How to treat intestinal metaplasia
Intestinal metaplasia (Intestinal Metaplasia) is a common gastric mucosal lesion, usually related to chronic gastritis, Helicobacter pylori infection or long-term acid reflux. In recent years, the treatment of intestinal metaplasia has become a hot topic of concern to the medical community and patients. This article will provide you with structured treatment suggestions based on hot discussions and the latest research on the Internet in the past 10 days.
1. Definition and causes of intestinal metaplasia
Intestinal metaplasia refers to the pathological process in which gastric mucosal epithelial cells are replaced by intestinal epithelial cells, which may increase the risk of gastric cancer. Its main causes include:
| Cause | Proportion |
|---|---|
| Helicobacter pylori infection | 60%-70% |
| chronic gastritis | 50%-60% |
| long term acid reflux | 30%-40% |
| Smoking and drinking | 20%-30% |
2. Treatment methods for intestinal metaplasia
According to recent medical guidelines and clinical practice, the treatment of intestinal metaplasia mainly includes the following aspects:
1. Helicobacter pylori eradication treatment
If Helicobacter pylori is detected positive, eradication treatment needs to be given priority. The following are the recommended first-line options for 2023:
| drug combination | Course of treatment | efficient |
|---|---|---|
| Proton pump inhibitor + amoxicillin + clarithromycin | 14 days | 85%-90% |
| Proton pump inhibitor + amoxicillin + metronidazole | 14 days | 80%-85% |
| bismuth quadruple therapy | 10-14 days | 90%-95% |
2. Medication
For patients without Helicobacter pylori infection or after eradication, the following drugs can be used to relieve symptoms and repair mucous membranes:
| drug type | function | Commonly used drugs |
|---|---|---|
| proton pump inhibitor | Inhibit gastric acid secretion | Omeprazole, pantoprazole |
| Mucosal protectant | Promote mucosal repair | Sucralfate, rebamipide |
| Antioxidants | Reduce oxidative damage | Vitamin E, selenium yeast |
3. Endoscopic monitoring and treatment
Depending on the degree and scope of intestinal metaplasia, regular endoscopic monitoring is recommended, and endoscopic treatment is performed when necessary:
| Grading | Monitoring frequency | Treatment recommendations |
|---|---|---|
| Mild | every 3 years | Medication + Lifestyle Adjustments |
| Moderate | every 1-2 years | Drug therapy + endoscopic follow-up |
| Severe | every 6-12 months | Endoscopic mucosal resection (EMR) |
3. Lifestyle adjustment
In addition to drug treatment, lifestyle improvements are crucial for the reversal of intestinal metaplasia:
| Adjustment items | specific suggestions | scientific basis |
|---|---|---|
| diet | Eat more fresh fruits and vegetables and avoid pickled and grilled foods | Reduce nitrite intake |
| Quit smoking and limit alcohol | Quit smoking completely and drink less than 1 drink/day | Reduce risk of mucosal damage |
| weight management | Control BMI between 18.5-24.9 | Reduce acid reflux |
4. Latest research progress
Recent (August 2023) research published in the international journal "Gut" shows:
| Research direction | discover | Potential applications |
|---|---|---|
| Microbiome Modulation | Specific probiotics can improve intestinal metaplasia | Adjuvant treatment options |
| targeted therapy | Wnt/β-catenin pathway inhibitors are effective | future drug development |
5. Answers to Frequently Asked Questions by Patients
Q: Can intestinal metaplasia become cancerous?
A: Incomplete intestinal metaplasia has a high risk of becoming cancerous (about 5%-10%) and requires close monitoring.
Q: How long does it take for treatment to be reviewed?
A: Gastroscopy should be repeated 6 months after Helicobacter pylori eradication, and the frequency will be determined based on the grade thereafter.
Summary: The treatment of intestinal metaplasia requires comprehensive measures, including eradication of the cause, drug repair, regular monitoring and lifestyle adjustments. Early intervention can significantly reduce the risk of cancer, and patients are advised to follow medical advice and standardize treatment.
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