Script - Stomachache
P:Good afternoon Doctor.
D:Good afternoon. What is your problem?
P:I have a stomachache.
D:What do you feel?
P:I have a strong pain and heartburn.
D:How long have you had this pain and
acidity?
P:For 2 months now. It does not go way! My stomach hurts after every meal.. Even at night the pain persists.
D:Tell me, in the last 2 months, have you eaten any
kind of heavy foods, or something different?
P:No.
D:How strong is the pain from a scale of 1 to 10. How would you describe the intensity of the pain?
P:Between 4-5
D:Is the pain continuous or does it come and
go?
P:It come and goes.
D:Does the pain come after meals?
P:That's possible because it hurts every time after
eating.
D:Is there a kind of food that affects you
more?
P:Greasy food.
D:Greasy food affects you?
P:Yes. At home we eat a lot of greasy food.
D:Where in the abdomen does it hurt? Point please!
Does the pain travel to your chest, shoulder, back or across your abdomen?
P:It hurts in the middle. Sometimes, the pain
travels across my abdomen.
D:Besides the pain, you said you have
heartburn?
P:Yes, after a burp, I feel a kind of sour
taste.
D:Do you feel like this more during the day or in
the evenings?
P:Both. I feel the acidity during the day and at
night.
D:Is it worse when lying down?
P:Yes, I taste the acid in my mouth?
D:Besides greasy food, is there any other kind of
food that irritates your stomach? Like spicy foods?
P:No, at home we don't eat spicy food.
D:And tell me, how often do you regularly have a
bowel movement? Has that changed since you have been having these
problems?
P:It is regular. It hasn't changed since the
problem.
D:Have you noticed any change in the consistency of
the bowel movement?
P:Yes. It is a bit softer.
D:Have you noticed any change in color?
P:Yes, it is greener.
D:Greener, not darker? Any blood in your bowel
movement or black coloring of bowel movement?
P:No, not darker. I do not see any blood in my bowel
movement, either.
(Begin examination of the patient)
D:Okay. What we can do first is check your abdomen to
see where the pain comes from. You said the pain comes from the middle-part of
your abdomen?
P:Correct.
D:And does the pain move somewhere else, or does it
stay there?
P:It usually stays there.
D:But with the pain, do you always feel
acidity?
P:Correct.
D:Do you have nausea or vomiting?
P:No, not at the moment.
D:Tell me, what did you eat today?
P:I ate meat with tomato sauce.
D:Do tomatoes give you any trouble?
P:No, I have always eaten tomato sauce.
D:What about orange juice, does it affect your
stomach?
P:Sometimes.
D:What do you feel?
P:It gives me a strange metallic taste.
D:But it does not give you any acidity?
P:No, it doesn't.
D:And what do you do when you have
stomachaches?
P:Sometimes I take Alkaseltzer. It helps a
bit.
D:Yes, it helps. Do you take any Tums, Mylanta or
Maalox?
P:No.
D:Are you taking or have you been taking now or
before this problem any medication on a consistent basis, like Aspirin, Advil,
Motrin, etc.
P:No, usually Tylenol.
D:And if you take Aspirin, or any other kind of
anti-inflammatory medicine, do you think it could affect your stomach?
P:No, I can't really tell you.
D:Okay. As I was telling you before, I am going to
examine you. I want to examine your feces to check if you have any kind of
parasite. Do you come from the tropics, or have you traveled anywhere recently
such as the tropics, or overseas?
P:Yes.
D:Here in the United States, as well as in any other
part of the world, one can find parasites. These can affect your
stomach. Besides this, I want to look for any blood in your feces. You
said
you have not really seen any changes in your feces. It is only greener,
but not
darker. The digested blood, in case you have
something in your stomach and you could have a hemorrhage, could produce
a
chemical reaction so that you can have occult blood in your feces. Many
times we don't see the red color of blood or the black
color of the digested blood; therefore an examination is necessary. I
would also like to examine your upper gastrointestinal
system through X-rays and contrast. It is a very simple thing and it
does not
hurt. You will drink a thick substance. The
radiologist will see how you digest the substance and will see the
movements of
your stomach. We will have this type of examination
because your pain could not come from the stomach but from the
gall-bladder.
After the examination, we will decide what to do first,
the X-rays of an ultrasonic study of the gall-bladder. For now, do not
eat greasy food. Do not eat close to your
sleep time because it could cause you more acidity. Eat plain food,
nothing
spicy. As soon as I get the results from the medical
test, I will talk to you. Do you have any questions?
P:With so many medical tests, I was wondering if I
have an ulcer.
D:We need to think of that too. That is why I want
that test. I need to explain to you that an X-ray of
the upper intestine sometimes cannot detect an ulcer or other irritations.
If the pain persists after some antibiotics you will
need an endoscopy. An endoscopy is a medical
examination in which the doctor inserts a tube through your mouth or nose.Then,
the specialist will observe your stomach, from the small intestine to the large
one, and your gullet. Any other question?
P:No doctor, thank you.
D:Good. We will see each other next week. Good bye.
Doctor : Hello! What can I do for you?
Patient : Good Morning Doctor. I am not well.
Doctor : Please have a seat.
Doctor : Open your mouth. Doctor : How long have you not been feeling well?
Patient : Since yesterday. Doctor : No problem. Did you have a bowel movement
yesterday? Patient : No Doctor.Patient : Doctor, I feel dizzy.
Patient : I don’t feel like eating at all.
Doctor : Do you have any other problems?Patient : I feel like vomiting.
Doctor : Do you drink a lot of water?
Patient : No Doctor, I don't drink too much.
Doctor : Did you take any medication?
Patient : Yes Doctor, I took Anacin.
No comments:
Post a Comment