How are gastric varices treated? These principles must be followed

Gastric varices is a common disease in gastroenterology. The most common cause of gastric varices is liver cirrhosis, which can seriously threaten the patient's life. It requires timely diagnosis and treatment. The focus of treatment is liver disease. Patients should pay attention to rest and ensure adequate calorie intake in their diet.

(1) Rest: Patients should be given enough time to rest in bed to reduce physical exertion, improve liver circulation, and facilitate liver tissue regeneration. Work and life should be arranged reasonably according to the severity of the illness. Those with mild illness can do general work and avoid heavy physical or mental labor. Those with severe illness must stay in bed completely.

(2) Diet: Food that is sufficient in calories, high in protein, high in sugar, low in fat, and rich in vitamins. The total daily calorie intake for an average adult is 35 to 40 kCal per kilogram of body weight. The protein requirement is slightly higher than that of ordinary people, and is supplied at 1.5 to 2 g/kg body weight per day. However, the dosage should be increased or decreased according to the patient's tolerance. Patients with precursors of hepatic encephalopathy should limit their protein intake, and the dosage can be gradually increased as their condition improves. If the protein intake is less than 30g per day, liver cell regeneration will be hindered. Therefore, during the period of reducing or suspending the protein diet, human albumin (albumin), plasma or fresh whole blood should be infused intravenously. Patients with liver disease have different tolerance levels to proteins in different foods. They tolerate milk and casein better than meat protein and produce less ammonia after eating them. Plant protein contains relatively small amounts of methylthio amino acids, aromatic amino acids and thiols, which can change the intestinal flora and reduce ammonia production. Carbohydrates are the most important source of energy in the body's metabolic process, and are also an important component for synthesizing glycoproteins, preparing antibodies, enzymes, and cell composition. Maintaining the glycogen content in liver cells is beneficial to protecting the liver's detoxification function. Therefore, patients with cirrhosis need sufficient carbohydrates, but not too much, so as not to cause fat accumulation or even the formation of fatty liver. The fat in the food is generally maintained at 30-50g/d. Patients with cirrhosis are prone to deficiency of vitamins A, B1, B2, C and E, and should be supplemented. In addition, elements such as zinc, manganese, and selenium should be supplied appropriately. The diet of patients with cirrhosis should be low in residue, soft and easy to digest, avoid rough and hard foods, and avoid alcoholic beverages.

(3) Enhance immunity: You can choose human blood immunoglobulin, transfer factor, immune RNA, thymosin (thymosin), Poria polysaccharide or Lentinan polysaccharide, etc. Protect the liver: There are many types of liver protection drugs, and their effectiveness is not certain. Vitamin B, C, E and folic acid, as well as inosine, glucuronosyl lactone (liver tylosin), coenzyme A and ubidecarenone (coenzyme Q10) are commonly used. To reduce liver fibrosis, colchicine 1 mg/d can be used, 5 days a week, for 5 to 10 years, which can improve symptoms without obvious adverse reactions. Some people have also achieved improvement with malotilate. Traditional Chinese medicines such as Astragalus, Angelica, Bupleurum, Salvia miltiorrhiza, Red Peony Root and Cordyceps sinensis all have certain effects. However, attention must be paid to adverse drug reactions during long-term treatment and all factors that may damage the liver must be avoided. 2. Etiology and treatment of patients with portal hypertension, if caused by extrahepatic factors, as long as it is not a fatal primary disease, such as cancer compression or cancer thrombus blocking the portal vein or hepatic vein, it is expected that through the active cooperation of internal and external physicians and surgeons, the patient can be cured or the mortality rate can be minimized. If it is caused by intrahepatic factors, the cause can be eliminated in a few patients. For example, schistosomiasis can be treated with drugs such as praziquantel and nitrothiocyanate. Those caused by alcoholism should quit drinking. Most portal hypertension is caused by hepatitis virus-related cirrhosis, which is difficult to eliminate clinically. Generally, α-interferon, adenosine, adenosine monophosphate, acyclovir (acyclovir), polyinosin and ribavirin (virazole) can be used, all of which can be used together with immunomodulatory drugs.