Patient's question:
I have had chronic gastritis for many years. Recently, a gastroscopy examination diagnosed me with erosive gastritis, and I am currently undergoing treatment. I would like to ask the experts whether erosive gastritis belongs to chronic gastritis or acute gastritis? Are there any differences in treatment methods? Thank youDoctor's answer:
Hello, erosive gastritis should be classified as acute gastritis. Treatment:1. General Treatment: Identify and remove the cause, rest in bed, and provide light, easily digestible fluids. In cases of severe vomiting, fasting may be necessary.
2. Correction of Electrolyte Imbalance: Oral administration of glucose saline or oral rehydration solution (ORS), typically 1000ml. In severe vomiting or dehydration, intravenous fluids should be administered, using normal saline or balanced salt solution mixed with 5% glucose at a ratio of 2:1 or 3:1 for intravenous infusion.
3. Antibacterial Treatment: For bacterial-induced cases, oral tetracycline 0.5g four times daily or berberine 0.3g three times daily may be used. In cases with diarrhea, pipemidic acid or gentamicin can be administered.
4. Symptomatic Treatment: For significant abdominal pain, antispasmodics such as belladonna tablets (8mg, three times daily), propantheline (15mg, three times daily), or atropine (0.5mg, subcutaneous or intramuscular injection) can be used. For vomiting, metoclopramide (10mg, three times daily) or domperidone (10mg, three times daily) may be administered. Acupuncture at the points Sanyinjiao and Neiguan can also be used for pain relief and antiemetic effects.
Treatment for Chronic Gastritis: The Western medicine treatment for chronic gastritis primarily focuses on symptomatic relief.
- For severe insufficient gastric acid, oral dilute hydrochloric acid can be used to increase gastric juice acidity.
- For indigestion, pepsin mixture or multi-enzyme tablets can be taken.
- For fullness, nausea, and vomiting, domperidone, metoclopramide, cisapride, or mosapride may be used.
- In cases with bile reflux, prolonged bile reflux can damage the gastric mucosal barrier, leading to chronic superficial gastritis, which may progress to chronic atrophic gastritis. In such cases, gastric motility drugs can be used to prevent bile reflux, thereby protecting the gastric mucosa. Domperidone or cisapride can counteract bile reflux, promote emptying, and relieve vomiting.
- For significant abdominal pain, belladonna tablets or 654-2 can be used for spasm relief and pain reduction.
- For Helicobacter pylori infection, Lixun triple therapy should be added for eradication and.
Sucralfate and Mucosolvan are gastric mucosal protectants that can reduce the stimulating effects of external factors on the gastric mucosa, aiding in the recovery of mucosal lesions. They can be used for all types of chronic gastritis.
For chronic atrophic gastritis, adding Wéisūjīng can enhance the body's immunity, strengthen the activity of detoxifying enzymes, inhibit the growth of cancer cells, and prevent abnormal cell metabolism.