Patient's question:
Hello! Recently, I had an endoscopy for chronic superficial gastritis of the antrum, and the test result for Helicobacter pylori was positive. Is this condition serious? How should it be treated? What should I pay attention to in my daily diet? Are there any foods I need to avoid?Doctor's answer:
The stomach can be divided into four parts: the cardia, the fundus, the body, and the antrum. The entrance of the stomach is the cardia, and the exit is the pylorus. The antrum refers to the part between the pylorus and the incisura angularis. Gastritis of the antrum is more common in men over 30 years old and is characterized by fullness in the upper abdomen, dull or severe pain, often occurring in cycles, and may be accompanied by belching, acid reflux, vomiting, poor appetite, weight loss, etc. Chronic antral gastritis may also manifest as anorexia, persistent abdominal pain, and hemorrhagic 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 pronounced. Additionally, when there is mucosal erosion, glandular atrophy, and intestinal gland hyperplasia, antral gastritis rarely exists alone 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, and should be given high attention. This condition is closely related to psychological factors; emotional fluctuations or fear and tension can exacerbate symptoms. It is also prone to occur during sympathetic nervous system excitation. In some patients with antral gastritis, the symptoms of upper abdominal pain are similar to those of duodenal bulb ulcers. Chronic antral gastritis is easily misdiagnosed as antral cancer and requires endoscopy for differentiation. The treatment of antral gastritis generally involves dietary control, sedation, antacids, spasmolytics, and analgesics, primarily for symptomatic relief. For those with emotional tension, low-dose sedatives can be used. For belching, nausea, and gastric emptying disorders, Domperidone 10 mg can be taken 2–3 times daily, or Metoclopramide 20 mg can be taken 2–3 times daily, or Cisapride 10 mg can be taken 2–3 times daily. For the inflammatory lesions of the antral mucosa, Mezim-S 0.67 g can be taken 3 times daily for 6–8 weeks. If the patient has upper abdominal pain accompanied by acid reflux, Ranitidine 400 mg can be added, taken once daily for 1 month. Or Famotidine 20 mg can be taken once nightly for 1 month. If the pathological diagnosis of chronic antral gastritis shows Helicobacter pylori infection, Dexamethasone 2 tablets can be taken 3 times daily for 4–6 weeks, or Amoxicillin 500 mg can be taken 3 times daily for 4 weeks.