November 27, 2022

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Is erosive gastritis really “rotten” in the stomach?

Is erosive gastritis really “rotten” in the stomach?

Is erosive gastritis really “rotten” in the stomach?   Clinically, patients constantly ask me anxiously: Doctor, my gastroscope report is erosive gastritis. Is the stomach rotten? Is it just stomach cancer? How long can I live?

So, what exactly is the erosive gastritis mentioned in the report? Is it serious? Is it really bad?

Is erosive gastritis really "rotten" in the stomach?

What is erosive gastritis?

Erosive gastritis is divided into acute erosive gastritis and chronic erosive gastritis.

Acute erosive gastritis is an acute gastritis characterized by multiple erosions of the gastric mucosa, also known as acute gastric mucosal lesions or acute erosive hemorrhagic gastritis. It is one of the important causes of upper gastrointestinal bleeding, accounting for about 20% of upper gastrointestinal bleeding . This is often life-threatening!

Drinking a lot of alcohol, taking large doses of non-steroidal drugs, mental stress, nervousness and anxiety and other bad moods, staying up late are the main causes.

In chronic erosive gastritis, generally, symptoms such as fullness, pantothenic acid, belching, irregular abdominal pain, and indigestion are usually seen after meals. For these patients, some gastroscopy reports are a little vague. Although the report says erosion, it is not as serious as you think.

Most of them are caused by diet and drinking, but they are actually caused by slight damage or inflammation of the mucosal layer, or congestion and bleeding of tiny blood vessels.

Is erosive gastritis serious?

The acute ones should be dealt with in time, the chronic ones are not serious! It can even heal itself.

Erosive gastritis is a benign disease. The gastric mucosa is stimulated by various reasons, such as physical, chemical, etc., to cause inflammation of the mucous membrane. If it is slightly more serious, it reaches the mucosal layer. The mucosal erosion is not serious. It is a benign disease. It is completely self-healing. With mucosal protective agent plus acid inhibitor, proper diet control, it can be cured in about 7-10 days.

In layman’s terms, erosive gastritis caused by eating, drinking, and eating stimulating food is the mucosal congestion and swelling, and the mucosal layer is a little damaged.

Roughly speaking, our stomach has four layers from the inside out:

Mucosal layer, submucosa, muscle layer, serosal layer.

Generally speaking, erosive gastritis only damages the most superficial layer, so it is easy to repair.

 What’s the performance?

1. Symptoms of erosive gastritis are mostly non-specific, and can include nausea, vomiting and upper abdominal discomfort.

The harm of chronic erosive gastritis to human health cannot be ignored. If it cannot be treated in time to effectively curb the development of the disease, then peptic ulcers and even upper gastrointestinal bleeding will occur, directly endangering the lives of patients.

2. Most patients are usually asymptomatic or have different degrees of dyspeptic symptoms such as abdominal pain, acid reflux, fullness after meals, loss of appetite, etc. Patients with atrophic gastritis may have anemia, diarrhea, glossitis and water thinness, etc. Individual patients with mucosal erosion have obvious upper abdominal pain and may have bleeding. Therefore, the patient is reminded that once the symptoms of gastrointestinal disease appear, they must be treated as soon as possible.

3. Acute erosive gastritis has a rapid onset, sudden upper gastrointestinal bleeding during the course of the original disease, manifested as hematemesis and melena, and melanoma alone is rare. Bleeding is often intermittent. Heavy bleeding can cause syncope or shock, accompanied by anemia. The upper abdomen is painful and uncomfortable or tender during bleeding. Endoscopy, especially emergency endoscopy within 24 to 48 hours after the onset of the disease, shows gastric mucosal erosion, bleeding, or superficial ulcers, especially in the upper gastric body.

4. Acute erosive gastritis has become one of the important causes of upper gastrointestinal bleeding, accounting for about 20% of upper gastrointestinal bleeding.

5. The clinical symptoms are mostly dull or severe pain in the upper abdomen, accompanied by nausea and other symptoms. A small number of patients exhibited hematemesis and/or tarry stools due to the severe symptoms of the original disease, and the bleeding is often intermittent. Some patients exhibited acute massive bleeding, with severe illness and hemorrhagic shock.

How to cause it?

1. Exogenous factors (about 2/3):

Certain drugs such as non-steroidal anti-inflammatory drugs aspirin, phenylbutazone, indomethacin, adrenal corticosteroids, certain antibiotics, alcohol, etc., can damage the mucosal barrier of the stomach, resulting in increased mucosal permeability and hydrogen in the gastric juice Ions penetrate back into the gastric mucosa, causing erosion and bleeding of the gastric mucosa. Adrenal corticosteroids can increase the secretion of hydrochloric acid and pepsin, decrease the secretion of gastric mucus, and slow down the turnover of gastric mucosal epithelial cells, which leads to this disease.

2. Intrinsic factors (about 1/3):

Including severe infection, severe trauma, intracranial hypertension, severe burns, major surgery, shock, excessive strain and fatigue. Under stress, it can excite the sympathetic nerve and the vagus nerve. The former causes gastric mucosal vasospasm and reduces blood flow, while the latter makes the submucosal arteriovenous short circuit open, promotes mucosal ischemia and hypoxia, and causes gastric mucosal epithelial damage. Erosion and bleeding occurred. Severe shock can cause the release of serotonin and histamine. The former stimulates parietal cells to release lysosomes and directly damages the gastric mucosa, while the latter increases the secretion of pepsin and gastric acid and damages the gastric mucosal barrier.

3. Microbiological factors:

Salmonella, Helicobacter pylori, certain influenza viruses and enteroviruses. Among them, Helicobacter pylori is the most common.

4. Physical factors:

Eating foods that are too hard, too cold, too hot, too spicy, or rough, and other bad eating habits. How to eat, you know, I won’t go into details.

5. Chemical factors:

Certain drugs, spirits, etc. Long-term use of aspirin, indomethacin, clopidogrel, ibuprofen, vitamin C and other drugs; love to drink, this is the most common reason.

How to treat?

1. For acute erosive gastritis, it should be treated as follows:

(1) Western medicine can choose acid inhibitors (including H2 receptor antagonists, proton pump inhibitors), gastric mucosal protective agents, hemostatic sensitivity, etc. Oral thrombin can be taken when the amount of bleeding is large.

(2) If there is a small amount of bleeding and the stool is black or rusty, Yunnan Baiyao, Panax notoginseng powder, etc. can be taken orally in Chinese medicine. If necessary, endoscopic intervention to stop the bleeding, such as placing a titanium clip.

(3) Mass bleeding is not a matter of gastroenterology. If the blood pressure drops sharply, the stomach is severely painful, and the vital signs are in danger, surgery should be considered immediately. The famous painter Chen Yifei seemed to have died of acute stomach bleeding. This gives us very limited rescue time.

(4) In endoscopic treatment, hemostatic agents such as thrombin may be sprayed locally through the gastroscopic biopsy orifice, or hemostasis by electrocoagulation and titanium clamps.

2. Chronic erosive gastritis is enough

(1) Eradication of Helicobacter pylori

(2) Combination of acid-suppressing drugs, mucosal protective agents, and prokinetic drugs (promoting prokinetic drugs are prohibited for those with signs of active bleeding).

(3) Auxiliary symptomatic treatment to eliminate accompanying symptoms.

(4) Chinese medicine treatment, this is the best, no need to check again, feel the pulse, look at the tongue, and just take a few medicines.

(source:internet, reference only)


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