Atrophic gastritis is one of the most common gastric diseases, and many risk factors may increase the risk. This study aimed to assess the relationship between dietary factors and clinical symptoms of patients with atrophic gastritis. A cross-sectional study was conducted from October 2018 to October 2020 in the Center of Gastroenterology and Hepatology of Bach Mai Hospital with a total of 3508 atrophic gastritis patients aged ≥40 years (female/male ratio was 1.68). All patients were interviewed based on a designed questionnaire and underwent a gastroscopy procedure. The most common symptoms were epigastric pain (73.9%), belching/heartburn (42.4%), the feeling of fullness (41%), reflux symptom (15.4%). A majority of patients had mild atrophic gastritis (C1, C2) (80.4%), followed by moderate atrophic gastritis (C3, O1) (17%), and severe atrophic gastritis (O2, O3) (2.6%). A diet with much deep-fried or grilled food increased the risk of epigastric pain (OR 1.343; 95%CI 1.002-1.801); diets with much meat or nuts increased the risk of the feeling of fullness (meat: OR 1.296; 95%CI 1.100-1.526 and nuts: OR 1.316; 95%CI 1.033-1.676), and belching/heartburn (meat: OR 1.243; 95%CI 1.058-1.461 and nuts: OR 1.376; 95%CI 1.082-1.751). Diets with much salt or nuts increased the risk of reflux symptoms (salt: OR 1.359; 95%CI 1.055-1.752 and nuts: OR 1.532; 95%CI 1.023-2.293). A diet with many vegetables was a protective factor that can help to decrease the risk of moderate and severe atrophic gastritis (OR 0.616; 95%CI 0.403-0.941). In conclusion, diets and food types are factors that affect the risk of clinical symptoms among patients with atrophic gastritis, so the action of adjusting diets and daily food also play an important role in atrophic gastritis.
Aim. Causes, clinical features, and diagnostic approaches for small bowel (SB) bleeding were analyzed to derive recommendations in dealing with this clinical condition. Methods. We included 54 patients undergoing surgical treatment for SB bleeding, from January 2009 to December 2019. Detailed clinical data, diagnosis procedures, and causes of bleeding were collected. Results. Among 54 cases with SB bleeding, the most common causes were tumors (64.8%), followed by angiopathy (14.8%), ulcers (9.3%), diverticula (5.6%), tuberculosis (3.7%), and enteritis (1.9%). Most tumors (32/35 cases, 91.4%) and vascular lesions (8/8 cases, 100%) were located in the jejunum. The incidence of tumors was higher in the older (30/41 cases, 73.1%) than that in patients younger than 40 years of age (5/13 cases, 38.5%, P < 0.01 ). Common initial findings were melena (68.5%) and hematochezia (31.5%). The overall diagnostic yield of computed tomographic enterography (CTE) was 57.4% (31/54 cases), with the figures for tumors, vascular lesions, and inflammatory lesions being 71.4% (25/35 cases), 62.5% (5/8 cases), and 12.5% (1/8 cases), respectively. Double-balloon enteroscopy (DBE) definitively identified SB bleeding sources in 16/22 (72.7%) patients. Conclusion. Tumors, angiopathy, ulcers, and diverticula were the most common causes of SB bleeding in Northern Vietnamese population. CTE has a high detection rate for tumors in patients with SB bleeding. CTE as a triage tool may identify patients before double-balloon enteroscopy because of the high prevalence of SB tumors.
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