Chronic atrophic gastritis is a common disease, and data show that more than half of people over 55 years of age have atrophic gastritis on gastroscopy. Many people are very worried after finding out atrophic gastritis, especially those with intestinal epithelial hyperplasia and atypical hyperplasia, and they feel very afraid when they hear that atrophic gastritis is prone to cancer. So how should people with atrophic gastritis control the development of the disease and avoid the occurrence of cancer?
First of all, we should eliminate or reduce the pathogenic factors, mainly Helicobacter pylori
It is widely believed that the development of atrophic gastritis is mainly related to H. pylori infection, duodenal fluid reflux, prolonged application of non-steroidal anti-inflammatory drugs, alcohol abuse, irritating and high-salt diet, and other factors. Therefore, eliminating or reducing these pathogenic factors can reduce the occurrence of atrophic gastritis and the progression of gastric mucosal atrophy.
In particular, H. pylori infection is the main pathogenic factor of atrophic gastritis. H. pylori can directly attack the gastric mucosa and its metabolites can destroy the gastric mucosa, and at the same time can act as an antigen to induce an immune response, and it has been reported that antibodies to H. pylori can be detected in 80% of patients with moderate to severe atrophic gastritis. Therefore, eradication of H. pylori is the main measure to control atrophic gastritis. Eradication of H. pylori can partially reverse gastric mucosal atrophy and thus reduce the risk of progression from precancerous state of gastric cancer to gastric cancer. Eradication of H. pylori has an intervening effect on the atrophy of coexisting intestinal chemosis, although it is difficult to reverse intestinal chemosis in the short term. In addition, H. pylori eradication helps to block the progression of low-grade intraepithelial neoplasia to high-grade intraepithelial neoplasia or gastric cancer in the gastric mucosa. Therefore, for patients with atrophic gastritis, once H. pylori infection is detected, it should be removed completely without hesitation.
Next, drugs that enhance gastric mucosal defense and delay gastric mucosal atrophy can be used
The reduction of gastric mucosal defense is an important cause of gastric mucosal atrophy. Strengthening the defense of gastric mucosal protective factors and promoting the repair of damaged mucosa is an important part of the treatment of atrophic gastritis. The treatment of atrophic gastritis still does not have special drugs, mainly using gastric mucosal protective agents, gastric mucosal nutrients and proprietary Chinese medicine treatment.
1, gastric mucosal protective agent: gastric mucosal protective agent according to the role of drugs are divided into two kinds: one does not absorb into the blood, acting directly on the lesion, neutralize gastric acid, short duration of action, commonly used: aluminum thioglycollate, magnesium aluminum carbonate, bismuth pectin, rehabilitation of new liquid, etc.; the other absorbed into the blood, play a systemic role, external defense gastric acid erosion, internal repair mucosal damage, play a long time endogenous protective effect, improve Gastric mucosal barrier, to promote the healing of erosion, commonly used are: teprenone, rebapartite, glutamine, gefalte, etc.
2, gastric mucosa nutrients: commonly used are vitamin E, methylcobalamin, folic acid, monkey mushroom tablets, prostaglandin E, lamb’s stomach extract vitamin B12 capsules, etc. These drugs can increase the nutrition of gastric mucosa cells, improve the regenerative capacity of gastric mucosa cells, and promote mucosal renewal and recovery.
3, Chinese medicine treatment: Chinese medicine has certain advantages in relieving the clinical symptoms of patients with atrophic gastritis and inflammation of the gastric mucosa, etc. Some Chinese medicines can reverse the atrophy, intestinalization or heterogeneous hyperplasia of the gastric mucosa and relieve clinical symptoms. Commonly used are: Morodan, Gastric Fuchun, etc.
The third should pay attention to the regulation of life diet
The occurrence of atrophic gastritis is closely related to poor lifestyle. Long-term consumption of high-fat, high-sugar, high-salt foods, fried, pickled, smoked, spicy and other irritating foods, long-term sleep irregularities, long-term smoking, alcohol abuse can increase the burden on the stomach, disrupt the rhythm of gastric secretion, aggravate mucosal damage, and induce mucosal carcinogenesis.
Therefore, try to avoid taking foods and drugs that stimulate or damage the gastric mucosa, and eat more fresh vegetables, fruits, dried fruits, cereals, beans, lean meat, fish, shellfish and eggs, etc. Fresh vegetables contain folic acid, vitamin C and β-carotene, which can increase the nutrition of gastric mucosa cells and promote the regeneration of mucosa. In daily life, you also have to quit smoking, avoid alcohol, live normally, eat properly, exercise properly, maintain a good state of mind and avoid fear. This will help the recovery of atrophic gastritis.
Finally, it is very important to review the gastroscopy regularly
Because there are no specific medications for atrophic gastritis, it is especially important to review the gastroscopy regularly. Regular review of gastroscopy can determine the severity of atrophic gastritis, detect precancerous lesions of gastric cancer, and provide endoscopic treatment if necessary. The generally recommended frequency of review is.
1. endoscopic and pathological follow-up every 1 to 2 years for atrophic gastritis without intestinal metaplasia and heterogeneous hyperplasia.
2, moderate to severe atrophy or with intestinal hyperplasia followed up every 1 year.
3, mild heterogeneous hyperplasia (low-grade endomorphic changes) followed up every 6 months.
4.Severe heterogeneous hyperplasia (high-grade endomatosis) requires immediate review of endoscopy and biopsy pathology, and if necessary, surgical treatment or endoscopic local treatment.
Summary
Atrophic gastritis is a common disease, some patients can develop into gastric cancer, there is no specific medicine for the treatment of atrophic gastritis, but patients with atrophic gastritis do not need to be afraid, if there is H. pylori infection, to be completely removed, to pay attention to the regulation of life and diet, available gastric mucosal protective agents, gastric mucosal nutrients, and proprietary Chinese medicine treatment, the most important thing is to regularly review the gastroscopy, if early lesions are found, you can timely treatment.