What to do for chronic non-atrophic gastritis with bile reflux

  Chronic non-atrophic gastritis, also known as superficial gastritis, is a type of chronic gastritis, a chronic inflammation of the gastric mucosa caused by a variety of etiologies.  Chronic non-atrophic gastritis with bile reflux is a chronic lesion of the gastric mucosa due to dysfunction of the pyloric sphincter and other causes of the flow of bile-containing duodenal contents into the stomach, causing inflammation, erosion and bleeding of the gastric mucosa, weakening the barrier function of the gastric mucosa and causing increased H+ diffusion. Reflux manifestations can be observed endoscopically: i.e., a large amount of light yellow to yellow-green retained fluid in the gastric lumen, or more bile-containing mucus attached to the gastric wall, or duodenal fluid containing bile in the form of yellow foam or water flow is seen to flow back into the stomach from the pyloric orifice, and the pyloric orifice is relaxed or in an open fixed state; gastritis manifestations: diffuse red changes in the gastric mucosa, edema of the mucosal folds, or accompanied by erosion and ulceration.  1, patient education: food should be diversified, avoid partial diet, pay attention to supplement a variety of nutrients, do not eat moldy food; eat less smoked, pickled, rich in nitrate and nitrite food, eat more fresh food; avoid too rough, strong, spicy food and a lot of long-term alcohol consumption, quit smoking; maintain a good state of mind and adequate sleep.  2, drug treatment: (1) gastric power drugs: can increase the peristalsis of the gastrointestinal tract, inhibit the reflux of bile into the stomach, and promote the emptying of reflux. Commonly used are: domperidone, mosapride, etc.  (2) Gastric mucosal protective agents are more diverse: the main function includes the combination with mucin of gastric mucosa to form a protective film to reduce the stimulation of gastric mucosa by refluxed bile and gastric acid, strengthen the role of the mucosal barrier of the digestive tract, facilitate the regeneration of gastric mucosa, promote the secretion of mucus from gastric mucosa, thus protecting gastric mucosa and promoting the healing of inflammation.  (3) combined with bile salts drugs: ① Daxi (aluminum magnesium carbonate), by combining with bile acid and lysophosphatidylcholine, and then reduce the bile salt damage to the gastric mucosa, the effect on bile reflux gastritis is obvious, the main clinical use of drugs; ② anion exchange resin (kolelene amine), after oral release of chloride ions, combined with bile acid, the formation of insoluble, non-absorbable complex, accelerate the bile salt and fecal excretion, reduce damage to the gastric mucosa.  (4) Gastric acid inhibitors: gastric acid and bile have a superimposed effect on gastric mucosa damage, and acid inhibitors are equally effective against bile reflux.  (1) H2 receptor blockers (H2RA): cimetidine, ranitidine, famotidine; (2) proton pump inhibitors (PPI): omeprazole, lansoprazole, rabeprazopam, tolazol, and esomeprazole, acid inhibition is much better than H2 receptor blockers.  (5) eradication of H. pylori infection: bile reflux gastritis can coexist with H. pylori infection, in the routine application of acid suppressants, gastric mucosal protective agents and gastric power drug therapy, should first consider eradication of H. pylori. The actual fact is that it is not only good for the healing of the lesion, but also reduces the chances of inducing cancer. Therefore, when chronic non-atrophic gastritis occurs, the cause should be clarified early and treated under the guidance of a clinician to avoid delaying the condition.