What medicine to take for high-position gastritis

High gastritis is a type of gastritis, which is a very common disease in life. Gastric disease is different from other diseases. Although it is not very serious, most of them require long-term conditioning, and it is difficult to cure simply by relying on medication. However, medications also play an important role, especially in providing relief when pain occurs. So, what medicine should I take for high-altitude gastritis? Let’s take a look below.

The so-called high-position gastritis is determined according to the location of the gastritis lesions. Oriental people generally suffer from antral gastritis more often, and the inflammation of the high-positioned gastric body and cardia is called high-position gastritis. The treatment principles are the same as those for ordinary gastritis.

1. Drug regimen for eliminating Helicobacter pylori infection

It has been confirmed that Helicobacter pylori (Hp) is the main cause of chronic gastritis. Eradication of Hp can significantly improve the chronic active inflammation of the gastric mucosa and is an important etiological treatment for patients with chronic gastritis, but it may not necessarily eliminate all symptoms of indigestion.

In particular, the following patients with chronic gastritis need Hp eradication treatment:

① Those with obvious abnormalities (gastric mucosal erosion, moderate to severe atrophy, moderate to severe intestinal metaplasia, atypical hyperplasia);

② Those with a family history of gastric cancer;

③ Patients with erosive duodenitis;

④ Patients with indigestion symptoms who have poor response to conventional treatment.

At present, clinical treatment often adopts a combination of medications, mostly centered on acid suppressants or bismuth agents, plus two antibiotics, referred to as triple or quadruple regimens.

Quadruple therapy: standard dose of proton pump inhibitor (prazole) + clarithromycin 500 mg + amoxicillin 1000 mg, twice a day for one week.

Triple therapy: standard dose of bismuth + amoxicillin 500 mg + metronidazole 400 mg, twice a day for two weeks. The eradication rate of Hp by triple therapy can reach 80%-90%. . For patients who fail triple therapy, quadruple therapy can be used to eradicate Hp. Bismuth can both protect the gastric mucosa and kill Helicobacter pylori. Short-term use rarely causes adverse reactions except for black tongue coating and black stools. However, long-term use is not recommended to avoid excessive accumulation of bismuth in the body.

In recent years, studies have shown that other antibiotics such as gentamicin, streptomycin, kanamycin, furazolidone, etc. can kill Hp. Hp has a high resistance rate to metronidazole, which affects the efficacy. Furazolidone has a strong anti-Hp effect, and Hp is not easy to develop resistance to it.

2. Acid suppression therapy

Experts recommend that acid suppression therapy be used when you have gastric mucosal erosion or gastritis with symptoms such as heartburn, acid reflux, and upper abdominal hunger pain. Commonly used acid suppressants include antacids (such as aluminum hydroxide, sodium bicarbonate, etc.), H2 receptor blockers (such as azithromycin) or proton pump inhibitors (such as prazole).

3. Gastric mucosal protective agent

This type of drug is often used for patients with gastric mucosal erosion, bleeding or obvious symptoms. Bismuth, sucralfate, aluminum carbon preparations, etc. can be used. The effect of sucralfate in preventing acute gastric mucosal lesions is equivalent to that of H2 receptor antagonists, and has no obvious side effects.

4. Prokinetic drugs

People with low gastric motility (often manifested as indigestion) can choose prokinetic drugs, such as domperidone, mosapride, metoclopramide, etc.; upper abdominal pain caused by gastric muscle spasm can be treated with antispasmodics. How to choose and take appropriate medicine? Everyone must use it reasonably under the guidance of a doctor or pharmacist and must not take it blindly. Improper selection of prokinetic drugs may lead to more adverse reactions. For example, metoclopramide, also known as metoclopramide, has a strong antiemetic effect and can enhance gastric motility, but the drug can cause muscle tension disorders, manifested as compulsive mouth opening, tongue protrusion, torticollis, restlessness, etc. This adverse reaction is called extrapyramidal reaction, and the incidence rate is 4%-25%. Adverse reactions to domperidone are rare when used in conventional doses and include dry mouth and rash.

5. Digestive aids

If there is obvious atrophic gastritis and lack of gastric acid and pepsin secretion, the patient often experiences loss of appetite and upper abdominal distension. If there are no mucosal attack factors such as gastric acid, acid suppressants may not be used during treatment, but digestive aids may be considered.

6. Traditional Chinese Medicine

Traditional Chinese medicine believes that long-term illness is mostly caused by weakness. Patients with various types of gastritis have varying degrees of spleen deficiency, qi stagnation and blood stasis, and kidney deficiency. Therefore, Chinese medicines that strengthen the spleen and kidney, regulate qi and activate blood circulation, and clear away heat and digestion are often used to treat gastritis. Such as tonic Chinese medicines such as astragalus, licorice, white peony root, jujube, and fried Atractylodes; qi-regulating Chinese medicines such as tangerine peel, immature bitter orange, and costus root; blood-activating and blood-stasis-removing Chinese medicines such as salvia miltiorrhiza, Corydalis, and Ligusticum chuanxiong; digestive aid Chinese medicines such as chicken gizzard lining, radish seed, and Millettia repens.