Problem description:

Bile reflux is a very painful disease, and I know it very well. I usually burp when I have no appetite, and my stomach hurts like a fire, and it is a paroxysmal spasm. You can't eat cold, greasy and hard food. If you are too tired, your stomach will feel uncomfortable.

I have been to various hospitals, received various treatments and taken various medicines, but I still can't completely cure this damn disease. Daxi, Wei Dimei and Wei Likang have all taken it.

Excuse me: what medicine can this disease be completely cured?

Please help me, I thank you all!

Analysis:

Hello: the treatment of bile reflux gastritis;

With the popularization of gastroscopy, bile reflux gastritis is easier to find.

Cholate, bicarbonate in bile, lecithin and trypsin in duodenal juice are indispensable substances for digesting fat and protein. If they stay in the duodenum, bile reflux gastritis will not occur. However, if bile returns to the stomach for various reasons, these reflux liquids will become a group of out-and-out "troublemakers" and can cause many gastritis symptoms.

Drug treatment of bile reflux gastritis is like eliminating the "enemy at the entrance". In order to make it easier for readers to remember, we might as well call some of the latest treatment methods several "styles of play".

"closing method"

At the junction of stomach and duodenum, there is an annular muscle inner ring, which is called "pyloric sphincter" in medicine. Usually it is closed tightly to prevent the liquid (including bile) in the duodenum from flowing back into the stomach. Only when the food in the stomach has been digested can it be opened in time, so that chyme can enter the intestine for further digestion.

If the pressure of pyloric sphincter drops due to various reasons, the closure is not tight, or the duodenum shows reverse peristalsis, "bad elements" can take advantage of the gap to enter.

Some drugs can close the pyloric sphincter by strengthening the regulation of neuromuscular function.

Commonly used drugs are: (1) motilium, 10 mg each time, 3-4 times a day; ⑵ Prebos, 5- 10 mg, 3-4 times a day; (3) metoclopramide, each time 10 mg, 3-4 times a day.

Choose one of the above drugs. It should be noted that the above drugs should be taken before meals 15-30 minutes, and the taking time should not be less than 2 weeks.

Second, the "expulsion law"

Once bile enters the stomach, if it can strengthen the peristalsis of the stomach, these "uninvited guests" will be driven out of the "gate" before they can contact the gastric mucosa, and naturally they will not cause damage to the gastric mucosa. If we strengthen the forward peristalsis of duodenum and reduce its pathological reverse peristalsis, it will also be beneficial to the treatment of bile reflux gastritis. The commonly used drugs mentioned above have such an effect.

Third, the "collection method"

Bile has entered the stomach, and measures can be taken to dispose of it in the stomach and "contract in place".

Some drugs, such as smecta, have the effect of adsorbing substances such as bile. Smecta's flaky structure, like sandwich wafer, has a lot of adsorption capacity, thus absorbing bile salts and excluding toxic hemolytic lecithin (one of the "culprits" causing gastritis). Smecta can also cover the damaged gastric mucosa thinly to isolate harmful factors.

When taking it, pour 1 bag of smecta (3g) into 50ml warm water and shake it evenly to make it look like milk, and then take it.

If these treatments are used together, the effect is better.

Bile reflux gastritis is partly caused by biliary diseases (such as gallstones, cholecystitis and cholecystectomy). Or related to some duodenal diseases (such as pyloric canal's or duodenal ulcer, after subtotal gastrectomy, etc.). ), it is more effective to treat these diseases.

Prevention and treatment of bile reflux gastritis;

1. Oral gastric motility drugs can inhibit bile reflux to the stomach. Commonly used drugs are: ① domperidone (also known as domperidone).

This medicine can enhance gastrointestinal peristalsis, regulate the normal activities of gastrointestinal tract, make food smoothly enter small intestine from stomach, and inhibit bile reflux. It is usually taken before meals 15 ~ 30 minutes. ② Prebos (also known as Cisapride). It is a new generation of gastric motility drug, which is equivalent to motilium, but its efficacy is 3 ~ 4 times greater. ③ Metoclopramide (also called metoclopramide). It is an older gastric motility drug.

2. Commonly used oral gastric mucosal protective agents are: ① sucralfate. The drug can be combined with mucin in gastric mucosa to form a protective film to protect gastric mucosa from bile damage. ② Gastrin. It can form a film in the stomach to cover the gastric mucosa, thus reducing the reflux of bile and gastric acid to the gastric mucosa. ③ Smecta. It is a gastric mucosal protective agent, which can strengthen the mucosal barrier of digestive tract and is beneficial to gastric mucosal regeneration. ④ Gastrine. Can promote the secretion of mucus in gastric mucosa, thus protecting gastric mucosa. ⑤ Giffords. Has that effect of protecting gastric mucosa and promote inflammation healing, and can be taken before or half an hour after meals.

3. Dietotherapy diet should be light, do not eat greasy food, so as not to increase bile secretion and aggravate reflux and illness. You should chew slowly and avoid overeating. Avoid drinking tea, spirits, strong coffee and eating spicy, too cold, too hot and rough food.

4. Remove some aggravating factors, including quitting smoking, avoiding emotional stress and not taking drugs that have * * * effects on gastric mucosa, such as aspirin, indomethacin, painkillers and phenylbutazone.