Since gastroscopy, barium X-ray capsule endoscopy and other advanced detection means used in clinical, gastric sinusitis patients seem to be more and more, because a significant part of society believes that gastric sinusitis will become cancer, so patients are very afraid of “gastric sinusitis” and fear.
A. Types of sinusitis
Gastric sinusitis is a common disease, especially in China. The stomach is anatomically divided into three parts: the upper part is called the fundus, the middle part is called the body, and the lower part is called the sinus. If the sinus portion of the stomach becomes inflamed, it is known as sinusitis.
According to the pathological changes, gastric sinusitis can be further divided into two categories.
① lesions involving only the superficial layer of the gastric mucosa, called chronic superficial gastritis.
② lesions involving the glands of the stomach, resulting in glandular atrophy, is called chronic atrophic gastritis.
Atrophic gastritis is not rare, accounting for about 5% to 10% of chronic gastritis, and its cancer rate is 2,55%, that is, for every 100 patients with atrophic gastric sinusitis, about 2,55 people may become gastric cancer after 10 years. This shows that not all sinusitis will become cancerous, but only atrophic sinusitis has the possibility of becoming cancerous. The most reliable way to distinguish whether sinusitis is superficial or atrophic is endoscopy. The mucosa of the gastric sinus is biopsied by endoscopy and then made into a pathological section to be observed under a microscope. In atrophic gastritis, a decrease in gastric mucosal glands is seen, and there may be intestinal glandular metaplasia or atypical hyperplasia.
Second, gastric sinusitis and intestinal glandular hyperplasia
After atrophy of gastric mucosal glands in gastric sinusitis, the morphology of regenerated cells is the same as that of intestinal mucosal cells, which is called intestinal glandular hyperplasia (referred to as intestinalization). If the morphology is the same as that of large intestine gland, it is called large intestine glandular metaplasia; if the morphology is the same as that of small intestine gland, it is called small intestine glandular metaplasia; small intestine glandular metaplasia will not turn into cancer, and not all large intestine glandular metaplasia will turn into cancer, among which incomplete large intestine metaplasia is more likely to turn into cancer, which is called “precancerous lesion” of gastric cancer, and patients should be followed up regularly. Generally, endoscopy should be done once every six months to one year for early detection of cancer and early treatment.
The etiology of gastric sinusitis
(a) Acute gastritis is prolonged.
(b) Bile reflux into the stomach, long-term stimulation of the gastric mucosa.
(iii) Hp infection, which grows beneath the gastric mucus, on the surface of the gastric mucosa, and leads to inflammation or glandular atrophy through the gradual destruction of the mucosa.
(iv) Autoimmune reaction, i.e. the patient produces multiple antibodies of his own that destroy the gastric mucosal cells and glands.
(v) Long-term use of non-steroidal anti-inflammatory drugs, such as aspirin, indomethacin, etc.
IV. Treatment of gastric sinusitis
(i) Diet regulation
Eat less sweet food, drink less strong tea, coffee, quit smoking and alcohol. Because, too sweet food and strong tea, coffee will increase the secretion of gastric acid, destroy the protective function of the gastric mucosa; smoking can cause bile reflux, and affect the blood circulation of the gastric mucosa; drinking alcohol can weaken the resistance of the gastric mucosa. The second is to eat quantitatively and regularly, chew and swallow slowly. It is not necessary to eat fine and soft food for years.
(ii) Drug treatment
The main drug is the drug to protect the gastric mucosa or kill Hp; followed by symptomatic treatment drugs. So far there is not a special drug can cure gastric sinusitis. Gastric mucous membrane protective agent can be chosen from aluminum thioglycollate 1g tid, bismuth potassium citrate (bismuth gum, Denox) 2 tablets bid or teprenone 50mg tid taken orally. The general course of treatment is 1 to 3 months, it is not necessary to take medication for a long time, and it is unnecessary for someone to take medication continuously for 1 to 2 years. Symptomatic treatment is also important. Domperidone 10mg tid, metoclopramide 10mg tid or mosapride 5mg tid can be used for those with abdominal distension and bile reflux. 150mg bid of ranitidine can be used for those with acid reflux. folic acid (FA) is effective against intestinal glandular hyperplasia. some patients with chronic atrophic gastritis with intestinal glandular hyperplasia or heterogeneous hyperplasia were selected by the Shanghai Clinical Research Institute of Digestive Diseases. Some patients with chronic atrophic gastritis with intestinal glandular hyperplasia or heterogeneous hyperplasia were given FA orally, and the glandular atrophy and intestinal hyperplasia improved significantly after six months.
(C) the stomach has nine fears, medication carefully
1, a fear of mental stress: after prolonged depression, melancholy or trauma, prone to gastroesophageal reflux ulcer disease.
2, two fear of overwork: whether physical or mental labor, overwork will cause insufficient blood supply to the stomach and intestines, too much gastric acid and reduced mucus, gastric mucosa damage.
3, three afraid of excessive alcohol: alcohol itself can directly affect the gastric mucosa, but also can cause fatty liver, cirrhosis and acute and chronic pancreatitis, aggravating gastric injury.
4, four fear of addiction to smoking: smoking will stimulate the secretion of gastric acid and pepsin, increasing the damage to the gastric mucosa.
5, five fear of hunger and satiety: hunger, gastric acid, pepsin relative secretion, if overeating and overexpansion of the stomach, the food stays for a long time and other causes of gastric injury.
6, six fear of bacterial infection: it has been identified that Helicobacter pylori is one of the important causes of gastric ulcer and duodenal ulcer patients, Helicobacter pylori can be transmitted to others through tableware, dental appliances and close contact.
7, seven fear of night eating: night before bedtime eating is the worst habit, especially after autumn, night long easy night eating, not only cause sleep deprivation, resulting in obesity “autumn fat”, but also due to night eating stimulate excessive secretion of gastric acid and induce ulcers.
8, eight afraid of nitrite: it is known that nitrite is the culprit of cancer, and smelly fish and shrimp, rotten vegetables, fire nitrate cooking “red meat” moldy food in the nitrite content is very high, long-term consumption will make the risk of stomach cancer rate greatly increased.
9. Nine fears of indiscriminate use of drugs: drugs have therapeutic effects, but there are also unfavorable side effects to the body, drugs that can cause gastric damage include: aspirin, pau d’arco, anti-inflammatory pain, prednisone and many antibacterial agents, as well as digitalis, reserpine and many kinds of anti-tumor drugs and antihistamines.
In short, eliminate the causative factors, adjust the psychological factors, avoid stimulating factors and human factors conducive to the recovery of gastric sinusitis.
V. Other treatments for gastric sinusitis
Some people believe that the patient with gastric sinusitis can prevent gastric cancer by surgery, which is wrong. On the one hand, not all sinusitis will definitely become cancerous, on the other hand, not only can surgery prevent gastric cancer, but the incidence of gastric cancer after surgery is 6% higher than that of those who do not have surgery. Only when a patient has severe intestinal adenosis or severe atypical hyperplasia, surgery is needed. Because the possibility of becoming cancerous is already extremely high at that time.