Introduced in this issue
Love to eat pickled food, overly hot diet, these are the causes of malignant tumors of the digestive tract!
Why do annual physical examinations detect malignant tumors?
How to prevent digestive tract tumors?
People with a history of trauma are also at high risk of gastrointestinal cancer?
...
The program group of "Face to Face with Famous Doctors" specially invited Chief Physician Wang Xinxin, Director of the Department of Gastroenterology of Zhujiang Hospital of Southern Medical University, to give you the prevention and treatment of malignant tumors of the digestive tract.
Etiology of malignant tumors of the digestive tract
1
Causes of esophageal cancer
1. Diet:
1. Nitrosamines and mycomycins: pickled foods (sauerkraut, dried radish, salted fish, etc.).
2. Vitamin and trace element deficiencies.
3. Excessive hot eating, kung fu tea, alcoholism.
2. Precancerous Diseases/Lesions:
Corrosive esophageal burns, esophageal achalasia, esophageal diverticulum, reflux esophagitis, Barrett's esophagus, etc.
3. Genetic factors:
About 1/4 to 1/2 of patients with esophageal cancer have a positive family history.
2
Causes of stomach cancer
1. Infectious factors:
HP infection, Epstein-Barr virus infection.
2. Precancerous Diseases/Lesions:
Postoperative gastric, chronic atrophic gastritis, intestinal metaplasia, gastric polyps, gastric intraepithelial neoplasia, giant gastric mucosal hypertrophy, etc.
3. Genetic factors:
The incidence of gastric cancer in first-degree relatives is 2-4 times higher.
3
Causes of colorectal cancer
1. Dietary factors:
Nitrosamine compounds: pickled foods (sauerkraut, dried radish, salted fish, etc.) long-term high-fat, low-fiber, low-calcium and high-phosphorus diet.
2. Precancerous Diseases/Lesions:
Colorectal polyps (adenomas), sessile serrated lesions, laterally developing tumors, chronic inflammation of the colorectum (ulcerative colitis, Crohn's disease, schistosomiasis, chronic bacillary dysentery, chronic amoebic enteropathy, etc.).
3. Genetic factors:
About 20% of colorectal cancer attributable risk is related to genetic background.
4. Others:
After cholecystectomy, radiation damage, etc.
Clinical symptoms of malignant tumors of the digestive tract
1
Esophageal cancer symptoms
Early symptoms:
1. Asymptomatic.
2. No specific symptoms: local inflammation can cause retrosternal discomfort, burning, pain, and subxiphoid discomfort.
Late symptoms:
dysphagia, regurgitation, retrosternal or dorsal scapular pain, subxiphoid pain, hiccups, dry cough.
2
Stomach cancer symptoms
Early symptoms:
1. Asymptomatic: more than 70%.
2. No specific symptoms: epigastric discomfort, belching, acid reflux, early satiety.
Late symptoms:
Epigastric pain, decreased appetite, weight loss, nausea, vomiting, hematemesis or melena, epigastric mass.
3
Causes of colorectal cancer
It may be asymptomatic in the early stages.
As the tumor grows in size and complications occur, it may occur:
1. Changes in bowel habits and stool characteristics: diarrhea, constipation, thinning of stools, bloody stools, etc.
2. Abdominal pain.
3. Nausea, vomiting, abdominal distension, etc. may occur when accompanied by intestinal obstruction.
4. Anemia, emaciation, fatigue, etc.
5. Abdominal mass.
People at high risk of gastrointestinal malignancy
1
People at high risk of esophageal cancer
The high-risk group for esophageal cancer screening is ≥ 40 years old and meets any one of the following criteria:
1. Born or residing in an area with a high incidence of esophageal cancer.
2. Have precancerous diseases or precancerous lesions of the upper gastrointestinal tract, such as low-grade intraepithelial neoplasia, Barrett's esophagus.
3. First-degree relatives have a history of esophageal cancer.
4. Have squamous cell carcinoma of the head and neck and/or respiratory tract.
5. Have high-risk factors for esophageal cancer (such as heavy smoking, heavy drinking, eating too fast, hot eating and other bad habits, indoor air pollution, etc.).
2
People at high risk of stomach cancer
The high-risk group for esophageal cancer screening is judged to be > age 40 years old, male or female, and meet any one of the following criteria:
1. People in areas with a high incidence of gastric cancer.
2. H. pylori 感染者。
3. Chronic atrophic gastritis, gastric ulcer, gastric polyps, residual gastric disease, hypertrophic gastritis, pernicious anemia and other gastric precancerous diseases.
4. First-degree relatives of gastric cancer patients.
5. Presence of other risk factors for gastric cancer (high salt, pickled diet, smoking, heavy alcohol consumption, etc.).
3
People at high risk of rectal cancer
First-degree relatives have a history of colorectal cancer, I have a history of cancer (any history of malignancy), I have a history of intestinal polyps.
Those who have two or more of the following:
1. Chronic constipation (constipation in the past 2 years, more than 2 months per year).
2. Chronic diarrhea (diarrhea has lasted for more than 3 months in the past 2 years, and each episode lasts for more than 1 week).
3. Bloody stool.
4. History of adverse life events (occurred within the last 20 years and caused significant mental trauma or distress to the respondent after the event).
5. History of chronic appendicitis or appendectomy.
6. History of chronic biliary tract disease or gallbladder resection.
Prevention of malignant tumors of the digestive tract
1
Pay attention to your lifestyle habits
In life, we must achieve "three farewells", control our legs, open our legs, and feel comfortable.
1. Say goodbye to unhealthy foods: pickled, grilled, high-fat, low-calcium-high-phosphorus, overly fine, moldy, overnight foods, etc.
2. Say goodbye to unhealthy eating habits: overheated eating, kung fu tea, hungry meals, overeating, etc.
3. Say goodbye to bad habits: smoking, drinking, staying up late.
Keep your mouth shut: three meals are regular and quantitative, the ingredients are fresh, and the meat and vegetables are matched. Open your legs: Exercise can help you control your weight and boost your immunity. Relaxation: Relieve stress and let go of yourself.
2
Regular medical check-ups
Conventional physical examination packages cannot detect digestive tract tumors: this is why some people have annual physical examinations, but in the end, they still get into the middle and advanced stages of digestive tract malignant tumors. Therefore, the physical examination needs to include a gastrointestinal endoscopy.
The benefits of gastrointestinal endoscopy are included in the physical examination program:
1. Covering the blind areas of routine physical examination: esophagus, stomach, colorectum.
2. Timely detection of early gastrointestinal tumors and precancerous diseases/lesions.
For the general population, it is recommended to start gastroscopy and colonoscopy at the age of 40.
For people at high risk of gastrointestinal tumors, gastroscopy/colonoscopy should be undergo in time, and it is best for such people to go to a qualified digestive endoscopy center for gastroscopy/colonoscopy.
3
other
1. Prevention of Helicobacter pylori infection.
2. Eradication of Hp can reduce the risk of gastric cancer.
3. Active treatment of precancerous diseases/lesions.
Examinations and examinations related to malignant tumors of the digestive tract
The main tests for malignant tumors are: fecal occult blood test, fecal genetic test, gastrointestinal tumor markers, Helicobacter pylori (Hp) detection, gastric function test, gastrointestinal angiography, chest and abdominal CT examination, gastrointestinal endoscopy.
Wang Xinxin
Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Director, Chief Physician, Professor
Doctor of Medicine, Doctoral Supervisor, Postdoctoral Cooperative Supervisor
He is a visiting scholar at the University of Hong Kong and Cleveland Clinic, and a postdoctoral fellow at New York University
Outstanding Young Medical Talent of Guangdong Province
Director of the Internal Medicine Professional Base for Standardized Training of Residents
Vice Chairman of Digestive Endoscopy Branch of Guangdong Medical Association
Vice Chairman of Digestive Endoscopy Branch of Guangdong Medical Doctor Association
Leader of the Small Bowel Endoscopy Group of the Digestive Endoscopy Branch of Guangdong Medical Association
Deputy head of the Inflammatory Bowel Disease Group of the Gastroenterology Branch of Guangdong Medical Association
He has been engaged in clinical work for more than 20 years, specializing in the diagnosis and treatment of difficult and complex intestinal ulcer diseases and gastrointestinal tumors, mainly including inflammatory bowel disease (ulcerative colitis and Crohn's disease), Behcet's disease, lymphoma, ischemic enteritis, unexplained intestinal ulcer diseases, gastrointestinal tumors, etc. He is proficient in the diagnosis and treatment of gastric and colonoscopy, especially endoscopic techniques such as magnification, staining, NBI, capsule endoscopy, etc., and has rich experience in the diagnosis and treatment of early gastrointestinal lesions.
This issue of "Face to Face with Famous Doctors" program was broadcast live on Guangdong Radio and Television Zhujiang Economic Channel, Southern Life Radio, as well as the official Weibo of Guangdong Radio and Television Station, Guangdong TV Electric Shock News APP, Guangdong Listening APP, and Famous Doctor Face to Face Video Audio and Video Live Simultaneously, with a total of 80,000 views.
The program "Face to Face with Famous Doctors" was broadcast live from 10:00 a.m. to 11:00 a.m. on Guangdong Radio and Television Station's Pearl River Economic Channel, and from 4:00 p.m. to 5:00 p.m. on Southern Life Radio. As well as the live broadcast on the official Weibo of Guangdong Radio and Television Station, the Electric Shock News App, the Yueting App, and the face-to-face video account of famous doctors, you will be agreed at 10:00 every morning.
Editor: Chen Junchao, Shi Jiawen (intern)