What Is Erosive Esophagitis?

Erosive gastritis is divided into acute erosive gastritis and chronic erosive gastritis. Acute erosive gastritis is an acute gastritis characterized by multiple gastric mucosal erosions, also known as acute gastric mucosal lesions or acute erosive hemorrhagic gastritis, which is one of the important causes of upper gastrointestinal bleeding, accounting for about 20% of upper gastrointestinal bleeding . Chronic erosive gastritis, also known as verrucous gastritis or pimples-like gastritis, generally only sees symptoms such as fullness after meals, pantothenic acid, belching, irregular abdominal pain, and indigestion.

Basic Information

English name: erosive gastritis
Visiting department: Gastroenterology
Common causes: Non-steroidal anti-inflammatory drugs, steroid hormones, alcohol, stress, etc. as incentives

Common symptoms: Epigastric pain, acid reflux, vomiting, black stool, syncope or shock, etc.
Contagious: no

Etiology of erosive gastritis

Endogenous factor

Critical illnesses such as severe trauma, large-scale burns, sepsis, intracranial lesions, shock and severe organ failure, etc. are the most common causes of acute erosive gastritis.

2. Exogenous factors

Certain drugs, such as non-steroidal anti-inflammatory drugs, steroid hormones, certain antibiotics, and alcohol, can damage the gastric mucosal barrier, leading to increased permeability of the mucosa. Hydrogen ions in the gastric juice return to the gastric mucosa, causing gastric mucosal erosion and bleeding .

Clinical manifestations of erosive gastritis

Acute erosive gastritis

The onset is relatively rapid. Sudden upper gastrointestinal bleeding during the course of the primary disease, manifested as vomiting and black dung. Black dung alone is rare. Bleeding is often intermittent. Excessive bleeding can cause syncope or shock, anemia. There is epigastric discomfort or tenderness during bleeding.

2. Chronic erosive gastritis

Symptoms are mostly nonspecific indigestion symptoms such as epigastric pain, acid reflux, postprandial fullness, and loss of appetite.

Erosive gastritis examination

Upper gastrointestinal endoscopy

(1) The gastric mucosa of acute erosive gastritis is often multiple punctate or diffuse congestion, erosion, bleeding, etc .;

(2) Chronic erosive gastritis has multiple wart-like, swollen, wrinkle-like, or pimples-like bulges on the gastric mucosa, with a diameter of 5-10 mm. Mucosal defects or umbilical depressions can be seen at the top. There is erosion in the center, and there is no redness around the bulge, but it is often accompanied There are erythema of similar size, which is more common in the gastric antrum, and can be divided into persistent and disappearing types. In the Sydney system classification of chronic gastritis, it belongs to a special type of gastritis. The endoscopic classification is bulging erosive gastritis and flat erosive gastritis.

2. Laboratory related inspections

(1) When the patient has vomiting blood or tar-like stool indicating acute massive bleeding, hemoglobin decreases, and stool and vomitus occult blood tests are positive.

(2) Detection of Helicobacter pylori.

3. Other imaging studies

(1) Barium meal examination of gastrointestinal tract Due to the popularization of endoscopic techniques, barium meal examination of gastrointestinal tract is currently not recommended. Barium meal tests often fail to detect erosive lesions. Because barium can be applied to the surface of the mucosa, it can not be used for endoscopic or angiographic examinations in the near future, so it is not suitable for patients with acute active bleeding.

(2) Angiography In the case of acute erosive gastritis bleeding, superselective angiography of the superior mesenteric artery can locate the diagnosis of bleeding, and it is often negative during intermittent bleeding.

Diagnosis of erosive gastritis

1. Clinical manifestations.

2. Endoscopy.

3. Laboratory inspection.

4. Other imaging studies.

Erosive gastritis treatment

Drug treatment

Divided into Western medicine and Chinese medicine.

(1) Western medicine can be intravenous or oral acid inhibitors (including H ₂ receptor antagonists, proton pump inhibitors), gastric mucosal protective agents, etc. When the amount of bleeding is large, thrombin can be taken orally.

(2) Chinese herbal medicine can be taken orally, such as Yunnan Baiyao.

(3) H. pylori-positive patients can be given eradication therapy.

Symptomatic treatment

If upper gastrointestinal bleeding and shock occur, corresponding measures should be taken.

3. Endoscopic treatment

Local hemostatic agents such as thrombin can be sprayed locally through the gastroscope biopsy orifice, or electrocoagulation can be used to stop bleeding.