First, what is “old stomach disease”? “Old stomach disease” refers to chronic gastritis, peptic ulcer and other chronic gastric diseases with a long duration and easy to recur. What kind of people are willing to get “old stomach disease”? (A) by the “Helicobacter pylori” infected What is the “Helicobacter pylori” in 1979, pathologist Warren, in chronic gastritis patients with gastric sinus mucosa tissue slices observed a curved bacteria, and found that this bacterial neighboring the In 1979, Warren, a pathologist, observed a curved bacterium on mucosal tissue sections of the sinuses of patients with chronic gastritis and found that the mucosa adjacent to this bacterium was always inflamed, thus realizing that this bacterium and chronic gastritis might be closely related. 1981, Marshall, a gastroenterologist, collaborated with Warren and proved that the presence of this bacterium was indeed related to gastritis, and in April 1982, Marshall finally succeeded in culturing and isolating this bacterium from a biopsy sample of the gastric mucosa. In order to further prove that this bacterium was responsible for causing gastritis, he and another doctor, Morris, went so far as to drink the culture fluid containing this bacterium, resulting in a serious illness.On October 3, 2005, the Karolinska Institute in Sweden announced that Marshall and Warren had been awarded the 2005 Nobel Prize in Physiology or Medicine for the discovery of Helicobacter pylori and the role of this bacterium in diseases such as gastritis and gastric ulcers. gastric ulcers, among other diseases. Yang Wen, Department of Geriatrics, The Second Hospital of Jilin University (2) People who often take “non-steroidal drugs” “Non-steroidal drugs” are: aspirin, anti-inflammatory pain, somatropin, painkillers, etc. They can weaken the gastric mucosa. They can weaken the defense and repair function of the gastric mucosa and cause disease. (C) mental tension, irregular life mental tension can destroy the balance of gastric acid regulation, resulting in increased gastric acid secretion, gastric, duodenal secretion, motility and mucosal blood flow regulation disorders; irregular life, hunger and satiety, like to eat stimulating food (hot and cold food, spicy food). (d) Smoking, excessive alcohol drinkers Nicotine in tobacco can change the pH of gastric juice, disturb the normal activity of gastric pylorus and induce or aggravate ulcer disease. What are the symptoms of “old stomach disease”? Chronic gastritis lacks specific symptoms, and the severity of symptoms is not consistent with the degree of gastric mucosal lesions. Most patients are often asymptomatic or have varying degrees of dyspeptic symptoms, such as epigastric pain, loss of appetite, postprandial fullness, acid reflux, belching, etc., peptic ulcers (gastric ulcers and duodenal ulcers) are cyclical and rhythmic episodes, that is, spring and fall; gastric ulcers manifested as postprandial pain, duodenal ulcers for the pain of starvation. Most of them develop when they are emotionally unstable or overworked. Fourth, “old stomach disease” need to do what examination? (A) Gastroscopy is the main method to diagnose “old stomach disease”. Chronic gastritis is divided into superficial gastritis, atrophic gastritis and chronic erosive gastritis; peptic ulcer is divided into gastric ulcer and duodenal ulcer. Pathologic tests can also be done to evaluate for malignancy. Gastroscopy is especially recommended for people over 40 years of age and those with changes in the pattern and nature of pain. （For those who cannot do gastroscopy or do not want to do it, this test is feasible and is not as accurate as gastroscopy. V. What are the reasons for “old stomach disease” not being cured for a long time? （What are the reasons for the prolonged treatment of “old gastropathy”? In addition to the application of medication, the treatment of “old stomach disease” is more important is the treatment of mental nerves and diet. No matter how good the medication is, if you don’t pay attention to the removal of mental factors and the regulation of diet, it will be difficult to cure “old stomach disease”. At present, the main methods of drug treatment for “old stomach disease” are: eliminating Helicobacter pylori, inhibiting gastric acid secretion, protecting gastric mucosa and symptomatic treatment. 1, eliminate Helicobacter pylori Helicobacter pylori has not been removed, is an important factor in the disease and recurrence. Effective antimicrobial drugs should be used to kill H. pylori under doctor’s guidance. Bismuth potassium citrate (colloidal bismuth subcitrate) + amoxicillin / or metronidazole / or dysentery, with about 2-4 weeks, can eliminate H. pylori. 2, inhibit gastric acid secretion (1) H2 receptor antagonist: cimetidine, ranitidine, famotidine and nizatidine. Disadvantages: affected by smoking, affecting sexual function, occasionally mental abnormalities. Advantages: inexpensive; especially suitable for follow-up treatment after eradication of H. pylori treatment. (2) Proton pump inhibitors: omeprazole (Losec), lansoprazole, etc.. Inhibit gastric acid secretion is the strongest, the treatment of peptic ulcer speed, high healing rate; for the eradication of Helicobacter pylori treatment, the synergistic effect with antibiotics is better than that of H2 receptor antagonists, so it is the most commonly used basic drugs in the eradication of Helicobacter pylori treatment program. Fewer adverse reactions. 3.Protection of gastric mucosa Aluminum thioglycollate, colloidal bismuth (bismuth potassium citrate, colloidal bismuth subcitrate) and so on. Colloidal bismuth has the effect of inhibiting Helicobacter pylori and can be used as a component of the treatment program for the eradication of Helicobacter pylori, but it cannot be taken for a long time, and accumulation can cause neurotoxicity. (ii) Is the course of treatment sufficient? Some patients with symptoms disappeared after the use of medication, and then stop taking the drug, and then relapsed soon after. Therefore, the use of drugs can not be satisfied with the disappearance of symptoms, but should adhere to the course of treatment, can be expected to be cured. (iii) Is the diet reasonable? Gastric disease and diet are also closely related, so in the drug treatment, should be accompanied by a scientific diet. Diet should not be too full or too hungry, soft and easy-to-digest food, cold, hot and cold food is not suitable, stimulating food such as sour, sweet, spicy and strong taste of food is also not suitable. Some patients eat randomly while taking medication, resulting in poor efficacy, or causing relapse. Alcohol is absorbed by the gastric mucosa, destroys the mucosa, promotes the secretion of gastric acid, and worsens the ulcer; cigarettes can reduce the resistance of the gastric mucosa; carbonated beverages promote the secretion of gastric acid, which becomes the cause of systematic stimulation of the gastric mucosa. Spices, caffeine, fresh soup are also stimulating foods that promote the secretion of gastric juice. Spices used in small quantities are generally not a problem when removing meaty smells, but curry, spicy cabbage, and peppers, mustard, garlic, and horseradish used as hot flavors should be avoided. Caffeine is led by coffee, including green tea, black tea, and especially coffee, which promotes the secretion of gastric juices and must be strictly prohibited. Fresh broth is a component of the flavor of meat and fish, so avoid drinking large amounts on an empty stomach. Stewed meat must also be well skimmed floating oil, reduce the soup, eat more vegetables. Eat less fried food: because this kind of food is not easy to digest, will increase the burden on the digestive tract, eat more will cause indigestion, but also make the blood fat increase, is not good for health. Eat less pickled food: these foods contain more salt and certain carcinogenic substances, it is not advisable to eat more. Foods that should be applied: Proteins – The human body is made up of proteins, and the main components of the gastric mucosa, mucus, and various enzymes are various proteins. Because of this, it is necessary for gastric patients to consume more proteins than ordinary people. Protein-rich foods are meat, fish, soy products, eggs, dairy products, etc. Choosing foods with high protein content ensures that the necessary proteins are available without increasing the burden on the stomach. Vitamins, minerals – can improve the absorption of protein, as the main component of mucous membrane regeneration and blood, is a necessary nutritional element. Iron – ulcers accompanied by bleeding are prone to develop anemia, but iron supplements enhance gastric secretion and should generally be avoided. Therefore, it is necessary to supplement iron in the diet, and actively consume liver, fish, and dark-colored vegetables that contain a lot of iron. Sugar – as a source of energy, it is indispensable. Especially grains contain B vitamins, dietary fiber, plant proteins and other nutrients, which are digested by a small amount of gastric juice and stay in the stomach for a short period of time, making it the safest food for the stomach. However, if a large amount of sugar such as granulated sugar is consumed, it will promote the secretion of gastric acid and the residence time in the stomach becomes longer, so it should be controlled. Fats – are also one of the nutrients that need to be controlled. Both vegetable and animal fats will promote gastric juice secretion and make the stomach contents stay in the stomach for a longer period of time, increasing the burden on the stomach and intestines. There is no harm in eating less emulsified fats such as milk fats, margarine, salad dressings, etc. which are relatively well digested. (d) Do you have any bad habits? Tobacco, alcohol, coffee, strong tea and so on are very unfavorable to chronic gastric disease, are taboo. Some patients drink alcohol to stop stomach pain, it is very wrong. (E) Is life regular? The stomach and intestines are a certain rhythm, and according to the rhythm of the organ, no regularity will destroy the rhythm, so that the gastric acid secretion and peristaltic activity disorder. In addition, after the meal time the stomach will become empty, people with ulcers gastric mucosal resistance will be reduced, the mucosa is self-digested by the gastric juice, and become the cause of the deterioration of the condition. The tendency to overeat after an extremely empty stomach can also be a problem. Even if a dish is well digested, eating too much at once will promote gastric peristalsis, increase gastric juice secretion, and become a burden on the stomach. The amount of a meal should be seven or eight minutes full. (vi) Are you in a happy mood? Are you swallowing? Eat in a happy mood, while angry while eating will affect the gastrointestinal digestive function, after eating will feel bloating, hiccups. Overeating and eating too fast are factors that add burden to the stomach. Eating too fast, will make the number of chewing to feed live, chewing function is to break up the food, at the same time will be food and mouth digestive fluids – saliva mix, make the food in the stomach easy to digest. In addition, eating too fast, can make the appetite center of the brain full stomach feeling of transmission speed slower than the speed of eating, do not know full and over-eating. Breakfast and lunch interval is short, easy to eat in a hurry, so you should make an effort to get up early and leave enough time for breakfast, at least spend 30 minutes to eat. You should also take as much time as possible after eating to rest after meals.