What Is Intestinal Metaplasia?

In chronic gastritis, the gastric mucosal epithelium is transformed into small intestine or large intestinal mucosal epithelium containing Paneth cells or goblet cells, called intestinal metaplasia (abdominal intestinal metaplasia), which is a relatively common phenomenon, especially in Older people are more common. Intestinal metaplasia is often associated with chronic gastritis, especially chronic atrophic gastritis. Due to the development of gastrointestinal examination technology, especially the application of gastroscopy, a large number of early gastric cancers have been discovered and studied. It is believed that intestinal metaplasia of gastric mucosa is closely related to gastric cancer.

Intestinal metaplasia

In chronic gastritis, the gastric mucosal epithelium is transformed into small intestine or large intestinal mucosal epithelium containing Paneth cells or goblet cells, called intestinal metaplasia (abdominal intestinal metaplasia), which is a relatively common phenomenon, especially in Older people are more common. Intestinal metaplasia is often combined with

Intestinal metaplasia refers to the replacement of gastric mucosal epithelial cells by intestinal epithelial cells, that is, small intestine or large

Intestinal metaplasia is divided into small intestinal metaplasia (ie, complete intestinal metaplasia) and colonic metaplasia (ie, incomplete intestinal metaplasia) by a method called mucohistochemical staining.

Intestinal metaplasia: its epithelium is well-differentiated and it is a common mucosal lesion. It is widely seen in various benign gastric diseases (detection rate is 57.8%>, especially in chronic gastritis. Metaplasia also worsens with the development of inflammation, so It is believed that small intestinal metaplasia may belong to the nature of the inflammatory response.

Colonic metaplasia: its epithelial differentiation is poor, the detection rate in benign gastric disease is very low (11.3%), but the detection rate in the mucosa next to intestinal gastric cancer is high (88.2%), indicating colonic metaplasia and gastric cancer The occurrence is closely related.

Intestinal metaplasia refers to gastric mucosa, especially in the gastric mucosa of the pyloric gland. Turn into

Intestinal metaplasia can occur in the gastric mucosa of various backgrounds.

Eliminating pathogenic factors is the best way to treat and prevent chronic superficial gastritis. Therefore, you should avoid mental stress.

Patients with chronic superficial gastritis should have a light diet, regular and regular quantification, and avoid too acidic, too spicy, cold and rough food.

Drugs that protect the gastric mucosa

Gastroketone--is a succinate half-ester made after hydrolysis of glycyrrhizic acid, which can enhance the secretion of gastric mucus and prolong the stomach

Intestinal metaplasia

Epithelial cell life and mildly inhibits the activity of pepsin, so it can protect the gastric mucosa from bile damage and avoid H + reverse diffusion. Usage 100 mg / time, 3 times / day, changed to 50 mg / time after 2 weeks, 3 times / day, half an hour before meals, 4-5 weeks as a course of treatment. Side effects include sodium retention, so hydrochlorothiazide and potassium salts should be taken at the same time.

Sucralfate-This medicine can complex with pepsin, inhibit the enzyme to break down proteins, and complex with gastric mucosal proteins to form a protective film, preventing the penetration and erosion of gastric acid, pepsin and bile acid. In addition, this medicine can also promote the metabolism of gastric mucosal cells. Usage 1.0 g / time, 3-4 times / day.

Mezlin-S granules-This medicine contains water-soluble B334 and L-glutamine. Water-soluble B334 can directly affect the gastric mucosa and make local inflammation disappear. L-glutamine, together with the gastrointestinal epithelial components hexosamine and glucosamine, are involved in promoting tissue repair for therapeutic purposes. Usage: 670 mg / time, 3 times / day.

Gastritis dry syrup-the medicine is mainly composed of gentamicin sulfate, procaine hydrochloride, VitB12 and other ingredients. With anti-inflammatory, analgesic, and promote gastric mucosal repair. Usage 5 g / time, 3 times / day.

Smecta-This medicine has a strong ability to fix bacteria and viruses, and has a strong ability to cover the digestive tract mucosa. Through the interaction with mucus, the toughness of the mucous membrane of the digestive tract can be improved to resist various attack factors. Usage 3g / time, 3times / day.

Others: vitamin E 2-4 tablets / time, 3 times / day orally; gastrin 2-3 g / time, 3 times / day orally; aluminum hydroxide gel 10 mg / time, 3 times / Oral daily; Gaiweiping 4 tablets / time, 3 times / day orally; prostaglandin E250--150 mg / time, 3 times / day orally. Both can play a role in protecting and improving the gastric mucosa.

Drugs to eliminate gastric mucosal damage factors

Control of HP infection-HP is closely related to chronic gastritis, especially chronic active gastritis. There are drugs that kill HP.

Intestinal metaplasia

Conducive to the treatment of chronic superficial gastritis, in vitro test HP is sensitive to penicillin, aminoglycosides, tetracyclines, cephalosporins, macrolides, nitroimidazoles, furans and bismuth. Therefore, the following drugs are often used in clinical practice: tripotassium bismuth citrate (TDB) 120 mg / time, 4 times / day, 4 weeks as a course of treatment; ampicillin 1.5 g / time, 2 times / day, even serving 8 Days, changed to 1.0 / times, 2 times / day, 28 consecutive days; furazolidone 0.1 g / time, 3 times / day, continuous use for 2-4 weeks; metronidazole 0.4 g / time, 3 times / day Take orally for 14 days as a course of treatment; Rebecca takes 80 mg / time orally twice a day for 2 to 4 weeks as a course of treatment; and so on. In addition, the effect of HP removal can be enhanced by combined use.

Gastric parietal cell receptor antagonists-Histamine H2 receptors, gastrin receptors, and acetylcholine receptor antagonists, all can reduce gastric acid secretion and are used to treat gastritis, especially for those with high gastric acid. Cimetidine, ranitidine, famotidine, etc. are commonly used in clinical practice; propylglutamine, atropine, and probencin can also be used for this disease. Piperazine can selectively inhibit gastric acid secretion without significantly affecting heart rate, pupils, prostaglandins, and gastrointestinal motility. Usage 50 mg / time, 2 times / day. Losec is a H + -K + -ATPase blocker and can also inhibit gastric acid secretion.

Drugs for controlling and improving bile reflux-pyloric dysfunction, bile reflux destroys the gastric mucosal barrier and causes gastritis, so it can be treated with methotrexam, vomiting, domperidone, cisapride, and cholestiamine All drugs have the effect of promoting gastric emptying and preventing reflux. Specific usage: Metoclopramide 10 mg / time, 3 times / day; Zhiweiling 50--100 mg / time, 3 times / day; morpholine 10--20 mg / time, 3--4 times / day; Cisapride 5--10 mg / time, 2--3 times / day; cholestyramine 3--4 g / time, 4 times / day.

Anti-pepsin drugs-Sulfur polysaccharides can be combined with pepsin to inactivate them and avoid damage to gastric mucosa. Commonly used are sucralfate and chondroitin sulfate.