Many elderly people have been diagnosed with chronic atrophic gastritis. Some elderly people are very scared after seeing the diagnosis report, fearing that this stomach disease will become cancerous. In fact, after middle age, atrophic changes of gastric mucosa are quite common, especially in the elderly. The results showed that 83% of 30 elderly people over 70 years old in a nursing home had atrophic changes in gastric mucosa, but no canceration was found during follow-up. So now some experts believe that chronic atrophic gastritis may be a degenerative disease and a "semi-physiological phenomenon". Because the patient's stomach acid decreases, he may only have symptoms such as indigestion, abdominal distension and loss of appetite. Of course, chronic atrophic gastritis in the elderly should also be paid attention to, and those over 50 years old with gastric acid deficiency or hypoacidity should be reviewed regularly, especially those with intestinal metaplasia and atypical hyperplasia. In order to avoid cancer, we should pay attention to a reasonable diet, avoid eating hot food, eat less irritating and nitrate-rich foods, such as pickles, salted fish, bacon and smoked food, and eat more fresh vegetables and fruits.
Gastric ulcer in the elderly also has its own characteristics, and gastric acid is normal or even low; The older you get, the higher the position of the ulcer. The pain caused by ulcer is also atypical, lacking typical rhythmic pain in the upper middle abdomen. Because of the high position of gastric ulcer in the elderly, the pain can radiate to the chest or sternum, which is easy to be misdiagnosed as angina pectoris. Sometimes patients just have stomach upset and loss of appetite, which is not easy to relieve after eating and taking medicine. Ulcer lesions are relatively large. Nearly half of the ulcer lesions in the elderly over 60 years old are larger than 65438±0cm in diameter, and there are even huge ulcers over 3 ~ 5 cm, which is related to the obvious atrophy of gastric mucosa and poor repair function in the elderly. A few gastric ulcers will become cancerous, especially giant ulcers.
Elderly patients with peptic ulcer are often accompanied by many other diseases, which increases the difficulty of diagnosis and treatment. If the elderly have chronic bronchitis and emphysema, it will cause hypoxia, coronary heart disease and arteriosclerosis will cause insufficient blood supply to gastric mucosa and affect ulcer healing. Cerebrovascular accidents often involve the autonomic nerve center of hypothalamus, leading to stress ulcer or aggravating the original ulcer, causing massive bleeding and endangering life. Patients with chronic osteoarthralgia often take aspirin, indomethacin, paracetamol, ibuprofen and other anti-inflammatory and analgesic drugs. , causing gastric mucosal damage, aggravating peptic ulcer and inducing gastric bleeding. If you drink alcohol at the same time, the impact will be even greater. Old people who stay in bed for a long time are prone to decalcification of bones. The increase of blood calcium can stimulate the secretion of gastrin, and then increase gastric acid and pepsin, resulting in gastric mucosal damage.
Most cases of ulcer in the elderly have obvious incentives and their own characteristics. Various stimuli in the social environment are an important factor, such as the loss after retirement, the discord within the family, and the inability to correctly handle interpersonal relationships around them, which will all cause emotional fluctuations and easily lead to ulcers. So peptic ulcer is also a psychosomatic disease.
Ulcer in the elderly is easy to cause bleeding, and because of arteriosclerosis, it is difficult for blood vessels to contract and stop on their own, resulting in massive bleeding. Some elderly people usually don't pay much attention to the color of stool until there is obvious anemia, and further examination will lead to existing gastric bleeding. Pituitrin should be used with caution when the elderly suffer from gastrorrhagia, because it is easy to cause hypertension, coronary artery contraction, stroke, angina pectoris, arrhythmia and myocardial infarction, and blood transfusion should not be too fast, otherwise it will easily lead to heart failure. If there is too much bleeding, you should operate as soon as possible.
Gastric perforation is not uncommon in the elderly. Because the pain of the elderly is relatively dull, even if gastric perforation occurs, it sometimes feels too painful, and tenderness and abdominal muscle tension are not obvious. If we don't pay enough attention to it, it will have serious consequences.
Gastric cancer is also the main cause of gastric bleeding in the elderly. For the elderly with persistent gastric bleeding, the possibility of gastric cancer should be considered. For unexplained anemia, a fecal occult blood test should be done. If it continues to be positive, further examination is needed.
Because the symptoms of gastropathy in the elderly are often atypical, it is sometimes difficult to distinguish chronic gastritis, ulcer and gastric cancer simply by clinical symptoms. Therefore, for the elderly who have non-specific symptoms such as epigastric discomfort, belching, abdominal distension and vomiting, gastrointestinal barium meal examination and fiber gastroscopy should be done to avoid delaying diagnosis and treatment.
As soon as I submitted the proposal, I felt cramps in my stomach. Elaine, who is advertising, has always had a bad stomach. Because she is an advertising planner, there are often planning schemes to be completed on time. Elaine feels that her previously bad stomach is getting worse: she has a stomachache after working overtime and staying up late, and she has to lie quietly in bed to get better. But work can't be left behind. If she can't finish the plan because of rest, she can't afford it alone! In desperation, she can only take some stomach medicine casually and continue to work very hard.
Director Yan Ge, director of the Third Department of Guangdong Second Hospital of Traditional Chinese Medicine, pointed out that the pace of modern life is accelerating and the social competition is becoming increasingly fierce. Many people, especially young people, are struggling in their studies and careers. They are nervous because of job competition and the pressure of work and study, which leads to physical and mental diseases, that is, various gastrointestinal diseases caused by mental stress. The incidence rate is still increasing year by year. Because it is related to the development characteristics of modern society, physical and mental diseases are also called "modern fashion diseases". Among many physical and mental diseases caused by mental stress, the most common ones are autonomic nerve dysfunction and functional dyspepsia.
If you want to eat, it may be functional dyspepsia.
Xiao Wu, who has always been a good eater, has recently had an appetite but can't eat. He has always been a big eater at the dinner table, but he can't eat any more when he starts eating. The doctor asked Xiao Wu about his living habits. Although eating from time to time and sometimes eating too much is really a bad habit, he arranged for Xiao Wu to have a gastroscope, but found nothing unusual. It seems that everything is strange. However, experienced doctors suspect that the root cause of Xiao Wu's illness may be mental state. When the doctor inquired, it turned out that Xiaowu Company was competing for posts recently, and the final candidates were Xiaowu and his old classmates. Once Xiaowu lost in the competition and became a subordinate of an old classmate, which made Xiaowu care very much and often thought about how to behave better in front of the leader in order to have a sense of superiority. Over time, it becomes psychological pressure. This explains why Xiao Wu often wants to eat recently, but he is full after eating a little, which is probably functional dyspepsia.
Functional dyspepsia is a very common digestive tract syndrome. Functional dyspepsia usually manifests as abdominal distension, abdominal pain, belching and anorexia (not wanting to eat). When taking barium meal and gastroscope, there is nothing unusual, but I feel uncomfortable. Traditional Chinese medicine believes that functional dyspepsia is mostly related to spleen deficiency and liver depression, exogenous pathogenic factors or improper diet, and also has a great relationship with emotional disorder. It is also different because of different personal constitutions. People with cold constitution and hot constitution should be treated differently.
Suggested dietary therapy:
Mild constitution: Sini powder and dandelion (Sini powder has the functions of improving gastrointestinal blood circulation and anti-ulcer, while dandelion has the functions of strengthening stomach and stopping diarrhea, removing heat and toxic substances and eating toxic substances).
Cold constitution: Huangqi Jianzhong decoction and Radix Aucklandiae (Huangqi invigorating spleen and benefiting qi, Muxiang regulating spleen and eliminating dampness, and harmonizing gastrointestinal tract).
Weight: The specific weight must be prescribed by a professional Chinese medicine doctor.
Treatment of autonomic nervous dysfunction with combination of traditional Chinese and western medicine
Autonomic nerve dysfunction will cause gastrointestinal dysfunction, such as stomach pain and indigestion, and it is also easy to produce chronic gastritis, chronic colitis and irritable syndrome. Director Yan Ge believes that the autonomic nervous system is influenced by people's mood and mental state. Because it is in charge of the digestive system and affects the endocrine system, once the autonomic nerve function is disordered, it will affect the gastrointestinal function and digestion and absorption. If it is a woman, endocrine will also be affected and endocrine disorders will occur.
Irritable bowel syndrome is a common functional disease of large intestine or small intestine, which is caused by abnormal intestinal movement and secretion function. IBS is more common in young adults aged 20-50, which is characterized by intestinal overreaction to stimuli and is closely related to autonomic nervous dysfunction. The main symptoms are swelling and pain in the left lower abdomen, intermittent diarrhea, frequent diarrhea after meals, mucus, and sometimes constipation, as dry as sheep manure. Irritable bowel syndrome will contract more seriously if it is serious, which may cause hypoxia.
Director Yan Ge believes that clinical treatment has proved that the combination of traditional Chinese and western medicine can achieve good therapeutic effect on autonomic nerve dysfunction. Western medicine can give different drugs according to the degree of gastrointestinal surgery and the amount of gastric acid. If the relationship with mental factors is obvious, sedatives are also given according to the severity. Director Yan Ge made a suggestion to this kind of patients temporarily from the perspective of traditional Chinese medicine:
Ingredients: lily 30g, Polygonatum odoratum 30g, Adenophora adenophora 30g, quail 1. Ophiopogon japonicus 20g is added for patients with qi deficiency and fatigue. Method: Put all the ingredients in a saucepan to avoid frying. Suitable for 2-3 people, especially in autumn.