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The diagnosis and treatment of drug-induced mucosal injury should be emphasized in case sharing of small intestinal diseases

The diagnosis and treatment of drug-induced mucosal injury should be emphasized in case sharing of small intestinal diseases

  • Categories:Stomach healthy
  • Author:
  • Origin:
  • Time of issue:2021-01-19
  • Views:0

(Summary description)

The diagnosis and treatment of drug-induced mucosal injury should be emphasized in case sharing of small intestinal diseases

(Summary description)

  • Categories:Stomach healthy
  • Author:
  • Origin:
  • Time of issue:2021-01-19
  • Views:0
Information

The incidence of small bowel disease is low, and its overall incidence rate is about 1% of the total digestive tract diseases. The clinical manifestations are more common in gastrointestinal bleeding and abdominal pain than those in unknown causes. The incidence rate of tumor and vasodilatation is more common in the elderly, and the highest incidence of Crohn's disease (CD) is in young people. Due to the complexity of small intestinal diseases and various clinical manifestations, accurate diagnosis is particularly important for digestive physicians. Professor Qi Lingzhi, director of the second digestive department of Jilin Provincial People's Hospital, was invited to share the diagnosis and treatment process and clinical thinking of small intestinal diseases through the analysis of more than 10 classic cases of small intestinal diseases.

Timing of capsule endoscopy and balloon enteroscopy

Comprehensive examination and evaluation is very important for the diagnosis and differential diagnosis of small bowel diseases. Capsule endoscopy, balloon enteroscopy, CTE / MRE (small bowel imaging), digital subtraction angiography (DSA), radionuclide scanning, double contrast barium enterography and so on are commonly used in clinical examination of small bowel diseases. Among them, balloon enteroscopy is the gold standard for the diagnosis of small intestinal diseases, which has significant diagnostic value for unexplained gastrointestinal bleeding, chronic iron deficiency anemia and unexplained small intestinal obstruction. At the same time, CT / MRI enterography is also an effective means of clinical examination, which can effectively evaluate the lesions inside and outside the intestinal cavity. Its indications include small intestinal obstruction, small intestinal tumor, CD, unexplained gastrointestinal bleeding, unexplained iron deficiency anemia.

A case of iron deficiency anemia was diagnosed as a rare small intestinal ulcerative disease "CMUSE", which was often misdiagnosed as CD. It is characterized by multiple small intestinal ulcers with a lesion spacing of less than 4cm; the ulcers are mostly superficial without reaching the muscular layer, and the mucosa around the ulcer is normal; the ulcers are characterized by chronic recurrence, often accompanied by chronic gastrointestinal bleeding, anemia, and intestinal obstruction of different degrees; lack of clinical and laboratory evidence of inflammatory syndrome.

Professor Qi analyzed and summarized the diagnosis and treatment process of "chronic abdominal pain, diarrhea", "small intestinal segmental stenosis", "chronic iron deficiency anemia", "obscure gastrointestinal bleeding" and other cases, and found that: the course of small intestinal disease is long, the symptoms are not typical, often ignored; capsule endoscopy and balloon enteroscopy should grasp the important examination opportunity for the diagnosis of small intestinal bleeding; CT / MRI enterography Examination has certain advantages for the diagnosis of small intestinal tumors.

Effects of polyprazine on gastric mucosal injury and intestinal mucosal injury

The repair function of injury

In recent years, it has been reported that there is a high incidence of small intestinal mucosal injury associated with non steroidal anti-inflammatory drugs (NSAIDs). The incidence of small intestinal mucosal injury in patients with continuous use of NSAIDs can exceed 70%. Even short-term use (such as 2 weeks) can cause small intestinal mucosal injury. However, studies have found that ppz can repair both gastric mucosal injury and small intestinal mucosal injury.

To investigate the efficacy of polyprazeb in the treatment of small intestinal mucosal injury induced by NSAIDs, the results of clinical trials showed that polyprazeb significantly improved the small intestinal mucosal injury induced by LDA. Polyprazeb is a chelate of zinc and carnosine, which has the function of exogenous protection and endogenous repair, so it has rapid effect and good safety. For a patient with NSAIDs related enteritis, the symptoms were significantly relieved after 2 months of oral treatment.

It can be made clear that polyprazeb is a protective and restorative agent for gastrointestinal mucosa. In addition to the treatment of gastric ulcer, it can also improve intestinal injury, ulcerative colitis, oral ulcer and esophagitis.

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