Chapter 239 There are too many types of gastritis, the terrible Helicobacter pylori
"Take this to pay the fee, and after the examination, come here with the test results. After the examination, you don't have to wait in line anymore. Just talk to the nurse outside and they will let you in."
Write out the examination application form and give it to the patient.
In the past, you had to queue up in long lines to pay fees, and it took half a day to pay.
Now with the rapid development of mobile payment, payment has become very convenient.
You will no longer see long queues to pay bills in hospitals.
"thank you!"
After expressing their gratitude, the family member stood up and walked out with his daughter.
Zhou Can opened the door for them and sent them out.
The next patient was ushered in.
The clinic is always so busy.
Many people think that seeing a special specialist will cost hundreds of dollars, and at least an hour of detailed consultation will be required.
In fact, if the disease is familiar to the attending specialist, it may take less than ten minutes to complete the treatment.
When difficult and complicated diseases cannot be diagnosed on the spot, the patient will be sent away or hospitalized for observation and further detailed diagnosis, depending on the situation.
Therefore, there is really no need to see a specialist for common diseases.
You can get your illness cured by making an appointment for a few dollars.
The examinations and treatment plans performed are basically no different from those done by experts.
"Director Shang, please help me! I feel like I'm dying!"
The patient was an old man over seventy years old with a ruddy complexion and a plump body.
He was pushed into the clinic in a wheelchair by a woman in her forties.
After this patient came in, he kept groaning with a very painful expression.
"Don't worry, I will definitely give you good treatment now that you are here. I can hear that you sound strong when you speak, and you don't look like someone with any serious illness!" Director Shang comforted the patient while conducting a preliminary eye examination of the patient.
It is also called inspection.
This is the first diagnosis that all doctors must make when seeing a patient.
"I don't have any major problems, but recently I've been having stomach pain and bloating. After I eat, it feels like the stomach is about to come out of my mouth again after a while, which is very uncomfortable."
The old man hummed and described his symptoms.
The previous patient had abdominal distension, occasional mild abdominal pain, and a feeling of fullness after eating a few bites of food.
This patient's symptoms did not appear in the abdomen, but directly in the stomach.
After listening to the symptoms, Zhou Can looked at this interesting old man.
But I was muttering in my heart that this old man looked energetic and had a ruddy complexion, and he didn't look like he was seriously ill at all.
But no one can say for sure, we have to wait until the inspection is completed to know.
This kind of thing often happens when employees of many units have physical examinations: a person who looks healthy and has no serious symptoms, and his colleagues all think he is in good health.
The physical examination results showed mid-to-late stage liver cancer, rectal cancer, etc.
Zhou Can has seen many such examples.
Therefore, it is difficult to confirm whether the other person is suffering from a serious illness just by looking at him/her.
While recording the patient's symptoms, Director Shang asked about the patient's medical history and whether he had other symptoms.
After understanding the situation, it was found that in addition to bloating, stomach pain, and food reflux, the patient occasionally also suffers from pain in the lower back and waist.
As for the patient being in a wheelchair, that was a work-related injury many years ago.
An accident happened in the factory, which caused paralysis of his lower limbs. He has been using a wheelchair ever since. The old man also received a large sum of compensation. The house price was not expensive at that time, so he used the compensation to build a storefront and a house.
The thought is that even if I lose my ability to work in the future, I can still earn rent by renting out storefronts and houses.
This way you don’t have to worry about not having money to eat in the future.
In fact, God was very kind and took good care of this unfortunate old man.
The location of his self-built storefront gradually became a commercial center, and he saved a lot of money by collecting rent over the years. The house also took advantage of the rising real estate market, and its market value continued to rise.
In addition to bringing the old man an annual rental income of 270,000 to 280,000 yuan, the value of this self-built house is as high as more than 7 million yuan.
Therefore, the old man does not have to worry about his financial resources at all.
The middle-aged woman who pushed him to see the doctor was not the old man's daughter, nor was she a relative.
But she was a nanny hired by the old man.
According to the old man, his wife had passed away for several years. He only had one daughter who married far away. His daughter and son-in-law were very rich and owned more than a dozen chain supermarkets. They wanted to take him to live with them, but he was unwilling.
I feel more comfortable living alone.
Come to think of it, a 70-year-old man must be living a very comfortable life if he hires a 40-year-old nanny to take care of him 24 hours a day.
With a guaranteed life, plenty of money to spend and a comfortable life, the old man is naturally afraid of death.
If you feel any discomfort, run to the hospital immediately.
This time I had stomach pain and bloating, so I made an appointment directly with a special specialist.
Anyway, his age is there, so he is willing to spend some money to buy health.
"Director Shang, please tell me directly, is my disease stomach cancer? If it is cancer, I won't bother with it anymore."
After the old man finished telling his whole story, he saw Director Shang was silent and he couldn't help but get nervous again.
The female nanny leaned over, approached the old man and gently comforted him.
"You are blessed with good fortune, nothing will happen to you, just don't worry! Even if there is any problem, I will always stay by your side and take good care of you."
In front of so many doctors, the nanny and the old man spoke in a very intimate tone and manner. If there was no one around, I'm afraid they would be even more presumptuous.
Zhou Can has seen some similar gossip on TV and on the Internet.
The female nanny covets the male employer's property, tries hard to please the male employer, and then marries him, transforming from a nanny to a mistress. Then she uses various methods to make the male employer transfer the property to her name.
When the male employer dies, she will own the property alone.
Some female nannies are even more ruthless. Once they get the property and money, they will directly break up with their male employers.
Zhou Can couldn't help but worry about the old man.
Judging from the situation, the old man might have a hard time resisting the temptation of beauty and might be deceived.
"Huihui, you are still nice to me." The old man was very satisfied with the nanny's attitude.
Director Shang did not test a few young doctors this time. He directly issued an examination application and asked the patient to go for the examination.
After sending the patient away, he signaled Zhou Can not to let the patient in yet.
"Do you know what disease the patient just now had?"
Director Shang asked all the doctors under him.
"Doctor Huang, please tell me."
This time, the patient asked the attending physician directly, which shows that his disease is difficult to diagnose.
"It should be a disease like gastric ulcer or gastritis!" Huang Xinggui had obviously diagnosed the patient's disease secretly a long time ago.
Based on the symptoms described by the patient, it does look like gastritis.
"What are your diagnosis opinions?"
Director Shang asked several young doctors calmly.
"I dare not jump to conclusions. I must read the medical report before I can make a diagnosis."
Qiu Chengyu's answer was basically equivalent to admitting that he was unable to diagnose the patient's illness.
If the diagnosis is wrong, it is easy to be slapped in the face.
This vague statement is most advantageous.
"I think it should be gastritis!" Xie Lin's diagnosis was consistent with Huang Xinggui's.
"I think it might be a problem with the duodenum." Luo Jingyi could attribute any disease to the duodenum. She probably had a grudge against the duodenum in her previous life.
Zhou Can was the last to speak again.
It wasn't that he wanted to be the last to speak this time, but the old man's disease was very difficult to diagnose.
It is difficult to draw a conclusion based on just some symptoms without any examination basis .
"Doctor Zhou, I believe you have diagnosed the disease of the previous patient. The disease of the next patient is somewhat challenging. Tell me your diagnosis!"
Director Shang asked him with great interest.
In this situation, Zhou Can didn't want to spoil Director Shang's fun.
I had no choice but to answer, "When you and Luo Jingyi were examining the patient just now, I noticed that the patient had unusual eczema. And his paralyzed ankle was a little swollen. I originally thought that the eczema was caused by the chaotic private life between the patient and the female nanny. Later I thought about it and it shouldn't be the case."
These words made the two young female doctors blush a little.
Although they are all girls in their twenties and may have been in love before, they still feel embarrassed when hearing such a sensitive topic.
"Combined with the patient's occasional back pain, stomach bloating, stomach pain, food reflux and other symptoms, I suspected that the patient was likely suffering from eosinophilic gastroenteritis."
This is a fairly rare disease.
Patients will show symptoms of various gastrointestinal diseases and experience various physical discomforts.
This abnormal infiltration of eosinophils can cause inflammation-like reactions in the gastrointestinal tract, but it is different from ordinary inflammation.
It is only possible to make a diagnosis if the diagnosis and treatment experience is extremely rich, or the diagnosing doctor is extremely meticulous, has extensive basic medical knowledge in this area, and is rich in clinical experience.
"The clinical manifestations of this disease include mucosal, muscular and serosal types. The patient did not have intestinal obstruction, so the muscular type can be ruled out. The patient did not have a distended abdomen, and the ascites was mild, so the serosal type can also be ruled out. The patient mainly showed abdominal pain, nausea, vomiting, and mild diarrhea, so I boldly speculated that he was likely to have infiltration of the digestive tract mucosa, which belongs to the mucosal type."
Zhou Can further diagnosed and analyzed the patient's disease type.
His arguments were closely linked and logically rigorous, and the medical knowledge he displayed was extremely profound, which made other doctors admire him very much.
In particular, the two young female graduate students looked at Zhou Can with sparkling eyes.
The attending physician, Huang Xinggui, was amazed.
It was only at this moment that he was surprised to find that Zhou Can's diagnostic skills seemed to be even better than his as the attending physician.
I originally thought that Zhou Can’s diagnostic and treatment skills were at most at the level of a resident physician.
Now it seems that I really underestimated him.
They didn't know Zhou Can's brilliant achievements in other departments. Especially in the last month of general surgery, he was really a killer and successfully helped Mr. Liu diagnose many extremely difficult and complicated cases.
You know, in many of those cases, the patients had already seen experts and famous doctors in multiple hospitals, but the cause of the disease could not be found.
The results were all diagnosed by Zhou Can.
When he was still an intern, Zhou Can had an extraordinary talent in pathological diagnosis.
After nearly two years of regular training, he gained rich clinical experience and received generous advice from many chief physicians. In addition, he later made up for his basic medical knowledge crazily.
Ultimately, his diagnostic skills improved dramatically.
At present, he is nominally at the attending physician level, but his actual ability is not inferior to that of an associate chief physician.
Even when it comes to diagnosing some difficult and complicated diseases, his unique diagnostic ideas are better than those of the chief physician.
"Teacher, do you think Dr. Zhou's diagnosis is correct? It sounds like that to me!"
While Xie Lin was full of curiosity about this young trainee, she also developed a bit of admiration for him.
This old man's pathology is quite complicated, but his symptoms are extremely common.
The diagnosis is very difficult.
She thought the patient might have gastritis, which was the same diagnosis as that of the attending physician Huang Xinggui, but she was not confident at all.
This is like looking for a job. She has only an average degree and very little work experience, but a company says it can offer her 20,000 yuan a month. In this case, anyone with a normal mind would question it.
"My initial diagnosis was gastroenteritis, but after listening to Dr. Zhou Can's analysis, I completely agree with Dr. Zhou's point of view. The patient's disease is likely to be eosinophilic gastroenteritis, rather than a simple common gastroenteritis."
Director Shang is quite frank.
Even in front of students, he never tried to hide anything or flatter himself.
Instead, he honestly told the students that his original diagnosis was just gastroenteritis, and he was not able to make such an accurate diagnosis as Zhou Can.
"Dr. Zhou's diagnostic ability is so strong! I have to learn from you in the future."
Xie Lin looked at him with admiration.
When she found out that Zhou Can's diagnosis was more accurate than her teacher's, she was shocked beyond imagination.
"Hey, I just happened to catch up. Besides, the final diagnosis can only be known after the patient has completed the examination. Now we are just discussing it."
Zhou Can didn't dare to steal the limelight in front of Director Shang.
The most appropriate response is to be modest.
"Anyway, I just think you're amazing. I'll definitely learn more from you and ask for your advice in the future. By the way, the teacher said you've diagnosed the first patient's disease. Can you tell me what disease that young girl has?"
She took the opportunity to ask about the first patient’s diagnosis.
This time, the other two graduate students also pricked up their ears.
They also want to know the answer.
"Well... first of all, I have to state that my diagnosis may not be correct. It is just my personal opinion. The symptoms of the first patient, combined with the existing information about her, are very similar to atrophic gastritis caused by Helicobacter pylori infection."
Zhou Can gave his own diagnosis conclusion.
This disease is relatively common.
Especially in a famous hospital like Tuya, this type of patients are often seen.
Helicobacter pylori is also a major killer that causes gastric cancer.
"So it's this disease. No wonder you can prescribe three tests at once! Oh, I suddenly realized that I have been learning from the teacher for so long, but I still don't know anything."
Xie Lin patted her head gently, looking very adorable.
This made Zhou Can and others laugh.
A young girl who is not bad looking can indeed bring a certain amount of happiness to a man when she acts cute.
The reason why this world is beautiful and why men are reluctant to leave is because of the various joys that female compatriots bring to male compatriots.
The warmth and coldness of the world, when it comes down to it, is nothing more than the love between men and women.
We should add another sentence to this philosophical saying: Without women in this colorful world, there is only the world left, without flowers.
"Doctor Zhou, can you tell me how you diagnosed that young female patient with Helicobacter pylori infection?"
Luo Jingyi has always been very quiet and shy. Apart from answering Director Shang's questions, she hardly speaks.
At this moment, he couldn't hold back the strong curiosity in his heart, so he took the initiative to ask Zhou Can.
"Maybe my nose works better! She yawned and although she blocked her mouth with her hand, the bad breath caused by Helicobacter pylori infection was still very obvious. After listening to her symptoms and combining her medical history and other information, I concluded that she was likely infected with Helicobacter pylori."
After Zhou Can answered, he hesitated for a moment.
Then he continued, "I think her mother should also be tested for H. pylori. The smell when she speaks is even worse than her daughter's."
You definitely can't say this in front of a patient.
Because it hurts one's self-esteem.
Now that there were only a few doctors discussing the issue, Zhou Can didn't have any concerns.
Helicobacter pylori is contagious to a certain extent.
Especially for a family, since they eat together every day, it is easy for them to infect each other. It is even more so for a couple. Basically, if one of them has the disease, the other cannot escape.
