Since the application of gastroscopy and other advanced detection means in the clinic, patients with sinusitis seem to be more and more, because a considerable part of society believes that sinusitis will become cancer, so patients are very afraid of “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, 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 the regenerated cells is the same as that of intestinal mucosal cells, which is called intestinal glandular metaplasia (referred to as intestinalization). If the morphology is the same as that of large intestine gland, it is called large intestine adenosis; if the morphology is the same as that of small intestine gland, it is called small intestine adenosis; small intestine adenosis will not turn into cancer, and not all large intestine adenosis will turn into cancer, among which incomplete large intestine adenosis 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.
(ii) Bile reflux into the stomach and long-term stimulation of gastric mucosa.
(iii) Hp infection. Hp grows beneath the gastric mucus, on the surface of the gastric mucosa, and causes inflammation or glandular atrophy through gradual destruction of the mucosa.
(iv) Autoimmune reaction, i.e. the patient produces multiple antibodies of his own, which destroy the gastric mucosal cells and glands.
(v) Long-term use of non-steroidal anti-inflammatory drugs, such as aspirin, indomethacin, etc.
Fourth, the treatment of gastric sinusitis
(I) Dietary regimen
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. Next is to eat quantitatively and regularly, chew and swallow slowly. It is not necessary to eat fine and soft food for years.
(C) drug treatment
The main drug is to protect the gastric mucosa or kill Hp drugs; followed by allopathic drugs. So far there is not a special drug to cure gastric sinusitis. Gastric mucosal protective agent can be chosen from aluminum thioglycollate 1g tid, bismuth potassium citrate (bismuth pectin, 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 for intestinal glandular hyperplasia. some patients with chronic atrophic gastritis with intestinal glandular hyperplasia or heterogeneous hyperplasia were selected by the Shanghai Clinical Institute of Gastroenterology. FA was given orally and the glandular atrophy and intestinal hyperplasia improved significantly after six months.
(D) The stomach has nine fears, medication carefully
A fear of mental tension after prolonged depression, melancholy or trauma, prone to gastroesophageal reflux ulcer disease.
Second fear of overwork Whether physical or mental labor, overwork will cause insufficient blood supply to the stomach and intestines, too much gastric acid and mucus reduction, damage to the gastric mucosa.
Alcohol itself can directly affect the gastric mucosa, but also can cause fatty liver, cirrhosis and acute and chronic pancreatitis, aggravating gastric damage.
Four fear of smoking addiction smoking will stimulate the secretion of gastric acid and pepsin, increasing the damage to the gastric mucosa.
Five afraid of hunger and satiety uneven gastric acid, pepsin relative secretion when hungry, if overeating and overexpansion of the stomach, food stay for a long time, etc. cause gastric damage.
Six fear of bacterial infection has been identified as 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.
Seven fear of night eating night before bed is the worst habit, especially after autumn, night long easy night food, not only cause lack of sleep, resulting in obesity “autumn fat”, but also because of night food to stimulate excessive secretion of gastric acid and induce the occurrence of ulcers.
Eight afraid of nitrite It is known that nitrite is the main 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 greatly increase the risk of stomach cancer rate.
Nine fears of indiscriminate use of drugs Drugs have therapeutic effects, but there are also adverse 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 a variety of antitumor drugs and antihistamines.
In short, eliminate the causative factors, adjust the psychological factors, avoid stimulating factors and human factors conducive to the recovery of 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 patients have precancerous lesions such as severe intestinal adenosis or severe atypical hyperplasia, they need to undergo endoscopic minimally invasive treatment or surgery.