When we say old gastric disease, we generally refer to chronic gastritis and gastric ulcers.
Gastritis and peptic ulcers occur in the mucosal layer of the stomach
First look at the causes of chronic gastritis and gastric ulcer (from Internal Medicine, 6th edition, People’s Health Publishing House).
Chronic gastritis causes.
1, Helicobacter pylori infection. Helicobacter pylori has flagella, can move through the mucus layer in the stomach to the gastric mucosa, and its secretion of adhesion factor can make it cling to the epithelial cells and colonize the stomach. The secretion of various toxic substances causes cell damage.
H. pylori colonized in the stomach
2. Dietary and environmental factors. High salt in the diet and lack of fresh vegetables and fruits are closely related to the occurrence of gastric mucosal atrophy, intestinal chemosis and gastric cancer.
High-salt diet is harmful
3, autoimmune. In autoimmune gastritis, autoantibodies exist in the patient’s blood, such as mural cell antibodies. Autoantibodies attack the mural cells and reduce the number of mural cells, leading to a decrease or loss of gastric acid secretion, and can cause pernicious anemia.
4. Other factors. When the pyloric sphincter (that is, the place where the stomach and duodenum meet, anti-reflux about, similar to the entrance of the stomach, the function of the cardia) is not fully functional, the duodenal fluid containing bile and pancreatic juice flows back into the stomach, weakening the gastric mucosal barrier function. Other factors, such as alcohol abuse, taking long-term use of non-steroidal anti-inflammatory drugs (non-selective NSAIDs including: fotarolimus, etodolac, flupiprofen, ibuprofen, painkillers, ralifene, naproxen, sodium metronidazole, oxpromazine), certain irritating foods can repeatedly damage the gastric mucosa.
Can not take long-term non-steroidal anti-inflammatory drugs
Causes of peptic ulcer.
1, Helicobacter pylori (HP): There are two main reasons for confirming HP as peptic ulcer: first, the detection rate of H. pylori in peptic ulcer patients is significantly higher than that of the control group; second, a large number of clinical studies affirm that the recurrence rate of ulcer drops significantly after successful eradication of H. pylori, and the recurrence rate is as high as 50-75% after conventional acid suppression therapy, while the recurrence rate drops to less than 5% after eradication of HP.
2, non-steroidal anti-inflammatory drugs (NSAID): these drugs lead to the development of peptic ulcer by destroying the mucosal barrier is impaired mucosal defense and repair function.
3, gastric acid and pepsin: the final formation of ulcers is due to gastric acid and pepsin digestion of the mucosa itself, excessive secretion of gastric acid can lead to the development of ulcers, so oral acid suppressants, will treat ulcers.
4.Other factors.
(1) Smoking.
Smoking is harmful to health
(2) genetic factors, O-type blood gastric epithelial cell surface express more adhesion receptors and favor H. pylori colonization.
(3) Acute stress, which causes stress ulcers is the consensus. However, in patients with chronic ulcers, the pathogenic role of emotional stress and psychological disorders is inconclusive. Clinical observations have found that chronic mental stress and overwork do tend to make ulcers flare up or worsen. Emotional changes, possibly through neuroendocrine pathways, affect gastroduodenal secretion, motility and mucosal blood flow regulation.
Stress response
(4) Abnormal gastroduodenal motility: Studies have found that the increased gastric emptying in patients with duodenal ulcer is an increase in acid load in the duodenal bulb; delayed gastric emptying in some patients with gastric ulcer increases the reflux of duodenal fluid into the stomach and increases the gastric mucosal invasion factor.
In conclusion, peptic ulcer is a multifactorial disease, in which H. pylori infection and the use of NSAIDs are the main known causes, ulcerogenesis is the result of an imbalance between mucosal invasive and defensive factors, and gastric acid plays a key role in the formation of ulcers.
In this way, emotions have an impact on gastric disease, but they are not the key factor. Even a happy mood at all times does not guarantee the absence of gastritis and gastric ulcers. With the above mentioned causative factors, gastric diseases can be prevented or can be cured if H. pylori is eradicated, no smoking, no alcohol abuse, no long-term use of NSAIDs, and a healthy diet.