Precursor lesions for intestinal type gastric cancer

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Published in: Today Digital
Author: Dr. Diógenes Garcia, Gastroenterologist, Gastroenterology Department of the General Hospital of the Plaza de la Salud.

The gastric cancer model "intestinal type" describes a progression from chronic gastritis to chronic atrophic gastritis, to intestinal metaplasia, dysplasia and eventually to adenocarcinoma.

Chronic superficial gastritis caused by infection of Helicobacter pylori, pernicious anemia diets high in salt, eventually triggers chronic atrophic gastritis and intestinal metaplasia.

Gastric atrophy is accompanied by loss of the parietal cell mass and, therefore, a reduction in the production of hydrochloric acid and a decrease in the levels of ascorbic acid (vitamin C).

Intestinal metaplasia, is a potentially reversible change. The most common form of metaplasia in the stomach is the intestinal type. This occurs as a result of infection of Helicobacter pylori, bile reflux or can be experimentally induced by radiation.

Environmental risk factors:
- Diet. Food preserved with salt.

- Nitrous compounds. The nitrates in the diet are absorbed in the stomach and secreted in saliva in a concentrated form where they are reduced to nitrites by oral bacteria. The consumption of fruits and vegetables, particularly fruits, is probably protective against gastric cancer.

- Obesity, tobacco and occupational exposures in coal and tin mines.

- There is a possible protective effect in the intake of aines (non-steroidal anti-inflammatory drugs). The regular use of these agents is inversely proportional to the risk of distal gastric adenocarcinoma.

- There is an increased risk of gastric cancer after gastric surgery.
Factors related to the host for gastric cancer. Blood group, family predisposition, familial intestinal gastric cancer, genetic polymorphisms

Symptom:

- Anemia
- Weightloss
- Nausea
- Loss of appetite
- Early satiety
- Gastric polyp
- Carcinomatosis
- Abdominal pain
- Flatulence
- Feeling of fullness
- Meteorism (intestinal gas)
- Evacuation pattern alteration

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