Stomach symptoms during medication

Introduction Gasteropathy of Drugs is a drug-induced adverse reaction of the stomach, accounting for about one-third of the drug side effects. Many oral medications can cause stomach upset, but sometimes oral administration can cause stomach upsets such as nausea, vomiting, and loss of appetite. The clinical manifestations of drug-induced gastric diseases vary depending on the type of drug, the dose, and whether it is combined with stimulating stomach drugs. However, the stomach is stimulated, the gastric mucosal barrier suffers from different degrees of stomach damage, and severe gastric ulcers occur. With bleeding.

Cause

The cause of stomach symptoms during medication:

The pathogenesis of drug-induced gastric diseases is mainly as follows: 1. The drug interferes with the synthesis of mucin in gastric mucosal epithelial cells, affecting the quality and quantity of gastric mucus; inhibiting the synthesis of mucosal prostaglandins, inhibiting the normal proliferation of mucosal epithelial cells, renewing and forming granulation tissue, making the stomach The mucosal barrier is destroyed, renewed and granulation tissue is formed, the gastric mucosal barrier is destroyed, the obstacle is repaired, and the gastric mucosa is eroded to form an ulcer.

2. Affect the normal secretion of gastric mucosa, stimulate gastric acid and pepsin secretion. Some drugs cause thrombocytopenia, inhibit platelet aggregation, and reduce prothrombin and cause upper gastrointestinal bleeding.

3. Some drugs have stimulating and corrosive effects on the gastric mucosa, such as potassium chloride and iron salts. Some drugs affect the gastrointestinal motility and blood and lymph circulation of the gastric mucosa, and damage the normal function of the gastrointestinal tract.

an examination

Related inspection

Electronic gastroscope fiber endoscopy

Examination and diagnosis of stomach symptoms during medication:

The main condition for diagnosis is that during the course of medication, gastric symptoms appear and can be ruled out by other causes. Fiberoptic gastroscopy showed extensive congestion of the gastric mucosa, multiple erosions, bleeding points, and superficial ulcers. Sometimes I see active oozing in my stomach. The lesions are mostly located in the corpus, and a few involve the lower esophagus and the duodenum. Tissue biopsy of the lesion site, often inflammatory cell infiltration, superficial mucosal necrosis, hemorrhage and so on.

The clinical manifestations of drug-induced gastric diseases vary depending on the type of drug, the dose, and whether or not it is combined with a stimulating stomach drug. However, the main symptoms of the stomach are stimulated, the gastric mucosal barrier suffers from different degrees of damage, and severe gastric ulcers and hemorrhage occur.

1. Antipyretic analgesics: such as aspirin, indomethacin, inflammatory pain Xikang, phenylbutazone, ibuprofen, etc., easy to cause upper abdominal pain and discomfort, severe upper gastrointestinal bleeding, gastroscopy often have gastric mucosal inflammation, Smashed and ulcerated, bleeding. Upper gastrointestinal bleeding is more common in adults, occasionally in infants and young children.

2. Antibiotics: Many oral antibacterials such as tetracyclines, erythromycin, metronidazole, furans, etc., oral susceptibility, vomiting, abdominal pain, loss of appetite, aggravation of peptic ulcer and even bleeding; Bralow et al reported after oral penicillin In addition to the general gastrointestinal symptoms, acute abdominal pain and gastrointestinal bleeding can occur. Intravenous injection of erythromycin, amphotericin, mitomycin, etc., may also have gastrointestinal symptoms, occasionally gastrointestinal bleeding. Polymyxin is highly toxic to gastric epithelial cells, which can cause ischemia of the gastric mucosa, promote the release of histamine, and form gastritis and gastric mucosal damage.

3. Anti-tumor drugs: such as methotrexate, 6-mercaptopurine, 5-fluorouracil, etc., stimulate the gastrointestinal mucosa to produce diffuse inflammation, mucosal swelling, erosion or ulceration, etc., nausea, vomiting, anorexia symptoms, formation Gastritis or stomach ulcers.

4. Adrenal corticosteroids: including ACTH, various glucocorticoids, can induce gastrointestinal ulcers, or make ulcers relapse and worsen. Boland reported that prednisone in the treatment of rheumatoid arthritis, the incidence of peptic ulcers reached 37%. Gastrointestinal ulcers caused by adrenocortical hormones, also known as steroid ulcers (Steroid Ulcer), clinical symptoms are slightly different from general peptic ulcers. There is no obvious regularity of pain, which is often caused by insidious attacks. The lesions are already very serious, and even bleeding and perforation are discovered. This is because the skin care hormone increases the pain threshold and reduces the inflammatory response. Therefore, the gastrointestinal reaction should be closely observed before and during the medication, especially those with the original ulcer. Corticosteroids should be avoided in combination with salicylates, antipyretic analgesics and anti-drugs. Do not drink alcohol during medication, should be given a high protein, high vitamin and ulcer disease diet, if necessary, can be combined with acid, anti-ulcer drugs.

5. Other drugs: sympathetic blockers such as Jiang Bing Ling, Qi Yi Dian, etc. can promote gastric acid secretion, increase gastrointestinal motility, and prone to gastric ulcer. Phentolamine, phenol oxazoline, etc., have a histamine-like effect, which can aggravate the symptoms of gastric ulcer. Histamines stimulate gastric acid and pepsin secretion, and can often cause ulcer disease or exacerbate existing ulcer disease. Oral hypoglycemic agents such as metobutamide and insulin can increase the secretion of gastric juice, increase gastric acid, and prone to ulcer disease. Peitadine (anti-glare) is an H1-receptor agonist that stimulates gastric acid secretion and aggravates gastric ulcer. In addition, high-dose application of niacin and vitamin B6 can promote the release of histamine; caffeine, thyroxine, aminophylline, estrogen, captopril, etc. all cause stomach symptoms and promote the formation and occurrence of gastric ulcer. The possibility of bleeding.

Fiber gastroscopy: visible gastric mucosa extensive congestion, multiple erosions, bleeding points, superficial ulcers. Sometimes I see active oozing in my stomach.

Tissue biopsy: often inflammatory cell infiltration, superficial mucosal necrosis, hemorrhage, etc. Prone to gastric ulcer or gastritis, gastrointestinal bleeding.

Differential diagnosis

Symptoms of confusing stomach symptoms during medication

The main condition for diagnosis is that during the course of medication, gastric symptoms appear and can be ruled out by other causes. Fiberoptic gastroscopy showed extensive congestion of the gastric mucosa, multiple erosions, bleeding points, and superficial ulcers. Sometimes I see active oozing in my stomach. The lesions are mostly located in the corpus, and a few involve the lower esophagus and the duodenum. Tissue biopsy of the lesion site, often inflammatory cell infiltration, superficial mucosal necrosis, hemorrhage and so on.

The clinical manifestations of drug-induced gastric diseases vary depending on the type of drug, the dose, and whether or not it is combined with a stimulating stomach drug. However, the main symptoms of the stomach are stimulated, the gastric mucosal barrier suffers from different degrees of damage, and severe gastric ulcers and hemorrhage occur.

1. Antipyretic analgesics: such as aspirin, indomethacin, inflammatory pain Xikang, phenylbutazone, ibuprofen, etc., easy to cause upper abdominal pain and discomfort, severe upper gastrointestinal bleeding, gastroscopy often have gastric mucosal inflammation, Smashed and ulcerated, bleeding. Upper gastrointestinal bleeding is more common in adults, occasionally in infants and young children.

2. Antibiotics: Many oral antibacterials such as tetracyclines, erythromycin, metronidazole, furans, etc., oral susceptibility, vomiting, abdominal pain, loss of appetite, aggravation of peptic ulcer and even bleeding; Bralow et al reported after oral penicillin In addition to the general gastrointestinal symptoms, acute abdominal pain and gastrointestinal bleeding can occur. Intravenous injection of erythromycin, amphotericin, mitomycin, etc., may also have gastrointestinal symptoms, occasionally gastrointestinal bleeding. Polymyxin is highly toxic to gastric epithelial cells, which can cause ischemia of the gastric mucosa, promote the release of histamine, and form gastritis and gastric mucosal damage.

3. Anti-tumor drugs: such as methotrexate, 6-mercaptopurine, 5-fluorouracil, etc., stimulate the gastrointestinal mucosa to produce diffuse inflammation, mucosal swelling, erosion or ulceration, etc., nausea, vomiting, anorexia symptoms, formation Gastritis or stomach ulcers.

4. Adrenal corticosteroids: including ACTH, various glucocorticoids, can induce gastrointestinal ulcers, or make ulcers relapse and worsen. Boland reported that prednisone in the treatment of rheumatoid arthritis, the incidence of peptic ulcers reached 37%. Gastrointestinal ulcers caused by adrenocortical hormones, also known as steroid ulcers (Steroid Ulcer), clinical symptoms are slightly different from general peptic ulcers. There is no obvious regularity of pain, which is often caused by insidious attacks. The lesions are already very serious, and even bleeding and perforation are discovered. This is because the skin care hormone increases the pain threshold and reduces the inflammatory response. Therefore, the gastrointestinal reaction should be closely observed before and during the medication, especially those with the original ulcer. Corticosteroids should be avoided in combination with salicylates, antipyretic analgesics and anti-drugs. Do not drink alcohol during medication, should be given a high protein, high vitamin and ulcer disease diet, if necessary, can be combined with acid, anti-ulcer drugs.

5. Other drugs: sympathetic blockers such as Jiang Bing Ling, Qi Yi Dian, etc. can promote gastric acid secretion, increase gastrointestinal motility, and prone to gastric ulcer. Phentolamine, phenol oxazoline, etc., have a histamine-like effect, which can aggravate the symptoms of gastric ulcer. Histamines stimulate gastric acid and pepsin secretion, and can often cause ulcer disease or exacerbate existing ulcer disease. Oral hypoglycemic agents such as metobutamide and insulin can increase the secretion of gastric juice, increase gastric acid, and prone to ulcer disease. Peitadine (anti-glare) is an H1-receptor agonist that stimulates gastric acid secretion and aggravates gastric ulcer. In addition, high-dose application of niacin and vitamin B6 can promote the release of histamine; caffeine, thyroxine, aminophylline, estrogen, captopril, etc. all cause stomach symptoms and promote the formation and occurrence of gastric ulcer. The possibility of bleeding.

Fiber gastroscopy: visible gastric mucosa extensive congestion, multiple erosions, bleeding points, superficial ulcers. Sometimes I see active oozing in my stomach.

Tissue biopsy: often inflammatory cell infiltration, superficial mucosal necrosis, hemorrhage, etc. Prone to gastric ulcer or gastritis, gastrointestinal bleeding.

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