Patient's question:
What is gastritis?Doctor's answer:
The Etiology and Treatment of GastritisThe stomach is divided into four parts: the cardia, fundus, body, and antrum. The cardia is the entrance to the stomach, while the pylorus is the exit. The antrum refers to the part between the pylorus and the incisura angularis. Gastritis of the antrum is more common in men over 30 and is characterized by upper abdominal fullness, dull or severe pain, often occurring in cycles. It may be accompanied by belching, acid reflux, vomiting, poor appetite, and weight loss. Chronic antral gastritis may also manifest as anorexia, persistent abdominal pain, and blood loss anemia.
The lesions of antral gastritis are often limited to the mucosal muscle layer but can also spread to the muscular and serosal layers. The antral mucosa shows edema, congestion, inflammatory cell infiltration, and fibrous tissue hyperplasia, with the submucosa being most affected. Additionally, when there is mucosal erosion, glandular atrophy, and intestinal metaplasia, antral gastritis rarely exists in isolation and is often concurrent with peptic ulcers or gastric cancer. This is because antral gastritis is closely related to atrophic gastritis, gastric ulcers, and gastric cancer, warranting high attention.
This condition is closely associated with psychological factors. Emotional fluctuations or fear and tension can exacerbate symptoms. It is also prone to occur during periods of parasympathetic nervous system excitation. In some patients with antral gastritis, the upper abdominal pain symptoms resemble those of duodenal bulb ulcers. Chronic antral gastritis is easily misdiagnosed as gastric cancer and requires endoscopy for differentiation.
The treatment of antral gastritis generally involves dietary control, sedation, antacids, spasmolytics, and pain relief, primarily for symptomatic management. For individuals with tension, low-dose sedatives can be used. For belching, nausea, and gastric emptying disorders, Domperidone 10 mg twice or three times daily, or Metoclopramide 20 mg twice or three times daily, or Cisapride 10 mg twice or three times daily, may be selected. For antral mucosal inflammatory lesions, Mezim-S 0.67 g three times daily for 6–8 weeks can be administered. If the patient has upper abdominal pain accompanied by acid reflux, Tegretol 400 mg once daily for one month can be added, or Famotidine 20 mg once nightly for one month.
If the pathological diagnosis of chronic antral gastritis reveals Helicobacter pylori infection, De-Nol 2 tablets three times daily for 4–6 weeks, or Amoxicillin 500 mg three times daily for 4 weeks, can be prescribed.
In daily life, the following points should be noted:
1. Pay attention to dietary and lifestyle adjustments. Avoid long-term consumption of rough, irritating foods; avoid hot beverages and overly salty diets. Maintain regular, balanced meals to prevent overeating.
2. Avoid irritants. Do not use or use minimally medications that strongly irritate the stomach, such as corticosteroids, non-steroidal anti-inflammatory drugs, and drugs containing potassium, iron, or iodine. Additionally, quit smoking and drinking alcohol.
3. Maintain a positive and open-minded attitude.