Bile reflux gastritis after gastrectomy
Introduction
Introduction to bile reflux gastritis after gastric resection After the gastrectomy, bile reflux gastritis is reversed into the stomach due to bile, pancreatic juice, etc., which stimulates the mucous membrane to cause gastritis. The second type of surgery has a higher incidence than the type II surgery. Gastric juice analysis was gastric acid deficiency, X-ray barium meal examination showed no output obstruction performance, gastroscopic examination showed bile reflux into the stomach, residual gastric mucosa yellow staining, biopsy showed atrophic changes in gastric mucosa. basic knowledge The proportion of sickness: 0.004% - 0.009% Susceptible people: no specific population Mode of infection: non-infectious Complications: upper gastrointestinal bleeding, diarrhea, shock, dehydration
Cause
Causes of bile reflux gastritis after gastrectomy
(1) After partial gastrectomy, the pyloric sphincter is removed and the structure that prevents bile reflux is lost.
(2) pyloric sphincter dysfunction, pyloric open state, duodenum more unobstructed, bile back into the stomach, more patients in this state. Or Helicobacter pylori infection, resulting in pyloric inflammation, edema, infection, pyloric sphincter dysfunction.
(3) gallstones, long-term smoking, drinking, high-fat diet, etc. can also cause bile reflux.
Prevention
Prevention of bile reflux gastritis after gastrectomy
1 Yijin low-fat high-protein diet, such as milk, beans and fish.
2 to avoid greasy and full diet, should be a small amount of meals.
Complication
Complications of bile reflux gastritis after gastrectomy Complications upper gastrointestinal bleeding diarrhea shock dehydration
Some are associated with gastrointestinal bleeding, diarrhea caused by hemorrhagic shock and dehydration.
Symptom
Biliary reflux gastritis symptoms after gastrectomy Common symptoms Biliary reflux upper abdominal pain Nausea and vomiting Diarrhea Nausea bloating Upper gastrointestinal bleeding Bloating tongue inflammation Stomach acid deficiency
1. Sustained burning pain in the upper abdomen or burning pain behind the sternum. After the meal, the effect of the antacid is not obvious.
2. Bile vomiting, often occurs at night, symptoms can not be relieved after vomiting, food can be accompanied by vomit.
3. Can have anemia, weight loss, glossitis and diarrhea and other manifestations of chronic atrophic gastritis.
Examine
Examination of bile reflux gastritis after gastrectomy
Gastric juice analysis was gastric acid deficiency, X-ray barium meal examination showed no output obstruction performance, gastroscopic examination showed bile reflux into the stomach, residual gastric mucosa yellow staining, biopsy showed atrophic changes in gastric mucosa.
Diagnosis
Diagnosis and diagnosis of bile reflux gastritis after gastric resection
diagnosis
After gastrectomy, persistent upper abdomen burning pain accompanied by bilious vomiting should consider the possibility of bile reflux gastritis. Such as gastric juice analysis showed gastric acid deficiency; X-ray barium meal examination without input sputum obstruction performance; gastroscopy gastric mucosa showed atrophic gastritis, bile reflux gastritis can be diagnosed.
Differential diagnosis
It needs to be differentiated from gallbladder, extrahepatic biliary system and pancreatic diseases, recurrent ulcers, postoperative gastroparesis, output obstruction and chronic enterosis syndrome.
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