1. What is the incidence of chronic gastritis? Chronic gastritis should be the most familiar disease to the general public. Indeed, the incidence of chronic gastritis is relatively high. According to some data, the rate of chronic gastritis in adults is about 50% to 80%, or even higher. Some have clinical symptoms, some can be completely asymptomatic, but the presence of chronic gastritis can be confirmed by endoscopy and gastric mucosal biopsy. Therefore, people’s perception of chronic gastritis is confusing, and some are completely unconcerned and do not go for examination even if they have symptoms. Some are afraid that gastritis will threaten their lives. The actual fact is that you will be able to get a lot more than just a few of the most popular and popular items. 2. What types of chronic gastritis are there? Chronic gastritis is generally divided into chronic superficial gastritis, chronic atrophic gastritis, and certain rare and specific types of chronic gastritis. The so-called superficial gastritis, that is, the gastric mucosa histologically generally has inflammatory cell infiltration, tissue edema, etc.; while atrophic gastritis is manifested by the thinning of the gastric mucosal layer, atrophy, intestinal epithelial hyperplasia, etc. In fact, both pathological changes of superficial gastritis and atrophic gastritis can coexist. Generally, superficial gastritis predominates in young patients, while chronic atrophic gastritis predominates in older patients. Our stomachs are irritated by food on a daily basis and it is difficult to have a chance to fully recover from chronic superficial gastritis. Over time, many chronic superficial gastritis will slowly evolve into chronic atrophic gastritis. And chronic atrophic gastritis is parallel to increasing age, muscle aging, and organ atrophy. Therefore, the incidence of chronic atrophic gastritis is higher in elderly patients. 3. What are the main causes of chronic gastritis? Nowadays, it seems that the main causes of chronic gastritis are bacterial infection, mechanical injury, chemical injury (such as drugs, alcohol, duodenal biliopancreatic reflux), as well as certain immune factors and genetic factors. Among these factors, bacterial infection requires special attention. The so-called bacterial infection refers to Helicobacter pylori, which is often referred to as Hp infection, the Latin or English acronym for Helicobacter pylori. The reason why Hp should be emphasized is that long-term Hp infection can aggravate the damage to the patient’s stomach through mechanisms such as toxins and immune damage, and can even promote the deterioration of some lesions in the gastric mucosa that are related to gastric cancer. Other factors such as gastroduodenal reflux can be corrected with reasonable treatment, thus reducing chronic gastritis. 4.What is the relationship between chronic gastritis and gastric cancer? This is the most concerned and debated issue. As far as chronic gastritis itself is concerned, neither chronic superficial gastritis nor chronic atrophic gastritis will directly turn into gastric cancer. There have been different views on the relationship between chronic atrophic gastritis and gastric cancer. It is generally believed that after years of chronic atrophic gastritis, the gastric mucosa will develop pathological changes related to gastric cancer, such as atypical hyperplasia. If this atypical hyperplasia is not observed and treated, it will become cancerous after some time. Therefore, atypical hyperplasia is called “precancerous lesion”. There are also different grades of atypical hyperplasia. They are classified as mild, moderate or severe according to the degree of difference in tissue and cellular morphology and structure from normal tissue. Only severe atypical hyperplasia is closest to gastric cancer and is also considered not to get better. Most mild and moderate atypical hyperplasia can be reversed after treatment. Some severe atypical hyperplasia can take considerable time to fully transform into typical gastric cancer. We have seen a case of an elderly female patient with severe heart disease who had been followed up for three years, and the moderate atypical hyperplasia lesion in her stomach remained stable. According to the management routine, such a patient should be treated surgically. However, based on the woman’s general condition, surgery was not necessary. 5. What is “intestinalization”? ”Intestinal” is the abbreviation of intestinal epithelial metaplasia. “Intestinalization” is a name often seen in the pathology report of gastric mucosa biopsy. It refers to the morphological and functional changes in the gastric mucosa due to long-term chronic inflammation and other factors. It is morphologically similar to the mucosal epithelium of the small intestine or large intestine and functionally altered, i.e., the chemical composition of the small intestine or large intestine mucosal cells appears in the mucosal cells after special staining and microscopic observation. Some people further divide “intestinal chemosis” into small intestine chemosis and large intestine chemosis, and the two are complete and incomplete. Incomplete colorectal chemosis is more obviously related to gastric cancer. Therefore, in recent years, the medical profession has also classified “intestinal” as precancerous lesions. 6.What are the symptoms of chronic gastritis? They vary greatly. Some may not have any symptoms at all. Some have some milder symptoms, such as stomach fullness, vague pain, belching, reduced appetite, nausea, acid reflux and so on. Rarely, there are more severe manifestations such as upper abdominal pain and vomiting. There is usually no significant weight loss. 7.How to treat chronic gastritis? Chronic gastritis should be treated with this attitude: attention, examination, observation, and treatment. These symptoms are not specific to patients with chronic gastritis, and other digestive diseases or other systemic diseases can have similar symptoms. Most of these symptoms are mild in patients with chronic gastritis, and therefore, they may not be taken seriously. This is wrong. The reason why we should pay attention to the examination of chronic gastritis is that, in addition to clarifying the diagnosis, it is more important to track the changes in the development process of chronic gastritis and to address the factors that aggravate certain pathological changes in chronic gastritis, such as Helicobacter pylori infection and duodenal reflux, with the aim of preventing or early detection of gastric cancer. Patients with chronic gastritis should be examined regularly. The main means of examination is gastroscopy. For patients with chronic gastritis without atypical hyperplasia or intestinalization, gastroscopy is performed once a year. For patients with atypical hyperplasia, in mild cases, we advocate that gastroscopy should be repeated once in 6 months to 1 year; for moderate atypical hyperplasia, gastroscopy should be repeated once in 3 to 6 months. For patients with severe atypical hyperplasia, we advocate re-examining the gastroscopy immediately after receiving the pathology report. If the hyperplasia is still severe, we recommend surgical or endoscopic treatment to remove the lesion. After removal, the patient should be re-examined again in about 3 months to evaluate the effect of the treatment and then decide the frequency of re-examination depending on the situation. 8.How is chronic gastritis treated? Strictly speaking, it is difficult to completely cure chronic gastritis. All treatments for chronic gastritis are designed to address aggravating factors or symptomatic treatment. These treatments include: improvement of dietary habits, eradication of H. pylori infection, treatment of gastroduodenal reflux, inhibition or reduction of gastric acid secretion, protection of gastric mucosa, and Chinese herbal medicine. Sometimes the above treatment measures are used simultaneously. First of all, it is important to pay attention to the impact of dietary habits on chronic gastritis. The diet should be semi-liquid and soft, and the amount should be moderate. Pay attention to foods that are nutritious. Eat more high-protein foods and high-vitamin foods to ensure that the body has enough nutrients. For anemia and malnutrition, foods rich in protein and heme iron, such as lean meat, chicken, fish, liver, loin and other offal, should be added to the diet. Foods high in vitamins come with dark fresh vegetables and fruits, such as green leafy vegetables, tomatoes, eggplants, red dates, etc. Alcoholism, smoking, excessively spicy and rough and raw foods are not conducive to the recovery of chronic gastritis. Secondly, the relevant medication should be selected according to the individual’s main symptoms and the specific condition of the gastroscopy. For patients with epigastric pain or acid reflux, H2 receptor blockers (e.g. famotidine), proton pump inhibitors (e.g. omeprazole), and also gastric mucosal protectors (e.g. aluminum thioglycollate) can be used. Modern Chinese medicine has also accumulated considerable experience in the treatment of chronic gastritis, based on the principle of treating both the symptoms and the root cause, proposing treatments such as dredging the liver and spleen, clearing depressed heat, activating blood circulation and removing blood stasis, and summarizing a series of effective Chinese herbal formulas and acupuncture prescriptions, all of which have been clinically applied with good results. Chronic gastritis is not terrible. As long as the above-mentioned points, according to the doctor’s instructions for regular review, reasonable use of drugs, the condition can still be recovered or stable. 9, finally, to the audience in front of the computer friends four classic stomach tips: exercise for the platform: spleen main limbs, appropriate exercise can promote digestion, enhance appetite, so that the blood source of sufficient energy, essence, gas, spirit flourishing, the function of the viscera does not decline. Vegetarian food is the norm: vegetarian food mainly includes food with vegetable protein, vegetable oil and vitamins, such as flour, rice, grains, miscellaneous grains, beans and their products, vegetables, melons and fruits, etc. Wine should be a small amount: a small amount of wine can stimulate gastrointestinal peristalsis, to facilitate digestion, but also smooth blood flow, invigorate the spirit, eliminate fatigue, in addition to wind and dispel cold, but excessive drinking, many harmful effects. Do not worry about the intestines: Chinese medicine believes that: think can hurt the spleen. Meaning that excessive thinking, easy to hurt the spleen and stomach. Therefore, we must pay attention to character, sentiment and moral cultivation, to be open-minded, treat people kindly, do not be calculating, meditation, and do not bother about things outside the body. Try to avoid the stimulation and interference of bad emotions, often maintain a stable state of mind and optimism, which is also one of the best ways to maintain the spleen and stomach, to get rid of diseases and prolong life.