Chronic atrophic gastritis, abbreviated as (CAG), is a common disease, which is classified by the World Health Organization as a pre-cancerous state of the stomach, and is especially likely to become cancerous if accompanied by intestinal epithelial hyperplasia or atypical hyperplasia. Its onset is slow, lingering, prolonged and difficult to cure, and treatment is tricky. There is no atrophic gastritis in the literature of traditional Chinese medicine, and it belongs to the category of "stomach and epigastric pain" and "abdominal distension" in traditional Chinese medicine. Because chronic atrophic gastritis, to the stomach and epigastric part of the spleen full of pain is common, or spleen full and no pain, there are still a few patients with no obvious symptoms, so the National Association of Chinese Medicine, the third academic conference on spleen and stomach that chronic atrophic gastritis can be attributed to the identification of "gastric plumping" certificate, on the theory of atrophic gastritis, since the advent of the fiberoptic gastroscope, the visual observation coupled with a biopsy, the atrophic gastritis of the visual observation of the stomach and epigastric pain, and the atrophic gastritis of the stomach. Since the introduction of fiberoptic gastroscopy, visual observation and biopsy have made the diagnosis of atrophic gastritis clearer. It is generally believed that the incidence of atrophic gastritis tends to increase with age. It has been reported in China that 74.2% of atrophic gastritis cases occur above 40 years of age, while only 8.7% of cases occur in young people below 30 years of age. The incidence of atrophic gastritis increases by an average of 1.25% for each year of age. A series of cases analyzed by PENA in Spain found that the incidence and severity of atrophic gastritis increased with age. The overall incidence rate in China is 4-30%, and the incidence rate in men is 3-4 times higher than that in women. There are obvious regional differences in this disease.

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Overview of superficial gastritis

Experience: chronic superficial gastritis symptoms are diverse and not necessarily proportional to the condition, the diagnosis needs to rely on the gastroscopy and pathologic examination. This disease belongs to the range of Chinese medicine gastric pain, heart under the scope of the plague, easy to recurring episodes, prolonged, mostly manifested as cold and heat mixed, poison and stagnation of each other; if the congestion of the middle jiao to the stomach pain, plumpness is the main symptom. Gastroscopy shows that the red and white gastric mucosa is the main manifestation of the cold and heat syndrome, while congestion, edema, erosion, etc. are the manifestations of toxic stasis. In the treatment, the rational combination of antibiotics and western medicines to strengthen the stomach, and accompanied by half Xia Laxing Heart Soup flavored, pungent and bitter descending, cold and heat and adjusted, and discretionary support to detoxification and dissipation of stasis, insecticidal drugs, so it showed a miraculous effect.

Experts believe that most of the symptoms of superficial gastritis are mild or painless, self-limiting, and can disappear on their own. After a few months or years the lesions can also be completely recovered.

So, how can superficial gastritis be "cured" without medicine?

1, pay attention to diet and life management. Avoid long-term intake of rough, stimulating food; avoid overheated drinks and salty diet; to do diet, regular quantitative, to prevent overeating.

2, avoid stimulation. Do not use or minimize the use of strong gastric stimulation of drugs, such as corticosteroids, non-steroidal anti-inflammatory drugs and potassium, iron, iodine and other drugs; and to give up alcohol and smoking.

3, optimistic and open-minded. Some medical experts pointed out that many patients with gastric disease symptoms do not come from gastric disease itself, but from the psychological factors of fear of disease. Therefore, the mental and psychological conditioning is very important. The fact that you can't be a good sport and you can't be a bad sport is a good reason why you shouldn't be a good sport.

Of course, chronic superficial gastritis can't be cured without medication. The middle-aged and elderly and immune imbalances are prone to develop into chronic atrophic gastritis, and this possibility increases with age. Therefore, superficial gastritis in middle-aged and elderly people should be treated early. In addition to antibacterial treatment, the principle of treatment should also be given at the same time gastric mucosal protective agents and inhibit gastric acid drugs.

Chronic gastritis

Chronic gastritis refers to chronic inflammatory lesions of the gastric mucosa caused by different causes. It is common and its incidence increases with age.

The causes may be: long-term use of non-steroidal anti-inflammatory drugs and alcohol abuse; reflux of duodenal fluid; cigarette smoking; immune factors; infectious factors (Helicobacter pylori HP infection); long-term use of foods or medications that have a strong stimulation of the gastric mucosa, such as strong tea, strong alcohol, coffee, spicy and rough foods and certain drugs. In addition, there are age factors, gastric mucosal nutritional factor deficiency, genetic factors.

Chronic gastritis is divided into the following seven types:

1) erythema/exudative gastritis; ② flat erosive gastritis; ③ elevated erosive gastritis; ④ atrophic gastritis; ⑤ hemorrhagic gastritis; ⑥ intestinal-gastric reflux gastritis; ⑦ wrinkled wall hyperplasia gastritis.

Clinical manifestations

The symptoms of chronic gastritis are not specific, and a considerable number of patients have no clinical symptoms.

The course of chronic gastritis is prolonged. The duration of the disease varies from half a year to several decades, and the symptoms are sometimes mild and sometimes severe. The symptoms may be aggravated by weather changes, especially in the fall and winter seasons, cold and hard foods such as fried foods, fatigue, and mental factors.

About 50% of the patients often epigastric discomfort, dull pain, burning pain, feeling of fullness, no obvious rhythmic, generally heavier after eating. Loss of appetite, belching, acid reflux, nausea, hiccups, epigastric bloating or vague pain after meals and other symptoms of dyspepsia are also more common. Part of the patient's appetite is not affected, but eating a little more bloating symptoms increased significantly.

Those with gastric mucosal erosion may have a small amount or a large amount of upper gastrointestinal bleeding, prolonged small amount of bleeding can cause iron deficiency anemia.A type of gastritis can appear obvious anorexia, general weakness, weakness, weight loss, indifference. In typical pernicious anemia, tongue atrophy and peripheral neuropathy, such as sensory abnormalities in the limbs, may occur.The gastrointestinal symptoms of type B gastritis are more obvious, especially when there is bile-sweat reflux, which is sometimes quite similar to peptic ulcer, and there may be recurrent small amounts of upper gastrointestinal bleeding, or even vomiting of blood. Physical signs are not obvious, sometimes there is light pressure pain in the epigastrium.

Treatment

Most of the symptoms of superficial gastritis can disappear on their own, and the lesions can be completely recovered after several months or years.

Elimination of causes: various possible causative factors or aggravating factors should be removed, such as quitting smoking and alcohol, reducing salt intake; correcting bad dietary habits, avoiding diets that irritate the stomach, and eating soft and easily digestible diets, avoiding overly rough, overly strong spices, and overly hot, overly cold diets. To develop a chewing and slow swallowing, in order to achieve easy digestion, reduce the purpose of gastric stimulation, eat less salted, smoked, not fresh food; as well as to stop taking certain drugs that stimulate the gastric mucosa, especially aspirin and other non-steroidal anti-inflammatory drugs; there is a nasal cavity and pharyngeal foci of chronic infections should be cleared, chronic bronchitis should be avoided to phlegm swallowed.

Medication:

①Gastric mucosal protection drugs Commonly used drugs are colloidal bismuth subcitrate (CBS), aluminum sulfate, Simida, Mazeline-S, aluminum hydroxide gel, gastric membrane and cover the stomach and so on.

②Adjustment of gastrointestinal motor function drugs Upper abdominal fullness with gastroparesis or domperidone and so on. Hiccups, bloating or reflux phenomenon is dominated by the use of gastric power drugs, such as gastroenterology, morcellators or cisapride (Prevacid).

③Antibiotics If gastroscopy found that the Helicobacter pylori test is positive, antibiotics should be taken, clarithromycin, hydroxybenzylpenicillin, gentamicin, furazolidone, streptomycin, kanamycin, tetracycline, shikimicin, etc., have the effect of removing HP, generally two can be used, often combined with gastric mucosal protective agents and acid suppression agents.

4 Acid suppressants Commonly used drugs are cimetidine, ranitidine, famotidine, sodium bicarbonate (baking soda), magnesium hydroxide, gastric shuping, aluminum hydroxide gel, cover gastric equality.

⑤ For those with severe epigastric pain, oral atropine, probenecid, belladonna tablets or 654-2 (25-10mg) can be taken to reduce gastric acid secretion and relieve abdominal pain symptoms. As such drugs have side effects such as dry mouth, palpitations, and difficulty in urination, they should be used with caution or contraindicated in patients with prostatic hypertrophy, glaucoma, and cardiovascular disease.

Also available are digestive drugs such as yeast tablets, lactase, flatulence tablets and so on. If the phenomenon of acid reflux can also be used to inhibit the acidic drugs such as tamoxifen, ranitidine, famotidine, etc. Only one can be used. Prevent bile reflux can take cholestyramine to adsorb bile; with blood vomiting and blood in the stool, metacyclomidine oral; atrophic gastritis bloating is more prominent, lactobacillus tablets oral or hepatic and gastric qiqi pain tablets orally, and pay attention to do not serve acidulants, such as gastroplasma, baking soda, and so on.

Surgical treatment: chronic atrophic gastritis with severe atypical hyperplasia, surgery should be considered. Severe atrophic gastritis and intestinalization in the gastric antrum is not an absolute indication for surgery, because the residual stomach after surgery is also prone to chronic atrophic gastritis, intestinalization and cancer.

The cancer rate of atrophic gastritis is about 1%, so it should be followed up by regular gastroscopy. Especially for those with polyps, heterogeneous hyperplasia, or those with focal indentation or elevation. Mild atrophic gastritis with a very smooth gastric mucosa is less likely to be cancerous.

Prevention

It is important to develop good dietary habits, to eat regularly, eat small meals and eat soft food that is easy to digest. Avoid foods that are raw, cold, hard, rough, greasy, and contain too much fiber. Do not overeat. Eating should be chewed and swallowed slowly, which helps digestion and absorption, thus reducing the burden on the stomach. Avoid drinking strong tea, coffee, alcohol, etc.; eat less food that is easy to produce flatulence, such as potatoes, sweet potatoes, onions, boiled soybeans and so on. Quit smoking and do not eat spicy and irritating food. Avoid eating too hot, too acidic and smoked food for a long time. You should also avoid long-term use of drugs that irritate the gastric mucosa, especially aspirin. Botaxone, anti-inflammatory pain, prednisone and so on. In addition, pay attention to the combination of work and rest, regular life, maintain optimistic and happy mood, avoid tension, anxiety, depression. Most patients are asymptomatic or have varying degrees of dyspeptic symptoms such as epigastric pain, loss of appetite, postprandial fullness, acid reflux. Individual patients with mucosal erosion epigastric pain is more obvious, and may have bleeding.

Some patients often feel the epigastric bloating discomfort, belching, by a number of hospitals and a number of gastroscopy diagnosed as "superficial gastritis", long-term use of a variety of Chinese and Western medicines and no significant effect, but the medical cost of a lot of money. Similar patients are not uncommon. In fact, many of these patients are accompanied by insomnia, anxiety, irritability, panic, suspicion and other neuropsychiatric symptoms, and some patients are always suspected of suffering from gastric cancer and seek medical treatment everywhere, repeatedly requesting to do gastroscopy. In terms of treatment, patients should be advised to quit smoking and drinking, avoid stimulating food and overeating, and at the same time, focus on spiritual and pacifying therapy, increase physical work and exercise, improve the body's resistance and immunity, distract patients' attention and other non-pharmacological treatments, and appropriately apply mood stabilizers and gastric stimulants and other symptomatic treatments, so that the patients can understand and accept your treatment plan, and enhance the confidence of overcoming the disease, and there is no need to spend a lot of money on long-term medication. There is no need to spend a lot of money on long-term medication and frequent gastroscopy, increasing unnecessary pain. Individual patients who have persistent and progressive symptoms should have a timely review of gastroscopy so as not to miss the diagnosis of malignant diseases.

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