What Are the Symptoms of Mild Gastritis?

Chronic gastritis refers to various chronic gastric mucosal inflammatory lesions caused by different etiologies, and it is a common disease. Its incidence rate ranks first among various gastric diseases. Since the widespread application of fiber endoscopy, the understanding of this disease has improved significantly. Chronic superficial gastritis, chronic erosive gastritis, and chronic atrophic gastritis are common. The latter mucosal intestinal metaplasia, often involving the cardia, is accompanied by loss of G cells and reduced gastrin secretion, and may also involve the body of the stomach, with loss of the secretory glands, leading to a decrease in gastric acid, pepsin, and endogenous factors .

Basic Information

English name

chronic gastritis

Visiting department

Gastroenterology

Multiple groups

Middle-aged and above

Common locations

stomach

Common causes

Related to factors such as Helicobacter pylori infection, viruses or irritants

Common symptoms

Often asymptomatic or with stomach pain and bloating

Contagious

no

Causes of chronic gastritis

1. Helicobacter pylori infection, virus or its toxin

More common after acute gastritis, gastric mucosal lesions develop into chronic superficial gastritis over time. Mainly refers to Helicobacter pylori infection.

2. Irritating substances

Long-term drinking of irritating substances such as strong alcohol, strong tea, and strong coffee can damage the gastric mucosal protective barrier and cause gastritis.

3. Drug

Some medicines such as butapine, indomethacin, simoxifen and salicylate, digitalis, etc. can cause chronic gastric mucosal damage.

4. Chronic infection of the mouth and throat.

5. Bile reflux

The bile salts contained in bile can destroy the gastric mucosal barrier and cause the hydrogen ions in gastric juice to diffuse into the gastric mucosa and cause inflammation.

6.X-ray irradiation

Deep X-ray irradiation of the stomach can cause gastric mucosal damage and gastritis.

7. Environmental change

If the environment changes and climate changes, if people cannot adapt within a short period of time, it can cause neurological disorders that dominate the stomach, causing gastric juice secretion and gastric movement to become uncoordinated, resulting in gastritis.

8. Long-term mental stress and irregular life.

9. Impact of other lesions

Such as uremia, ulcerative colitis, etc. can cause chronic gastritis.

Clinical manifestations of chronic gastritis

Chronic gastritis lacks specific symptoms, and the severity of the symptoms is not consistent with the extent of gastric mucosal lesions. Most patients are asymptomatic or have varying degrees of dyspepsia such as epigastric pain, loss of appetite, postprandial fullness, and acid reflux. Patients with chronic atrophic gastritis may have anemia, wasting, glossitis, diarrhea, etc. Individual patients with mucosal erosion have more obvious upper abdominal pain and may have bleeding, such as vomiting and melena. Symptoms often recur, with irregular abdominal pain. Pain often occurs during eating or after meals. Most of them are located in the upper abdomen, around the umbilicus, and some patients are not fixed. Mild intermittent pain or dull pain, severe severe colic. .

Chronic gastritis examination

Gastric juice analysis

Measure basic gastric secretion (BAO) and histamine test or pentapeptide gastrin to determine the amount of large secreted acid (MAO) and peak acid secreted amount (PAO) to determine gastric acid function, which is helpful for chronic atrophic gastritis Diagnosis and guidance of clinical treatment. Chronic superficial gastritis has more normal gastric acid, and extensive and severe chronic atrophic gastritis has lower gastric acid.

2. Serological testing

Chronic atrophic gastritis usually has a moderately elevated serum gastrin, which is because gastric acid deficiency cannot inhibit G cell secretion. If the lesion is severe, not only the secretion of gastric acid and pepsinogen is reduced, but also the secretion of endogenous factors is reduced. As a result, vitamin B ₁₂ is also reduced; serum PCA is often positive (more than 75%).

3. Gastrointestinal X-ray barium meal examination

With the development of digestive endoscopy, upper gastrointestinal angiography is rarely used in the diagnosis of gastritis. When using gas-barium double contrast to show the microstructure of gastric mucosa, atrophic gastritis may have relatively flat and reduced gastric mucosa.

4. Gastroscopy and biopsy

Gastroscopy and pathological biopsy are the main methods to diagnose chronic gastritis. Superficial gastritis is most often seen in the antrum of the stomach, mostly with diffuse mucus on the surface of the gastric mucosa, with gray-white or yellow-white exudates, red and white or variegated mucosa at the lesion, like measles-like changes, and sometimes erosion. The mucosa of chronic atrophic gastritis is mostly pale or off-white, or it can be red and white, and the white area is sunken; the folds become thinner or flat, and the mucosa becomes purple-blue because of the thinning of the mucosa; the lesions can be diffuse or mainly In the gastric antrum, if accompanied by proliferative changes, the surface of the mucosa is granular or nodular.

Biopsy specimens were used for pathological examination to determine chronic superficial gastritis, chronic atrophic gastritis, intestinal metaplasia, and dysplasia. Feasible pathological biopsy for rapid urease test.

Diagnosis of chronic gastritis

Chronic gastritis has no specific symptoms and few signs. X-ray examination generally only helps to exclude other gastric diseases. Therefore, the diagnosis should be performed by gastroscopy and gastric mucosa biopsy. Helicobacter pylori can be found in gastric mucosa in 50% to 80% of patients in China.

Differential diagnosis of chronic gastritis

Gastric cancer

Symptoms of chronic gastritis such as loss of appetite, epigastric discomfort, anemia, etc. X-ray signs of a few gastroenteritis gastritis are quite similar to gastric cancer, and special attention should be paid to identification. Gastroscopy and biopsy of the vast majority of patients can help identify.

2. Peptic ulcer

Both have chronic upper abdominal pain, but the abdominal and regular abdominal pain above peptic ulcer is the main, while chronic gastritis pain is rarely regular and mainly indigestion. Identification depends on gastroscopy.

3. Chronic biliary disease

Such as chronic cholecystitis and cholelithiasis often have chronic right upper quadrant pain, abdominal distension, dyspnea and other indigestion symptoms, which are easily misdiagnosed as chronic gastritis. However, no abnormal findings were found in gastrointestinal examination of the disease, and abnormalities in cholecystography and B-ultrasound could be finally diagnosed.

4. Other

Such as hepatitis, liver cancer and pancreatic diseases can also be delayed due to symptoms of loss of appetite, indigestion and other symptoms. A comprehensive physical examination and related examinations can prevent misdiagnosis.

Treatment of chronic gastritis

Most of the chronic superficial gastritis can be reversed, and a small part can be turned into chronic atrophic gastritis. Chronic atrophic gastritis gradually increases with age, but mild cases can be reversed. Therefore, the treatment of chronic gastritis should be started as early as chronic superficial gastritis, and the treatment of chronic atrophic gastritis should also be insisted on.

Eliminate the cause

Eliminate all factors that may cause disease, such as avoiding diets and medicines that have a strong irritation to the gastric mucosa, and quit smoking and alcohol. Pay attention to food hygiene to prevent overeating. Actively treat chronic diseases of the mouth, nose, and throat. Strengthen exercise to improve physical fitness.

2. Drug treatment

Atropine, prubensin, belladonna mixture, etc. can be used during pain. PPI proton pump inhibitors such as rabeprazole, lansoprazole, and omeprazole can be used to increase gastric acid. H2 receptor blockers such as cimetidine, ranitidine, and aluminum hydroxide can be used in patients with mild symptoms. Amine, etc. Those with gastric acid deficiency or no acid can be given 1% dilute hydrochloric acid or pepsin mixture, and those with indigestion can add pancreatin tablets, multi-enzyme tablets and other digestive aids. Gastric mucosa biopsy revealed H. pylori plus antibiotics. Those with obvious bile reflux can use metforman and morphine to enhance peristalsis of the gastric antrum and reduce bile reflux. Aluminum magnesium carbonate tablets, cholestyramine, and sucralfate can be combined with bile acids to reduce symptoms.

Prevention of chronic gastritis

1. Keep mentally happy

Depression or excessive tension and fatigue can easily lead to pyloric sphincter dysfunction, bile reflux and chronic gastritis.

2. Quit smoking and drinking

The harmful components in tobacco can promote the increase of gastric acid secretion, which has a harmful stimulating effect on gastric mucosa. Excessive smoking can cause bile reflux. Excessive drinking or long-term drinking of strong alcohol can make the gastric mucosa congestion, edema, and even erosion, and the incidence of chronic gastritis is significantly increased. Should quit smoking and alcohol.

3. Use with caution and avoid using drugs that damage the gastric mucosa

Long-term abuse of these drugs can cause damage to the gastric mucosa, which can cause chronic gastritis and ulcers.

4. Actively treat oropharyngeal infections

Do not swallow sputum, snot and other carrier secretions into the stomach to cause chronic gastritis.

5. Pay attention to diet

Too irritating foods such as too acidic and spicy and foods that are difficult to digest in the cold should be avoided as much as possible. When you eat, you should chew slowly and make the food fully mixed with saliva. Diet should be quantified on time, nutritious, and eat more foods containing vitamins A, B, and C. Avoid irritating drinks such as strong tea and espresso.