Since 1981 Health School

  Chapter 453 Chronic abdominal pain and diarrhea

  Chen Qi thought it was impossible, we met on the first day, you are not borrowing money from me, are you?

  This is the typical thinking of Chinese people, full of caution and caution.

  Of course he said it politely: "Mr. Chief, if you need help, just tell me, I can help."

   Nguema said a little worriedly:

   "I have a daughter who is 15 years old this year. She has had abdominal pain and diarrhea for 2 months, and she is about to die. I wonder if you can help us treat it. If not, she may die."

  Chen Qi was a little surprised, and looked back at Piet who was working as an interpreter:

   "What's going on? This Chief Nguema is your friend, and you are also a doctor. Why didn't he even cure his daughter's diarrhea? It shouldn't be."

  For doctors, antidiarrheal treatment is not complicated. Chen Qi is a little puzzled. Why is Pieter not willing to help even a small problem when he is a friend of this African chief?

   It has been delayed for two months? Even Iron Man can't stop it.

  Pieter waved his hands in embarrassment after hearing this:

"No, no, actually, I came here a week after the little girl had diarrhea. I tried all kinds of medicines, from antidiarrheal medicines, antibiotics, and I even took him to Freetown Hospital for an injection. I took all kinds of treatments, and they didn't work at all. .”

   "Antidiarrheal treatment is ineffective?"

  Chen Qi thought it would be troublesome, this is not ordinary diarrhea.

  The treatment of common diarrhea is actually very simple,

  For example, at the end of 2022, people all over the country are rushing for antidiarrheal drugs, such as montmorillonite powder, Changyanning, Keshi Sha, probiotics, oral rehydration salt powder, etc.

  If there is dehydration, then infusion to replenish electrolytes and water; after a long time, it is a big deal to add some zinc to protect the intestinal mucosa.

   This set of combined punches, if it is just ordinary diarrhea, it will definitely be effective. To put it more harshly, even if you don’t need any treatment, ordinary diarrhea can stop the recovery by itself.

  Clinically, according to the length of the disease course, diarrhea can be divided into acute and chronic categories. The onset of acute diarrhea is sharp, and the course of the disease is within 2 to 3 weeks, most of which are caused by infection.

  Chronic diarrhea refers to recurrent diarrhea with a course of more than two months or an intermittent period of 2 to 4 weeks. The etiology is more complicated and can be caused by infectious or non-infectious factors.

  If the diarrhea lasts for 2 months, there must be other serious problems. If the root cause of the disease is not cured, the diarrhea will not stop.

  Chen Qi came to aid Africa, isn't it just to treat the locals, so he didn't hesitate, and stood up all of a sudden:

   "Let's go, let's see how the patient is doing first?"

  The village where Nguema is located is not so much a village as a stockade, because Chen Qi shuttles around the village, and the local people are almost all thatched houses.

   There is no electricity yet, basically in a primitive tribal state.

  Even if they went to the chief’s (village head) house, they just changed to a bigger thatched house.

   I don’t know if the typhoon is blowing here in Sierra Leone. If this is in Haidong Province, such a thatched house will definitely be blown away every year during the typhoon season.

  When Chen Qi followed Nguema and walked into the thatched cottage, he smelled the smell of dung mixed with the smell of vegetation.

  Nguema turned on the flashlight, pointed to a black girl lying in the corner and said:

   "This is my poor daughter, her name is Luciana."

  When the little girl heard a stranger coming in, she also raised her head and glanced. Because of dehydration, her eyeballs were very large, and she blinked with curiosity in her clarity.

   This is a beautiful little African girl, at least Chen Qi thinks so, probably because Luciana looks more in line with the aesthetics of oriental people.

   And after all, it is the daughter of the village head's family. She is wearing a worn-out T-shirt, but she doesn't "wear a mask", so she doesn't see anything wrong.

  Chen Qi observed these things, not to say that he is a hungry ghost, even girls from others.

   But as a doctor, he has too many things to consider.

  For example, the patient girl in front of me is good-looking, well-developed, and her family conditions are also good. She obviously belongs to the "silly, white and sweet" type, and she is obviously more attractive to boys.

   Making a bed in this place, making a quilt in the sky, sparsely populated, getting into the grass is equivalent to the African savannah with free housing. A 15-year-old girl can already give birth to the next generation.

  Will pregnancy cause diarrhea for a long time?

  Because if it is really pregnant, and the gestational sac is not in the uterine cavity, but in the fallopian tube or other locations, it is an ectopic pregnancy, which will also cause abdominal pain and diarrhea.

  Doctors can only do exclusion one by one under the premise of not being able to accurately detect the cause.

   "Pieter, ask if Luciana has a boyfriend or husband."

  Pieter was full of question marks, thinking that you came to see the diarrhea, why do you care if he has a boyfriend? Could it be that he fell in love with another girl?

   Seeing Piet's expression, Chen Qi knew that he had misunderstood, and quickly explained:

   "I need to know whether she has a new life history to rule out pregnancy or certain gynecological diseases."

   "Oh, so it's this one, hehe, okay, I'll ask right away."

  Chief Nguema looked at Chen Qi strangely after hearing this, but he still asked his daughter, after all, the old father didn't know if she had ever drilled the prairie with a man.

  The little girl shook her head shyly after hearing this, expressing that she was still a complete body.

  Pregnancy can be ruled out, Chen Qi felt that his thoughts should be more focused on the patient's own stomach.

  So he sat on the right side of the little girl, pulled off his clothes, and began to palpate the abdomen.

   It was about the first time that Luciana was touched by a man, so he was a little embarrassed. Chen Qi thought that he was really a baby, and he didn't lie just now.

   After palpation, the entire abdomen was checked, and there was no obvious abdominal pain.

   Didn’t Chen Qi just diagnose a misdiagnosed appendix, and strike while the iron is hot, so he focused on checking the McBurney’s point in the right lower abdomen, and there was no obvious pain in the patient.

   This is a headache.

  The etiology of chronic diarrhea is more complex than acute.

  Intestinal mucosal lesions, overgrowth of bacteria in the small intestine, defects in intestinal transport, insufficient digestion, intestinal motility disorders, and certain endocrine diseases and extraintestinal tumors may lead to the occurrence of chronic diarrhea.

   Such as chronic amoebic dysentery, chronic bacterial diseases, intestinal tuberculosis, schistosomiasis, Crohn's disease, ulcerative colitis, uremic enteritis, tumor cancer, small intestinal malabsorption, irritable bowel syndrome, etc.

  Chen Qi can think of 17 or 18 diseases in one breath.

   Even if it is not the cause of the intestinal tract itself, other diseases can also cause secondary diarrhea.

  For example, diseases of the stomach and liver, gallbladder and pancreas, such as atrophic gastritis, chronic hepatitis, chronic pancreatitis, and chronic cholecystitis.

   Or systemic diseases, such as hyperthyroidism, diabetes, systemic lupus erythematosus, niacin deficiency, food and drug allergies, etc.

   It is estimated that some readers have already fainted, isn’t it just diarrhea, and so many diseases can be detected?

  Look, you see, it is too difficult to be a doctor. Finding the real cause of so many unknown diseases is really no different from finding a needle in a haystack.

  This not only requires the doctor's superb clinical skills, solid medical and surgical foundation, and accurate sixth sense, but also requires a large number of auxiliary examinations to prove whether the doctor's guess is correct.

  It also proves that doctors and machines are equally important to modern medicine, and both are indispensable.

  Since the interrogation and physical examination could not find anything, Chen Qi decided to get a cheat, took out the portable color ultrasound machine in his space, and did a preliminary examination.

  Anyway, the vast prairie and primitive tribes are not afraid of them leaking secrets.

   "Pieter, wait for me, I have a B-ultrasound machine in my car, which can just be used for inspection."

  Dr. Hei was shocked when he heard this, "Dr. Chen, you actually carry the B-ultrasound machine with you? If something goes wrong, the loss will be huge."

   There is no pharmaceutical company in Sierra Leone, so in this poor country, even a single antipyretic is imported, which also leads to high medical prices.

  Inspection equipment is even more precious, because if a machine breaks down, Sierra Leone cannot repair it at home, and has to be sent abroad for maintenance, which is another huge sum of money.

  So Piet really wants to scold this Huaguo doctor to death.

  There are no roads in the prairie, after all the pits were dug, and the car was bumped like a boat, but a precision medical instrument was actually placed on such a car?

   This made Dr. Hei gnash his teeth angrily, cursing the other party as a prodigal son.

  Chen Qi didn't know the mental activities of the African doctor. He just went around in the car, and then took out a bag from the trunk.

   "Doctor Chen, this, this is the B-ultrasound machine?"

  For Piet, the B-ultrasound machine is already a medium-sized instrument, not to mention anything else, the monitor alone is that big, but in Chen Qi's hand it is just a light handbag?

  Chen Qi smiled:

   "This B-ultrasound machine is very powerful. It has not yet been put into the market and is in the state of laboratory research, so you have to keep it a secret when you go back. Today I will let you see what is called the most advanced instrument of this era."

   After finishing speaking, while Piet was stunned, Chen Qi took out the "notebook", opened it, turned it on, installed the probe, and applied the couplant, all in one go.

  African doctors in 1986, where have you seen this kind of color LCD screen? Still so thin.

  As soon as the probe was placed on the patient's abdomen and moved slightly, the organs in the abdomen were clearly displayed.

  Compared with LCD ultra-clear screens, the screen resolution of this big picture tube is simply scum, this is the progress brought about by technology.

  Pietro's eyeballs almost fell to the ground, the whole process was ohmygod! oh my god!

  He couldn't find any other words to describe his shock. The arrogance of the so-called European and American students was smashed in front of this color ultrasound machine.

  Pieter never dreamed that Huaguo was so developed?

   This is no longer the development of medicine, but the development of science and technology. This is an advanced instrument that even European and American countries have never seen.

  Chen Qi didn't care how shocked Piet was, he felt like a policeman now, and he must find out the cause of the black girl's long-term abdominal pain and diarrhea.

  It was quiet in the thatched cottage, all flashlights and oil lamps were turned off, only the light from the color Doppler ultrasound screen.

  Chen Qi and Piet got together head-to-head, and checked the organs one by one. The heart, liver, spleen, lungs, kidneys, gallbladder, and pancreas all showed normal.

  Chen Qi's brows have become more and more wrinkled, so his key inspection object is the intestines.

  It turned out that no obvious lesions were found in the inspection from the duodenum to the jejunum, ileum, cecum, appendix, descending colon, sigmoid colon, and rectum.

  It is in the colon, there seems to be a small cord-like echo, but because it is very small, it will not be displayed when the probe is passed over, and there is no way to judge what it is.

  Chen Qi put away the ultrasound instrument, put his chin in his hand, and said in a deep voice:

   "Piet, it seems that we are in trouble. Now we can only confirm that there is intestinal obstruction, but we can't judge what caused it."

  Pieter also felt Chen Qi's appearance, resting his chin with his hand:

   "Yes, it seems that I have to go to the hospital for a comprehensive examination, and I can only wait for death at home."

  The two looked at the Nguema chief again.

   Going to the hospital, even if you only charge the cost price for going to the Friendship Hospital, is definitely a huge expense for African natives.

   Nguema was a little embarrassed when he heard it. If it wasn't for the money, he wasn't stupid. He would have sent his daughter to the hospital a long time ago. Why wait until now?

  Who knew that the black girl Luciana raised her head at this time, looked at her father with tears in her eyes, and called softly:

   "Dad, I want to live, please..."

   Chen Qi and Piet were both moved by these words, and Nguema directly threw the "battle of power" in his hand to the ground:

   "Okay, Dad will treat you. You go to the hospital with this Hua Guo doctor for treatment. Dad will come to find a way for the medical expenses. We have a lot of sheep at home. I will have money when I sell the sheep."

sheep?

  Chen Qi, who came from the big food country, was happy when he heard that there were sheep. The camp where the Friendship Hospital is located occupies a large area, and many places are still in the state of green grassland. How good would it be to raise a few sheep?

   It can also help solve the diet of the team members. After all, mutton is better than seafood, right?

   "Chief Nguema, otherwise, all the medical expenses of your daughter will be covered by me. You can give me the sheep. We Chinese people like to eat sheep."

  Since Chief Nguema has made a decision, he is also a cheerful person:

   "Okay, when you go back tomorrow, bring my daughter and my family's sheep. Is 20 enough or not?"

  For the African natives in the prairie, there are fertile grasslands everywhere, so the cost of raising sheep is very low, and it is very convenient and practical.

  But in this poor country, it is very difficult to sell sheep for cash. After all, there are too many tribes raising sheep, but too few rich people eat sheep.

  So Chief Nguema wanted to sell the sheep to raise money for his daughter's medical treatment. It would take hundreds of miles to drive the sheep to a big city, and he might not be able to sell them.

   Now that Dr. Chen wanted sheep but not money, Nguema of course agreed.

  Early the next morning, Chen Qi didn't continue hunting, and took 5 young bulls and 20 sheep, and quickly drove towards Freetown.

  In the car, Luciana showed a smiling face accompanied by his family.

   While driving, Chen Qi was thinking, what kind of disease could this be?

  (end of this chapter)