My medical skills add experience

Chapter 200 This is Pseudoenteritis, Family Members Strongly Demand This Test

Decades ago, there were a lot of good teachers with selfless dedication, and teachers were very respected objects in everyone's mind.But look at today, all kinds of disguised ways of accumulating money and charging fees.The teacher secretly investigates the parents of the students in the class, which one is rich and which one is an official, and then treats them in various ways.

The receipt of various miscellaneous fees in some schools makes parents doubt life.

Teachers are no longer keen on how to teach children well, but think about how to make money, actively complete the school's charging tasks, and get promotions and evaluations.This is all worrying.

Not to mention doctors, there are more and more mouse droppings, and there are fewer and fewer virtuous doctors.

The Kamata Department of Hospital swept the world.

Hospitals are bundled with marketing.

So much so that some hospitals put up all kinds of shocking slogans, welcome to visit next time!Congratulations to a certain department for achieving new highs!Dedicated meetings to discuss how to retain patients…

In the end, the vast majority of civilians will be the victims.

"The inspection materials are so thick, you have gone to a lot of hospitals, right?"

While chatting with the family members, Director Jia began to give the child a simple physical examination to get closer to the doctor-patient relationship.

"That's right, I went to no less than twenty hospitals. But I couldn't find any disease."

The child's father said with a bitter face.

"How much food can he eat a day now?"

"He eats two small bowls of rice a day, and he likes to eat strong, spicy and salty vegetables."

the child's mother replied.

Usually, it is the mother who takes care of the children more.

"A 17-year-old boy only eats two small bowls a day, which is indeed too little." After Director Jia finished speaking, he turned to Zhou Can and said. "Measure the patient's body temperature, pulse and other basic data."

Director Jia continued to ask the family members about the child's situation.

"Is he still having diarrhea?"

"Hey! As long as you eat something, you will have diarrhea."

"This disease has lasted for two years?"

"It has been more than two years now. At that time, the child was in the third year of junior high school, about the second half of the third year of junior high school. One day the teacher called and told us that the child lost weight rapidly in a short period of time, and asked us to take the child to the hospital for an examination. Through After asking, we found out that the child has had diarrhea in school for more than a month, and his appetite has been decreasing.”

The school is closed management.

Many children who are far away from home may only go home once or twice a semester.

Eating dirty things in school should be very unlikely to cause diarrhea.Otherwise, it is impossible to have only one child with diarrhea, but a large number of children with diarrhea.

And it is impossible for school meals to have problems every day.

"After taking the child home, do you still have diarrhea after eating home food?"

"Hey! The diarrhea still persists. After taking the antidiarrheal medicine, it had some effect at the beginning. Later, I took it more often, and the child's body had obvious problems, so we dared not give him any more."

Many western medicines have relatively serious side effects.

Long-term use of a certain western medicine is very prone to some 'drug overdose syndrome'.

Because our body has to metabolize the drugs we eat, there is a cycle.

It could be a day, it could be a week, or even longer.

The metabolic cycle depends on the drug.

So far, there is no drug that can remain in the body for a long time.

This is why many diseases need to take medicine on time.

The child's digestive function itself had a problem, and he was constantly taking antidiarrheal medicine.One day or two is fine, but after a long time, the old drug ingredients have not been completely metabolized, and new antidiarrheal drugs are taken, which continuously causes the drug ingredients to accumulate in the body.

When this amount reaches a certain concentration, the body will experience obvious discomfort.

When taking western medicines, there are side effects, stop taking them immediately, and you can basically get better quickly.

"Director Jia, the patient's blood pressure is high, heart rate is too fast, body temperature is normal, body is extremely weak, anorectal prolapse..."

After Zhou Can completed the basic physical examination for the patient, he showed the data to Director Jia for review.

Now, the patient's pre-diagnosis records, medical records, medical history and other information are all recorded by Zhou Can.Director Jia is only responsible for diagnosis and asking patients for key information.

This is also a further training for Zhou Can, laying a solid foundation for him to sit alone in the clinic in the future.

"The high blood pressure should be related to the body being too thin. The heart rate exceeds the normal value, which should be related to the body being overloaded. The root of all symptoms should still be caused by diarrhea."

Director Jia made a series of condition analysis.

Many people think that only fat people will have high blood pressure, but this is actually wrong.

Strictly speaking, both fat and thin people have the probability of getting this disease.

It is caused by excess blood circulating in the body.

The patient's long-term diarrhea has led to prolapse of the anus, indicating that the patient's diarrhea is very serious.

Director Jia took the patient's blood test, B-ultrasound film, X-ray examination, colonoscopy, electrolyte test... and checked them one by one.

The doctors tried their best to find out the cause of the patient's diarrhea.

Even E. coli was checked.

Unfortunately, the patient's etiology is complicated and confusing, and the real cause of the disease has not been found out.

Many diseases are particularly cunning. They are good at various camouflage and create many smoke bombs, so that doctors can never find where their "true body" is.

Director Jia frowned tightly after going through all the patient's examination materials carefully.

All necessary checks have been done.

Basically there is no need to do it again.

There are several data abnormalities in the blood picture, but there are traces to follow, which can be linked to diarrhea.

All tests point to one disease, enteritis.

The patient had a colonoscopy, and indeed there was enteritis, but it was definitely not ordinary enteritis.Otherwise, the previous doctors who have diagnosed are all fake doctors.

Moreover, some doctors have treated the patient's disease as chronic enteritis, and the effect is not satisfactory.

Director Jia was in a predicament for a while.

Even though he was well-informed, it was difficult to diagnose the real cause of the disease for a while.

The patient has become emaciated like this, and blindly prescribing the medicine without finding out the cause is tantamount to pushing the patient into the gate of hell.

It is estimated that within a month, the patient will have to lie in the intensive care unit.

"Qiu Hong, Zhou Can, take a look together!"

Facing the expectant eyes of the patient's family, Director Jia couldn't hold back his old face, so he temporarily recruited two cobblers to make up for it.

To ease the awkward atmosphere.

After reading the inspection materials, Qiuhong raised several questions, all of which were rejected by Director Jia.

Zhou Can kept silent.

His rule is not to speak easily, and once he speaks, it is a very constructive opinion.

Time passed in a minute and a second.

The family members have been disappointed many times, so they seemed to have expected it when they saw Director Jia failed to say a specific result.

The despair in my heart grew a little more.

At this time, Zhou Can heard a slight borborygmus from the patient.He couldn't help but move slightly, and quickly leaned over, leaning close to the patient's abdomen to listen to the sound.When a patient suffers from a lung disease, the doctor often listens to the patient for phlegm sounds and the like.

Diarrhea is rarely checked bowel sounds.

"Does he have frequent bowel sounds?" Zhou Can asked the boy's mother directly.

Normally, his mother should take care of him more, and since women are more thoughtful, she might notice the bowel sounds.

"It's not bad! The closer it is to the meal, the more frequently his stomach growls. There is also a sound after eating, about half an hour later. But it's another kind The sound is a bit like water being shaken in a bottle, making a "crash clatter" sound."

This information provided by the patient's mother is critical.

Zhou Can has always been good at diagnosing the pathological mechanism of patients and diagnosing lesions with unconventional ideas.

After asking the family members, Zhou Can didn't have anything to say.

Instead, he picked up the patient's examination report to check again, showing a pensive expression from time to time.

He accompanies Director Jia to make consultations in the Department of Gastroenterology, and has made many great achievements.Assisted in the diagnosis of nearly ten difficult cases.

Director Jia praised him as a ghost more than once.

At this moment, Zhou Can showed such an almost obsessed performance, Director Jia had a glimmer of expectation instead.

He patiently asked Zhou Can to think carefully.

The family members secretly wondered why this expert surnamed Jia mainly focused on students?
Usually students are mainly teachers who teach!

Naturally, they didn't know Zhou Can's ability, let alone Zhou Can's special position in digestive surgery.

Director Jia and Qiu Hong waited patiently for Zhou Can, and the family members naturally would not rush him.

For them, the most concerned thing is whether they can find out the cause of their son's illness and cure it.As for who can find out, it doesn't matter at all.

Time goes by.

Families are increasingly hopeless.

At this moment, Zhou Can suddenly said something that didn't make sense.

"His enteritis must be pseudoenteritis!"

"What do you mean?"

The family members asked puzzledly.

"That is to say, your son may have fake enteritis." Qiu Hong helped explain.

"False enteritis? Then what's wrong with my son?"

The patient's father's eyes brightened slightly.

"When I took my son to another hospital for treatment, a specialist surnamed Qin also said similar things. He said that the enteritis my son had might be just a symptom, and the real cause of the diarrhea might be something else. It's a pity he I tried my best, but still failed to find out the real cause of the disease. What the young doctor said is very similar to that expert’s opinion, which shows that he has real skills.”

After waiting for so long, the patient's father thought that the name of Tuya Hospital did not match the reality.

It doesn't matter if the cause cannot be diagnosed, but the attending physician who is known as a super expert actually asked a young doctor to help diagnose it.And focus on the young doctor.

It's just ridiculous.

At this moment, Zhou Can said that his son's illness was pseudoenteritis, and he realized that this young doctor is not ordinary, but has real skills.

"Director Jia, do you think the patient is not sick at all?"

What Zhou Can said again was even more shocking than the last sentence.

If he hadn't diagnosed his son with pseudoenteritis, the child's father would have stood up angrily and turned the table over.

what the hell.

If there is no illness, who would take the child to seek medical treatment and medicine?

"Doctor, my son is so sick, how could he be fine?" the child's mother asked angrily.

"Hmm... What I said is not sick, and what you understand is not sick are two different things. I mean, he doesn't have any substantial lesions."

Zhou Can explained and looked at Director Jia again.

His eyes were persevering in keeping the real from the fake, shining with a confident and firm light.

"what do you mean?"

Director Jia's eyes narrowed, he was thinking quickly about the meaning of Zhou Can's words.

Qiu Hong's wonderful eyes stared at Zhou Can.

She felt that the consultation with Zhou Can was completely at two levels of thinking.She can't even touch the wind.

I don't know what Zhou Can's thinking is.

The bigger the gap, the more she admired this junior.It can even be called worship.

"Can you do a 24-hour monitoring of the patient's brain waves? I suspect that he may be mentally ill, causing digestive system disorders." Zhou Can gave his own diagnosis.

The family members don't understand these professional medical terms at all, so they can only watch and listen in a daze.

However, there was a light of hope in their eyes.

It was the endless hope after finally seeing a glimmer of light in the endless darkness.

They are looking forward to the exciting moment when the cause is diagnosed.

"Nervous digestive disorder? But his symptoms are obviously not like it! I have diagnosed many cases of this disease, but I have never seen it." Director Jia has decades of experience in diagnosis and treatment, so it is impossible that he has not encountered it before. Cases of nervous digestive disorders.

He has long been screened for similar diseases.

"Tell me about your diagnostic basis and diagnostic thinking."

Director Jia did not hastily agree to Zhou Can's request for brain wave monitoring.

He wanted to see if the young man's diagnosis basis and dialectical thinking were reasonable.

"My basis is relatively simple, which is to start with the patient's bowel sounds, and then make inferences based on various examination data, medical history, and symptoms." Zhou Can said very straightforwardly.

"The patient's mother responded that the patient would send out a 'cuckoo' bowel sound as a hunger signal when it was time to eat. It shows that the patient's intestines can normally feed back the hunger signal to the body after detecting that there is no nutrient delivery. Half a meal after a meal After an hour or so, his intestines will make a 'crackling' sound again, which is a precursor to diarrhea."

"I think it only takes two tests to diagnose whether it is a neurodigestive disorder. The first is 24-hour brain wave monitoring. The purpose is to check the brain wave peaks at different times and infer the patient's mental state at different times of the day. The second is to listen to the specific part of the patient's bowel sounds about half an hour after the meal. It can be indirectly inferred that the speed and state of the intestinal contents in the colon before the diarrhea occurs."

Zhou Can roughly explained the way of diagnosis.

Since the patient must have diarrhea every time he eats, it means that the food is still liquid when it is output from the colon.

According to the bowel sounds, inferring the peristaltic speed of the colon, it can only be said that Zhou Can is worthy of the title of ghost.

"Director Jia, please promise to do these tests for our son! We don't care about the amount of money, even if the cause is not found out, we are willing, and we will not blame Dr. Zhou."

The family members of the patient were the first to strongly request Director Jia to agree to do this brain wave monitoring.

They don't know how to treat diseases, but Zhou Can's detailed analysis seems to make sense.

Either way, it's worth giving them a try.

Examination is not like surgery, and the risk of brain wave monitoring is almost zero.

As for spending some money, they really don't care.

My worst fear is not seeing hope.

Now that there is hope, what else is there to say.

"Don't be impatient, I'll make arrangements for you!"

After listening to Zhou Can's analysis, Director Jia felt that this novel way of diagnosis was unique, eclectic and very interesting.

He is full of expectations for the diagnosis result.

If the cause is found out, it is really a neurodigestive disorder, and he should be able to write a thesis.

(End of this chapter)