Question
The main symptoms are a slight pain, constipation, dry mouth, and lack of appetite. The onset of the illness has exceeded two years, and the examination result is ulcerative gastritis. How should it be treated?
Answer
The treatment of ulcerative gastritis should be based on the underlying cause, which is often due to medications (especially nonsteroidal anti-inflammatory drugs), alcohol, and acute stress, such as severe illness in patients. Less common causes include radiation, viral infections (such as cytomegalovirus), vascular damage, and direct trauma (such as nasogastric tube insertion). Under endoscopy, the mucosa can be seen to have pinpoint surface ulceration that does not invade the deep layer, often accompanied by a certain degree of bleeding. Acute stress gastritis is a type of ulcerative gastritis seen in severely ill patients, where the proportion of significant upper gastrointestinal bleeding due to mucosal damage in the stomach and duodenum increases clinically. Risk factors include severe burns, central nervous system trauma, sepsis, shock, respiratory failure associated with mechanical ventilation, liver and kidney failure, and multi-organ dysfunction. Other predictive factors for acute stress gastritis include the duration of hospitalization in the intensive care unit and the length of time during which enteral nutrition was not received. In summary, the more severe the patient’s condition, the higher the risk of significant bleeding. The pathological mechanism for severe patients developing acute ulcerative gastritis may be a weakened gastric mucosal barrier function. A reduction in blood flow to the gastric mucosa and possibly increased acid secretion (such as burns, central nervous system trauma, and sepsis) can promote mucosal inflammation.