Why does atrophic gastritis have to be reviewed-if you don’t check it, you don’t know if it becomes cancerous!

Before the beginning of the text, let’s look at a real consultation and response: This is a conversation between a patient consulting Professor Yu Guang this morning, which shows how little people know about gastrointestinal endoscopy! ! ! 57-year-old Lao Hu is the owner of a supermarket near our hospital. He usually smokes, drinks, and plays mahjong and does everything. Five years ago, he was diagnosed with chronic atrophic gastritis with mild intestinal metaplasia. He was positive for Helicobacter pylori. At that time, there were no obvious symptoms. Therefore, he prescribed triple drugs for two weeks to eradicate Helicobacter pylori. He also asked him to recheck Helicobacter pylori one month after taking the medicine, and recheck gastroscope and pathological biopsy once a year. And we must get rid of the problems of smoking and drinking, staying up late to play cards. I was also afraid that he was too worried and told him that although this is a precancerous lesion, as long as the eradication of Helicobacter pylori is confirmed and the gastroscope is reviewed once a year, there is no symptom. In fact, there is no need to worry about it or even special treatment. But review is more important than taking medicine, so remember! Boss Hu smiled and agreed. It may be because I am busy or I don’t care about myself. A few months have passed and I haven’t seen him come to review the Helicobacter pylori. Years have passed and I haven’t seen him come to review the gastroscope. At the time, I thought he had checked in other hospitals, so I didn’t care too much. Four or five years later, on May 22 this year, Lao Hu suddenly came to my clinic again. It turned out that he was drunk once two months ago. Since then, he has had a bad appetite, fullness and discomfort, can’t eat, belching, repeatedly, and taking medicine does not improve. So I thought of coming to the hospital for an examination. I asked him: How can I still smoke and drink? It was intestinal metaplasia 5 years ago…He said embarrassedly: I have stopped drinking for the past two months, and I still smoke fewer cigarettes. It turned out that he didn’t think there were any symptoms, it was all caused by drinking, so he didn’t take the doctor’s words seriously! Neither broke the bad habit, nor did it go to review. So I gave him two examinations: carbon fourteen breath test and gastroscope. The results came out quickly: Carbon 14: DPM value as high as 1840, +++, Gastroscope: Severe antrum atrophy, intestinal metaplasia? Two suspicious lesions in the upper part of the stomach were biopsied. Four days later, the pathological results came out: Stomach dysplasia (high-grade intraepithelial neoplasia), and focal cancer. Fortunately, Lao Hu’s re-examination was fairly timely. It was considered early cancer and could be completely cured under endoscopy, eliminating the trouble and pain of major surgery. If you wait another year, two years, or even a few years before the re-examination, not only the endoscopist can do nothing but the surgeon may shake his head and sigh! From this case, we should pay attention to the following points: Although atrophic gastritis, intestinal metaplasia, and dysplasia are precancerous lesions, they are not terrible. Don’t be burdened with thoughts, and don’t be paralyzed. Strategically despise them. Pay attention to it tactically. Do the following, generally there will be no problems. First, get rid of bad problems Gastric cancer can also be said to be eating problems, such as pickled, smoked, processed meat, leftovers, eat as little as possible or not, eat more fresh vegetables and fruits, and pay attention to balanced nutrition ; Must quit smoking and drinking. Tobacco and alcohol are first-class carcinogens, not only stomach cancer, but almost all tumors are related to them. Another, three meals should be timely and even, don’t stay up late, don’t be stressed, and less angry. Second, it is necessary to eradicate Helicobacter pylori Helicobacter pylori is the main culprit of gastric cancer, and it is an important promoter in the process of atrophic gastritis. Many experts believe that in the stage of atrophy and mild intestinal metaplasia, after eradication, it may be reversed; even if it cannot be reversed, it can at least maintain the status quo and stop progressing. This is tantamount to putting the brakes on gastric cancer; another point is very important , That is the post-treatment review: no matter whether the triple or quadruple is currently used, 100% of the eradication can not be guaranteed. Therefore, one month after taking the medicine, a review must be performed to confirm whether the eradication is successful. Thereafter, breath test every 1-2 years to see if it recurs. The third and most important thing is that — Gastroscopy follow-up is a very important part of atrophic gastritis, regular gastroscopy + pathological biopsy! We can grasp the progress of the gastric mucosa through review, and if there is a change, we can take positive measures. For example, oral medication, or timely endoscopic resection like Lao Hu, it will be fine. The general recommended frequency of re-examination is: 1. Patients with atrophic gastritis without intestinal metaplasia and dysplasia can be followed up with endoscopy and pathology every 1 to 2 years; 2. Every 6- for patients with moderate to severe atrophy or with intestinal metaplasia 12 months follow-up