Abdominal pain may be life-threatening

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Text: Li Ji

(Hong Kong News) There are 5 major reasons that can cause upper abdominal pain. Dr. Liang Jieren from the Emergency Department of the Sanatorium and Hospital pointed out that the most common cause of epigastric pain is caused by stomach diseases, especially in urban areas where work pressure is high, meals are irregular, eating too fast or excessively, and falling asleep shortly after dinner is easy. Acid reflux is caused, and patients experience symptoms such as “heartburn”, bloating and stomach pain.

Cause 1. Acid Reflux Causes Stomach Pain

If the patient persists in stomach pain, the doctor can use gastroscopy to check whether the stomach is inflamed, bleeding, or even has developed into a gastric ulcer. Once it is confirmed that the stomachache is caused by acid reflux and the symptoms are mild, after excluding cancer and other causes, the doctor will generally prescribe gastric acid neutralizers and gastric acid secretion inhibitors; if the patient has gastric ulcers, the doctor will prescribe “proton Pump Inhibitors” in the hope of suppressing stomach acid more effectively.

Reason 2. Gallstones or cholecystitis

The gallbladder is located below the liver. Its function is to store and secrete bile produced by the liver to help digest fat and alcohol.

He said that when you eat too much greasy food, cholesterol, fat, etc. may accumulate and form stones. The patient’s pain is usually located in the upper right abdomen, and most of them occur 2 to 3 hours after eating. Gallstones may block the bile ducts and cause inflammation, resulting in severe pain, fever, and symptoms of jaundice, such as yellowing of the whites of the eyes.

If cholecystitis is caused by blockage of the bile duct, it can grow two to three times its original size. At present, cholecystectomy is the most direct and effective treatment method. After the operation, the patient’s ability to digest fat will be weakened, so excessive eating of greasy food should be avoided.

Reason 3. Right upper quadrant pain due to hepatitis

He pointed out that about one-tenth of the population in Hong Kong are carriers of hepatitis B virus, and the route of transmission is mostly mother-to-child transmission.

“The hepatitis B virus can lie dormant in the body for many years,

There is no chance of onset until the age of 30 to 40.

When hepatitis occurs, the pain is usually in the upper right abdomen,

Since it is a chronic disease,

The degree of pain will be lower than that of gallstones or cholecystitis.

If the patient is diagnosed with hepatitis B or other hepatitis, the general doctor will prescribe antiviral drugs to suppress the onset of hepatitis. “

Reason 4. Heart disease Coronary heart attack

Since the heart and stomach are located close to each other, a heart attack or coronary heart disease attack may cause upper abdominal pain. The pain will be on the left side of the chest, and the patient will feel like being pressed by a heavy object. An electrocardiogram is required to confirm the pain Is it from heart disease.

He reminded that doing more exercise and eating a healthy diet can help reduce the risk of heart disease. If you feel heart discomfort, shortness of breath, or cold sweat after exercising, it is recommended to conduct a detailed examination to find out the cause.

Cause 5. Epigastric pain due to aortic tear

The large arteries extend from the heart to the chest cavity, upper abdomen, and lower abdomen, and are responsible for supplying blood to the whole body. When you are old and have high blood pressure for a long time, the arteries will degenerate and become swollen. When the blood vessels become too swollen to bear the pressure, they will tear and bleed continuously.

“A large artery tear can also cause upper abdominal pain. The golden treatment time is only 30 minutes to 3 hours. If proper treatment is not received, it may be fatal.”

Indistinct symptoms of gallstones can easily be mistaken for indigestion

Gallstones are stones formed in the gallbladder. The main cause is gallbladder dysfunction or poor eating habits, which make the substances in the bile accumulate and form stones.

Gallstones are generally divided into cholesterol stones, pigment stones and a mixture of the two. Women, people with diabetes, obesity, middle age, multiple births, family medical history, patients with liver disease, and people who are taking birth control pills are more likely to suffer from gallstones, so special attention should be paid.

Right upper quadrant discomfort after eating fatty food

Nearly 80% of gallstone patients have no obvious symptoms, and a small number of people experience discomfort in the upper right abdomen after eating fatty food, and the pain can be reflected to the back. Because the symptoms of gallstones are not obvious, they are often mistaken for indigestion and easily confused with gastritis and gastric ulcer. To know whether there are gallstones in the gallbladder, it is usually confirmed by ultrasound scan. After many patients are confirmed by examination, they will immediately ask the doctor: “How many stones are there in the gallbladder?”

In fact, ultrasound scan can only see the shadow of gallstones, but cannot know the exact number of gallstones. In addition, doctors usually recommend that patients undergo upper gastrointestinal endoscopy to rule out the possibility of other upper gastrointestinal diseases.

Gallstones cause symptoms requiring surgery

Usually the second question patients ask is treatment. If the gallstones do not cause any symptoms, the doctor usually recommends to monitor the condition first; if the gallstones have caused symptoms, or have had complications due to them, surgery is recommended as soon as possible.

When there are symptoms such as jaundice, fever or persistent pain, it may be a warning sign of inflammation or complications and requires immediate treatment. If the patient has porcelain gallbladder (porcelain gallbladder), diabetes, or has suffered from typhoid fever, although symptoms do not appear, it is also recommended to treat it as soon as possible.

The most effective treatment for gallstones is surgical removal of the gallbladder. At present, minimally invasive laparoscopy is generally used for cholecystectomy. The surgeon will make 3 or 4 incisions on the patient’s abdominal wall, allowing instruments to enter the abdominal cavity through the incisions to remove the gallbladder. The operation is usually completed in about 1 hour. If there are no complications, you can be discharged from the hospital the next day.

In the past, there was also the development of the “minimally invasive single-hole technique” for surgery. The process required a large incision at the navel of the patient, and then the lens and instruments were placed into the abdominal cavity.

Gallbladder removal does not affect bile secretion

The single-hole technique is suitable for cases without inflammation and requires special lenses and instruments. Although the single-hole technique can reduce the number of incisions, the incision is relatively large, and the postoperative pain is also more obvious. It should also be noted that if the gallbladder itself is thin (commonly known as “big gall”) and the gallbladder wall is severely adhered, traditional open surgery may be required.

Many patients are concerned that they will not be able to eat greasy food due to lack of bile after gallbladder removal. In fact, bile is not secreted by the gallbladder, but by liver cells; the gallbladder is mainly used to store and concentrate bile, so that it can be released from the intestinal tract to digest fat when eating. Even if the gallbladder is removed, bile secretion will not be affected, but diarrhea may be caused by changes in the absorption of bile salts in the initial stage.

Some patients after surgery may have post-cholecystectomy syndrome, diarrhea after eating fatty food. The frequency of diarrhea varies from person to person, ranging from one or two times to five or six times. Some patients who suffer from diarrhea can use drugs to promote fat absorption. When the body gets used to it, these symptoms usually disappear gradually.

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