At present, the diagnosis of various gastritis in the world is mainly based on the gastric mucosal manifestations and pathological changes under gastroscope. All kinds of gastritis have their own characteristics under gastroscope:
(1) Chronic superficial gastritis: the gastric mucosa is mainly red and white, mainly red, or slightly variegated, with mild congestion and edema, and sometimes slight old and new bleeding spots can be seen.
(2) erosive gastritis: the gastric mucosa is hyperemia and edema, accompanied by a little flaky erosion. There are two forms of gastric erosion, one is complete, and the lesions are mostly round or quasi-round mucosal protrusions. The erosion center is covered with gray necrosis, and the edge is swollen and congested. The other is incomplete erosion, the lesion is located on the flat mucosa, which is punctate, flaky, linear or shapeless, and its center is red fresh bleeding or brown old bleeding, accompanied by white or yellow fur, and the surrounding is red.
(3) Bile reflux gastritis: Gastroscopy showed that the mucosa was obviously edema, congestion, rough and fragile, with yellow-green bile on the surface and a large amount of bile in the mucus lake.
(4) Verrucous gastritis: also known as chronic erosive gastritis. The gastric mucosa is mainly pockmarked or sky-shaped, figuratively speaking, it is like a belly button-like protrusion with a diameter of about 0.5 cm, which is mainly found in the gastric antrum, followed by the lower part of the stomach. The distribution is scattered and the number varies.
(5) Atrophic gastritis: the gastric mucosa is red and white, mainly white, and the range can be large or small, and it can also be distributed in pieces. Dialysis showed submucosal vascular network. The folds of gastric mucosa become thinner and thinner, and sometimes fine particles formed by epithelial cell proliferation can be seen on the mucosa.
It should be pointed out that although the names of various gastritis are common in China, what they see and describe under endoscope is not exactly the same, which mainly depends on the knowledge and experience of gastroscope doctors.
acute gastritis
Etiology includes drugs (especially non-steroidal anti-inflammatory drugs), alcohol and acute stress and other serious diseases. Rare causes include radiation, viral infection (such as cytomegalovirus), vascular injury and direct trauma (such as nasal feeding intubation).
chronic gastritis
Endoscopic manifestations are often multiple punctate or aphthous ulcers. Chronic non-erosive gastritis can be idiopathic or caused by drugs (especially aspirin and non-steroidal anti-inflammatory drugs, see the treatment of peptic ulcer), Crohn's disease or viral infection. Helicobacter pylori may not play an important role here.
Gastroenteritis is mainly manifested by neutrophil infiltration in gastric mucosa and cardia. Chronic gastritis often has a certain degree of atrophy (mucosal dysfunction) and metaplasia, often involving the cardia, accompanied by G cell loss and decreased gastrin secretion, and also involving the stomach body, accompanied by oxyntic gland loss, resulting in decreased gastric acid, pepsin and endogenous factors.
The criteria for judging the nature of gastroenteritis are mainly determined by gastroscopy of stomach and enteroscopy of intestine. Tube examination is to check mucosal lesions, which are caused by pathogenic bacteria.
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