Chronic atrophic gastritis (CAG) refers to the localization of the gastric mucosa, extensive glandular reduction, atrophy and thinning of the mucosa. Chronic atrophic gastritis has no specific symptoms, high recurrence rate, and is associated with certain gastric cancer risk and is not easy to cure. How to treat chronic atrophic gastritis correctly is a problem that doctors and patients pay attention to.
I. The main cause of atrophic gastritis
1. Helicobacter pylori (HP) infection is the most important cause of chronic atrophic gastritis.
Chronic non-atrophic gastritis, atrophic gastritis (atrophy, intestinal metaplasia), dysplasia and carcinogenesis may occur after HP infection.
2. Dietary factors, mental factors are the key factors inducing chronic atrophic gastritis.
Patients with chronic atrophic gastritis should eat more fresh vegetables, fruits and so on. Eating more fresh vegetables and fruits can reduce the relative risk of stomach cancer. Patients with chronic atrophic gastritis should eat regularly and have a light diet.
Eat less or eat marinated, smoked and fried foods.
Due to long-term stressful work, most people are accompanied by mental stimulation and different degrees of depression, which can affect nerve function and cause various pathological changes in the stomach. Abnormal secretion of gastric glands, organic disease, induce chronic Gastritis, and then developed into chronic atrophic gastritis.
II. Atrophic gastritis drug treatment target
The treatment goals of chronic atrophic gastritis are:
1 Delay or block the progression of the disease, reduce the risk of cancer;
2 Improve the clinical symptoms of the patient.
III. Drugs that delay the progression of the disease
Including the eradication of Helicobacter pylori drugs, folic acid and other nutrients.
1. Eradication of Helicobacter pylori drugs
For patients with Helicobacter pylori (HP)-positive, eradication of HP is the most basic treatment for chronic atrophic gastritis, which can reverse atrophy and delay the progression of intestinal metaplasia. Follow-up studies have shown that eradication of HP can reduce the risk of gastric cancer by 39%.
A quadruple therapy consisting of PPI + sputum + 2 antibacterials is recommended for 10 or 14 days.
2. Supplementing nutrients such as folic acid
Supplementation of folic acid, vitamin C, β-carotene, etc. can be used as a method for preventing gastric cancer in chronic atrophic gastritis, but it is still controversial.
For some patients with low folate levels in the body, proper supplementation of folic acid can improve the pathological state of chronic atrophic gastritis and reduce the occurrence of gastric cancer.
Vitamin C, beta-carotene:
It is an antioxidant and has been studied to reduce the incidence of gastric cancer. However, a number of studies on the prevention of gastric cancer by antioxidants are controversial.
IV. Symptomatic treatment of chronic atrophic gastritis
Chronic atrophic gastritis may have no obvious symptoms, and may also manifest as non-specific symptoms of dyspepsia, such as abdominal discomfort, fullness, pain, etc.; some patients may have gastroesophageal reflux disease, manifested as acid reflux, heartburn, etc.; Patients may have bile reflux symptoms, such as mouth bitter, noisy, and hernia.
For the above various clinical symptoms, gastrointestinal motility drugs, gastric mucosal protective agents, acid suppressants and other drugs can be appropriately treated for symptomatic treatment.
Pathological features of chronic atrophic gastritis: gastric glandular gland destruction, atrophy, with or without intestinal metaplasia and intraepithelial neoplasia and other precancerous lesions.
– Intestinal metaplasia (intestinal metaplasia) refers to the appearance of epithelial cells similar to the small intestine or large intestine mucosa in the gastric mucosa.
According to the pathological characteristics of chronic atrophic gastritis and the main symptoms of patients, the drugs with corresponding pharmacological effects can be used for treatment.