A small drink is good for the soul, a big drink is bad for the body! The reasoning is understood, how can we do? Xiao Wang is 28 years old, the Spring Festival home and good buddies get together, said “deep feelings, a bite; shallow feelings, lick a lick”, during the meeting Xiao Wang high emotions, happy to drink, half a kilogram of white wine down, and a few glasses of red wine. After returning home, he began to feel sick, vomiting a lot of food, wine, but also with a little blood. At first, he did not care, did not expect, a few hours later vomited again, actually vomited a lot of blood, and dizziness, nausea, cold sweat, general weakness, family members rushed him to the hospital. The doctor initially considered that the upper gastrointestinal bleeding, symptomatic treatment and emergency arrangements for gastroscopy. As a result, the gastroscopy revealed a mucosal laceration injury at his gastric cardia, which was bleeding continuously. He was immediately transferred to the operating room for a partial gastrectomy to stop the bleeding. Tao Shuangyou, Department of Splenic and Gastrointestinal Diseases, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine At a young age, drinking until the stomach is cut, many people look at it as a rare thing, a sigh of relief, but in the eyes of our gastroenterologists, this is not uncommon. Especially since China’s wine culture has been around for a long time, almost “no wine is a banquet”, and wine is an indispensable cheering element for festivals, weddings and birthdays, family and friends gatherings, business negotiations, etc. Drinking to the esophageal cardia mucosa tear, resulting in life-threatening hemorrhage of tragic cases, every time we are distressed. The culprit: drinking alcohol to raise the pressure in the stomach The cardia is the part of the esophagus that connects to the stomach and is the entrance to the upper end of the stomach. The lower esophageal sphincter here serves to tighten the upper gastric opening, preventing the stomach contents from flowing back into the esophagus during gastric peristalsis, thereby preventing acid burns to the esophageal lining (the stomach lining itself is acid-resistant). However, under certain abnormal conditions, such as a sudden and dramatic increase in intra-abdominal or intragastric pressure, due to the relative weakness and poor elasticity of the mucosa in the lower esophagus and cardia area, and the lack of support from surrounding tissues, the cardia mucosa will be forcibly pressed into the lumen of the esophagus where the pressure is low, and under the impact of high pressure, the lower esophagus and cardia mucosa will be forcibly expanded and torn, and bleeding will occur when the small veins in the mucosa are torn, and once the small arteries are torn and bleeding Once the small artery is torn and bleeding is serious and difficult to stop by itself, the damage will be unpredictable. Therefore, bleeding from mucosal tears of the esophageal cardia is quite dangerous. Drinking a lot of alcohol may cause this abnormal situation: when a full meal, the stomach full of food or liquid generally can no longer tolerate the rise in pressure, vomiting or dry vomiting after drinking alcohol, or picking the throat to force vomiting, may cause a sudden increase in pressure in the stomach, resulting in mucosal tearing. The reflux of stomach acid and pepsin, as well as the direct corrosive effect of alcohol, are “accomplices” in bleeding. Mucosal tears are more likely to occur if there is a chronic inflammation, ulcer, or hiatal hernia in the area. In addition to alcohol consumption, any condition that causes increased intra-abdominal and intragastric pressure, such as straining during constipation, violent coughing, sneezing, childbirth, vomiting after a full meal, food poisoning, chest massage, lifting heavy objects, abdominal trauma, severe wheezing, seizures, and rough gastroscopy, can cause mucosal tears in the esophageal cardia. A typical mucosal tear of the esophageal cardia presents with nausea, dry heaving or vomiting followed by vomiting of blood. The length of time between vomiting and vomiting blood varies, with some vomiting followed by vomiting blood, while others vomit blood or black stool for several days after severe vomiting. A few are accompanied by severe pain in the upper abdomen. If a large amount of blood is vomited, it can lead to hemorrhagic shock and even life-threatening. The key to preventing mucosal tears in the esophageal cardia is not to drink alcohol. However, in China, where “no alcohol is good for a banquet”, it may be difficult to drink even a little bit less, not to mention not drinking at all. What to do? In addition to appealing to the wind to turn, for individuals, try to do “as little as possible, as little as possible” it. As mentioned above, any situation that causes an increase in intra-abdominal and intragastric pressure may also cause a tear in the esophageal cardia. Therefore, in case of severe vomiting, anti-emetic drugs such as morpholine, promethazine, gastroflucan, or pressure on the feet should be given as soon as possible. It is important to actively treat reflux esophagitis, esophageal hiatal hernia, habitual constipation, asthma and severe coughing to prevent them from occurring in the first place.