Which diseases are most common in emergency departments during the Spring Festival? These two are extremely dangerous!

Cholelithiasis and pancreatitis are both common and dangerous diseases during the Spring Festival, especially acute pancreatitis, which can be life-threatening in severe cases. The Spring Festival is a high-incidence period for pancreatitis, and the cause is still related to overeating and drinking a lot of alcohol.

Have a healthy Spring Festival:

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Written by Li Changqing (Doctor of Medicine, American-based gastroenterologist)

Generally speaking, doctors and patients don't want to stay in the hospital during the Chinese New Year, so before the Chinese New Year, most patients will be discharged as long as their condition allows. Some hospitals even close their outpatient clinics. But there is one place that will be very busy during the Chinese New Year, and that is the emergency department. Among this part of the increase in emergency patients, a considerable number are related to the diet during the Spring Festival. Some are because of eating wrong food, some are because of eating too much and too fast, and some are because of drinking. If you don't eat well or eat wrong, you may have to spend the Chinese New Year in the hospital, and it is not uncommon for your life to be endangered.

Since it is a disease related to diet, digestive diseases are naturally the first. The digestive system is divided into the digestive tract and digestive glands. The digestive tract is the tube from the mouth to the anus. The digestive glands include two large digestive glands and small digestive glands distributed in the mucosa of the digestive tract. The two large digestive glands are the pancreas and the liver. The pancreas and liver have their own set of duct systems, which intersect with the digestive tract through a nipple-like structure on the duodenum, called the duodenal papilla. This structure is very important and is the only intersection of the two large digestive glands and the digestive tract. The gallbladder is attached to the liver and does not have the function of a digestive gland. It is a special structure in the liver's duct system. Digestive diseases include digestive tract diseases and hepatobiliary and pancreatic diseases.

Problems related to the liver, gallbladder and pancreas mainly include two types of diseases, one is related to cholelithiasis, and the other is related to pancreatitis. Here we also need to understand the mechanism of visceral pain. There are generally two factors that cause visceral pain, one is stress and the other is chemical reactions. The symptoms related to cholelithiasis are mainly related to stress, and the symptoms related to pancreatitis are mainly related to chemical reactions.

Cholelithiasis includes gallbladder stones and bile duct stones, many of which have no symptoms. Those without symptoms do not need treatment, but once symptoms occur, treatment is required.

A common symptom of cholelithiasis related to diet during the Spring Festival is biliary colic. The main function of the gallbladder is to store bile. When eating, especially greasy food, it will stimulate the gallbladder to contract and discharge bile. Bile must first pass through the very thin cystic duct, enter the common bile duct, and then enter the small intestine through the duodenal papilla. Without bile, fat digestion is difficult. If there are stones in the gallbladder, the gallstones are easily blocked when passing through the cystic duct. Once blocked, the pressure in the gallbladder will increase, and the increased pressure will cause pain. Gallbladder contraction is intermittent, so the pain will come in waves until the stones are discharged, and the pain suddenly disappears. This is the mechanism of biliary colic.

If a relatively large stone blocks the common bile duct, the bile produced by the liver cannot be excreted, and the bilirubin will be passively absorbed into the blood, causing the skin to turn yellow. This is the origin of jaundice.

Whether it is the cystic duct or the common bile duct, if the blockage lasts too long, affecting the blood supply and breeding bacterial infection, cholecystitis or cholangitis will occur. In addition to pain, there will be symptoms such as fever and chills, and in severe cases, shock.

During the Spring Festival, eating a high-fat diet and drinking alcohol are both high-risk factors for cholelithiasis and can easily induce acute attacks. During every festival, there are a lot of patients with acute attacks of cholelithiasis. The root cause of cholelithiasis is bile duct obstruction. The primary goal of treatment is to relieve pressure and remove the stones that block the bile duct. In the past, when there was no endoscope, surgery was basically required. Now with duodenoscopes, endoscopists can relieve the obstruction of the common bile duct through the duodenal papilla and drag the stones into the intestines.

Of course, it is better not to happen. After all, you have to endure pain before the operation, and no doctor is willing to do complicated operations during the Spring Festival. Even if the doctor is willing to do it, the anesthesiologist and nurse must cooperate. Therefore, even if cholelithiasis will occur sooner or later, try to avoid it during the Spring Festival.

People at high risk of cholelithiasis include those with a history of cholelithiasis, obese people, and women taking birth control pills (the hormones used in birth control pills can increase cholesterol production and affect gallbladder motility).

In addition to biliary colic, cholecystitis and cholangitis, cholelithiasis can also easily cause pancreatitis. The duodenal papilla is not only the opening of the bile duct to the intestine, but also the opening of the pancreatic duct to the bile duct. The two ducts meet at the duodenal papilla. If there is inflammation in the bile duct, the pressure in the pancreatic duct will also increase.

The pancreas is the main digestive gland in the human body, which contains various enzymes for digesting food, including amylase, lipase and protease. The carbohydrates, fats and proteins we eat are large molecules like chains, which need these enzymes to cut into small molecules before they can be absorbed.

An obvious question is: the cells of the pancreas are also composed of proteins, so why doesn't the pancreas digest itself? This is because the enzymes inside the pancreas are inactive, called zymogens, and can only be activated in the intestines. If the pancreatic juice secreted by the pancreas cannot be discharged for a long time, the pancreatic enzymes will be activated on the spot. After activation, they will digest their own pancreatic tissues and produce an inflammatory response.

Pancreatitis is caused not only by cholelithiasis, but also by alcohol and high blood lipids, which are called alcoholic pancreatitis and hyperlipidemic pancreatitis respectively. The Spring Festival is a time when various types of pancreatitis are most common. The reason is self-evident, and it is related to overeating and drinking a lot.

Acute pancreatitis is divided into mild pancreatitis and severe pancreatitis according to the severity of the disease. Mild cases are easy to deal with, and can be cured with a little attention or even without treatment; but severe cases are very dangerous. Not only abdominal pain and bloating, but also fever, dyspnea, shock, intestinal paralysis, ascites, renal failure, mental disorders, etc., can be life-threatening. Many patients need to be admitted to the ICU for expensive and complicated treatment.

During the Spring Festival, many cases of severe pancreatitis suddenly appeared, which brought a serious problem: the intensive care unit was insufficient. The author had seen several patients with severe pancreatitis who died while waiting for a bed in the emergency room.

The most important measure to avoid gallstones and pancreatitis is to control your diet and not overeat. If you really can't resist delicious food, it is recommended to maintain a normal eating frequency and slow down your eating speed. Secondly, the diet should be as low in oil and sugar as possible, and high in vegetables and fruits. The third is to avoid drunkenness. The safe drinking speed is about equivalent to no more than one can of beer per hour.

Reference Links

[1] https://www.msdmanuals.cn/professional/SearchResults?

This article is supported by the Science Popularization China Starry Sky Project

Produced by: China Association for Science and Technology Department of Science Popularization

Producer: China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.

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