chronic gastritis Chronic gastritis refers to a chronic inflammatory condition of the gastric mucosa caused by various factors, characterized pathologically by predominant lymphocytic infiltration. In some patients, advanced stages may involve atrophy and metaplasia of the gastric mucosal glands, leading to epithelial dysplasia, which is closely associated with the development of gastric cancer.

Chronic gastritis refers to chronic inflammatory lesions of the gastric mucosa caused by various factors, characterized pathologically by lymphocytic infiltration. In some patients, gastric mucosal atrophy and metaplasia may occur in the later stages, leading to epithelial neoplasia, which is closely associated with the development of gastric cancer.

Biological Factors

Helicobacter pylori (Hp) infection is the most common cause of chronic gastritis, leading to chronic inflammation and damage to the gastric mucosa. Over 90% of chronic gastritis patients are infected with Hp.

Immune Factors

Autoimmune gastritis (also known as type A atrophic gastritis) primarily involves atrophy of the gastric body, occurring on the basis of autoimmune abnormalities. Patients' serum can detect parietal cell antibodies, and those with pernicious anemia may also show intrinsic factor antibodies.

Physical Factors

Long-term consumption of strong tea, spirits, coffee, excessively hot or cold food, or rough-textured food can cause repeated damage to the gastric mucosa.

Chemical Factors

Long-term and high-dose use of nonsteroidal anti-inflammatory drugs such as aspirin, indomethacin, can inhibit the synthesis of gastric mucosal prostaglandins and disrupt the mucosal barrier.

Nicotine in tobacco can affect the blood circulation of the gastric mucosa.

Reflux of bile, pancreatic juice, and intestinal juice for various reasons can also damage the gastric mucosal barrier.

Others

The incidence of atrophic lesions in chronic gastritis increases with age.

Patients with gastric mucosal erosion may present with hematemesis, melena, and long-term slight bleeding can lead to iron-deficiency anemia.

Patients with autoimmune gastritis may develop pernicious anemia, accompanied by general weakness, anorexia, weight loss, anemia, and may also be accompanied by glossitis, peripheral neuropathy, and other symptoms.

Some chronic gastritis patients may experience forgetfulness, anxiety, depression, and other psychological symptoms.

Patients with chronic gastritis may experience acute episodes triggered by alcohol consumption, irritating diets, psychological stress, etc., and may require treatment to inhibit gastric acid secretion and protect the gastric mucosa. If there is significant abdominal cramping, spasm relief treatment should be provided. Additionally, consuming a light and easily digestible diet can generally yield good results.

TCM interventions for chronic gastritis mainly include:

Chinese Herbal Medicine

For patients with liver-stomach qi stagnation, treatment involves soothing the liver, regulating qi, and treating the stomach.

For patients with liver-stomach depression-heat syndrome, treatment involves clearing liver heat and treating the stomach.

For patients with spleen-stomach damp-heat syndrome, treatment involves clearing heat and resolving dampness.

For patients with spleen-stomach qi deficiency, treatment involves nourishing qi and invigorating the spleen.

For patients with spleen-stomach deficiency-cold syndrome, treatment involves warming the middle and invigorating the spleen.

For patients with stomach yin deficiency, treatment involves nourishing yin and invigorating the stomach.

For patients with stasis of stomach collateral, treatment involves promoting blood circulation and resolving stasis.

Acupuncture and Moxibustion

Using warm needle therapy combined with moxibustion can effectively alleviate symptoms in patients with chronic gastritis and spleen-stomach deficiency-cold syndrome.

Common acupuncture points used in treatment include Zusanli (ST36), Zhongwan (CV12), Zusanli (ST36), Pishu (BL20), Neiguan (PC6), and others.

Exercise caution and avoid medications that may damage the gastric mucosa, such as aspirin and sodium diclofenac.

Diet should be diversified, avoiding selective eating, and paying attention to the intake of various nutrients. Consumption of fruits and drinking milk is beneficial, and consuming soft and easily digestible foods can help nourish the stomach, such as rice porridge. If there is significant abdominal distension, it may be appropriate to reduce the intake of gassy foods such as soy products.

Avoid consuming moldy foods; consume less smoked, fatty, and foods rich in nitrate and nitrite, and consume more fresh foods.

Avoid excessively rough, strong, spicy foods, and long-term excessive alcohol consumption and smoking.

Rest should be observed during acute episodes, and appropriate activities should be carried out regularly to avoid prolonged overwork.

Maintain a good psychological state and sufficient sleep, avoiding stimuli from negative emotions.

The elderly are more prone to deficiencies in vitamins and trace elements, which should be considered for supplementation.

Discontinue unnecessary nonsteroidal anti-inflammatory drugs.

For patients requiring long-term use of aspirin, clopidogrel, etc., preventive administration of proton pump inhibitors (PPIs) or H2 receptor antagonists (H2RAs) may be considered.

For patients with bone and joint diseases, anti-inflammatory treatment with celecoxib, etc., can be considered.

Promote civilized dietary habits and avoid excessive drinking.

Improve dietary and lifestyle habits.