What is moderate gastritis? 5. Moderate gastric erosive gastritis

Clinical presentation. 1.Acute erosive gastritis.

The onset is acute, and the upper gastrointestinal bleeding occurs suddenly during the course of the primary disease, manifested as hematemesis and black stool, which is rare in patients with melena alone. Bleeding is often intermittent. Heavy bleeding can cause syncope or shock and anemia. Bleeding is accompanied by vague epigastric pain, discomfort, or tenderness.

2.Chronic erosive gastritis.

Symptoms are mostly non-specific dyspepsia symptoms such as vague epigastric pain, acid reflux, postprandial fullness, and loss of appetite.

Examine. 1.Upper gastrointestinal endoscopy.

1) Acute erosive gastritis: The gastric mucosa is often punctate or diffuse congestion, erosion, bleeding, etc.;

2) Chronic erosive gastritis gastric mucosa has multiple wart-like, swollen fold-like or papule-like protrusions, with a diameter of 5 10 mm, mucosal defects or umbilical depressions can be seen at the apex, erosions in the center, and there is no imitation Zheng fiber redness around the bulge, but it is often accompanied by red spots similar to the size of the plexus, and the gastric imitation sinus is more common, which can be divided into persistent type and disappearing type. In the Sydney Systematic Classification of Chronic Gastritis, it belongs to a special type of gastritis, and the endoscopic classification is elevated erosive gastritis and flat erosive gastritis.

2.Laboratory tests.

1) When the patient has hematemesis or tarry stool indicating acute massive bleeding, hemoglobin decreases, and the stool and vomit occult blood test is positive.

2) Helicobacter pylori detection.

3.Other imaging tests.

1) Gastrointestinal barium swallow examination Due to the widespread application of endoscopic technology, gastrointestinal barium swallow examination is not advocated at present. Barium swallow examination often fails to reveal erosive lesions. Because barium can be applied to mucosal surfaces, endoscopy or angiography is not available in the near future, so it is not indicated in patients with acute active bleeding.

2) Angiography can locate and diagnose bleeding by superselective angiography of the superior mesenteric artery when bleeding from acute erosive gastritis, and it is often negative when bleeding is intermittent.

Diagnosis. 1.Clinical presentation.

2.Endoscopy.

3.Laboratory tests.

4.Other imaging tests.

**。1.Drugs**.

It is divided into Western medicine and Chinese medicine.

1) Western medicine can be intravenous or oral antacids (including H2 receptor antagonists, proton pump inhibitors), gastric mucosal protectors, etc. Thrombin may be taken by mouth when bleeding is heavy.

2) Traditional Chinese medicine can be taken orally, Yunnan Baiyao, etc.

3) Helicobacter pylori positive patients can be given ****.

2.Symptomatic**.

If there is upper gastrointestinal bleeding, shock, etc., corresponding measures should be taken.

3.Endoscopically**.

Hemostatic agents such as thrombin can be sprayed locally through the gastroscopic biopsy orifice, or electrocoagulation can be performed to stop bleeding.