How is atrophic gastritis treated?
In terms of Western medical treatment: treatment should be directed at the cause as much as possible and follow the principle of individualization. Removing the cause, relieving symptoms and improving inflammation of the gastric mucosa are the goals of treatment. It is also necessary to prevent complications and regular monitoring to prevent malignant changes.
(1) Diet should be based on soft, semi-liquid food that is easy to digest, and reduce the intake of stimulating food and drinking alcohol, strong tea and coffee.
(2) Do a good job of disease education and maintain a good state of mind.
(3) Avoid the use of drugs that damage the gastric mucosa such as aspirin, anti-inflammatory pain, cortisone, etc.
Drug treatment
(1)Hp eradication
(2) Acid suppression or antacid therapy. Those with limited atrophic lesions, with gastric mucosal erosion or with symptoms such as heartburn, acid reflux, and epigastric hunger pains as the main symptoms. According to the severity of the disease or symptoms, choose antacids, H2 receptor blockers or proton pump inhibitors.
(3) Gastric mucous membrane protective agents, for those with gastric mucous membrane erosion, bleeding or obvious symptoms. The drugs include colloidal bismuth with bactericidal effect, aluminum carbonate preparation with antacid and bile salt adsorption effect, and aluminum thioglycollate with mucosal protection effect. Specific drugs are
(1) Aluminum thioglycollate, colloidal bismuth, bismuth and citrate complex, gefaltein (Huizhong-G ), etc;
② Prostaglandins;
③ Teprenone;
(iv) Rebapent (Membranoside);
⑤ Glutamine (Metzolim).
(4) Gastrointestinal motility drugs are suitable for people with symptoms such as upper abdominal fullness and early satiety. Drugs such as gastrofacial, dopamlidone, cisapride, mosapride, etc.
(5) antispasmodic drugs: when gastritis leads to stomach spasmodic pain can be used appropriately anticholinergic drugs.
(6) Digestive drugs: when the gland atrophy, mucosal barrier effect is reduced, gastric acid, digestive enzyme secretion is weakened, resulting in delayed gastric emptying, epigastric distension, the use of digestive enzyme drugs (Dagest, etc.), can improve the symptoms of indigestion.
(7) Other: antidepressants, sedative drugs. For those who have poor sleep and obvious psychiatric factors.
Treatment of complications
(1) Pernicious anemia Diagnosis: positive PCA, positive internal factor antibodies, apply folic acid, vitamin B12 treatment.
(2) Pre-cancerous lesions of the stomach. Chronic atrophic gastritis with moderate or severe intestinal epithelial hyperplasia and atypical hyperplasia belong to pre-cancerous lesions of the stomach. For chronic atrophic gastritis with intestinal hyperplasia, the main focus is on treatment of the primary disease. Atypical hyperplasia is classified into mild, moderate and severe according to the severity of the disease. For mild or moderate heterogeneous hyperplasia, regular follow-up is possible, and the follow-up period can be once a year for mild heterogeneous hyperplasia, while half a year is appropriate for moderate cases. Chinese medicine treatment or chemical intervention can be used during the follow-up period. Endoscopic mucosal resection can be considered for adenomatous and small lesions of severe heterogeneous hyperplasia, while surgical resection can be performed for more extensive lesions.
For TCM treatment.
The treatment should be based on yin and yang, qi and blood, cold and heat, deficiency and actuality. Generally, the treatment is divided into liver and stomach disharmony, often using Chai Hu Dredging Liver Drink plus or minus. For damp-heat in the spleen and stomach, we use Scutellaria ping gastric san plus or minus; for dampness and turbidity, we use Huopu Xia Ling Tang plus or minus. For stagnant blood in the stomach ligament, use Dan Shen Drink and Tao Hong Si Wu Tang plus or minus. For the evidence of weakness of spleen and stomach, use Xiang Sha Liu Jun Zi Tang with addition and subtraction; for the evidence of deficiency of gastric yin, use Yi Gastric Tang with addition and subtraction.
How to take care of atrophic gastritis?
1, get rid of the cause of the disease. Atrophic gastritis patients should first thoroughly treat acute gastritis, as well as chronic infections of the mouth, nose and throat, such as dental trough overflow pus, tonsillitis, sinusitis, etc. Otherwise, bacteria or viruses are often swallowed or directly stimulate the stomach, can be repeatedly developed.
2, proper diet. Food is not fresh, hard, indigestible and irregular eating, can produce physical and chemical damage to the gastric mucosa. The high-fat, high-sugar, high-salt, high-oil food, fried, pickled and smoked, spicy and other irritating foods, can increase the burden on the stomach.
3, quit drinking and avoid smoking. Long-term nicotine stimulation, can make too much stomach acid, thus producing harmful effects. According to statistics, more than 20 cigarettes a day, about 40% can occur gastritis. Long-term alcohol abuse, can cause damage to the gastric mucosa, the higher the concentration of ethanol (alcohol), the more intense the damage.
4, stable emotional essence. Heavy mental stress, depression or anxiety, resentment, tension, fear and other conditions that persist and strongly stimulate the patient, can often affect gastric peristalsis and gastric acid secretion, and induce gastritis or make the condition worse. Therefore, maintaining a good mood is a prerequisite for maintaining normal gastric peristalsis and improving atrophic gastritis as well as other types of gastritis.
5, to prevent infection. In patients with gastritis there are more than 50% of H. pylori infection and can be infectious. The mouth – mouth, mouth – feces is the main route of transmission of H. pylori, in poor quality drinking water, some swimming pool water, as well as the patient’s tartar, saliva, vomit, feces, can be found in the H. pylori.
Therefore, it is recommended to share food (especially in families with gastritis patients) and keep the “mouth” shut. Do not drink raw water, do not eat raw vegetables, wash your hands before and after meals, keep your mouth clean, rinse your mouth or brush your teeth after eating, so that oral bacteria are removed in a timely manner.
6, reasonable use of drugs. Some drugs have direct or indirect damage to the gastric mucosa, which can lead to gastric mucosal erosion and ulcers. These drugs are often antipyretic analgesics, antibiotics, painkillers, anticancer drugs, hormones, such as aspirin, indomethacin (anti-inflammatory pain), ibuprofen, erythromycin, etc.. Patients should not abuse these drugs, and even if they want to use them, it is best to take them after meals.
7. Combination of labor and rest. Patients should pay attention to exercise, improve physical fitness, adapt to the cold and warm climate changes (some gastritis attacks and seasonal changes, such as the turn of autumn and winter or winter and spring). Work (including physical and mental labor) should not be too busy and stressful, and eat on time (a high percentage of drivers suffer from gastritis).
Prevention
1, the food eaten should be fresh and rich in nutrients, to ensure that there is sufficient protein, vitamins and iron intake. The actual food is not too cold or too hot, and you don’t need to use or use less stimulating condiments such as fresh spicy powder.
2, moderate alcohol consumption, do not smoke to avoid nicotine damage to the gastric mucosa; avoid long-term use of anti-inflammatory painkillers, such as aspirin and corticosteroids, to reduce gastric mucosal damage.
3.Regular examination, gastroscopy if necessary.
4, in case of worsening symptoms, wasting, anorexia, black feces and other conditions should be promptly checked at the hospital.