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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
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.)
How to treat bleeding from gastric ulcers?
If it is a mild gastric ulcer bleeding, it may only manifest as black stool without any obvious specific discomfort symptoms and stable vital signs. This condition can be managed by controlling the diet and appropriately taking or intravenously using proton pump inhibitors such as omeprazole, lansoprazole, etc., which often can be curative. If the bleeding is considerable, presenting symptoms like vomiting coffee-colored or dark red liquid, fainting, profuse sweating, blood pressure drop, etc., this condition requires timely hospital treatment. Medication primarily includes proton pump inhibitors combined with hemostatic drugs, nutritional support, prevention of complications, etc. If the medical treatment is ineffective, endoscopic hemostasis might be needed, and further more, surgical intervention may be considered.
Can I eat apples with acute gastroenteritis?
Apples are one of the essential fruits in our daily life, containing a rich array of nutrients, such as minerals, fruit acids, vitamins, fiber, etc., which are greatly beneficial to our human body. Acute gastroenteritis is usually caused by exposure to cold or improper diet, primarily characterized by symptoms such as abdominal pain, diarrhea, vomiting, and sometimes fever and chills. In this case, targeted treatment should be firstly applied, and the diet should consist mainly of light and easily digestible food, such as porridge and soft noodles, while avoiding raw, greasy, spicy foods, and alcoholic beverages. Apples are relatively cold in nature; it is best to avoid eating them raw under these circumstances. If there is a real desire to eat apples, steaming them before eating should be feasible.
Can acute gastroenteritis cause shock?
Acute gastroenteritis often manifests as symptoms such as vomiting, abdominal pain, and diarrhea, sometimes accompanied by fever, dizziness, fatigue, etc., often caused by factors such as exposure to cold or improper diet. These include what we refer to as viral enteritis and bacterial enteritis. In most cases, symptoms gradually alleviate after symptomatic treatment, and some may improve without treatment. However, a few patients, such as those with uncontrollable vomiting and diarrhea, coupled with an inability to eat, may experience worsening dizziness, significant fatigue, dry mouth, poor skin elasticity, and reduced urine output. These symptoms indicate the development of hypovolemic shock, which requires attention.
Atrophic gastritis with intestinal metaplasia what medicine to take
Chronic atrophic gastritis with intestinal metaplasia often arises from untreated chronic superficial gastritis, primarily due to Helicobacter pylori infection. Therefore, it is essential to first check for Helicobacter pylori infection. If an infection is present, quadruple therapy is generally used to eradicate the bacteria, which may improve the atrophy. If there is no Helicobacter pylori infection, treatment mainly involves protecting the gastric mucosa. While there are no specific Western medicines for this, traditional Chinese medicine and a differential diagnosis approach often yield good results. Regular follow-ups are also important. (Specific medications should be used under the guidance of a doctor.)