Gastrointestinal diseases mainly refer to general inflammatory gastrointestinal diseases (acute and chronic gastritis, acute and chronic appendicitis , etc.), peptic ulcers, gastric cancer , esophageal cancer, colorectal cancer, and irritable bowel syndrome. Currently, the incidence of gastrointestinal diseases is high,nine out of ten people suffer from stomach problems. These diseases are characterized by their long course, difficulty in treatment, and frequent relapses.
Etiology and common diseases
Medical experts have discovered that gastrointestinal diseases are caused by an imbalance between protective and aggressive factors in the gastric mucosa, resulting in a situation where the protective factors in the gastrointestinal mucosa are weaker than the aggressive factors, thus leading to gastrointestinal diseases.
Differential diagnosis
- Ultrasound scanning is suitable for local cross-sections of organs, but it is not as good as X-ray barium meal examination and endoscopy for overall observation.
- The morphology and color of the mucosa are not as easily observed as those of barium X-ray examination and endoscopy.
- The detection rate of small ulcers, superficial lesions, and functional lesions is low, and the rate of missed diagnosis and misdiagnosis is high.
Various gastrointestinal examination methods cannot replace each other, but rather complement and reinforce each other. Only by combining them organically can the detection rate of lesions and the accuracy of diagnosis be improved, thus better serving clinical practice.
Examine
Ultrasound is not widely used in the gastrointestinal tract due to the influence of gas; it serves as a supplement to endoscopy and gastrointestinal X-ray imaging. Ultrasound examination also has its advantages: it can show changes in the filling and emptying of the gastrointestinal lumen, as well as the peristalsis, thickness, and layered structure of the gastrointestinal wall; it has good visualization capabilities for tumors and other gastrointestinal wall thickening diseases, indicating the location and extent of lesions, and can show the metastasis of malignant tumors. Endoscopic ultrasound (EUS) can distinguish the tissue structure of each layer of the gastrointestinal wall, thus it is superior to other imaging methods in judging the depth of invasion of gastric and rectal cancers into the gastrointestinal wall and direct infiltration of adjacent organs. Fine-needle aspiration biopsy and interventional treatment can also be performed under EUS guidance. Transabdominal ultrasound cannot provide satisfactory observation of the entire stomach; it provides satisfactory visualization of the gastric cardia and antrum, but the visualization of the gastric fundus and body is often unsatisfactory, thus limiting its clinical practical value. It has now been replaced by endoscopic ultrasound.
In X-ray examinations, contrast imaging is the primary method, including barium meal examination of the gastrointestinal tract, barium enema of the colon, double-contrast barium contrast radiography of the stomach and intestines, double-contrast radiography of the small intestine, and double-contrast radiography of the colon. Multiphasic gastric and colonic contrast radiography should still be the ideal initial examination method for gastrointestinal diseases.
Angiography is mainly used for the diagnosis of gastrointestinal bleeding and vascular lesions. It can immediately determine the location of bleeding and provide reliable information for embolization treatment or surgical treatment.
The gastric wall in the antrum is significantly thickened, with irregular enhancement and visible ulcers on the surface.
In this area, CT and MRI are primarily used to determine the extent of tumor invasion beyond the endoscopic cavity, the degree of wall thickening, the presence of invasion of adjacent organs, lymph node metastasis, and peritoneal metastasis. The advantages of CT and MRI include the ability to measure the thickness of the gastrointestinal wall, assess lymph node enlargement, understand the relationship between the lesion and surrounding organs, and clarify the peri gastric fat layer and vascular invasion. The main functions of CT and MRI are staging of gastrointestinal malignancies, development of treatment plans, evaluation of treatment effectiveness, detection of recurrent lesions, and sometimes, aiding in differential diagnosis.
MRI is valuable for evaluating postoperative recurrence of rectal cancer and for characterizing lesions. With the development of rapid scanning and artifact-eliminating sequences, the application of respiratory and cardiac gating techniques, and the development of intraluminal contrast agents, coupled with MRI’s inherent multi-planar imaging and high tissue contrast resolution, MRI aids in the detection and differentiation of lymph node, retroperitoneal, and distant organ metastases. It also plays a role in the diagnosis of inflammatory gastrointestinal lesions.
Treatment principles
The integration of traditional Chinese medicine (TCM) and Western medicine in the treatment of gastrointestinal diseases can reduce the adverse reactions of Western drugs and improve patient compliance. In the prevention and treatment of complex gastrointestinal diseases, the synergistic mechanisms of TCM and Western medicine can be utilized to achieve high cure rates. The future of TCM-Western medicine in the treatment of gastrointestinal diseases should move towards a high-standard, rigorous, open, diversified, and sustainable scientific system, strengthening “targeted,” “individualized,” and “comprehensive” approaches. Only then can the integration of TCM and Western medicine in the treatment of gastrointestinal diseases achieve breakthrough progress and fully leverage the respective advantages of Western and TCM in syndrome differentiation and treatment. Traditional medicine is profound and extensive; utilizing TCM and Western medicine in the treatment of gastrointestinal diseases can combine the strengths of both approaches while avoiding their respective weaknesses, which has positive significance for the treatment of gastrointestinal diseases.