Patient's question:
Bloating in the upper left abdomen for decades, with ups and downs, loose stools, and belching. Gastric ultrasound results: The cardia ring is normal in size, the gastric wall layers are clear, the echo in the gastric antrum is reduced, with a thickness of 0.5 cm, the echo in the duodenal bulb is reduced, with a thickness of 0.3 cm, normal gastric peristalsis, no space-occupying changes observed in the stomach, and the lower boundary of the stomach is two to three fingers below the navel. Diagnosis: Moderate gastric prolapse, chronic superficial gastritis. Is this correct? Please prescribe some medicine for me in a systematic way. Thank you very much!Doctor's answer:
Hello, because it is an ultrasound examination, it should be possible to make such a judgment! Please follow the doctor's advice for medication, pay attention to your diet, and have regular follow-up examinations! How to treat gastric prolapse? (1) Strengthen nutrition Children with gastric prolapse are usually thin and malnourished, so they should be given nutrient-rich, easily digestible foods, especially with rich protein and fat content. Due to their small appetite, they should be given small, frequent meals to gradually adapt to the stomach's capacity. After meals, they should lie flat for a while and never overeat. After a period of dietary adjustment, the body will gradually become stronger, and the symptoms of gastric prolapse will also be greatly reduced. (2) Full-body rehabilitation exercises After lunch, the child should lie flat with the head in a low position and the pelvic area elevated for 20–30 minutes. After lying flat, the legs should be straightened, then raised and lowered repeatedly. After a short rest, repeat the exercise several times. Alternatively, while lying flat, the legs can perform pedaling motions as if riding a bicycle. After dinner, take a walk, and then lie flat and massage the abdomen. Apply gentle upward pressure from below the navel and then perform circular massages on the stomach area. Doing this every day can gradually help the stomach move upwards. (3) exercises The child should lie flat on a hard board with the head straight, legs straight, and toes pointing upwards. Place the hands on both sides of the thighs, relax the entire body, and perform diaphragmatic breathing, where the abdomen protrudes during inhalation and sinks during exhalation. Repeat several times. Each inhalation and exhalation should be maintained at a rate of 16–18 times per minute. During inhalation, focus on the Dantian point (1.5 inches below the navel), and during exhalation, also focus and relax the limb muscles. After 15 minutes, perform, lying flat with the hands behind the head, contracting the abdominal muscles, and gradually lifting the upper body while bringing the elbows towards the knees, then returning to the starting position. The number of should start small and gradually increase, with a 3-month course. During rehabilitation exercises, running and jumping movements are strictly prohibited, and standing or sitting for long periods should be avoided.Chronic superficial gastritis [Treatment] I. Dietary therapy: Dietary therapy is the foundation of treating chronic superficial gastritis. Meals should be moderate, regular, and nutrient-rich, with easily digestible foods. Avoid stimulating foods and drinks; II. Eliminate the cause: Remove all possible causative factors and actively treat chronic diseases that can damage the gastric mucosa; III. Symptomatic treatment should avoid blind medication and irrational use, and appropriate treatment drugs should be selected based on different clinical manifestations: (1) For those with high stomach acid: H2 receptor blockers such as Tagamet, Ranitidine, and Famotidine, or H+/K+-ATPase inhibitors such as Losec or Omeprazole can be given; (2) For those with low stomach acid or normal stomach acid: Medication should primarily focus on gastric mucosal protectants such as sucralfate or colloidal bismuth preparations. New gastric mucosal protectants like Protonix and Sustac have been used in clinical practice and can be appropriately selected; (3) Prokinetic agents: To prevent duodenal fluid, bile reflux, and accelerate gastric emptying, Metoclopramide or Cisapride can be used; (4) Eradicate Helicobacter pylori: For Helicobacter pylori-associated gastritis, active eradication of Helicobacter pylori should be carried out, commonly using antibiotics or colloidal bismuth preparations. Colloidal bismuth, when taken for 4 weeks, often achieves satisfactory results in Helicobacter pylori eradication, such as De-Nol. The dosage and usage of these drugs must follow medical advice.
What should chronic gastritis patients pay attention to in their diet? (1) Eat small, frequent meals, eat at regular times, and avoid overeating. For those with mild conditions, a low-fiber semi-liquid diet with five meals a day can be adopted. During the recovery period, a low-fiber soft meal with four meals a day is advisable. If calorie intake is insufficient, supplement with meals that combine dry and wet foods, such as 1 cup of milk with 2 slices of biscuits, 1 cup of malted milk, or boiled eggs. (2) Prevent anemia or malnutrition. Patients with atrophic gastritis often suffer from iron-deficiency anemia. The diet should provide sufficient and balanced energy and nutrients. For those with anemia or malnutrition, increase foods rich in protein and heme iron, such as lean meat, fish, chicken, liver, and offal, while also paying attention to the intake of vitamin C and B vitamins, including vitamin B12 and folic acid. Increase the intake of fresh vegetables and fruits, such as tomatoes, eggplants, jujubes, and leafy greens, to provide vitamin C and aid iron absorption. (3) Adjust gastric acid secretion. Patients with gastritis should eat meat with short fibers and soft texture, such as fish, shrimp, chicken, tender beef, and lean pork. Patients with atrophic gastritis, who have low stomach acid secretion, should be given nutrient-rich, concentrated broth from fish, chicken, meat, and mushrooms, rice porridge, acidic foods, aromatic seasonings, and moderate sweet and sour foods. For patients with high-acid chronic superficial gastritis, the opposite approach should be taken. Avoid nutrient-rich, concentrated broth and use cooked fish, shrimp, chicken, and lean meat for cooking, such as steamed fish pieces, braised fish fillets, fried chicken meatballs, and scrambled egg custard, to reduce stomach acid secretion and irritation. Instead, drink more milk, soy milk, toasted bread, and fresh vegetables and fruits to neutralize stomach acid. (4) Food choices should be light, low in fat, low in irritation, and easily digestible. Fatty foods like lard, cream, and fried foods can delay gastric emptying and easily cause a sense of fullness. Spicy alcohol, chili peppers, onions, curry, pepper, mustard powder, strong coffee, and other irritating foods should be avoided. Also, avoid hard, sour, spicy, salty, cold, hot, or overly rough foods. Examples include cold salads, spicy cabbage, and sweet and sour lotus root slices. For staple foods, choose fine noodles, noodle sheets, steamed buns, rolls, steamed cakes, buns, dumplings, bread, and rice. Avoid unleavened foods like homemade pancakes, filled pancakes, and dumplings. Additionally, avoid coarse grains and poorly processed, hard-to-digest foods like corn cakes, glutinous rice, and rice cakes, as these stay in the stomach for a long time and increase the burden on the gastrointestinal tract. (5) Food preparation should be fine, small, soft, and tender. Cooking methods such as steaming, boiling, stewing, braising, and simmering should be used to protect the gastric mucosa. Eat vegetables and fruits without rough fiber, such as tender cucumbers, tomatoes (without skin or seeds), peeled eggplants, winter melons, tender cabbage, spinach leaves, potatoes, and carrots. Cut them into thin strips, small cubes, or thin slices and cook them until tender, or mash some, like mashed potatoes, for easier digestion. Fruits should be ripe, with skin and seeds removed, such as bananas, apples, and pears, and it is important to chew and swallow slowly.
Why are patients with gastric diseases not advised to drink strong tea and coffee? Tea and coffee contain theophylline and caffeine. Caffeine can stimulate the gastric glands, increasing the secretion of gastric acid and pepsin and other digestive fluids. When the stomach is damaged due to various reasons and exhibits conditions such as gastritis or gastric ulcers, strong tea and coffee can cause increased gastric acid secretion, directly worsening the condition, reducing the effectiveness of gastric medications, and hindering recovery.
Why are patients with chronic gastritis not advised to drink large amounts of beer? Scientists have found that drinking large amounts of beer can cause chronic gastritis, and for those who already have chronic gastritis, it can worsen or lead to recurrent symptoms. The gastric mucosa can synthesize a substance called prostaglandin E, which inhibits gastric acid secretion and protects the gastric mucosa. A lack of prostaglandin E can cause damage to the gastric mucosa. Drinking beer can inhibit or reduce the synthesis of prostaglandin E in the gastric mucosa. After drinking large amounts of beer, patients often experience upper abdominal fullness, increased burning sensation, frequent belching, and reduced appetite, all signs of gastric mucosal damage.