Clinics, hospitals, and pharmacies are all relatively special business places. Nothing happens and few people go in and hang out.

Unlike supermarkets and clothing stores, which are packed with customers all day long.

"It turns out that you are an acquaintance of Sister Ou. Sister Ou is a regular customer of our clinic. She is very enthusiastic and often helps promote our small clinic for free."

Li Jingsheng stood up and poured the man a glass of water.

Then he poured three glasses of water for the family of three who were buying health medicines. The little boy wanted to drink, but his mother wouldn't let him.

I guess they are worried that there are many patients in the clinic and they are easily infected with viruses and bacteria.

It was one thing for people not to drink, but Li Jingsheng had to pour water for them.

Otherwise, customers will have a psychological gap and feel like they are being treated differently.

I might not come next time.

"Dr. Li, you said that my stomach has been bloated recently and I feel a little weak. Do I need to take some digestion tablets or something?" The man took two sips of water and finally revealed his purpose.

"How long has this been going on?"

Li Jingsheng’s current gastroenterology diagnosis is at the proficiency level, which is equivalent to the level of a senior resident physician.

It is basically sufficient for diagnosing general digestive tract diseases.

Currently, his health points have accumulated to 227 points from 204 yesterday.

When treating an ordinary patient, his health will increase relatively slowly.

With so much 'surplus food' at home, he didn't panic at all.

At worst, it will cost dozens of health points to upgrade the diagnosis of gastroenterology to another level.

He also discovered a very interesting phenomenon.

For example, if you prescribe medicine to a cold patient, you will only gain 1 health point on the spot. Then, after the patient recovers, you will still gain at least 1 health point.

If you can get a good review, it will be even better, and you will directly get an extra 10 points of health reward.

The most enjoyable part is when the patient gives him a pennant. Each pennant is a reward of 100 health points.

It's just that this kind of thing is rare.

"I can't remember exactly when it started. I guess it happened in the first half of the year. At the beginning, after eating for a long time, I would occasionally feel a little bloated in my stomach. Recently, this phenomenon seems to be getting worse.

It’s getting worse. I don’t know if it’s caused by gaining weight, so I came here to ask you for advice.”

As the man spoke, he took out a pack of blue Furong King cigarettes, pulled out one and handed it to Li Jingsheng.

"Thank you, I don't smoke. Smoking is not allowed in the clinic, please be patient."

Li Jingsheng waved his hand and declined.

We also advise men not to smoke in the clinic.

The watch on the man's hand is actually a Rolex, and the cigarettes he smokes are also of a certain quality, indicating that his family must be well-off.

"Is it after eating every time I feel bloated? Or is there no pattern?"

Watching the man put the cigarette back, Li Jingsheng continued his consultation.

"Well... sometimes it happens after a meal, and sometimes it seems to appear three or four hours after a meal. There is no pattern. Recently, whenever I sit down, I feel a little uncomfortable here."

The man pointed to his stomach.

Closer to the upper abdomen.

Li Jingsheng had already begun to secretly observe this man. His face was a little yellowish, closer to waxy yellow. The sclera also had a yellowish tinge.

In Li Jingsheng's opinion, this is somewhat abnormal.

My figure does look a bit fat. I visually estimate that I am about 1.7 meters tall and my weight may be over 70 kilograms.

"Have you measured your weight last year?"

There was no scale in Li Jingsheng's clinic. Later, he wanted to buy one after it opened, but he was short of money and it was not a necessity, so he never bought one.

Mr. Qiu from Modu Youyao said that he would give him a scale as a gift next time he gets the goods.

Then I won’t buy it even more.

Who doesn’t love free stuff?

"Last year, my weight was 67 kilograms. This year, I weighed 71 kilograms. I have gained a lot of weight."

The man answered directly.

"This way, you lie down on the bed inside and I'll touch your abdomen."

"Okay! Please take your time."

The man went to lie down on the bed in the infusion room. Li Jingsheng asked him to unzip his jacket, then lift up his shirt to expose his entire abdomen.

Slightly bulging, not particularly fat.

He felt around and found no tenderness or masses, basically ruling out the possibility of a larger tumor.

"How was it?"

"If you don't feel any lumps, it means there are no tumors growing in your stomach. This is a good thing. If you have abdominal distension that lasts for less than half a year, and the time is irregular, you are most afraid of tumors."

Li Jingsheng signaled the man to get up.

The two returned to the consultation table, and Li Jingsheng helped the man measure his blood pressure, heart rate and other basic physical signs.

The body temperature is 36.7 degrees, a perfectly normal body temperature.

The heart rate is 79 beats/min, and the heart sounds are also very normal.

Respirations are 18 times/min, and lung sounds are also normal.

The blood pressure is not high either, with systolic blood pressure of 130 and diastolic blood pressure of 80mmhg.

After checking here, this person is normal except for his complexion and slightly yellow sclera.

"Come, let me see your palms!"

According to internal medicine diagnosis experience, skin color and scleral jaundice will inevitably make people first suspect that there is a problem with the liver.

There were no obvious spider nevi or subcutaneous bleeding spots on the patient's body.

If the liver disease is severe, some patients will develop liver palms.

If the skin color, scleral jaundice, and liver palms are present, it can basically be concluded that it is liver disease.

However, after examining this man's hands, there was no sign of liver palms.

Li Jingsheng's diagnosis was in trouble at this time.

Small clinics have limited conditions and lack necessary laboratory test data and imaging examination data, making diagnosis difficult.

If you can check the transaminases in liver function and do a liver color ultrasound, it will be easier to diagnose.

"The physical weakness should last for more than half a year, right?"

Li Jingsheng asked.

"Awesome!" The man gave him a thumbs up. "I felt a little weak about a year ago, but it has become much worse recently."

"What about the food intake? Has it also decreased?"

Li Jingsheng asked again.

"How come you know everything? No wonder Sister Ou praises your superb medical skills. Over the past year, I have felt no appetite every time I sit at the dinner table. Recently, nothing I eat tastes good. My wife doesn't understand and says

I'm deliberately making excuses, I'm afraid I'm looking for wild foxes outside. I have no conscience, I'm this old and have a formal job, how is this possible!"

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The man complained quite aggrievedly.

As expected, this person works in a state-owned enterprise or public institution, and only in these units can he be considered to have a formal job.

Especially people over forty years old basically have this consensus.

Only an iron rice bowl can be called a formal job in their eyes.

"Haha, my eldest brother doesn't look like the kind of man who abandons his wife and children and only cares about romance and happiness."

Li Jingsheng smiled and praised the man.

"Do you usually have symptoms such as stomach pain, nausea, vomiting, and acid reflux?"

"No, if I had these problems, I would have gone to the hospital long ago. I just feel that my stomach is a little bloated, I have no strength, and there is no pain anywhere. I thought, it's just that the living conditions are too good, and I can't digest after eating too much."

The man said.

"With all due respect, your feeling does not sound like indigestion. It is probably a problem with the liver. The liver is different from other organs. It is called the most silent organ in the body. It has some early lesions and we don’t feel it at all.

There is no pain. I suggest you take time to go to the hospital tomorrow to check your liver function. If there is no problem, I have a lot of digestion tablets and stomach medicines for you to choose from. If there is any problem, it will not delay the condition.

."

Li Jingsheng gave very sincere suggestions out of responsibility for the patient.
To be continued...