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The Stomach
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Patients that are found to have any sort of chronic gastritis are at high risk. Autoimmune gastritis (with pernicious anemia) and atrophic gastritis carry a major risk of being precancerous, and close follow-up by gastroscopy and biopsies is highly recommended. These two types of chronic gastritis can also be associated with achlorhydria, depending on the extent of the mucosal involvement.
The Treatment of the Special Forms of Mental Disease
Published in Francis X. Dercum, Rest, Suggestion, 2019
In the management of chronic alcoholism, we are especially to consider the underlying neurasthenic or neuropathic factors, and whatever plan of treatment we institute must take these factors into account. Secondly, and of equal importance, is the detailed study of the patient's symptoms. There is almost invariably present a marked chronic gastritis. The liver also should he carefully examined, bearing in mind, of course, the relation of alcoholism to cirrhosis. The heart and blood-vessels and the urine should be similarly studied. It is unnecessary to point out here possible changes in the lungs, save to mention the not infrequent coexistence of tuberculosis and alcoholism, and the further fact that many confirmed alcoholics suffer from chronic bronchitis. The practical point for the physician to remember, is the fact that the alcoholic is a man who is ill; that he is suffering not so much from the presence of the poison, a from a diseased nervous system and from various visceral complications, slight or pronounced, as the case may be.
The upper gastrointestinal tract, common conditions, and recommended treatments
Published in Simon R. Knowles, Laurie Keefer, Antonina A. Mikocka-Walus, Psychogastroenterology for Adults, 2019
The term ‘gastritis’ refers to inflammation of the lining of the stomach, and is seen commonly in asymptomatic individuals as well as those with abdominal symptoms undergoing endoscopy. Acute gastritis can occur as a result of infection (virus, Helicobacter pylori) or chemical irritation (alcohol, nonsteroidal anti-inflammatory drugs – e.g., ibuprofen or naproxen), and will usually resolve with time/removal of the cause and symptomatic treatment with acid suppression. Chronic gastritis may be due to Helicobacter pylori or reflux of bile from the duodenum into the stomach. Both of these conditions are common and often asymptomatic, but in the absence of a more definitive diagnosis, many abdominal symptoms for which no specific cause has been found (usually functional – see later) are incorrectly attributed by patients and doctors to chronic gastritis. This can lead to problems with an excessive focus on acid suppression (at increasing doses) rather than a reconsideration of the cause of the symptoms. If Helicobacter pylori is present in a patient with upper GI symptoms, it will usually be treated (see earlier) to reduce the risk of peptic ulcer and cancer, with any benefit to symptoms being a bonus.
Clinical outcomes of endoscopic treatment for gastric gastrointestinal stromal tumors: a single-center study of 240 cases in China
Published in Scandinavian Journal of Gastroenterology, 2022
Deqiong Wang, Qiang Ding, Li Cao, Xinxia Feng, Zerui Zhang, Panpan Lu, Xiaoyu Ji, Lili Li, Dean Tian, Mei Liu
GISTs lack specific clinical manifestations and are often found accidentally during the examination due to other reasons [4,5]. In this study, most patients (85.42%) showed clinical symptoms when they were admitted to the hospital. However, these clinical manifestations are not typical and are difficult to distinguish from the clinical symptoms of chronic gastritis, peptic ulcer, and other common abdominal diseases. For example, in this study, among these patients with clinical symptoms, about 66.34% of patients had chronic gastritis, 8.78% of patients had peptic ulcer, and 12.20% of patients had esophagitis. Although more than 80% of patients were discharged with clinical symptom relief, this may be related to the use of medications such as proton pump inhibitors during hospitalization. The clinical symptoms prompted the patient to seek medical attention and eventually discovered GISTs, but not necessarily caused by GISTs.
Gastroscopic results for the asymptomatic, average-risk population in Northern China: a cross-sectional study of 60,519 adults
Published in Scandinavian Journal of Gastroenterology, 2022
Yan Gong, Juan Kang, Rilige Wu, Fulin Ge, Yan-song Zheng, Qiang Zeng
Chronic gastritis was diagnosed by referring to the Chinese consensus on chronic gastritis (2017, Shanghai) [11]. The basic manifestations of non-atrophic gastritis, such as erythema (punctured, flake and strip), rough and uneven mucosa, haemorrhagic spots/spots, mucosal oedema, hyperaemia and exudation, can be seen under endoscopy. The manifestations of atrophic gastritis under endoscopy are red and mostly white mucosa, flat or even absent folds, and some exposed mucosa and blood vessels, which may be accompanied by mucosal granules or nodules. Atrophic gastritis can be diagnosed if a biopsy of chronic atrophic gastritis shows inherent gland atrophy. To make a clear clinical diagnosis, 2–3 pieces of tissue were taken from the gastric antrum and lesser curvature of the stomach and gastric body for biopsy, as were suspicious lesions. Histological changes of chronic inflammation, activity, atrophy, intestinal metaplasia, and intraepithelial neoplasia were assessed according to the New Sydney Gastritis Classification [12] and Vienna Classification [13]. Chronic gastritis was diagnosed as chronic non-atrophic gastritis or chronic atrophic gastritis by endoscopy combined with histopathological examination.
Potential utility of nano-based treatment approaches to address the risk of Helicobacter pylori
Published in Expert Review of Anti-infective Therapy, 2022
Sohaib Khan, Mohamed Sharaf, Ishfaq Ahmed, Tehsin Ullah Khan, Samah Shabana, Muhammad Arif, Syed Shabi Ul Hassan Kazmi, Chenguang Liu
The transmission of H. pylori from person to person can occur through saliva, and it might be spread out through the excrement of food or water, untreated water, poor hygiene, and crowded conditions that largely contribute to the prevalence of H. pylori infection [49]. In brief, it is more likely to be transmitted within the household conditions as it enters the body through the oral cavity and travels to the digestive system, where it infects the stomach or the first part of the small intestine, thereby causing inflammation at the targeted area. The most peculiar characteristic of H. pylori is to survive in the harsh acidic environment of the stomach. It produces urease upon entering the stomach, which then reacts with urea to form ammonia and neutralizes the surrounding environment, consequently leads to the overproduction of the stomach acid (Figure 1) illustrates the invasion of H. pylori infection in the stomach that comprises of six steps; 1) movement of the pathogen through normal stomach lining (mucosa), 2) causing inflammation of the stomach lining (chronic gastritis), 3) loss of stomach cells and weakening of digestive system (atrophic gastritis), 4) transformation of the stomach lining (intestinal metaplasia), 5) initial stages of stomach cancer (dysplasia), and finally cause stomach cancer (gastric adenocarcinoma) [49].