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Jiang Guo Ming
Gastroenterology
About me
In 1994, graduated from Nanjing University of Chinese Medicine and started working at Yanshan Branch of Liyang People's Hospital and Liyang Maternal and Child Health Hospital in the same year. From May 1999 to August 2000, underwent further training in the Gastroenterology Department of the First People's Hospital of Changzhou. Currently serving as the Director of the Emergency Department at the hospital, with the title of Associate Chief Physician.
Proficient in diseases
Mainly engaged in the treatment of gastroenterology with a combination of traditional Chinese and Western medicine, as well as the operation of digestive endoscopy.
Voices
Is atrophic gastritis serious?
Chronic atrophic gastritis, compared to chronic non-atrophic gastritis, is relatively more severe. It is usually due to the atrophy of the gastric mucosal glands that this condition occurs. Under gastroscopy, the gastric mucosa can be seen to become pale, and the submucosal blood vessels are easily exposed. Sometimes, the gastric mucosal cells are replaced by intestinal epithelial cells, which is what we refer to as intestinal metaplasia. Some believe that this condition is a precancerous lesion, so it must be given sufficient attention. Firstly, it is necessary to check for Helicobacter pylori infection; if present, comprehensive antibiotic treatment is required. Some believe that if Helicobacter pylori is completely eradicated, partial reversal of gastric mucosal atrophy can happen, and in some cases, it may even return to normal, making the eradication of Helicobacter pylori particularly important. If there is no Helicobacter pylori infection, symptomatic treatment is advocated, such as protecting the gastric mucosa, etc. Additionally, traditional Chinese medicine has relatively better effects in treating atrophic gastritis compared to Western medicine, and further diagnosis and treatment in a traditional Chinese medicine department can be considered. (Note: The use of medications should be under the guidance of a professional doctor.)
How to deal with indigestion and nausea?
If symptoms of indigestion and nausea appear in the short term, they may be caused by exposure to cold, improper diet, medication factors, and so on. In such cases, adjusting the diet or discontinuing the related medication should gradually relieve the symptoms. If this condition persists for a long period, it is necessary to rule out upper gastrointestinal issues. Initial steps should include relevant examinations, commonly involving procedures such as gastroscopy, tests for Helicobacter pylori, or upper gastrointestinal imaging, etc. Based on the results of these tests, targeted treatment should be administered, such as eradicating Helicobacter pylori. If there is no Helicobacter pylori infection, symptomatic treatment should be considered, such as enhancing gastric motility, protecting the gastric mucosa, or suppressing stomach acid, etc.
How to prevent and treat atrophic gastritis
Chronic gastritis includes two types: chronic non-atrophic gastritis and chronic atrophic gastritis. Chronic atrophic gastritis is generally more severe than chronic non-atrophic gastritis and usually accompanies intestinal metaplasia, which some refer to as a precancerous lesion. If chronic atrophic gastritis is present, formal medical treatment is necessary. Initially, it is advisable to check for Helicobacter pylori infection. If an Helicobacter pylori infection is found, timely eradication therapy is recommended, typically using quadruple therapy, which consists of a proton pump inhibitor, two types of antibiotics, and a bismuth agent. If there is no Helicobacter pylori infection, treatment generally focuses on symptomatic relief, such as protecting the gastric mucosa and enhancing gastric motility. Additionally, traditional Chinese medicine has shown satisfactory effects in treating chronic atrophic gastritis. It is also important to maintain good dietary and living habits, prefer light and easily digestible foods, and avoid raw, greasy, spicy, and irritating foods to help maintain a positive state of mind. Regular gastroscopy check-ups are necessary. (Medication should be taken under the guidance of a doctor.)
Can gastric lavage be performed for peptic ulcer?
Peptic ulcer is one of the common upper gastrointestinal diseases, including gastric ulcer, duodenal bulb ulcer, compound ulcer, etc. In this case, since the ulcer site is often deep, sometimes reaching the base layer, even the serous layer of the gastric mucosa. If gastric lavage is performed too vigorously, gastric perforation may occur. Therefore, generally, gastric lavage is not advocated, but in a few cases, such as organophosphate pesticide poisoning or other drug poisonings, etc. If gastric lavage is not performed promptly, it often leads to serious complications, even life-threatening. Therefore, gastric lavage is still needed in a few cases, and in these situations, the procedure must be gentle and not too prolonged.
What medicine is taken for duodenal ulcer?
Duodenal bulb ulcer, its main cause should be related to Helicobacter pylori infection. In this case, first check for Helicobacter pylori infection, generally using the carbon-13 or carbon-14 breath test. If there is Helicobacter pylori infection, then formal antibiotic treatment is required. For example, a proton pump inhibitor combined with two antibiotics, secondly, bismuth preparations, constitute the standard quadruple therapy, with a treatment duration of 10 to 14 days. If there is no Helicobacter pylori infection, symptomatic treatment is generally sufficient. For example, suppressing stomach acid, protecting the gastric mucosa, etc. At the same time, attention should be paid to regular dietary habits, quitting smoking and alcohol, and avoiding excessive fatigue, etc. (Specific medication use should be conducted under the guidance of a doctor.)
Can stomach polyps cause bleeding?
With the increasing popularity of gastroscopy, the detection rate of gastric polyps is rising year by year. Gastric polyps refer to the protrusions from the gastric mucosa into the gastric cavity, forming either round or semi-circular elevations. They are usually benign lesions, including hyperplastic polyps and adenomatous polyps. However, adenomatous polyps can potentially become cancerous and require prompt attention. If a polyp becomes eroded, it may cause a small amount of bleeding, but this generally does not lead to blood in the stool. Blood in the stool typically refers to intestinal bleeding, which can appear as bright red, dark red, or even jam-like or purplish colors. This is often caused by diseases around the anus or colon diseases, such as polyp ulceration or even tumors, etc., which should not have a significant connection with gastric polyps.
Clinical characteristics of peptic ulcer
Peptic ulcer is a common and frequently occurring upper gastrointestinal disease. The most likely cause may be infection by Helicobacter pylori, with other potential causes including irritation from smoking and alcohol, poor dietary and living habits, severe psychological stress, or medications, among others. The primary change is usually an excessive secretion of gastric acid, which irritates the gastric mucosa leading to self-digestion and the appearance of gastric or duodenal erosion and ulcers. Clinically, it often presents as long-term, periodic, rhythmic upper abdominal pain, which may be located in the upper left abdomen or slightly right of the navel, and is often accompanied by regurgitation, belching, acid reflux, nausea, etc. If there is ulcer bleeding, it often presents as black stools or even vomiting blood, among other symptoms.
How to treat peptic ulcers?
The treatment of peptic ulcers should be based on specific causes, as well as the patient's gender, age, medical history, and medication history, among other factors. Generally speaking, the primary cause of peptic ulcers is usually Helicobacter pylori infection. Therefore, the first step is to test for Helicobacter pylori. If Helicobacter pylori is present, antibacterial treatment is required, with the first choice being quadruple therapy, which includes a proton pump inhibitor, two types of antibiotics, and a bismuth agent, administered over a 10 to 14-day treatment course. If there is no Helicobacter pylori infection, the first choice would be proton pump inhibitors and gastric mucosal protective drugs, combined with symptomatic treatment. Meanwhile, it is crucial for patients with peptic ulcers to develop good eating and living habits, and relaxing their mindset can also be helpful.
The main symptoms of peptic ulcers
Common types of peptic ulcers, including gastric ulcers, duodenal bulb ulcers, complex ulcers, and anastomotic ulcers after gastric resection, share common characteristics and have their own distinct symptoms. Abdominal pain is a usual symptom. The pain from duodenal bulb ulcers tends to be dull, bloating, or blunt, and it is generally more noticeable when hungry. The pain often eases after eating as food neutralizes stomach acid. Sometimes, there is pain at night. If the ulcer is beyond the bulb or is a penetrating ulcer, it often comes with back pain; gastric ulcers primarily manifest as postprandial pain, meaning pain occurring half an hour to an hour after eating, which gradually alleviates; complex ulcers often present with both types of symptoms mentioned above. As peptic ulcers are often associated with excessive stomach acid, symptoms like acid reflux, heartburn, and nausea are common.
What to do about gastritis pain?
Upper abdominal pain caused by gastritis is usually due to excessive secretion of gastric acid, which irritates the gastric mucosa. In such cases, acid-suppressing medications are preferred, commonly including H2 receptor antagonists and proton pump inhibitors, with proton pump inhibitors being the first choice. Treatment plans should also be determined based on underlying diseases and the presence of Helicobacter pylori infection. If Helicobacter pylori infection is present, formal quadruple therapy should be initiated to eradicate the bacteria. If there is no infection, symptomatic treatment with proton pump inhibitors as the first choice is sufficient. Some patients may experience upper abdominal pain due to episodic gastric spasms. In such cases, antispasmodic pain relievers such as scopolamine butylbromide or anisodamine can be used for symptomatic treatment. It is also important to eat a light, easily digestible diet and to avoid exposure to cold. (Note: Please use medication under the guidance of a clinical doctor and based on specific circumstances.)