws3">intensa), <span class="_7 blank"> </span>distensão <span class="_12 blank"> </span>progressiva, <span class="_7 blank"> </span>náuseas <span class="_7 blank"> </span>e <span class="_7 blank"> </span>vômitos <span class="_7 blank"> </span>que <span class="_7 blank"> </span>ocorre <span class="_7 blank"> </span>devido <span class="_7 blank"> </span>a <span class="_7 blank"> </span>falta <span class="_7 blank"> </span>de </div><div class="t m0 x3 h6 y86 ff3 fs3 fc0 sc0 ls1 ws3">progressão do <span class="_8 blank"> </span>bolo alimento <span class="_8 blank"> </span>e do <span class="_8 blank"> </span>conteúdo entérico (obstrução <span class="_8 blank"> </span>proximal o <span class="_8 blank"> </span>vômito </div><div class="t m0 x3 h6 y87 ff3 fs3 fc0 sc0 ls1 ws3">contém alimento parcialmente digerido e bile; obstrução distal o vômito é fecalóide). </div><div class="t m0 x2 h5 y88 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">DOENÇA<span class="_2 blank"></span> <span class="_3 blank"> </span>CELÍACA: <span class="_1 blank"> </span>afecção <span class="_3 blank"> </span>difusa <span class="_3 blank"> </span>e <span class="_3 blank"> </span>crônica <span class="_3 blank"> </span>da <span class="_3 blank"> </span>mucosa <span class="_1 blank"> </span>do <span class="_3 blank"> </span>intestino <span class="_3 blank"> </span>delgado <span class="_3 blank"> </span>proximal </span></div><div class="t m0 x3 h6 y89 ff3 fs3 fc0 sc0 ls1 ws3">causada pelo glúten, substância que gera a <span class="_1 blank"> </span>reação inflamatória responsável pela atrofia </div><div class="t m0 x3 h6 y8a ff3 fs3 fc0 sc0 ls1 ws3">da <span class="_3 blank"> </span>mucosa <span class="_3 blank"> </span>intestinal. <span class="_9 blank"> </span>Há <span class="_3 blank"> </span>deficiência <span class="_3 blank"> </span>na <span class="_3 blank"> </span>absorção <span class="_9 blank"> </span>de <span class="_3 blank"> </span>todos <span class="_3 blank"> </span>os <span class="_9 blank"> </span>nutrientes <span class="_1 blank"> </span>e <span class="_9 blank"> </span>os <span class="_3 blank"> </span>sintomas </div><div class="t m0 x3 h6 y8b ff3 fs3 fc0 sc0 ls1 ws3">são <span class="_6 blank"> </span>gerados <span class="_4 blank"> </span>pela <span class="_6 blank"> </span>ingestão <span class="_4 blank"> </span>de <span class="_6 blank"> </span>qualquer <span class="_4 blank"> </span>alimento, <span class="_6 blank"> </span>contendo <span class="_4 blank"> </span>ou <span class="_6 blank"> </span>não <span class="_4 blank"> </span>o <span class="_6 blank"> </span>glúten, <span class="_4 blank"> </span>pois <span class="_6 blank"> </span>a </div><div class="t m0 x3 h6 y8c ff3 fs3 fc0 sc0 ls3 ws3">mucosa <span class="_5 blank"> </span>está <span class="_5 blank"> </span>previamente <span class="_5 blank"> </span>atrofia<span class="_1 blank"> </span>da. <span class="_5 blank"> </span>Os <span class="_5 blank"> </span>sintomas <span class="_5 blank"> </span>mais <span class="_6 blank"> </span>comuns <span class="_5 blank"> </span>são: <span class="_5 blank"> </span>dor <span class="_5 blank"> </span>e <span class="_6 blank"> </span>distensão </div><div class="t m0 x3 h6 y8d ff3 fs3 fc0 sc0 ls1 ws3">abdominal, esteatorreia, diarreia crônica, comprometimento nutricional, anemia. </div><div class="t m0 xb h3 y8e ff1 fs0 fc0 sc0 ls3 ws0">Int<span class="ff4 ws8">"</span><span class="ws3">tino gr<span class="_2 blank"></span>o<span class="ff4">#</span>o</span></div><div class="t m0 x2 h4 y8f ff2 fs1 fc0 sc0 ls3 ws3">SINAIS E SINT<span class="_0 blank"></span>OMAS <span class="_2 blank"></span>ASSOCIADOS </div><div class="t m0 x2 h5 y90 ff3 fs2 fc0 sc0 ls8">\u2022<span class="fs3 ls3 ws3">AL<span class="_2 blank"></span>TERAÇÃO DO HÁBITO INTESTINAL: pode ser variável, <span class="_1 blank"> </span>com quadros <span class="_1 blank"> </span>de diarreia ou </span></div><div class="t m0 xc h6 y91 ff3 fs3 fc0 sc0 ls1 ws3">constipação e a alternância do ritmo é um sintoma importante. </div></div><div class="c x1 y1a w2 h7"><div class="t m0 x4 h8 y1b ff3 fs4 fc1 sc0 ls2 ws3">Gabriela Reis Viol</div></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf6" class="pf w0 h0" data-page-no="6"><div class="pc pc6 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/b2059c16-b174-46e7-8e10-adbf30b5d20d/bg6.png"><div class="c x6 y1e w5 hb"><div class="t m0 x4 h6 y1f ff3 fs3 fc0 sc0 ls1 ws4">1. <span class="ws3">Disenteria: <span class="_3 blank"> </span>alternância <span class="_3 blank"> </span>de <span class="_3 blank"> </span>hábito <span class="_9 blank"> </span>normal, <span class="_1 blank"> </span>desde <span class="_9 blank"> </span>que <span class="_1 blank"> </span>eventual <span class="_3 blank"> </span>ou <span class="_9 blank"> </span>explicada <span class="_1 blank"> </span>por <span class="_9 blank"> </span>fatores </span></div><div class="t m0 x7 h6 y20 ff3 fs3 fc0 sc0 ls1 ws3">circunstanciais. <span class="_11 blank"> </span>Caso <span class="_e blank"> </span>haja <span class="_e blank"> </span>alternância <span class="_11 blank"> </span>insidiosa, <span class="_e blank"> </span>há <span class="_11 blank"> </span>possibilidade <span class="_e blank"> </span>de <span class="_11 blank"> </span>neoplasia, </div><div class="t m0 x7 h6 y21 ff3 fs3 fc0 sc0 ls1 ws3">colopatia neuropsicogênica e doença diverticular de sigmoide. </div><div class="t m0 x4 h6 y22 ff3 fs3 fc0 sc0 ls1 ws4">2. <span class="ls3 ws3">Obstipação: constipação. </span></div><div class="t m0 x4 h5 y92 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">PRODUTOS <span class="_a blank"> </span>P<span class="_2 blank"></span>A<span class="_2 blank"></span>T<span class="_0 blank"></span>OLÓGICOS <span class="_5 blank"> </span>NAS <span class="_5 blank"> </span>FEZES: <span class="_5 blank"> </span>são <span class="_5 blank"> </span>encontrados <span class="_5 blank"> </span>produtos <span class="_a blank"> </span>re<span class="_1 blank"> </span>lacionados <span class="_5 blank"> </span>à </span></div><div class="t m0 x8 h6 y24 ff3 fs3 fc0 sc0 ls1 ws3">inflamação como: muco (prolapsos ou condições <span class="_12 blank"> </span>de hipersecreção) pus (patologia </div><div class="t m0 x8 h6 y25 ff3 fs3 fc0 sc0 ls1 ws3">cutânea perianal <span class="_12 blank"> </span>infectada) e <span class="_12 blank"> </span>sangue (patologias <span class="_12 blank"> </span>hemorrágicas abaixo <span class="_12 blank"> </span>do controle </div><div class="t m0 x8 h6 y26 ff3 fs3 fc0 sc0 ls3 ws3">esfincteriano <span class="_14 blank"> </span>\u2014 <span class="_11 blank"> </span>hemorroidas, <span class="_11 blank"> </span>fístulas <span class="_14 blank"> </span>perianais <span class="_11 blank"> </span>\u2014 <span class="_14 blank"> </span>ou <span class="_11 blank"> </span>acima <span class="_11 blank"> </span>em <span class="_14 blank"> </span>pacientes <span class="_11 blank"> </span>com </div><div class="t m0 x8 h6 y27 ff3 fs3 fc0 sc0 ls1 ws3">hipotonia anal. </div><div class="t m0 x4 h5 y28 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">DOR <span class="_1 blank"> </span>ABDOMINAL: <span class="_9 blank"> </span>dor <span class="_a blank"> </span>em <span class="_9 blank"> </span>cólica <span class="_9 blank"> </span>com <span class="_9 blank"> </span>alívio <span class="_9 blank"> </span>após <span class="_9 blank"> </span>evacuação <span class="_9 blank"> </span>(mais <span class="_a blank"> </span>acentuado <span class="_9 blank"> </span>para <span class="_9 blank"> </span>a </span></div><div class="t m0 x8 h6 y29 ff3 fs3 fc0 sc0 ls1 ws3">dor dos cólons). Localiza-se preferencialmente à esquerda e no hipogástrio. </div><div class="t m0 x4 h5 y2a ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">ENTERORRAGIA/HEMA<span class="_2 blank"></span>T<span class="_0 blank"></span>OQUEZIA: <span class="_12 blank"> </span>presença <span class="_12 blank"> </span>de <span class="_7 blank"> </span>sangue <span class="_7 blank"> </span>vermelho <span class="_12 blank"> </span>vivo <span class="_7 blank"> </span>nas <span class="_12 blank"> </span>fezes </span></div><div class="t m0 x8 h6 y2b ff3 fs3 fc0 sc0 ls3 ws3">(hemor<span class="_1 blank"> </span>ragia <span class="_c blank"> </span>dig<span class="_1 blank"> </span>estiva <span class="_c blank"> </span>ba<span class="_1 blank"> </span>ixa), <span class="_c blank"> </span>mas <span class="_c blank"> </span>se <span class="_c blank"> </span>o <span class="_c blank"> </span>tr<span class="_1 blank"> </span>ânsito <span class="_c blank"> </span>in<span class="_1 blank"> </span>testin<span class="_1 blank"> </span>al <span class="_c blank"> </span>for <span class="_c blank"> </span>lento<span class="_1 blank"> </span>, <span class="_c blank"> </span>pode <span class="_c blank"> </span>ser </div><div class="t m0 x8 h6 y2c ff3 fs3 fc0 sc0 ls3 ws3">caracterizado como melena. </div><div class="t m0 x4 h5 y2d ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">COMPROMETIMENTO <span class="_7 blank"> </span>NUTRICIONAL: <span class="_10 blank"> </span>emagrecimento <span class="_10 blank"> </span>(perda <span class="_15 blank"> </span>de <span class="_15 blank"> </span>nutrientes <span class="_10 blank"> </span>pelas </span></div><div class="t m0 x8 h6 y2e ff3 fs3 fc0 sc0 ls3 ws3">fezes) e anemia. </div><div class="t m0 x4 h5 y2f ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">SINTOMAS <span class="_2 blank"></span>ASSOCIADOS À EV<span class="_16 blank"></span>ACUAÇÃO </span></div><div class="t m0 x4 h6 y30 ff3 fs3 fc0 sc0 ls1 ws4">1. <span class="ls9 ws3">URGÊNCIA<span class="_16 blank"></span> <span class="_c blank"> </span>EV<span class="_16 blank"></span>ACUOACIONAL<span class="ls3">: <span class="_c blank"> </span>s<span class="_1 blank"> </span>e<span class="_1 blank"> </span>n<span class="_1 blank"> </span>s<span class="_1 blank"> </span>aç<span class="_1 blank"> </span>ã<span class="_1 blank"> </span>o <span class="_c blank"> </span>d<span class="_1 blank"> </span>e <span class="_d blank"> </span>ev<span class="_1 blank"> </span>a<span class="_1 blank"> </span>c<span class="_1 blank"> </span>u<span class="_1 blank"> </span>aç<span class="_1 blank"> </span>ã<span class="_1 blank"> </span>o <span class="_c blank"> </span>i<span class="_1 blank"> </span>m<span class="_1 blank"> </span>i<span class="_1 blank"> </span>n<span class="_1 blank"> </span>e<span class="_1 blank"> </span>nt<span class="_1 blank"> </span>e<span class="_1 blank"> </span>, <span class="_c blank"> </span>à<span class="_1 blank"> </span>s <span class="_d blank"> </span>ve<span class="_1 blank"> </span>z<span class="_1 blank"> </span>e<span class="_1 blank"> </span>s </span></span></div><div class="t m0 x7 h6 y31 ff3 fs3 fc0 sc0 ls1 ws3">acompanhada de incontinência fecal. </div><div class="t m0 x4 h6 y93 ff3 fs3 fc0 sc0 ls1 ws4">2. <span class="ls3 ws3">INCONTINÊNCIA<span class="_2 blank"></span> <span class="_1 blank"> </span>FECAL: <span class="_1 blank"> </span>perda <span class="_3 blank"> </span>involuntária <span class="_1 blank"> </span>de <span class="_1 blank"> </span>material <span class="_3 blank"> </span>fecal <span class="_1 blank"> </span>devido <span class="_1 blank"> </span>a <span class="_3 blank"> </span>características </span></div><div class="t m0 x7 h6 y33 ff3 fs3 fc0 sc0 ls1 ws3">das fezes ou a incompetência do esfíncter anal. </div><div class="t m0 x4 h6 y94 ff3 fs3 fc0 sc0 ls1 ws4">3. <span class="ws3">PUXO: <span class="_3 blank"> </span>contração <span class="_3 blank"> </span>anal <span class="_3 blank"> </span>dolorosa <span class="_9 blank"> </span>ou <span class="_1 blank"> </span>não, <span class="_9 blank"> </span>reflexa <span class="_1 blank"> </span>e <span class="_3 blank"> </span>involuntária, <span class="_9 blank"> </span>remanescendo <span class="_1 blank"> </span>matéria </span></div><div class="t m0 x7 h6 y95 ff3 fs3 fc0 sc0 ls1 ws3">fecal na ampola retal. </div><div class="t m0 x4 h6 y96 ff3 fs3 fc0 sc0 ls1 ws4">4. <span class="ls3 ws3">TENESMO: contrações anais autônomas e dolorosas com desejo intenso de defecar<span class="_2 blank"></span>. </span></div><div class="t m0 x4 h6 y97 ff3 fs3 fc0 sc0 ls1 ws4">5. <span class="ls3 ws3">SENSAÇÃO <span class="_5 blank"> </span>DE <span class="_5 blank"> </span>EV<span class="_2 blank"></span>ACUAÇÃO <span class="_5 blank"> </span>INCOMPLET<span class="_16 blank"></span>A: <span class="_6 blank"> </span>persistência <span class="_5 blank"> </span>da <span class="_5 blank"> </span>sensação <span class="_6 blank"> </span>de <span class="_5 blank"> </span>que <span class="_5 blank"> </span>há </span></div><div class="t m0 x7 h6 y98 ff3 fs3 fc0 sc0 ls3 ws3">fezes a serem exoneradas mesmo após a evacuação. </div><div class="t m0 x4 h4 y99 ff2 fs1 fc0 sc0 ls3 ws3">DOENÇAS DO INTESTINO GROSSO </div><div class="t m0 x4 h5 y3a ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">P<span class="_16 blank"></span>ARASITOSE: <span class="_12 blank"> </span>a tricuríase <span class="_12 blank"> </span>é <span class="_12 blank"> </span>uma <span class="_12 blank"> </span>parasitose <span class="_12 blank"> </span>com <span class="_12 blank"> </span>habitat <span class="_12 blank"> </span>no <span class="_12 blank"> </span>intestino <span class="_12 blank"> </span>grosso. Os </span></div><div class="t m0 x8 h6 y3b ff3 fs3 fc0 sc0 ls1 ws3">sintomas <span class="_15 blank"> </span>são: <span class="_15 blank"> </span>alteração <span class="_15 blank"> </span>do <span class="_15 blank"> </span>hábito <span class="_15 blank"> </span>intestinal, <span class="_15 blank"> </span>produtos <span class="_15 blank"> </span>patológicos <span class="_15 blank"> </span>nas <span class="_15 blank"> </span>fezes, <span class="_15 blank"> </span>dor </div><div class="t m0 x8 h6 y3c ff3 fs3 fc0 sc0 ls1 ws3">abdominal e sintomas associados à evacuação e comprometimento nutricional. </div><div class="t m0 x4 h5 y3d ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">COLITES <span class="_7 blank"> </span>INFECCIOSAS <span class="_15 blank"> </span>- <span class="_15 blank"> </span>DIARREIA<span class="_2 blank"></span> <span class="_12 blank"> </span>AGUDA: <span class="_7 blank"> </span>processo <span class="_7 blank"> </span>in<span class="_1 blank"> </span>flamatório <span class="_7 blank"> </span>de <span class="_15 blank"> </span>qualquer </span></div><div class="t m0 x8 h6 y3e ff3 fs3 fc0 sc0 ls3 ws3">segmento <span class="_9 blank"> </span>do <span class="_a blank"> </span>intestino <span class="_9 blank"> </span>grosso. <span class="_a blank"> </span>São <span class="_9 blank"> </span>ca<span class="_1 blank"> </span>usadas <span class="_9 blank"> </span>principalmente <span class="_a blank"> </span>por <span class="_9 blank"> </span>vírus <span class="_a blank"> </span>e <span class="_9 blank"> </span>bactérias. <span class="_a blank"> </span>Os </div><div class="t m0 x8 h6 y3f ff3 fs3 fc0 sc0 ls1 ws3">sintomas <span class="_15 blank"> </span>são: <span class="_10 blank"> </span>diarreia <span class="_10 blank"> </span>com <span class="_10 blank"> </span>muco <span class="_10 blank"> </span>e <span class="_15 blank"> </span>pus, <span class="_10 blank"> </span>dor <span class="_10 blank"> </span>abdominal, <span class="_10 blank"> </span>sintomas <span class="_10 blank"> </span>associadas <span class="_15 blank"> </span>a </div><div class="t m0 x8 h6 y40 ff3 fs3 fc0 sc0 ls3 ws3">evacuação e febre. </div></div><div class="c x1 y1a w2 h7"><div class="t m0 x4 h8 y1b ff3 fs4 fc1 sc0 ls2 ws3">Gabriela Reis Viol</div></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf7" class="pf w0 h0" data-page-no="7"><div class="pc pc7 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/b2059c16-b174-46e7-8e10-adbf30b5d20d/bg7.png"><div class="c x6 y5f w6 hd"><div class="t m0 x4 h5 y60 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">SÍNDROME <span class="_9 blank"> </span>DO <span class="_3 blank"> </span>INTESTINO <span class="_9 blank"> </span>IRRITÁVEL: <span class="_9 blank"> </span>quadro <span class="_9 blank"> </span>relacionado <span class="_3 blank"> </span>com <span class="_9 blank"> </span>hábitos <span class="_9 blank"> </span>alimentares </span></div><div class="t m0 x8 h6 y61 ff3 fs3 fc0 sc0 ls1 ws3">e <span class="_11 blank"> </span>fatores <span class="_e blank"> </span>psicogênicos. <span class="_11 blank"> </span>É <span class="_e blank"> </span>uma <span class="_11 blank"> </span>dor <span class="_e blank"> </span>crônica <span class="_11 blank"> </span>recidivante, <span class="_e blank"> </span>sem <span class="_11 blank"> </span>lesão <span class="_e blank"> </span>inflamatória. </div><div class="t m0 x8 h6 y62 ff3 fs3 fc0 sc0 ls1 ws3">Caracteriza-se por contrações espásticas da musculatura do cólon ou <span class="_8 blank"> </span>imobilidade. </div><div class="t m0 x8 h6 y63 ff3 fs3 fc0 sc0 ls1 ws3">Relaciona-se <span class="_15 blank"> </span>a <span class="_15 blank"> </span>hipersensibilidade <span class="_15 blank"> </span>visceral <span class="_15 blank"> </span>e <span class="_15 blank"> </span>pequenos <span class="_15 blank"> </span>aumentos <span class="_10 blank"> </span>de <span class="_15 blank"> </span>pressão. <span class="_15 blank"> </span>Os </div><div class="t m0 x8 h6 y64 ff3 fs3 fc0 sc0 ls1 ws3">sintomas são: alteração do hábito intestinal (diarreia crônica) com alternância, <span class="_8 blank"> </span>dor </div><div class="t m0 x8 h6 y65 ff3 fs3 fc0 sc0 ls1 ws3">abdominal <span class="_1 blank"> </span>com <span class="_3 blank"> </span>distensão <span class="_1 blank"> </span>e <span class="_1 blank"> </span>sintomas <span class="_3 blank"> </span>ao <span class="_1 blank"> </span>evacuar <span class="_3 blank"> </span>e <span class="_1 blank"> </span>flatulência. <span class="_3 blank"> </span>Nunca <span class="_1 blank"> </span>há <span class="_3 blank"> </span>enterorragia <span class="_1 blank"> </span>e </div><div class="t m0 x8 h6 y66 ff3 fs3 fc0 sc0 ls1 ws3">emagrecimento evidente. </div><div class="t m0 x4 h5 y9a ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3 v1">CONSTIP<span class="_16 blank"></span>AÇÃO FUNCIONAL: dor abdominal e alteração do hábito intestinal. </span></div><div class="t m0 x4 h5 y68 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">RETOCOLITE <span class="_4 blank"> </span>ULCERA<span class="_2 blank"></span>TIV<span class="_16 blank"></span>A<span class="_0 blank"></span> <span class="_8 blank"> </span>IDIOPÁTICA: <span class="_8 blank"> </span>doença inflamatória <span class="_4 blank"> </span>ulcerativa superficial. </span></div><div class="t m0 x8 h6 y69 ff3 fs3 fc0 sc0 ls1 ws3">Associado <span class="_e blank"> </span>a <span class="_e blank"> </span>diarreia <span class="_e blank"> </span>crônica, <span class="_e blank"> </span>leva <span class="_e blank"> </span>a <span class="_e blank"> </span>má <span class="_e blank"> </span>absorção <span class="_e blank"> </span>e <span class="_e blank"> </span>consequente <span class="_e blank"> </span>desnutrição, </div><div class="t m0 x8 h6 y6a ff3 fs3 fc0 sc0 ls1 ws3">hipovitaminose, emagrecimento, enterorragia e dor abdominal em cólica. </div><div class="t m0 x4 h5 y6b ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">DOENÇA<span class="_2 blank"></span> <span class="_a blank"> </span>DE <span class="_a blank"> </span>CROHN: <span class="_a blank"> </span>é <span class="_a blank"> </span>uma <span class="_a blank"> </span>doença <span class="_a blank"> </span>granulomatose <span class="_9 blank"> </span>fistulizante <span class="_a blank"> </span>que <span class="_a blank"> </span>acomete <span class="_a blank"> </span>todo <span class="_a blank"> </span>o </span></div><div class="t m0 x8 h6 y9b ff3 fs3 fc0 sc0 ls1 ws3">TGI. Associa-se <span class="_12 blank"> </span>a <span class="_12 blank"> </span>diarreia <span class="_12 blank"> </span>crônica <span class="_7 blank"> </span>com <span class="_12 blank"> </span>consequente <span class="_12 blank"> </span>desnutrição, <span class="_7 blank"> </span>perda <span class="_12 blank"> </span>ponderal, </div><div class="t m0 x8 h6 y9c ff3 fs3 fc0 sc0 ls1 ws3">hipovitaminose, enterorragia, dor abdominal em cólica. </div><div class="t m0 x4 h5 y9d ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">DOENÇAS <span class="_a blank"> </span>ORIFICIAIS <span class="_9 blank"> </span>(HEMORROIDA<span class="_2 blank"></span> <span class="_a blank"> </span>E <span class="_a blank"> </span>FISSURA<span class="_2 blank"></span> <span class="_3 blank"> </span>ANAL): <span class="_a blank"> </span>muitas <span class="_9 blank"> </span>vezes <span class="_a blank"> </span>evolui <span class="_a blank"> </span>sem </span></div><div class="t m0 x8 h6 y9e ff3 fs3 fc0 sc0 ls1 ws3">sintoma. <span class="_15 blank"> </span>Hemorroida <span class="_15 blank"> </span>interna <span class="_15 blank"> </span>é <span class="_10 blank"> </span>indolor <span class="_15 blank"> </span>e <span class="_15 blank"> </span>com <span class="_10 blank"> </span>sangramento <span class="_15 blank"> </span>comum, <span class="_15 blank"> </span>causada <span class="_15 blank"> </span>por </div><div class="t m0 x8 h6 y9f ff3 fs3 fc0 sc0 ls1 ws3">constipação <span class="_14 blank"> </span>intestinal <span class="_11 blank"> </span>frequente. <span class="_11 blank"> </span>Hemorroida <span class="_14 blank"> </span>externa: <span class="_11 blank"> </span>dolorosa <span class="_11 blank"> </span>e <span class="_14 blank"> </span>com <span class="_11 blank"> </span>pouco <span class="_11 blank"> </span>ou </div><div class="t m0 x8 h6 ya0 ff3 fs3 fc0 sc0 ls1 ws3">nenhum sangramento. <span class="_12 blank"> </span>Fissura: relacionada a <span class="_12 blank"> </span>constipação, fezes muito <span class="_12 blank"> </span>enrijecidas, </div><div class="t m0 x8 h6 ya1 ff3 fs3 fc0 sc0 ls1 ws3">pode haver ou não enterorragia. </div><div class="t m0 x4 h5 ya2 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">NEOPLASIA: <span class="_6 blank"> </span>o <span class="_6 blank"> </span>adenocarcinoma <span class="_6 blank"> </span>pode <span class="_6 blank"> </span>se <span class="_5 blank"> </span>a<span class="_1 blank"> </span>presentar <span class="_6 blank"> </span>como <span class="_6 blank"> </span>massas <span class="_5 blank"> </span>ulceradas, <span class="_6 blank"> </span>lesão </span></div><div class="t m0 x8 h6 ya3 ff3 fs3 fc0 sc0 ls1 ws3">polipoide, <span class="_9 blank"> </span>infiltrada <span class="_3 blank"> </span>ou <span class="_9 blank"> </span>estenosante. <span class="_3 blank"> </span>Possui <span class="_9 blank"> </span>fatores <span class="_3 blank"> </span>de <span class="_9 blank"> </span>risco <span class="_3 blank"> </span>como <span class="_9 blank"> </span>tabagismo, <span class="_9 blank"> </span>genética, </div><div class="t m0 x8 h6 ya4 ff3 fs3 fc0 sc0 ls1 ws3">alimentação <span class="_1 blank"> </span>pobre <span class="_3 blank"> </span>em <span class="_1 blank"> </span>fibras <span class="_3 blank"> </span>e <span class="_3 blank"> </span>recaem <span class="_1 blank"> </span>gorduras, <span class="_3 blank"> </span>doença <span class="_1 blank"> </span>inflamatória <span class="_3 blank"> </span>intestinal <span class="_3 blank"> </span>prévia <span class="_1 blank"> </span>e </div><div class="t m0 x8 h6 ya5 ff3 fs3 fc0 sc0 ls1 ws3">etc. <span class="_a blank"> </span>Cursa <span class="_a blank"> </span>com <span class="_a blank"> </span>alternância <span class="_a blank"> </span>do <span class="_a blank"> </span>hábito <span class="_a blank"> </span>intestinal, <span class="_a blank"> </span>dor <span class="_a blank"> </span>abdominal, <span class="_5 blank"> </span>enterorragia, <span class="_9 blank"> </span>produtos </div><div class="t m0 x8 h6 ya6 ff3 fs3 fc0 sc0 ls3 ws3">patológicos (presente nos casos mais avançados). </div></div><div class="c x1 y1a w2 h7"><div class="t m0 x4 h8 y1b ff3 fs4 fc1 sc0 ls2 ws3">Gabriela Reis Viol</div></div><div class="c xb ya7 w7 he"><div class="t m0 xd hf ya8 ff2 fs3 fc0 sc0 ls3 ws7">DELGADO</div></div><div class="c xe ya7 w7 he"><div class="t m0 xf hf ya8 ff2 fs3 fc0 sc0 ls3 ws7">GROSSO</div></div><div class="c x2 ya9 w7 he"><div class="t m0 xf hf yaa ff2 fs3 fc0 sc0 ls3 ws7">VOLUME</div></div><div class="c xb ya9 w7 he"><div class="t m0 xf h6 yaa ff3 fs3 fc0 sc0 ls3 ws7">GRANDE</div></div><div class="c xe ya9 w7 he"><div class="t m0 xd h6 yaa ff3 fs3 fc0 sc0 ls3 ws7">PEQUENO</div></div><div class="c x2 yab w7 h10"><div class="t m0 x10 hf yac ff2 fs3 fc0 sc0 ls3 ws3">NÚMERO DE </div><div class="t m0 x11 hf yad ff2 fs3 fc0 sc0 ls3 ws7">EV<span class="_16 blank"></span>ACUAÇÕES</div></div><div class="c xb yab w7 h10"><div class="t m0 xd h6 yae ff3 fs3 fc0 sc0 ls3 ws7">PEQUENO</div></div><div class="c xe yab w7 h10"><div class="t m0 xf h6 yae ff3 fs3 fc0 sc0 ls3 ws7">GRANDE</div></div><div class="c x2 yaf w7 he"><div class="t m0 x12 hf yb0 ff2 fs3 fc0 sc0 ls7">ODOR</div></div><div class="c xb yaf w7 he"><div class="t m0 x13 h6 yb0 ff3 fs3 fc0 sc0 ls3 ws7">DESAGRADÁVEL</div></div><div class="c xe yaf w7 he"><div class="t m0 x5 h6 yb0 ff3 fs3 fc0 sc0 ls3 ws7">TÍPICO</div></div><div class="c x2 yb1 w7 he"><div class="t m0 x10 hf yb2 ff2 fs3 fc0 sc0 ls3 ws3">MUCO E PUS</div></div><div class="c xb yb1 w7 he"><div class="t m0 x14 h6 yb2 ff3 fs3 fc0 sc0 ls3 ws7">AUSENTES</div></div><div class="c xe yb1 w7 he"><div class="t m0 xd h6 yb2 ff3 fs3 fc0 sc0 ls3 ws7">POSSÍVEL</div></div><div class="c x2 yb3 w7 h10"><div class="t m0 x15 hf yb4 ff2 fs3 fc0 sc0 ls3 ws3">ALIMENTOS MAL<span class="_0 blank"></span> </div><div class="t m0 x16 hf yb5 ff2 fs3 fc0 sc0 ls3 ws7">DIGERIDOS</div></div><div class="c xb yb3 w7 h10"><div class="t m0 xd h6 yb6 ff3 fs3 fc0 sc0 ls3 ws7">POSSÍVEL</div></div><div class="c xe yb3 w7 h10"><div class="t m0 x14 h6 yb6 ff3 fs3 fc0 sc0 ls3 ws7">AUSENTES</div></div><div class="c x2 yb7 w7 h10"><div class="t m0 x17 hf yb8 ff2 fs3 fc0 sc0 ls3 ws3">SINTOMAS </div><div class="t m0 x15 hf yb9 ff2 fs3 fc0 sc0 ls1 ws9">EV<span class="_16 blank"></span>ACUACIONAIS</div></div><div class="c xb yb7 w7 h10"><div class="t m0 x14 h6 yba ff3 fs3 fc0 sc0 ls3 ws7">AUSENTES</div></div><div class="c xe yb7 w7 h10"><div class="t m0 x14 h6 yba ff3 fs3 fc0 sc0 ls3 ws7">POSSÍVEIS</div></div><div class="c x2 ybb w7 h11"><div class="t m0 x15 hf ybc ff2 fs3 fc0 sc0 ls3 ws3">DOR <span class="_0 blank"></span>ABDOMINAL<span class="_0 blank"></span> </div></div><div class="c xb ybb w7 h11"><div class="t m0 x18 h6 ybd ff3 fs3 fc0 sc0 ls3 ws3">HEMIABDOME DIREITO E </div><div class="t m0 x19 h6 ybe ff3 fs3 fc0 sc0 ls3 ws7">MESOGÁSTRIO</div></div><div class="c xe ybb w7 h11"><div class="t m0 x11 h6 ybf ff3 fs3 fc0 sc0 ls3 ws3">HEMIABDOME </div><div class="t m0 x1a h6 ybc ff3 fs3 fc0 sc0 ls3 ws3">ESQUERDO E </div><div class="t m0 x11 h6 yc0 ff3 fs3 fc0 sc0 ls3 ws7">HIPOGÁSTRIO</div></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf8" class="pf w0 h0" data-page-no="8"><div class="pc pc8 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/b2059c16-b174-46e7-8e10-adbf30b5d20d/bg8.png"><div class="c x6 y5f w8 h12"><div class="t m0 x4 h4 yc1 ff2 fs1 fc0 sc0 ls3 ws3">SINAIS DE <span class="_2 blank"></span>ALERT<span class="_16 blank"></span>AS DO TGI </div><div class="t m0 x4 h5 yc2 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3 v1">Disfagia e odinofagia; </span></div><div class="t m0 x4 h5 yc3 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">Sangramento (hematêmese, melena, enterroragia); </span></div><div class="t m0 x4 h5 yc4 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls1 ws3">Perda de peso e comprometimento nutricional; </span></div><div class="t m0 x4 h5 yc5 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3">Exame físico alterado (anemia, massa palpável); </span></div><div class="t m0 x4 h5 yc6 ff3 fs2 fc0 sc0 ls0">\u2022<span class="fs3 ls3 ws3 v1">Icterícia. </span></div><div class="t m0 x4 h4 yc7 ff2 fs1 fc0 sc0 ls3 ws3">HEMORRAGIA<span class="_2 blank"></span> D. <span class="_0 blank"></span>AL<span class="_16 blank"></span>T<span class="_16 blank"></span>A<span class="_2 blank"></span> x HEMORRAGIA<span class="_2 blank"></span> D. BAIXA<span class="_0 blank"></span> </div></div><div class="c x1 y1a w2 h7"><div class="t m0 x4 h8 y1b ff3 fs4 fc1 sc0 ls2 ws3">Gabriela Reis Viol</div></div><div class="c x2 yc8 w9 h13"><div class="t m0 x1b h14 yc9 ff2 fs6 fc0 sc0 lsb">HDA</div></div><div class="c x1c yc8 w9 h13"><div class="t m0 x1b h14 yc9 ff2 fs6 fc0 sc0 lsb">HDB</div></div><div class="c x2 yca w9 h15"><div class="t m0 x15 h16 ycb ff3 fs7 fc0 sc0 lsa ws3">Foco da lesão acima da </div><div class="t m0 x16 h16 ycc ff3 fs7 fc0 sc0 lsa ws3">junção ílioduodenal</div></div><div class="c x1c yca w9 h15"><div class="t m0 x1d h16 ycb ff3 fs7 fc0 sc0 lsa ws3">Foco da lesão abaixo da </div><div class="t m0 x14 h16 ycc ff3 fs7 fc0 sc0 lsa ws3">junção ilioduodenal</div></div><div class="c x2 ycd w9 h17"><div class="t m0 x1a h16 yce ff3 fs7 fc0 sc0 lsa ws3">Hematêmese - 100%</div></div><div class="c x1c ycd w9 h17"><div class="t m0 xd h16 yce ff3 fs7 fc0 sc0 ls3 ws3">Hematêmese - 0%</div></div><div class="c x2 ycf w9 h17"><div class="t m0 x1e h16 yd0 ff3 fs7 fc0 sc0 lsa ws3">Melena - 90%</div></div><div class="c x1c ycf w9 h17"><div class="t m0 x1e h16 yd0 ff3 fs7 fc0 sc0 lsa ws3">Melena - 10%</div></div><div class="c x2 yd1 w9 h17"><div class="t m0 x17 h16 yd2 ff3 fs7 fc0 sc0 ls3 ws3">Enterorragia - 10%</div></div><div class="c x1c yd1 w9 h17"><div class="t m0 x17 h16 yd2 ff3 fs7 fc0 sc0 ls3 ws3">Enterorragia - 90%</div></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div>
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