How to identify giant gastric mucosal hypertrophy?

  In general, anyone with gastric symptoms, swelling and hypoproteinemia should be alerted to the possibility of giant gastric mucosal hypertrophy. However, there are some patients who may be asymptomatic for a long time without hypoproteinemia. When this disease is suspected, further barium X-ray should be done to observe the presence of giant mucosal folds.  The normal gastric mucosa thickness is 0.7-0.8 mm, sometimes up to 1 mm. If the gastric mucosa is thicker than 1 mm, it is called hypertrophy or hyperplasia. In a gastrointestinal X-ray, if the width of the gastric mucosa is seen to be greater than 1 cm, it is often considered to be chronic hypertrophic gastritis. However, X-rays have their one-sided nature. Therefore, the most confirmatory value is under fiberoptic gastroscopy or surgical biopsy.  In laboratory tests, the amount of serum protein is reduced, usually below 60 g/L, with very low albumin and propaglobulin, which can often occur suddenly. If intravenous I marker albumin is administered, a significant loss from gastric juice and a significant increase in radioactivity in the feces is seen. Hemorrhagic anemia may occur in those with gastric bleeding. Gastric juice secretion function tests often show low gastric acid.  In the treatment of giant gastric mucosal hypertrophy, the main focus is on symptomatic treatment. In patients with hypoproteinemia, attention should be paid to eating high-protein foods, and severe cases should be supplemented with intravenous albumin, such as intravenous infusion of healthy human blood albumin 10 to 20 grams per week (in 1 to 2 doses). If there is also gastric erosion or ulcer, the treatment is the same as ulcer disease. If internal treatment is ineffective, total gastrectomy can be considered. It is believed that giant gastric mucosal hypertrophy is related to gastric cancer, and gastric cancer occurs in about 8% of patients with this disease, so patients who have been clearly diagnosed with giant gastric mucosal hypertrophy should be regularly followed up and examined.