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18
Wang Hui Jie
Gastroenterology
About me
Shijiazhuang Central Hospital, Department of Gastroenterology, attending physician.
Proficient in diseases
Engaged in clinical front-line medical work, proficient in dealing with common and frequently occurring diseases in this profession, capable of carrying out daily medical teaching and scientific research work in this profession.
Voices
Hemorrhoids bleeding and rectal cancer differences
The difference between hemorrhoids bleeding and colorectal cancer, first of all, hemorrhoid bleeding is often bright red, and generally is not mixed with stool, such as blood on paper, blood droplets, and in severe cases, gushing bleeding which may cause symptoms of anemia, and it is not significantly related to stool, meaning it is not very mixed. However, sometimes, bleeding caused by irritating hemorrhoids during defecation might be slightly mixed, but generally, it is not. As for colorectal cancer, if bleeding occurs, it is often in the later stages and the blood is usually dark red or purple-red, generally not in large amounts, and it is often mixed with stool. You might also see mucus and pus. Therefore, if there is bleeding, we recommend promptly undergoing a colonoscopy to avoid missing a diagnosis of colorectal cancer.
Early symptoms of gastric cancer
The early symptoms of gastric cancer are not specific or characteristic in clinical presentations, and there are no specific signs either. It can also be said that there are no symptoms or signs at all. Some patients may be diagnosed with gastric cancer after presenting with symptoms of bleeding, such as vomiting blood, blood in stool, or black stools. Therefore, it is recommended for individuals over 40 years old to consider undergoing gastroscopy, especially if they experience discomfort or pain in the upper abdomen, weight loss, or have a history of poor gastric mucosa conditions seen in previous gastroscopies, including atrophy, intestinal metaplasia, or ulcers, as well as a history of testing positive for Helicobacter pylori. Regular follow-up gastroscopies are advised under these circumstances.
Can a colonoscopy detect rectal cancer?
Colonoscopy can detect colon and rectal cancer. It is the most important and primary method for examining colonic mucosal lesions. The large intestine includes the cecum, colon, and rectum. Colonoscopy allows direct visual inspection of lesions, including the size and color of the lesions, and whether there are ulcers and erosion, the nature of any attachments, etc. It also allows for direct biopsy. Firstly, it can assess the texture of the lesion, such as whether it is soft, hard, or brittle. Moreover, the biopsied sample can be analyzed histologically to determine the benign or malignant nature, depth of infiltration, etc. Different pathological characteristics have different prognoses and treatment methods, suitable for early cancers treatable under endoscopy, or those that can be removed during the process of the colonoscopy.
Can gastroscopy detect Helicobacter pylori?
Helicobacter pylori is a type of bacterium, hence it is invisible to the naked eye. However, during a gastroscopy, the gastroenterologist can infer whether a patient is infected with Helicobacter pylori by observing the mucosal appearance under the endoscope. For example, signs such as the disappearance of damages in the tiny veins, nodular changes resembling chicken skin, scattered congested spots, and others. To confirm the presence of a Helicobacter pylori infection, further tests are required. For instance, during a gastroscopy, a rapid urease test can be conducted where a tissue sample from the stomach is tested - this method is quite convenient. Alternatively, a tissue sample can be sent for pathological examination, which might take longer.
Can Helicobacter pylori cure itself?
Can Helicobacter pylori be self-healing? Helicobacter pylori is very stubborn; once infected, adults who do not undergo formal therapeutic interventions will be afflicted for life, meaning the cure rate is close to zero. Children, whose immune functions are not yet fully developed, may experience multiple exposures on the gastric mucosa and short-term colonization before Helicobacter pylori settles permanently, which could potentially lead to either colonization or loss of the bacteria. White populations have stronger immune resistance than colored populations. Tracking reports indicate that 50% of white children may lose the infection after contracting it, while only 4% of black children might. Generally, the infection rate is higher than the self-healing rate, indicating that Helicobacter pylori infections in adults are generally not self-resolving.
What should I do about rectal bleeding from an anal fissure?
Firstly, if rectal bleeding occurs before a doctor's diagnosis, it is imperative to seek medical attention promptly to rule out other conditions. The cause of the bleeding could be from a site above the anus or other diseases related to the anus, and it might not necessarily be an anal fissure. If diagnosed with an anal fissure, treatment generally involves the local application of ointment. It is important to avoid conditions in daily life that could lead to constipation or diarrhea, as these can irritate the mucous membrane of the anus and exacerbate the symptoms of an anal fissure. Dietarily, it is beneficial to eat more vegetables, fruits, and foods high in rough fiber to ensure that stools are well-formed. If anal fissures recur, do not avoid seeking medical help, as this could lead to the formation of scars and contractions around the anus, causing anal stenosis, at which point surgery would be necessary.
Medications for treating gastric ulcers
Here I will introduce several major types of medications for treating gastric ulcers, but specific medication use should be consulted with a doctor or pharmacist according to individual conditions. The first major type is anti-gastric acid medications. Since gastric acid plays a significant role in ulcerative lesions, it is considered appropriate to treat gastric ulcers by adjusting the stomach environment to a pH of 3.5. Anti-acid medications include antacids, H2 receptor antagonists, proton pump inhibitors, and others. The second major type is gastric mucosal protectants, which include some class B drugs, prostaglandin derivatives, and some containing sucralfate. The third major type is medications that treat Helicobacter pylori, with quadruple therapy currently being a common practice. Note: Medications should be used under the guidance of a doctor.
Can a gastroscopy detect Helicobacter pylori?
Since Helicobacter pylori is a type of bacterium, it cannot be seen with the naked eye. However, current research indicates that Helicobacter pylori is strongly associated with certain mucosal appearances under endoscopy. Therefore, endoscopists can infer the presence of an infection based on certain mucosal appearances observed during the procedure. However, if the only purpose is to test for Helicobacter pylori infection without needing a gastroscopy, then we can opt for non-invasive methods such as the carbon-13 urea breath test, carbon-14 urea breath test, stool antigen test, and serological antibody tests, which are commonly used methods of testing. Moreover, after treatment for Helicobacter pylori, it is recommended to use either the carbon-13 or carbon-14 urea breath test for examination.
The difference between duodenitis and duodenal ulcer
The difference between duodenitis and duodenal ulcer is as follows: A diagnosis of duodenitis under endoscopy indicates inflammation in the duodenal bulb or descending part, featuring patchy congestion or spotted, erosive conditions identified during the endoscopic procedure, which lead to the diagnosis of duodenitis. If isolated or multiple ulcerative lesions are found in a certain area, it is diagnosed as a duodenal ulcer. Benign ulcers typically have clear boundaries, with surfaces covered with white moss or blood scabs, and the surrounding area may exhibit redness, concentrated mucosa, among other characteristics. Depending on these different presentations, there are different stages of the disease. Both duodenitis and duodenal ulcers are considered benign lesions.
Can reflux esophagitis be cured?
Reflux esophagitis can be cured, however, the recurrence rate of reflux esophagitis is more than 80%, and generally requires maintenance treatment. The treatment principles are acid suppression, enhancing the pressure of the lower esophageal sphincter, and protection of the mucosa. Next, let's specifically introduce non-drug treatments. Dietary therapy is very important, mainly involving reasonable dietary intake and good eating habits, which play a significant role in prevention. Another is positional therapy, mainly avoiding lying down immediately after meals, as well as quitting smoking and alcohol, reducing negative pressure, and taking some related medications or undergoing surgical procedures, etc. Generally, a combination of treatments is used to improve efficacy, and the treatment course should not be less than three months.