American Medical Association Family Medical Guide - American Medical Association [501]
If you need to avoid milk and other dairy products (which are major sources of calcium), a doctor will recommend taking a calcium supplement and eating other calcium-rich foods (see page 5), including green vegetables and fish with bones (such as sardines). Hard cheeses are OK because they contain minimal amounts of whey. (Most lactose is in the whey portion of cheese.) Lactose-reduced milk and other products are available in most grocery stores. If an infant or young child has symptoms of lactose intolerance, a doctor may recommend giving the child soy milk instead of cow’s milk.
Disorders of the Large Intestine
The large intestine is a tube about 2 inches in diameter and 5 feet long consisting of the colon (the longest section) and the rectum. The first part of the colon is a pouchlike chamber called the cecum. The appendix (a thin, wormlike pouch that is part of the immune system) hangs from the cecum. The rest of the colon runs up the right side of the abdomen (ascending colon), across and under the rib cage (transverse colon), and down the left side of the abdomen (descending colon and sigmoid colon). The rectum is a short tube about 5 inches long that points down from the end of the colon to the anus. Fluid and mineral salts from the contents of the intestine are absorbed through the colon wall into the bloodstream. The large intestine compacts indigestible solids and moves them toward the rectum. Waste is released from the rectum through the anus in the form of stool.
The large intestine
The large intestine is made up of two parts—the colon and the rectum. Undigested food (in liquid form) flows from the small intestine into the large intestine, where most of the water is absorbed back into the body. The partly solid waste (stool) that remains moves down into the rectum. The appendix is a thin sac that hangs from the first part of the large intestine called the cecum.
Appendicitis
Appendicitis is inflammation of the appendix (a small, narrow sac that branches out from the large intestine). If a piece of stool or food plugs up the appendix, it can become swollen and inflamed. Appendicitis is rare in children younger than 2. If appendicitis is not treated, the swollen appendix may burst, releasing the contents of the intestine into the abdomen and causing peritonitis (inflammation of the membrane that lines the abdominal cavity; see page 759). The apron of tissue that covers the intestines also covers the appendix and may prevent an infection from spreading.
Symptoms
The main symptom of appendicitis is abdominal pain that grows more severe over several hours. Usually the pain begins around the navel and then moves to a small area in the lower right abdomen. Slight pressure on the area will increase the pain. Other symptoms can include fever, nausea, vomiting, and loss of appetite. Some people notice that they have not had a bowel movement for a day or two before the attack, while others have bouts of diarrhea. Do not take a laxative if you have symptoms of appendicitis; it can cause an inflamed appendix to rupture.
Diagnosis
Appendicitis is sometimes difficult to diagnose because other disorders have similar symptoms. If you have symptoms of appendicitis, your doctor will perform a physical examination and press on your abdomen to locate the site of the pain. If your doctor thinks you have appendicitis, he or she will admit you to a hospital and order a number of tests, such as blood tests, a CT scan (see page 112), and ultrasound (see page 111), to rule out other disorders. If a diagnosis of appendicitis is uncertain, your doctor will recommend a surgical procedure called exploratory