Source: Listen to Dr. Lee
The female patient, surnamed Xiao, is 34 years old.
Half a year ago, Xiao began to have dizziness, unexplained dizziness, and dizziness without warning, sometimes dizziness when sitting on the computer, sometimes dizziness when brushing mobile phones, and dizziness when eating.
Different patients have similar experiences.
The family thought that it was a deficiency of qi and blood, bought a lot of blood and qi medicine to take, grandpa also took out the ginseng that had been treasured for many years to make tea for her, so it was handled for a period of time, and it felt that the dizziness situation did improve.
Your body is too weak, you have to make up for it, maybe it is the root of the disease that fell when you gave birth to a child the year before, and you have to raise it. The township doctor told Ms. Xiao.
When Ms. Xiao listened, she deeply believed that indeed since the birth of the second treasure the year before, her physical strength has been much worse, and she will have dizziness from time to time, especially when squatting and standing up (changing position), which is more serious this year.
You have to look for gynecology and endocrinology in this case, and a doctor who knows you has suggested Ms. Xiao. Do not think that it is a simple deficiency of qi and blood, many women may have gynecological and endocrine problems after giving birth to children, especially endocrine dysfunction, which will cause a series of problems, do not be satisfied with only the diagnosis of qi and blood deficiency.
Qi and blood deficiency may be right, because my dizziness has improved after taking supplements, Ms. Xiao said.
In addition, I see that your anemia is somewhat obvious, you see that your face is a little yellow and white, the gums lack blood, it does look like anemia, anemia will also lead to dizziness, the so-called qi and blood deficiency may have a certain relationship with anemia.
Dizziness caused by anemia is all too common, the doctor said.
At the suggestion of this doctor friend, Ms. Xiao came to the gynecology department of the local hospital to check whether there were any gynecological diseases, such as whether there was a possibility of menorrhagia being too long, many women have such and such problems in the body after giving birth to children, and disorders such as menorrhagia or too little are possible.
The gynecologist carefully consulted the situation, Ms. Xiao's menstrual cycle is 35 days, thunder does not move, each menstrual period will last 5-7 days, the amount is not too much, not like the problem caused by menorrhagia.
Draw your blood first and see how serious the anemia is. The gynecologist said.
Doctor, must I be anemic? I usually eat a lot, but my physical strength is indeed poor, and sometimes it is easy to get tired from doing housework. Ms. Shaw said.
Easy to get tired is not necessarily anemia, may be caused by lack of exercise exercise, but your face and the color of the gums, indeed like anemia, normal people's face is rosy, the gums are also rosy, because the surface of the gums are capillaries, so the gums will reflect the color of blood, if a person is anemia, the blood red blood cells are reduced, the amount of hemoglobin is also small, the gums will become pale, there is no blood color, if there is such a situation, 99% are anemia.
After the gynecologist's answer, Ms. Xiao was even more worried, because she also noticed that her gums were indeed not as rosy as others, and her face felt very haggard and pale, and it was really not the face of a healthy person.
Without any surprise, Ms. Xiao's abstract result came out, and the hemoglobin was only 68g/L.
This is really bad, do not wait for the doctor to explain, Ms. Xiao herself got the test results, saw that the normal value of hemoglobin is 120-150g / L, and she only has 68g / L, that is really bad.
Such a low hemoglobin (hemoglobin), can completely cause you to be dizzy, ah, some people may also have fallen to the head for no reason to break the blood flow, must pay attention. The gynecologist said.
Ms. Xiao was depressed to the extreme.
Doctor, why am I so anemic? Ms. Xiao asked the gynecologist. At this time, gynecological B ultrasound is also done, and some hormone results have also come out, which are basically normal.
From the available information, unlike anemia caused by gynecological diseases, many women will have uterine fibroids or other diseases that cause excessive menstrual flow and lead to anemia, but your gynecological B ultrasound does not see obvious uterine fibroids, and your menstrual condition is basically normal, so for the time being, do not consider gynecological diseases.
Gynecologists continue to say that in addition to gynecological diseases can cause excessive bleeding, some digestive tract diseases, blood system diseases can also lead to anemia, such as long-term hemorrhoidal bleeding? Stomach ulcer bleeding? Or there may be some blood disorders.
I should have hemorrhoids, Ms. Xiao said a little embarrassed, sometimes the stool is dry and hard, can not be pulled out, there will be some blood out.
Is there a lot of blood in the stool? The gynecologist continued to ask.
Occasionally, 1-2 times a month. Ms. Shaw said. Every time after the stool is finished, the toilet paper will be stained with blood.
Have you ever tried pulling a lot of blood?
Not really.
In this way, your hemorrhoids are not enough to cause such a serious anemia, and anemia may have other causes. The gynecologist said that it is recommended that you have a gastroscope colonoscopy to see.
Because the cause of Ms. Xiao's anemia does not consider gynecological diseases, but considers other problems, the gynecologist did not say too much, and directly recommended that Ms. Xiao go to the gastroenterology clinic for treatment.
Ms. Xiao had to find a gastroenterologist.
As soon as the gastroenterologist saw Ms. Xiao's anemia and had hemorrhoids, he immediately recommended a colonoscopy.
In addition to doing a colonoscopy, a gastroscope may also be done. This is what the gastroenterologist said.
Do you usually have abdominal pain, nausea, etc.? Appetite? Will it be easy to get full early? The gastroenterologist asked some questions.
It's not obvious, I usually do copywriting, I often need to work overtime, and I can eat a bowl of rice at every meal. Ms. Shaw said.
Will there often be bloody stools and black stools? The gastroenterologist continued to ask.
, is like that, sometimes the color is not too normal. Ms. Xiao is a little embarrassed, sometimes a little bloody, sometimes a little black, sometimes yellow, I can't figure out if it's normal.
After the gastroenterologist asked a few more questions, he directly opened a single for colonoscopy and asked Ms. Xiao if she wanted to do the gastroscope by the way.
Ms. Xiao has heard that gastroscopic colonoscopy is very uncomfortable, a little resistant, and afraid of excessive price.
We can do anesthesia, painless, do an anesthetic before doing it, and wake up to do it without pain. As for the price, it adds up to almost 2,000, and if you are hospitalized, medicare can reimburse a part. The gastroenterologist explains.
Wouldn't it be uncomfortable, so thick a tube inserted from the mouth, think about it and be afraid. Ms. Xiao is still not at ease. Also, the tube in the colonoscope is so thick that it goes straight in from the anus, I can't accept it...
You don't do gastroscopy colonoscopy, I can't see your digestive tract clearly, whether it is peptic ulcer bleeding I am not sure. The gastroenterologist strongly recommended that Ms. Xiao do the endoscopy.
Are there other tests that can be substituted? Ms. Xiao was simply begging for a doctor, her brow furrowed, and she looked even more pitiful.
Gastroenterologists are a little impatient, saying that if you don't do gastroscopy colonoscopy, you must not look carefully, but if you really don't want to do it, then do barium meal contrast, but it is only to see the stomach and duodenum is more reliable, can not see the colon and hemorrhoids, can not judge whether there is colon cancer or other possibilities.
But the gynecologist said that I don't bleed much from hemorrhoids, maybe it's not the bleeding caused by hemorrhoids, right? Ms. Shaw said. If so, is it okay not to do a colonoscopy first?
Yes, then do barium food contrast first, look at the esophagus, stomach and duodenum, maybe you can find a problem. Not all stomach ulcers will have typical abdominal pain, bloating, but many stomach ulcers will lead to bleeding, if long-term stomach ulcers, it is entirely possible to cause anemia, in addition, gastric ulcers are not the most terrible, in case it is stomach cancer, it is tricky. The gastroenterologist said with a straight face.
Ms. Xiao trembled as soon as she heard stomach cancer, you know, her uncle died of stomach cancer the year before.
Do you have relatives in your family who have stomach cancer? The gastroenterologist asked.
It's my uncle. When he was in his 80s, he found advanced stomach cancer and left within a few months. Ms. Shaw said.
Generally speaking, if the immediate family has a malignant tumor, then the possibility of you suffering from malignant tumors is relatively high, but your uncle is far away from your side, and it will not necessarily have an impact. The gastroenterologist did not want to stimulate Ms. Xiao too much, and her tone eased up a bit.
The next day a barium meal examination of the digestive tract was arranged.
The results came out immediately.
There are mass lesions in the stomach.
When Ms. Xiao saw this result, her legs went soft. She herself has checked Baidu, mass lesions, most of which mean cancer. Could it be stomach cancer? Oh, my God.
The stool test results also came out, and the stool occult blood was positive, indicating that there was blood in the stool.
Ms. Xiao said that the stool used to be darker.
The doctor said, that's right, you have blood in your stool, although it is not bright red (mostly means hemorrhoids or colon cancer), it is black, that means that the upper gastrointestinal tract (stomach and duodenum) bleeding, the blood through the intestine digested, when discharged it becomes black. It is estimated that this mass lesion in the stomach is the curse.
Is it stomach cancer? Ms. Xiao asked the doctor in a panic. It's a curse that can't be avoided.
Not necessarily, the gastroenterologist shook his head, saying that from the barium meal results look a bit like, but not sure, eventually still have to do a gastroscopy, and gastroscopic forceps a part of the tissue out for pathological examination to determine whether it is or not.
Still have to do a gastroscopy. The gastroenterologist said emphatically.
Ms. Xiao's face was even more miserable, her eyes were confused, and she said let's do it, her voice was very small.
From her tone, it seemed that she had already identified herself as stomach cancer, and the gastroscope was just waiting for the death god's verdict. The husband also came, and after learning the result, he was also very nervous, and at this time he could only continue to comfort his wife.
Don't scare yourself first, wait for the results of the gastroscopy. The gastroenterologist said. My words are not comforting words, they are true. Arrange a gastroscopy tomorrow.
Fasting and water fasting began on the same day, emptying the digestive tract. When Ms. Xiao was hungry and panicked, the nurse would give some glucose water to replenish some energy.
The next day Ms. Xiao was taken into the endoscopy room, and as soon as propofol was pushed, she didn't know anything.
By the time Ms. Xiao woke up, the gastroscope had been done. At this time, he was accompanied by his husband, and the doctors and nurses were gone.
The doctor really didn't lie to himself, he really did it after a sleep.
The days to wait for the results were long and stressful. How eager the doctor was to tell himself that this was not cancer, not cancer, not stomach cancer.
However, the desolate scene of the uncle suffering from stomach cancer in the evening is still vivid.
During ms. Xiao's hospitalization, she lost several pounds.
Three days later, the Department of Gastroenterology approached Ms. Xiao with the pathological results and said that the pathological return did not see cancer cells, just an ordinary stomach ulcer.
The gastroenterologist has a relaxed tone and a smile.
When Ms. Xiao listened, she at first thought she had heard it wrong, but then when she listened carefully, she was very happy and almost jumped up, and the tears of indisputable anger slid down her cheeks.
Crying.
These days, Ms. Xiao has indeed suffered a lot. Psychological discomfort is very uncomfortable, dreaming that they are stomach cancer. Now the doctor told himself that it was not stomach cancer, just stomach ulcer, the feeling of regaining a new life, ordinary people can not feel empathy.
But your stomach ulcer is not small, you have to treat it well, in case of a big bleeding, it will be troublesome, besides, about 1% of gastric ulcers will become cancerous, and it is necessary to treat it as soon as possible. The gastroenterologist's face became serious.
Even so, Ms. Xiao almost kowtowed in thanks.
Continue to use hemostatic drugs, drugs to suppress gastric acid secretion (gastric acid secretion is also more serious gastric ulcers), and also gave an infusion of one unit of red blood cell suspension.
Ms. Xiao did not have any anemia in the days after being hospitalized, and the hemoglobin in the re-examination rose to 92g/L.
Finally, the diagnosis was clarified, Ms. Xiao's dizziness was caused by anemia, and anemia was caused by bleeding from gastric ulcers, not a large amount of bleeding, but a long-term small amount of bleeding, and the long-term flow of fine water would also kill people.
After 2 months of treatment, the stomach ulcer improved significantly when the gastroscopy was reviewed.
Ms. Xiao's face also became better-looking, the blood color of her gums returned, and even her skin became less dry.
Doctors joke that the stomach finds lumps, sometimes it is really arranged by fate, some people are stomach cancer, but most people are stomach ulcers, but we can also change the lifestyle, reduce the occurrence of stomach cancer, such as do not smoke and drink, do not eat too much pickled food, early detection of stomach ulcers, early treatment, can also reduce the occurrence of stomach cancer.
In this way, Ms. Xiao is still lucky.
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