▎ WuXi AppTec content team editor
Some fans quickly guessed the answer - it is indeed cholelithiasis.
What the hell is going on? Let's see the truth.
The last issue of the truth review
In yesterday's mystery case, we mentioned that every time Kang Xiaomei ate a big meal, her stomach would swell and hurt.
For this symptom, many people at the beginning think that the stomach is not good, digestive problems, such as Kang Xiaomei herself thought it was just acute gastroenteritis, from our fan messages can also be seen.
However, it should be noted that acute gastroenteritis is characterized by diarrhea and vomiting, but she does not. And gastroenteritis is generally intermittent stomach pain, but her pain lasts a long time.
And this time her symptoms were different from before - not only did she have pain in her upper abdomen, but also a high fever, and there was pain radiating to her right shoulder and back.
This situation requires vigilance, it may be that there is a problem with the internal organs on the right side of our body , the liver and gallbladder. Because in the right scapula area, there is a region of nerve reflexes of the liver and gallbladder.
▲The location of the liver, gallbladder, and bile ducts. Image credit: 123RF
When hepatobiliary disease attacks, in addition to the typical right upper quadrant pain, it is also possible to undergo nerve reflexes that radiate to the right shoulder blade and right upper back causing pain.
Unfortunately, many people think that when this symptom occurs, they think that it is muscle soreness, neck and shoulder back strain, dragging it and not taking it seriously, or going to some "health care treatment" to try to alleviate it, but the effect is not good. Finally, after going around, it was found that the root of the disease was in the liver or gallbladder.
Sure enough, the doctor asked Kang Xiaomei to do CT examination and found that her gallbladder and intrahepatic and internal bile ducts had grown a lot of stones, resulting in biliary obstruction and bile duct dilation.
Finally, the doctor surgically removed the gallbladder for Kang Xiaomei and removed the stones with techniques such as stone removal and gravel removal.
Popular science time
The disease of gallstones (also known as cholelithiasis), everyone is familiar with it, and I have always heard that one or two relatives and friends have had gallbladder removal, and they have "no guts".
But exactly how it happens, what symptoms there are, many people do not have a concept in their minds.
The gallbladder grows under our liver like a "small gourd" and is specifically designed to hold the bile produced by the liver. When we eat, bile flows from the bile ducts into the intestines and is used to digest the fat in the food.
However, due to a variety of reasons to destroy the function of the gallbladder, bile composition and physicochemical properties change, the cholesterol, bilirubin, calcium salts and other supersaturation in it, will begin to precipitate and precipitate, into hard gallstones.
These small stones not only stop in the gallbladder, but also flow out with the bile.
▲ Common bile duct stones and gallbladder stones. (Translation in the lower left corner: "Common bile duct stones can block the flow of bile, triggering inflammation, infection, and jaundice.") The flow direction of the right figure is: gallbladder - cholescular duct - common hepatic duct - common bile duct - pancreatic bile duct - duodenum. Image source: 123RF
Most people have small stones, no obstruction or incarceration, no symptoms, just found on examination, this condition generally does not need treatment, but must be regularly reviewed.
Others may have mild symptoms, such as (right) vague pain in the upper quadrant, full burps, bloated stomach, constipation or diarrhea.
More and more stones are getting bigger and bigger, "stuck on the road", especially after drinking alcohol, eating a big meal or greasy food, and exertion, it may cause biliary obstruction, inducing biliary tract infection, acute cholecystitis, biliary pancreatitis, acute purulent cholangitis and so on.
At this time, the more typical symptoms are sudden and persistent pain in the upper abdomen (right), shoulder and back pain, nausea and vomiting, lack of appetite, jaundice (skin and whites of the eyes are obviously yellow), fever, chills, and severe shock.
Image credit: 123RF
The disease is more common in women than men, especially in women over the age of 40, because high levels of estrogen may affect the production of intrahepatic bilirubin and gallbladder emptying. In addition, obesity (high-cholesterol meats and high-fat greasy foods), elderly people, and people with family history are also high-incidence groups.
In recent years, with the improvement of living standards and more and more people with high-fat diets, cholelithiasis has also tended to be younger.
For example, Kang Xiaomei, who is not yet 30 years old, has grown so many stones, and the doctor said that this is inseparable from her usual bad eating habits.
In order to prevent gallstones, there are some instructions for everyone:
Eat regularly (especially for breakfast) so that the bile is drained regularly.
Instead of "abstaining from greasiness" completely, some healthy oils (such as olive oil with unsaturated fatty acids, fatty fish, nuts, etc.) can be eaten, which can promote gallbladder emptying. However, it is necessary to eat less fried foods, animal offal and other foods with saturated fatty acids and high cholesterol, and avoid overeating.
Control weight, eat more vegetable coarse grains, exercise regularly, but do not use extreme dieting or even fasting to lose weight.