Content Sources:
1. Chen Li. Guidelines for the comprehensive care of patients with gastric ulcers[N]. Public Health News,2024-06-07(015).
2. Cai Dandan. Analysis of the effect of systematic nursing intervention on chronic gastritis complicated with gastric ulcer[J].Chinese Journal of Metallurgical Industry Medicine,2024,
3. Zhou Xiaoli, Gao Xiaoyang, Liu Song, et al. Influencing factors of delayed bleeding after ESD for early gastric cancer and precancerous lesions after sterilization[J].Journal of Clinical Gastroenterology,2024,
Gastric ulcer is a common digestive system disease, people of any age can be affected, 40 to 60 years old middle-aged and elderly patients are the most common, and men are more than women, gastric ulcers are generally classified according to their location and gastric acid secretion, the most common type of gastric ulcer occurs near the small angle of the stomach, the proportion of gastric ulcers in patients with gastric ulcers is as high as more than 50%, another is worth noting that gastric ulcers occur in 1/3 of the stomach or around the cardia, which is prone to gastric bleeding.
Jiang Siming is a patient with a stomach ulcer, but in the fall of 2021, he did not know that he had a stomach ulcer. Jiang Siming, 43 years old, is a photographer for a nature journal magazine, specializing in photographing wild birds, and for professional reasons, Jiang Siming often needs to squat on the mountain, often squatting for several days, eating some dry food when he is hungry, and boiling water on the spot when he is thirsty, and people gradually become lean.
In the autumn of 2021, Jiang Siming learned that there was a rare bird in China in a local ravine, so he packed up his things and hurriedly went up the mountain to squat. However, before he set off, he vomited several times because of stomach discomfort, but due to his curiosity and excitement about rare birds, Jiang Siming didn't care about the small episode of stomach pain at the moment, and after drinking a few sips of hot water, he felt relieved and left this matter behind.
On October 16, 2021, Jiang Siming entered the deep mountains and old forests under the leadership of the local bird guide, and walked a lot of rugged mountain roads to reach the destination, which is a ravine, the temperature is very low and the humidity is very high.
At 8 o'clock in the evening, it has been more than 6 hours since Jiang Siming squatted in the ravine, Jiang Siming's whole body was soaked, his body was shivering with cold, his lips were pale, and his face was bloodless, and more importantly, the long-term cold and hunger made his abdominal pain worse, different from the clammy and cold of the skin, his stomach seemed to be burning, and the burning pain was getting stronger and stronger.
Early the next morning, Jiang Siming was woken up by a strong discomfort in his stomach, when he woke up, Jiang Siming's nose was a little blocked, he smiled helplessly, he caught a cold as expected, he wanted to sit up and drink two sips of water to take some cold medicine and then go back to sleep, but he didn't expect to feel a rusty fishy sweet smell in his throat as soon as he sat up, Jiang Siming retched a few times, picked up the water on the bedside and drank two sips to suppress the urge to vomit, but after two sips of water, Jiang Siming instantly began to vomit, what he didn't expect was, All that came out was coffee-colored and unidentified substance.
Jiang Siming, who noticed that something was wrong, couldn't sit still, and quickly got up and went to the hospital, and after gastroscopy, it was found that there was an ulcer with a diameter of about 1.5cm in the antrum, obvious bleeding could be seen at the bottom of the ulcer, the surrounding mucosa was congested and edema, the mucosal folds in the gastric antrum were thinned, and a small amount of chronic inflammation could be seen. Gastroscopic biopsy results were positive for Helicobacter pylori. Routine blood examination showed a decrease in hemoglobin, other indicators were normal, and the results of biochemical tests were normal, and the diagnosis was gastric ulcer, Helicobacter pylori infection, accompanied by bleeding.
Jiang Siming didn't expect his stomach disease to be so serious, he looked at the test results with a worried face, and the doctor saw that he had been depressed, and comforted him and said: "Stomach ulcer is not a very serious disease, as long as you can improve your life and rest, quit spicy and stimulating food, and combine it with medication, you will slowly get better, and stomach diseases must be nourished." ”
Listening to the doctor's words, Jiang Siming felt that his mood was indeed a lot better, and he decided to go home and take medicine to nourish his stomach, and after being discharged from the hospital, Jiang Siming's symptoms slowly disappeared. However, not long after being discharged from the hospital, Jiang Siming devoted himself to work again, and in the face of his wife's serious dissuasion, Jiang Siming took the doctor's words to deal with it, "The doctor said that this is not serious, as long as you take medicine and raise it for a while, I don't have any discomfort now, it must be completely fine, you don't have to worry too much." ”
Since May 2022, the weather has gradually become hotter, and everyone has gradually taken off their heavy padded jackets and changed into cool short sleeves. At this time, Jiang Siming's wife found that Jiang Siming seemed to be thinner than before, and the clothes that were a little small before were still free to wear on her body, especially if she couldn't wear black clothes, black was thin, and Jiang Siming, who was already lean, was like a slender thin bamboo pole.
But Jiang Siming himself didn't care about this, always laughing and saying that it was because he often had to go over mountains and mountains at work, and even joked that he was called "wearing clothes to look thin, and undressing to have meat".
Until June 22, 2022, Jiang Siming happily joined a photography team formed by a group of friends, completely ignoring the symptoms of dizziness and black stool that he had always had during this time, but this time he was not so lucky. At four o'clock in the afternoon of June 22, his wife, who was at work, received a call from the hospital, saying that Jiang Siming had fallen because of a coma and was sent to the central hospital.
The examination results showed that the hemoglobin was 8.5 g/dL, the red blood cell count was 2.5 × 10^12/L, and the fecal occult blood test was strongly positive. Gastroscopy revealed an ulcer about 3 cm in size in the antrum, and the biopsy result was a moderately low-grade adenocarcinoma with lymph node metastasis; Abdominal CT examination showed that the gastric antrum mass was about 3.5 cm × 2.5 cm, the boundary was clear, the enhanced scan showed uneven enhancement, multiple metastases of different sizes in the liver, the maximum diameter was about 2 cm, and the retroperitoneal lymphadenopathy was enlarged; CEA 20 ng/mL，CA19-9 150 U/mL。
With the test results, Jiang Siming's wife couldn't accept it for a while, and was stunned for a long time before asking, "Doctor...... Is there a mistake? How could it be stomach cancer? Half a year ago, it was a stomach ulcer, but he was already healed......"
The doctor pondered for a long time when he heard Jiang Siming's wife's words, and then turned to Jiang Siming's previous medical records, and only raised his head after carefully pondering it, and asked Jiang Siming about his eating habits and work content during this period while comforting Jiang Siming's wife, but as all the details of his life unfolded, the doctor's brows became deeper and deeper, and finally sighed deeply and said: "I finally understand why it has developed so rapidly in just half a year, it turns out that the culprit is hidden here!" ”
Hearing this, Jiang Siming's wife looked at the doctor suspiciously, the doctor felt her inquiring gaze, shook his head and sighed helplessly: "Actually, what your husband said is right, originally a stomach ulcer is not a serious disease, as long as it is well maintained, there will be no problems, but ......"
"Doctor, it's because he has been eating irregularly for a long time because of his work, isn't it?!" Jiang Siming's wife broke down and cried, interrupting the doctor's words, grabbed the doctor's hand and asked tremblingly. But the doctor shook his head and said regretfully: "If it was just a simple irregular diet, it might not have developed so quickly, in fact, the fundamental reason is that he made a serious mistake, and it was this mistake that made stomach cancer get closer and closer to him......
It turns out that Jiang Siming likes to eat pickled vegetables and bean curd and other heavy pickles very much, and every time he goes up the mountain, he brings some bread to eat with bean curd or pickles, and because the shooting time is often fleeting, sometimes Jiang Siming suddenly wants to shoot in the middle of eating, so he puts the uneaten food on the stone ground casually, and waits until the filming is finished before continuing to eat, but Helicobacter pylori is widely present in nature, which also leads to Jiang Siming's Helicobacter pylori infection repeated and prolonged.
Pickled fermented foods such as fermented bean curd are high in salt and can irritate the gastric mucosa for repeated ulcers. A high-salt diet will lead to an increase in gastric acid secretion, irritate the gastric mucosa for a long time, cause gastric mucosal damage, easily cause gastric ulcers, and even increase the risk of gastric cancer.
Pickled fermented foods such as fermented bean curd contain substances such as nitrite and have carcinogenic effects. During the curing process, nitrates in food are converted into nitrite, which combines with amines in the body to form nitrosamines, which are strong carcinogens and increase the risk of stomach cancer due to long-term consumption of preserved foods.
Helicobacter pylori infection can cause chronic gastritis and increase the risk of stomach cancer. Helicobacter pylori infection can lead to chronic gastritis, and long-term chronic inflammation can irritate the gastric mucosa, causing the gastric mucosal cells to become cancerous, and then develop into gastric cancer. Pickled fermented foods such as fermented bean curd do not cause H. pylori infection by themselves, but they can irritate the gastric mucosa, aggravate chronic gastritis, and indirectly increase the risk of H. pylori infection.
The combination of H. pylori infection and a high-salt diet significantly increases the risk of stomach cancer. This is because a high-salt diet can damage the gastric mucosa, and Helicobacter pylori infection will aggravate the inflammatory response of the gastric mucosa, and the interaction between the two will further accelerate the occurrence and development of gastric cancer.