An emergency night shift, at 12 midnight, I just finished rescuing a patient and was about to rest when I suddenly felt a sharp pain in my “stomach” (upper abdomen), as if someone was twisting it hard .
I stooped down from the pain, like boiled dried shrimp, can only be better.
Image source: Zhanku Hailuo
Gallstones? peptic ulcer? Digestive perforation?
With my irregular diet, these are all possible.
I gently touched and pressed my belly (palpation). Fortunately, it was soft, and there was no peritonitis, so gastrointestinal perforation was not considered for the time being.
I gently pressed the part under the right rib cage (gallbladder area) again, and it didn’t hurt.
I was about to give myself an abdominal ultrasound when I felt a sudden bowel movement… After expelling a lot of watery stools, there was basically no abdominal pain.
At this point, I initially concluded that I was eating.
First, I took a look at my excrement and saw no blood and no pus.
Fortunately, not a serious bacterial infection.
The amount is relatively large, and it is as thin as water. In addition to the location of the previous pain, I preliminarily judged that it was a problem with the small intestine.
If it’s a problem with the large intestine, you will have more bowel movements, but less per bowel movement, and the pain will be closer to the belly button.
Small bowel-related diarrhea is generally heavy, prone to dehydration and stomach cramps.
Next, I checked my body temperature, 37°C, no high fever; heart rate around 60 beats per minute, blood pressure 100/60 mmHg. I wrote it down and used it as a basic value for later monitoring and comparison.
Image source: Zhanku Hailuo
Finally, I review the suspicious foods of the last 1 week. Why is it 1 week? Because some bacterial infections have an incubation period, they will not develop symptoms at that time.
Grilled skewers, lo-mei, hot pot, sashimi…all may harbor pathogenic bacteria.
Image source: Zhanku Hailuo
But now my body feels fine, so let’s take a look.
In the second half of the night, my “stomach” was still cramping and diarrhoea.
I forced myself to drink 1000ml of water (dehydration is even scarier) even though I had abdominal pain as soon as I drank water.
When I got off the night shift at 8am, I was still flustered, thirsty, and lethargic. Since the onset of the disease, I have been without urine, and my heart rate has accelerated to 100 beats per minute. I know that I am a bit dehydrated.
I prescribed 1000 ml of sugar saline (glucose and sodium chloride injection) to myself, and I lost it in more than an hour at the fastest speed.
(Photo credit: taken by Dr. Ma)
Also pay attention to the problem of potassium deficiency, but the potassium-containing liquid has a limit on the infusion rate, so during the infusion, I drank the potassium (potassium citrate granules) that should be supplemented.
(Photo source: Dr. Ma )
After replenishing more than 3,000 ml of fluid (defecation volume + basic requirement), I felt that the whole person was alive again, and the heart rate slowly dropped to about 70 beats. Although I haven’t urinated yet, I have the strength to walk home.
Go home with “stomach” pain and diarrhea that has not improved.
I gave myself a tablet of 654-2 (racemic anisodamine), a colic relief. After about 20 minutes, the pain got better.
I took oral rehydration salts and montmorillonite powder again. The former is a sweet and salty liquid that can avoid dehydration and replenish electrolytes; the latter can improve diarrhea.
(Photo credit: taken by Dr. Ma)
(Photo credit: taken by Dr. Ma)
Slowly, the body started to gain some strength and the pain got better.
The next day, I started to try to eat, I drank some gruel first, replenishing fluids, sugar, and electrolytes.
Image source: Zhanku Hailuo
The pain came back, but it was bearable. I had to go ahead and eat some noodles and vegetables, and the pain didn’t get worse.
I was able to eat and drink, and my urine output gradually increased. On the third morning, I was back to normal work.
Many diseases can be covered with abdominal pain and diarrhea, such as pancreatitis, appendicitis, cholecystitis, ectopic pregnancy and even myocardial infarction.
So, whether or not you have definitely eaten something unclean, you must first rule out the possibility of other diseases.
But you are not me. To rule out the disease, I still need to go to the hospital to seek help from a doctor.
There are 3 key steps before seeing a doctor.
1. Remember what kind of poo you pull
Yes, it is recommended that you take a good look at your poo.
If possible, please take a photo.
Because it may be difficult for you to identify bloody, tarry, tarry stools. Just take a picture for the doctor.
Sometimes, there may be residual normal stools in the first bowel movement, please refer to the abnormal ones.
If possible, estimate total bowel movements.
Challenge: Please hold back! Wait until you go to the hospital, and do a stool test by the way, which is excellent for judging the condition.
Don’t worry that all you are pulling is water, the hospital has a small bottle of watery stool.
Image source: Zhanku Hailuo
2. Is there any dehydration
Assessing dehydration is complex, but it can be simple:
Whether there is decreased urine output, whether you are thirsty and want to drink water.
In addition, heart palpitations, dizziness, and fatigue can also be symptoms of dehydration.
If you have and you cannot drink a lot of water, go to the hospital immediately and as soon as possible.
3. Remembering carefully
Review carefully about your eating, traveling, and pet-owning experiences;
Ask friends who have recently eaten together if they have the same symptoms.
If yes, make an appointment to see a doctor together.
Also pay attention to separate meals with family members to avoid infection.
If you have taken antibiotics or been hospitalized in the past 3 months, or have had high-risk sex, or are taking immunosuppressants (such as prednisone) or have Falling diseases, be sure to tell the doctor, because special pathogens must be considered in this case.
Most acute diarrhea resolves on its own.
For people who are not seriously ill and do not have high-risk diseases, such as me, it is enough to pay attention to hydration and maintenance of nutrition. Antibiotic treatment is generally not required.
Antibiotics can be considered in the following situations, but you can’t eat them by yourself. It should be judged by a doctor:
1. Severe symptoms, such as fever, frequent bowel movements per day.
2. Features of an invasive bacterial infection, such as mucoid or bloody stools (requires a photo or specimen test of the stool to help determine).
3. Special circumstances, such as age over 70 years or combined with heart disease and diseases that damage immune function, etc.
It is best to drink rehydration by yourself, dilute fruit juice or oral rehydration salts can be used. Rehydration salts are available at pharmacies.
If severe dehydration occurs, such as thirst, decreased urine output, lack of energy, etc., go to the hospital for intravenous fluids. After the condition improves, it can be changed to oral rehydration.
In terms of diet, it is still necessary to maintain adequate nutrition. If you don’t want to eat or you still have symptoms of nausea and vomiting, you can eat some liquid food in the short term, such as gruel.
After severe diarrhea, avoid fatty foods (such as large fish and meat) until bowel function returns to normal.
In addition to yogurt, the gut may have difficulty digesting other dairy products, so temporarily avoid foods that contain lactose, such as milk.
Image source: Zhanku Hailuo
Special Tips
1. Prevention is the best treatment. Remember to wash your hands before meals and divide meals between meals.
2. Separate raw and cooked dishes when preparing food, and eat fresh and fully heated seafood.
Image source: Zhanku Hailuo
3. Cook the food when shabu-shabu, avoid eating raw food.
*The content of this article is for the popularization of health knowledge and cannot be used as a specific diagnosis and treatment suggestion, nor can it replace the face-to-face consultation of a licensed physician, and is for reference only.
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