Medical English 專欄(一)

THE DIGESTIVE SYSTEM

(I)               Case

Juan, a 58-year-old recent immigrant from Latin America, developed severe severe upper abdominal pain the day before coming to the emergency room. X-rays showed air in his abdomen, and in the operating room he was found to have a hole in his duodenum, the first part of the small intestine, just past his stomach outlet, caused by a perforated peptic ulcer. The hole was surgically closed and he recovered well. He afterward carefully followed the postoperative recommendation to avoid the danger of a recurrent ulcer.

(II)           Q & A

Q: You look very pale. Do you have any trouble?

A: 1. My stomach hurts.

   2. I have frequent heart burn.

   3. I have no appetite and difficulty swallowing.

   4. My stomach aches when I drink coffee or alcohol.

   5. My stool has turned black.

   6. My stool is stained with blood.

   7. I am nauseous and vomiting. I burp too much.

Q: Do you have an appointment?

A: 1. No. But I would like to see the doctor right away.

   2. It is urgent. I feel weak and very uncomfortable.

   3. No. But I feel severe pain in my abdomen. It worries me.

   4. No. But I think it is urgent. Please do help.

(III)        What did she say?

Helen’s ulcers today are nothing but a memory – an awful memory. “I’d be hungry, but I couldn’t eat. I’d have these bad pains in my stomach, stinging kinds of pains that would last sometimes for about an hour. And I’d wake up during the night with the pain – just about every night.”

“The doctors at first gave me the drug Tagamet, which I’d take for about three to four months. The ulcers would go away, but then within a month they would usually come back.”

“I used to get upset a lot at my husband when he was drinking. When I’d get upset, that’s when the pain would start”.

(IV)        Stomach Pain & Peptic Ulcer

Stomach pain can take many forms, varying from a vague feeling of indigestion or discomfort to a distinct burning, wave- like pain in the central part of your upper abdomen that may move through to your back. Discomfort can be worse between meals and at night, and may be relieved by eating or by antacids, which temporarily buffer the acid.

Belching, vomiting, hiccups, and stomach distension may be signs of underlying stomach disease, affecting the stomach’s motility and outflow. Loss of appetite, weight loss, or anemia may be your first sign. Bleeding from the stomach may produce a tar-hued stool, or vomiting of bright red blood or “coffee grounds” – colored material.

Bleeding is the most common ulcer complication requiring surgery, and the leading cause of death in ulcer patients. If your ulcer eats into your intestinal wall’s tiny blood vessels, a slow ooze of blood, evidenced by black, tar-like stools, can develop. If one of your larger arteries is penetrated, bleeding can be massive, making your stools maroon or red, and causing you to vomit bright red blood.

          

(V)           Habits that head off ulcers

(A)  Discard your cigarette

You have three reasons to quit smoking.

1.      People who smoke get more ulcers.

2.      People who smoke have ulcers that heal more slowly.

3.      people who smoke get their ulcers back more quickly.

(B)   Check your medicines

Do not take aspirin, ibuprofen, or naproxen. Try acetaminophen instead.

(C)   Think about what you put in your mouth.

1.      Try eating smaller, more frequent meals.

2.      Avoid coffee, tea, cola, and other products that contain caffeine.

3.      Avoid spicy or greasy foods, that seem to bring on symptoms.

4.      Limit your alcohol intake.

(D)  Keep calm

Learn to relax and manage stress.

(VI)        Vocabularies

                    Peptic ulcer

                         Gastritis

                         Appendicitis

                         Enterocolitis

                         Hemorrhoid

                         Heart burn

                         Diarrhea

                         Constipation

                         Hepatitis

                         Cirrhosis

                         Gallstone

                         Pancteatitis

                         Tarry stool

(VII) Dialogues

P: What seem to be my friend’s trouble, Doctor?

D: It’s duodenal ulcer, caused by hyperacidity.

P: How about her liver and gallbladder? She had acute hepatitis several years ago. Besides, part of her bile duct was removed last year.

D: The laboratory report shows nothing wrong with her gallbladder. Her liver, however, doesn’t function normally.

P: What is the cause of that?

D: I don’t really know. We can only say that malnutrition is the most common cause. Alcoholism, drug addiction, toxic and infectious agents can also produce liver disease. She doesn’t drink wine, does she?

P: No. What should she do now for fast recovery?

D: There is no royal way to fast recovery. She’ll recover only in a slow manner. I’ll give her tablets. She has to take them regularly.

P: Does he have a fatty liver?

N: Yes. It has been demonstrated that alcoholic beverages may produce a fatty liver. However, decreased removal of fat related to deficiency of protein appears to be the most critical factor.

P: What should he do?

N: It’s nothing serious. An appropriate diet and proper exercise are helpful.