Etiology and symptoms of esophagitis

Due to abnormal stimulation, esophageal mucosal edema and congestion occur, which is esophagitis. These stimuli include stomach acid, bile produced by duodenal vomiting, spirits, peppers, too hot vegetable soup, too hot tea and so on.

Under normal circumstances, gastric acid does not return to the esophagus. There is a high pressure area in the lower part of the esophagus to prevent gastric acid from flowing back to the esophagus. If the cardia becomes slack for some reason, the pressure in the high pressure area drops or even disappears, and gastric acid and bile flow back to the esophagus, which strongly stimulates the esophageal mucosa and causes esophagitis. Lying flat after a meal, overeating, eating too many sweets or greasy food will make the contents of the stomach reflux to the esophagus.

When you feel heartburn, or heartburn, you will feel obvious pain behind the sternum when drinking hot water or eating irritating food. These are all symptoms of esophagitis. There is also choking cough when swallowing food, which is caused by esophageal edema, esophageal narrowing or spasmodic contraction of esophageal wall caused by inflammatory stimulation. Esophagitis should be diagnosed and treated in time, otherwise it will deteriorate into esophageal mucosal ulcer and hematemesis or hematochezia.

According to your description, if you don't have the above symptoms, you should also belong to upper respiratory tract inflammation, which may be a persistent attack of chronic pharyngitis. It is suggested that in addition to active use of related drugs, daily diet conditioning can also prevent and treat chronic pharyngitis and reduce its recurrence.

1. Eat foods rich in collagen and elastin, such as pig's trotters, pigskin, tendons, fish, beans and seafood. It is beneficial to the repair of the injured part of chronic pharyngitis.

2. Eat more foods rich in B vitamins, such as animal liver, lean meat, fish, fresh fruits, green vegetables, milk and beans. It is beneficial to promote the repair of injured pharynx and eliminate airway mucosal inflammation.

3. Eat less or no fried, spicy and irritating foods, such as fried dough sticks, hemp balls, fried cakes, peppers, garlic and pepper.

4. Drink some diet drinks to relieve sore throat and promote the secretion of body fluids. The following two cases are for reference: green tea and honey drink: 5g of green tea and proper amount of honey. Put the green tea in a cup, pour it into boiling water, and add honey to drink, 1 dose per day. It can clear away heat, relieve sore throat, moisten lung and promote fluid production. Lily and mung bean soup: 20 grams of lily, 50 grams of mung bean, and appropriate amount of rock sugar. Decoct lily and mung bean with water, and add crystal sugar to drink, daily 1 dose. It can clear away heat and moisten the lungs, nourish yin and promote fluid production.

What are the clinical manifestations of chronic superficial gastritis?

The most common symptom of chronic superficial gastritis is epigastric pain, and some patients may have no symptoms. Its clinical manifestations are as follows:

1. Upper abdominal pain: the pain is irregular and has nothing to do with diet. Generally, it is diffuse burning pain, dull pain and swelling pain in the upper abdomen. Very few patients show colic and radiate to the back, which is easy to be misdiagnosed as angina pectoris.

2. Hiccup: Due to gastric acid deficiency, gas production by fermentation in the stomach and other factors, gas accumulates in the stomach and causes hiccups.

3. Abdominal distension: Abdominal distension occurs due to food retention, delayed emptying, indigestion and eating undigested food.

4. Loss of appetite: Chronic superficial gastritis often has loss of appetite or sometimes good or bad.

5. Nausea and vomiting: Inflammatory gastric mucosa is accepted, stimulated by biological factors, affected by gastric motility disorder and gastric reverse peristalsis, resulting in nausea and vomiting.

6. Constipation and diarrhea: Most patients have constipation symptoms, and diarrhea is relatively rare.

What are the clinical manifestations of chronic superficial gastritis?

The clinical manifestations of chronic superficial gastritis lack specificity. Different patients have different clinical manifestations. Some patients may have no symptoms and characteristics, and most patients may have dull pain in the upper abdomen, fullness after eating, loss of appetite, belching and so on. And the symptoms can be mild or severe, and they can recur or exist for a long time. The possible clinical manifestations of the disease were summarized.

(1) The most common symptom is epigastric pain, accounting for about 85%. Most patients with chronic superficial gastritis have irregular epigastric pain, which has nothing to do with diet (some patients are comfortable on an empty stomach and uncomfortable after meals). Generally, it is chronic upper abdominal burning pain, dull pain and distending pain. Symptoms are often aggravated by eating cold food, hard food, spicy or other irritating foods, and a few are related to climate change. This antispasmodic antacid for epigastric pain is not easy to relieve.

(2) Abdominal distension, accounting for 70%. It is often caused by gastric retention, delayed emptying and indigestion.

(3) belching, accounting for about 50% of patients. The gas in the patient's stomach increased and was discharged through the esophagus, which temporarily relieved the feeling of fullness in the upper abdomen.

(4) Recurrent bleeding is also a common manifestation of chronic superficial gastritis. The cause of bleeding is the acute inflammatory changes of gastric mucosa based on chronic superficial gastritis.

(5) Others: loss of appetite, acid regurgitation, nausea and vomiting, fatigue, constipation or diarrhea.

(6) Chronic superficial gastritis lacks typical positive signs. There may be tenderness in the upper abdomen during physical examination, and a few patients may have emaciation and anemia.

What are the causes of chronic superficial gastritis?

The pathogenic factors of chronic superficial gastritis have not been fully understood so far, and it has been found that almost any factor that can affect the body can cause chronic superficial gastritis. Among them, the clear reasons are:

(1) Bacteria, viruses and toxins: more common after acute gastritis. Gastric mucosal lesions exist or recur for a long time and gradually evolve into chronic superficial gastritis.

(2) Chronic infection of nasal cavity, oral cavity and pharynx: chronic infection focus of nasal cavity, oral cavity and pharynx, such as alveolar abscess, tonsillitis, sinusitis and other bacteria or their toxins, can repeatedly stimulate gastric mucosa and cause chronic superficial gastritis. Studies have found that 90% of patients with chronic tonsillitis have chronic inflammatory changes in their stomachs.

(3) Smoking: Nicotine is the main harmful component in tobacco. Long-term heavy smoking can make pyloric sphincter relax, duodenal juice reflux, gastric blood vessels contract and gastric acid secretion increase, thus destroying gastric mucosal barrier and leading to chronic inflammatory diseases. According to Ewald, 40% of people who smoke more than 20 cigarettes a day will develop gastric mucosal inflammation.

(4) Drugs: Some drugs, such as salicylic acid, corticosteroids, digitalis, indomethacin, phenylbutazone, etc., can cause chronic gastric mucosal damage.

(5) Irritating food: Long-term consumption of spirits, strong tea, coffee, spicy and rough food, and irregular eating patterns such as hunger or satiety can destroy the protective barrier of gastric mucosa and cause gastritis.

(6) circulatory and metabolic dysfunction: the structural and functional integrity of gastric mucosa and its defense against various injury factors are closely related to adequate mucosal blood flow. Congestive heart failure or portal hypertension makes the stomach stay in a state of blood stasis and hypoxia for a long time, which leads to the weakening of gastric mucosal barrier function, the decrease of gastric acid secretion and the proliferation of bacteria, which is easy to cause inflammatory damage of gastric mucosa. In chronic renal failure, urea is excreted from the gastrointestinal tract, and bacteria or intestinal hydrolases produce ammonium carbonate and ammonia, which causes irritating damage to the gastric mucosa, leading to congestion, edema and even erosion of the gastric mucosa.

(7) Bile or duodenal juice reflux: Bile reflux is an important cause of chronic gastritis, which can be found or diagnosed by fiberoptic gastroscope. Due to the dysfunction of pyloric sphincter or after gastric surgery, duodenal juice or bile can reflux into the stomach, destroy the gastric mucosal barrier and promote H? +and pepsin diffuse back to mucosa, causing a series of pathological reactions, leading to chronic gastritis.

(8) Helicobacter pylori (HP) infection: 1983, Australian scholars Marshall and Warren first isolated HP from gastric antrum mucosa and epithelial cells of patients with chronic gastritis. Since then, many scholars have done a lot of experimental research on patients with chronic gastritis, and HP has been cultivated in the gastric mucosa of 60% ~ 90% patients with chronic gastritis, and then it is found that the infection degree of HP is positively correlated with the inflammation degree of gastric mucosa. Therefore, in 1986, the 8th World Gastroenterology Society proposed that HP infection is one of the important causes of chronic gastritis. The pathogenic mechanism of HP may be mainly through destroying the gastric mucosal barrier, making H+ diffuse reversely, and finally causing gastric mucosal inflammation.

(9) Psychosomatic factors: Being in a state of mental stress, anxiety or depression for a long time due to unhealthy mental health can cause imbalance between sympathetic and parasympathetic nerves. In particular, the long-term excitement of sympathetic nerves will also lead to the dysfunction of gastric mucosal blood vessels, the decrease of gastric mucosal blood flow, the destruction of gastric mucosal barrier, and the formation of chronic inflammatory reaction of gastric mucosa over time.

Prohibited drugs for superficial gastritis

Patients with chronic superficial gastritis are in a state of congestion, edema, punctate bleeding and erosion, so there are certain restrictions on the drugs they take. If you take or use the following drugs by mistake, it will aggravate the damage of gastric mucosa and aggravate the symptoms such as upper abdominal discomfort, nausea and vomiting; In severe cases, it will cause gastric ulcer and imperceptible gastric bleeding, which will make patients unconsciously anemia, physical decline, low resistance, and easy to be complicated with other diseases.

Drugs prohibited for patients with chronic superficial gastritis are:

(1) Salicylic acid: aspirin, sodium salicylate.

(2) Aniline: paracetamol and phenacetin.

(3) Pyrazolinone: Butazone, aminopyrine.

(4) Other anti-inflammatory organic acids: indomethacin and ibuprofen.

(5) Antibiotic: tetracycline.

(6) Glucocorticoids: prednisone, dexamethasone and cortisone.

Chronic superficial gastritis is a common and frequently-occurring disease, which can affect men, women and children, and has a long course of disease, easy recurrence and great influence on health.

There are many drugs for treating chronic superficial gastritis. In the past, analgesics (such as 654-2, propofol, etc. ), antacids (such as metoclopramide, sucralfate) and traditional Chinese medicine have been used, but the long-term effect is not good.

Because the cause of chronic superficial gastritis is not very clear, it is mainly symptomatic treatment. It can be used according to different conditions: ① drugs for protecting gastric mucosa: sucralfate, gastrin, Hericium erinaceus tablets, Maizilin -S, etc. ② Drugs to reduce gastric acid secretion: such as anticholinergic drugs, atropine, propofol, 654-2, etc. H2 receptor blockers, such as cimetidine, ranitidine and famotidine. And prostaglandin e! , Losec, etc. ; ③ Colloidal forceps preparation: Denol, etc. ④ Drugs to promote gastrointestinal peristalsis: metoclopramide, chlorpyrifos, etc. And the newly developed Cisapride. The general treatment schedule is 4-6 weeks. When one drug is ineffective, another drug can be selected or added, and the combination of drugs in the same category should not be selected. It can also be treated with traditional Chinese medicine, which can be treated according to the clinical symptoms and characteristics of patients and combined with etiology and pathology.

Generally, oral ranitidine and gentamicin are effective in treating chronic superficial gastritis with few side effects and low recurrence rate. The specific method is:

(1) ranitidine: 2 tablets each time, daily 1 time, taken orally before going to bed, for 2 weeks and 3 times;

(2) Gentamicin tablets: 2 tablets each time, 3 times a day for 3 weeks. If individual patients have epigastric discomfort after taking gentamicin, they can change to kanamycin, 0.5g each time, and take it orally twice a day.

If the patient has obvious epigastric pain, you can take 654-2 or propranolol, and stop using it after the pain is relieved; If the epigastric fullness is obvious, lactase can be taken for 3 days before ranitidine and gentamicin (each time 1.5-3.0g, 3 times a day). When accompanied by dyspepsia, multi-enzyme tablets were used in combination at 1 week; Patients with severe symptoms, nausea and vomiting and unable to eat should be given gentamicin intravenously and metoclopramide intramuscularly, and then given gentamicin and ranitidine orally after vomiting stops.

The hospital diagnosed me as superficial gastritis, and I felt uncomfortable if I didn't pay attention to eating. My friend said that he had stomach trouble, so he refused to take medicine and insisted on drinking honey water to treat the disease. I held on to more than one friend with the feeling of giving it a try, which was really good. The method is to make a cup of honey water with warm boiled water after getting up every morning (honey and water can be mastered according to your drinking habits), and then have breakfast after more than an hour of activity. I still insist on drinking a cup every day, gradually replacing the habit of drinking tea. I have had inflammation and constipation. (Excerpted from the Internet)

How to recuperate patients with chronic superficial gastritis

General principle: a diet with no stimulation, low fiber content, easy digestion and sufficient nutrition; Eat less and eat more; Relax and keep a good mood while eating.

1, eliminate the reason. Thoroughly treat acute gastritis; Quit smoking and drinking; Avoid irritating food and drugs; Treat chronic oral infection, diet, etc.

2. Eat more soft food. Eat easily digestible food, minimize irritation to gastric mucosa, chew slowly, let the teeth completely grind the food, and make the food fully mixed with gastric juice. Avoid cold, hot and sour and hard food. Eat less and eat more, and make coarse grains carefully. Patients with gastric diseases can eat five meals, and the demonstration examples are as follows:

Breakfast: 50 grams of rice porridge, 50 grams of flower rolls, boiled eggs 1, bean curd 1.

Meal 1: 300g milk with sugar15g biscuits15g.

Lunch: rice soft rice 100g, fried fish fillet 100g, spinach and egg soup.

Meal 2: 300 grams of soybean milk, 0/0 grams of sugar/kloc, and 25 grams of cake.

Dinner: 50 grams of rice porridge, 50 grams of cake, mashed potatoes with minced meat 150 grams.

3. If you have malnutrition or anemia, you should give more eggs and eat more fresh vegetables and animals' livers and kidneys.

4, hyperacidity, concentrated broth and acidic foods should be banned, so as not to cause more gastric acid secretion, milk, vegetable puree, starch, bread, etc. Yes, it's light and salty.

5, people with hypochlorhydria can give thick broth and gravy to stimulate gastric acid secretion, help digestion and promote appetite.

Health-care prescription for chronic superficial gastritis

1, regular life, optimistic, quitting smoking and drinking, not overeating, not hungry.

2, eat less and eat more meals, avoid indigestion and irritating food, such as coffee, spicy things.

3. For those with flatulence, pantothenic acid and belching, take motilium or metoclopramide half an hour before meals.

4. People with stomachache can use painkillers or other stomach medicines with analgesic effect.

5. There are few patients with chronic atrophic gastritis accompanied by malignant gastric cancer, so it is necessary to have a gastroscopy every year.

References:

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