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Warty gastritis

  Warty gastritis, also known as papular warty gastritis or chronic erosive warty gastritis, is a special type of warty gastritis.

  The characteristic is recurrent or persistent gastric multiple erosions of unknown cause. The erosions are typically warty, mostly distributed in the antral and transitional zones, and a few can be seen throughout the stomach. The lesions are round or elliptical, most with a diameter less than 10 millimeters, about 2 millimeters high, and some are strip-shaped, with most elevations having central depressions and erosions, pale red or covered with a yellow film. The typical cases of homogenous warty lesions seen under gastroscopy are generally not difficult to diagnose, but when encountering solitary or two irregularly elevated lesions, it is necessary to differentiate from early gastric cancer type II, polyps, and pseudolymphoma.

  In addition, superficial antral nodular gastritis can also appear erosion, which is generally flat erosion, but can also be elevated erosion. At this time, it is somewhat difficult to differentiate from the disease. However, generally, superficial antral gastritis often has bile reflux, Helicobacter pylori infection, or the use of non-steroidal anti-inflammatory analgesics, and the number of erosion foci is few. Generally, it can regress in a few days, several weeks, or up to 3 months. For the diagnosis of nodular gastritis, endoscopy is mainly relied upon. The disease is unrelated to the known causes of nodular gastritis. Early research considered it to be an allergic mechanism, with a natural course that is long and varies from individual to individual. Some regress in a few months, while others persist for many years. There is no effective treatment plan. If there are clinical symptoms, they can be treated according to peptic ulcer disease.

Contents

1. What are the causes of nodular gastritis
2. What complications can nodular gastritis lead to
3. What are the typical symptoms of nodular gastritis
4. How to prevent nodular gastritis
5. What laboratory tests need to be done for nodular gastritis
6. Dietary taboos for patients with nodular gastritis
7. Conventional methods of Western medicine for the treatment of nodular gastritis

1. What are the causes of nodular gastritis?

  In daily life, there are many patients with gastric diseases, and nodular gastritis is one of them. Then, what diseases cause nodular gastritis?

  1. HP Infection

  According to foreign reports, HP infection is the main etiology of the disease. In 37 cases of nodular gastritis abroad, 89% had HP infection. After 2-3 weeks of treatment with secretagogues, the clinical symptoms, endoscopic findings, and mucosal inflammatory cell infiltration were all significantly reduced, and 78% of the patients had HP disappearance. Similar reports have also been made in China.

  2. Abnormal Immune Mechanism

  Some scholars believe that nodular gastritis may be related to allergies. Andret et al. proposed that the disease may be related to local tissue type I hypersensitivity. They confirmed that there are immune cells containing IgE in the gastric mucosa of patients with nodular gastritis, with IgE cells accounting for 11% and 12% in the gastric body and antrum, respectively, 3% and 2.5% in atrophic nodular gastritis, and 2% and 1% in normal individuals. It is evident that the IgE cells in the mucosal layer of nodular gastritis are significantly increased. Some scholars have used disodium cromoglycate or H2(-) agents to treat nodular gastritis, and after one month, there is a significant improvement in clinical and endoscopic examination, and the IgE cells in the gastric mucosa also decrease accordingly.

  3. The High Acid Theory

  The coexistence of benign diseases with DU and/or GU is common, and there is no unified opinion on whether there is a common pathogenesis. Gastric ulcer, although not directly derived from nodular gastritis, has a high probability of coexistence. It is believed that nodular gastritis is related to high gastric acid, with H+ counterdiffusion into the gastric mucosal cells that already exist inflammation. Moreover, those with this disease find it difficult for ulcers to heal or are prone to recurrence. The age distribution of this disease is similar to that of peptic ulcer, and it is more common in young and middle-aged patients.

2. What complications can verrucous gastritis easily lead to?

  Verrucous gastritis, also known as pustular gastritis or chronic erosive gastritis, is a special type of chronic gastritis. Its characteristic is recurrent or persistent multiple erosions in the gastric mucosa, the cause of which is unknown. Verrucous gastritis can also cause various complications:

  One, Gastric hemorrhage

  Verrucous gastritis bleeding is not uncommon: mucosal atrophy becomes thin, blood vessels become visible, coarse food friction, mucosal erosion and bleeding, mainly manifested as melena. If the bleeding is large, it can suddenly vomit blood, and severe cases may have dizziness, palpitations, dark vision, profuse sweating, and even shock.

  Two, Anemia

  After a large amount of bleeding, verrucous gastritis is accompanied by two types of anemia:

  1, Megaloblastic anemia, also known as pernicious anemia, patients have anemia symptoms, such as dizziness, fatigue, palpitations, and pale complexion.

  2, Iron deficiency anemia, which is caused by chronic bleeding, and secondly, due to the reduced intake of verrucous gastritis patients and insufficient nutrition, and thirdly, due to the lack of gastric acid.

  Three, Gastric ulcer

  Gastric ulcer is present with superficial verrucous gastritis and erosive verrucous gastritis, with obvious inflammatory stimulation. The gastric mucosa atrophy becomes thin, accompanied by erosion and ulceration. It is necessary to perform a gastroscopy in a timely manner to avoid delaying diagnosis and treatment.

  Four, Gastric precancerous stage

  The malignancy of verrucous gastritis is closely related to the hyperplasia of verrucous gastritis. There are two types of verrucous gastritis that are prone to malignancy:

  1, Verrucous gastritis with pernicious anemia, the incidence of malignancy is more than 20 times higher than that of other gastrointestinal diseases, and it should be emphasized for gastrointestinal disease patients.

  2, Atrophic inflammation with intestinal metaplasia and severe atypical hyperplasia.

3. What are the typical symptoms of verrucous gastritis?

  Patients with verrucous gastritis generally experience upper abdominal pain, most commonly a hidden or bloating pain without regularity. The next is upper abdominal bloating, belching, and acid regurgitation. One-third of the cases have upper gastrointestinal bleeding (manifested as hematemesis or melena). A few cases may be asymptomatic. Although there are unique morphological and histological changes, the clinical manifestations are indistinguishable from those of common verrucous gastritis. After treatment or removal of the cause, the lesions can regress.

  In a few cases where the lesions progress to the stage of intestinal metaplasia, the papillary elevations are not easily resolvable, but the prognosis is still good. The characteristics include recurrent or persistent multiple verrucous elevations of the gastric mucosa, which are usually circular or irregular in shape, most of which are scattered in the antrum, also seen in the corpus, sometimes forming a bead-like string along the folds, or it can also be a solitary elevation in the antrum or a few lesions, with a diameter of about 5-10 millimeters and a height of about 2-3 millimeters. In the active phase, central erosion and concavity are common in the elevations, with blood crusts and dirty plaques covering the surface.

  Verrucous gastritis is more common in people aged 30-60, with males being more prevalent. The course of the disease is long, with some cases spontaneously resolving (immature type), while others can last for many years (mature type), and a few may undergo malignant transformation. Clinically, verrucous gastritis exhibits distinct upper gastrointestinal symptoms, which are mainly upper abdominal pain, followed by acid regurgitation, bloating, decreased appetite, nausea, vomiting, upper gastrointestinal bleeding, and weight loss. The main signs are upper abdominal tenderness, with a few patients showing weight loss and anemia.

4. How to prevent verrucous gastritis

  Verrucous gastritis, also known as papillary gastritis or chronic erosive gastritis, is a special type of chronic gastritis. Patients with atrophic gastritis mainly manifest reduced appetite, postprandial fullness, dull pain in the upper abdomen, etc. Due to the slow progression of the disease, many patients with atrophic gastritis neglect these symptoms, leading to delayed treatment and severe complications such as pernicious anemia and gastric cancer. Therefore, the prevention of atrophic gastritis is of great importance, and how to prevent it correctly is something many people are interested in.

  1. Eat more soft foods

  Eat easily digestible foods, minimize stimulation to the gastric mucosa, chew slowly, and let the teeth completely grind the food to ensure it is well mixed with gastric juices. Avoid raw, sour, spicy, and hard foods. Eat small meals more frequently, and prepare coarse grains finely.

  2. Eliminate the cause

  Completely treat acute gastritis; quit smoking and drinking; avoid刺激性 food and medication; treat chronic oral infections, maintain regular diet, etc.

  3. Eat more fresh vegetables

  If there is malnutrition or anemia, eat more eggs, fresh vegetables, and animal liver and kidneys. Understanding the prevention of atrophic gastritis is more important than treatment.

  4. Drink more meat broth

  For those with low stomach acid, concentrated meat broths and meat juices can be given to stimulate stomach acid secretion, aid digestion, and promote appetite.

  5. Avoid acidic foods

  For those with excessive stomach acid, avoid concentrated meat broths and acidic foods to prevent increased stomach acid secretion. Milk, vegetable puree, starch, and bread can be used, and the taste should be light, with less salt.

  6. Avoid刺激性食物

  Avoid hard, spicy, salty, hot, rough, and strongly stimulating foods. This includes fried foods, preserved meat products, chili, garlic, etc. It is best to avoid citrus juices, tomato products, coffee, alcohol, and all foods that directly irritate the esophagus.

  7. Nutritional dietary matching

  Choose foods that are rich in nutrition, easy to digest, and soft. Eat more foods containing plant proteins and vitamins. You can eat cooked millet, rice porridge, goat's milk, yogurt, white cheese, and condensed milk. If symptoms are severe, eat some soft foods, such as rice gruel, bananas, potatoes, and pumpkins.

  8. Eat small meals more frequently and chew slowly

  Eat small meals more frequently and choose easily digestible foods. Opt for liquid foods. For acute gastritis, avoid all foods and medications that irritate the stomach, and for those with bleeding, administer hemostatic treatment. Chewing slowly is very helpful for digestion, and food should be thoroughly chewed to ensure it is well mixed with saliva. High-fat foods, alcohol, sugars, and chocolate are prone to reflux, so if there are symptoms of heartburn, these foods should be avoided.

  Tips:In summary, patients with atrophic gastritis should eat less alkaline foods. Alkaline foods can neutralize stomach acid in large quantities, further reducing stomach acid, which is not conducive to the dispersion of inflammation in the stomach. Abstain from smoking and drinking, and avoid fried, greasy, high-salt, and foods with a high fat content. Eat more fresh, soft, easy-to-digest, and nutritious foods. Chew slowly and thoroughly during meals. Avoid eating cold or hot foods to reduce stimulation to the stomach. Eat small meals more frequently, with 5 meals a day being ideal.

5. What laboratory tests are needed for verrucous gastritis

  The examination of verrucous gastritis is not much different from that of general gastritis, and both require endoscopy and other examinations. Upper gastrointestinal contrast study is one of the commonly used examination methods.

  1. A small number of patients may need to undergo gastric and intestinal barium meal X-ray examination.

  2. Endoscopy is the best method for diagnosing verrucous gastritis. Endoscopy can observe the changes in the gastric mucosa, and at the same time, gastric mucosal tissue can be taken for tissue sections and observed under a microscope to determine the condition of the tissue lesions. The diagnosis is determined by the comprehensive results of endoscopy and pathological examination. Gastric mucosal biopsy and Helicobacter pylori test may be necessary.

  3. Gastric juice analysis may be necessary, to determine the basic acid output, maximum acid output, and pH value of the gastric juice.

  4. Upper gastrointestinal contrast study is one of the commonly used examination methods. This examination has certain value for the diagnosis of ulcers and tumors, but due to its limitation of only being able to observe the morphological changes of the stomach and not the changes of the gastric mucosa, it has certain limitations.

6. Dietary taboos for patients with verrucous gastritis

  Nowadays, the pace of life is getting faster and faster, and many people have irregular daily lives. Bad habits lead to a continuous increase in the incidence of gastritis, especially in summer when the weather is hot and food spoilage speeds up. Eating unclean food can easily trigger gastritis. Gastritis is one of the most common digestive system diseases, affecting our daily lives. To prevent gastritis, people can change their eating habits, chew slowly, and try to complete the mastication process in the mouth to reduce the burden on the stomach. Pay attention to keeping warm and fully meet the stomach's need for temperature. Reduce or stop using drugs such as aspirin and salicylates to minimize the stimulation to the stomach.

  Chapter 1: Vegetables that gastritis patients cannot eat

  1. Green beans are cold vegetables. People with symptoms of stomach cold and pain should definitely avoid eating green beans to prevent the exacerbation of the condition.

  2. Winter melon is a sweet and cold vegetable. People with yang deficiency symptoms of gastritis should definitely avoid eating winter melon to prevent the exacerbation of the condition.

  3. Cucumber is sweet and cool in nature. People with weak spleen and stomach should avoid eating cucumber. Chronic gastritis patients should also avoid eating cucumber during meals.

  4. Bamboo shoots are sweet and cold in nature. Since gastritis is often caused by eating too many cold foods, gastritis patients should avoid eating bamboo shoots in their diet.

  Chapter 2: Foods that gastritis patients cannot eat

  1. Do not eat crabs: Crabs are cold in nature. If you really want to eat crabs, you can prepare some ginger juice and dip the crabs into it.

  2. Do not eat chili: During the onset of gastritis, patients should avoid eating刺激性 spices such as wasabi, chili, and pepper.

  3. Do not eat fried cakes: Gastritis patients should not eat fried cakes because fried foods have a strong mechanical stimulatory effect on the gastric mucosa and are difficult to digest.

  4. Do not eat wasabi: During the onset of gastritis, patients should avoid eating刺激性 spices such as wasabi, chili, and pepper.

  5. Do not eat fried dough sticks: Gastritis patients should not eat fried dough sticks because fried foods have a strong mechanical stimulatory effect on the gastric mucosa and are difficult to digest.

  Chapter 3: Dietary taboos for gastritis patients

  1. Avoid strongly stimulating foods: such as coffee, chocolate thick soup, strong tea, cocoa, chicken soup, overly sweet foods, alcohol, sweet potatoes, etc.

  2. Avoid coarse fiber foods: such as corn flour, sorghum, etc. coarse grains, dried soybeans, celery, lotus root, bamboo shoots, chives, soybean sprouts, etc.

  3. Avoid gas-producing foods: foods rich in gas such as raw scallions, raw garlic, raw radishes, onions, garlic sprouts, etc. are not conducive to the nourishment of stomach diseases.

  4. Avoid hard foods: such as sausages, clam meat, preserved pork, ham, peanuts, etc. It is best to use clear liquid foods such as congee, almond tea, clear soup, light tea water, lotus root powder, thin noodle soup, peeled red date soup during an acute attack, mainly with salty food. As the condition improves, gradually transition to less fiber semi-liquid foods, try to avoid foods that produce gas and contain a lot of fat, such as milk, soy milk, sucrose, etc.

  Tips: Gastritis usually originates from food, so strictly controlling food hygiene is the key to preventing this disease. Improving food, drinking water hygiene and feces management, and vigorously eliminating flies are the fundamental measures to prevent the disease. Foods in the refrigerator should be kept separate from raw and cooked, and should be re-boiled before eating. Wash hands before meals and after defecation, disinfect vegetables and fruits before eating, choose clean and hygienic restaurants when traveling, etc., are all effective preventive measures that should be paid attention to.

7. Conventional Methods of Western Medicine for Treating Verrucous Gastritis

  Patients with verrucous gastritis will experience regular abdominal pain. In addition to regulating diet, patients also need to do some treatment.

  (1) General Treatment

  Try to rest in bed, take glucose-electrolyte solution orally to supplement the loss of body fluids. If there is persistent vomiting or obvious dehydration, then intravenous glucose salt solution of 5% to 10% needs to be supplemented with other relevant electrolytes. Encourage intake of light fluid or semi-liquid foods to prevent dehydration or treat mild dehydration.

  (2) Symptomatic Treatment

  Antiemetic drugs can be injected when necessary: for example, intramuscular injection of chlorpromazine 25-100mg per day. Antispasmodic drugs such as belladonna 8n can be taken 11 times, 3 times a day. Laxatives: such as Simethicone 1 bag per time, 2-3 times a day.

  (3) Antibiotic Treatment

  The therapeutic effect of antibiotics on this disease is controversial. For infectious diarrhea, appropriate targeted antibiotics can be selected, such as 0.3g coptis chinensis orally, 3 times a day, or 80,000u gentamicin orally, 3 times a day, etc. However, it should be prevented from the abuse of antibiotics.

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