From gastritis to high blood pressure… What if a disease was found on a health check-up? [인터뷰]

The purpose of health checkup is to discover health abnormalities that the person is not aware of. Many diseases have no obvious early symptoms. Because of this, they think they are healthy, but in reality they may have a disease without realizing it. Therefore, in order to detect the disease at an early stage and start treatment, it is necessary to undergo regular medical examinations.

The main diseases found in the health examination include atrophic gastritis, chronic hepatitis B, gallstones, high blood pressure, and hyperlipidemia. Internal medicine for treatment and management of each disease Director Nam Jun-yeol (Seoul Him Medical Clinic)Find out with

Q. I am curious about the potential for atrophic gastritis, intestinal epithelial metaplasia, and gastric cancer confirmed by gastroscopy.
As many gastroscopy is performed as a national examination, more and more people are diagnosed with atrophic gastritis and metaplastic gastritis. Atrophic gastritis is a condition in which the mucous membrane, which is the surface of the stomach, has become thinner due to chronic inflammation, and is a common form of gastritis that more than 10% of the population has. Intestinal epithelial metaplasia is a histological diagnosis of metaplastic gastritis. It refers to a state in which several cells of the normally differentiated gastric mucosa are gradually destroyed as a chronic inflammatory response continues and are transformed into cells similar to intestinal epithelial cells.

There are many people who are worried that if they are diagnosed with atrophic gastritis or intestinal metaplasia, it will lead to stomach cancer. Atrophic gastritis and intestinal metaplasia are risk factors that can increase the incidence of gastric cancer. It has also been reported that the risk of stomach cancer is 6 and 10 times higher, respectively. However, your chances of not getting stomach cancer are much lower than your chances of getting stomach cancer. Just as we do not go out because we are worried about a traffic accident when we go out, I hope that people who have been diagnosed with atrophic gastritis or intestinal epithelial metaplasia will not be greatly anxious about the occurrence of stomach cancer. In addition, atrophic gastritis or intestinal epithelial metaplasia is diagnosed with the naked eye by the doctor who performs the endoscopy.

Gastric cancer is a disease that can occur without atrophic gastritis or intestinal metaplasia. Therefore, regular gastroscopy is important, and if you are diagnosed with atrophic gastritis or intestinal epithelial metaplasia, it is desirable to discuss the follow-up period, lifestyle improvement, and Helicobacter eradication treatment with the doctor who saw the endoscopy directly.

Q. It is said that there are many cases of chronic hepatitis B being detected during medical examinations.
Hepatitis B virus is one of the viruses that can cause chronic hepatitis, and it is a risk factor that can cause a continuous inflammatory reaction of the liver, causing liver fibrosis, and leading to cirrhosis and liver cancer. Because there are many chronic hepatitis B patients in Korea, the country supports ultrasound and blood tests twice a year for chronic hepatitis B patients over the age of 40 and cirrhosis patients. Liver disease rarely causes symptoms until it is very advanced. Therefore, it is important for chronic hepatitis B patients to visit the hospital regularly, check their liver condition, and receive necessary treatment, even if there are no symptoms.

In the case of hepatitis B treatment, there are currently many antiviral drugs that have strong antiviral effects and are stable even after long-term use. Therefore, proper treatment can inhibit the progression to cirrhosis and reduce the risk of liver cancer.

Q. If gallstones are found, do they need treatment?

Abdominal ultrasonography often detects asymptomatic gallbladder and gallstones. It is known that the risk of developing symptoms in patients with asymptomatic gallstones increases by 2% each year, but about 80-90% of patients do not experience any problems during their lifetime. For this reason, prophylactic surgery for asymptomatic gallbladder and gallstones is generally not recommended. However, if there are clinical symptoms such as biliary colic or complications related to gallstones such as cholangitis or acute pancreatitis occur, cholecystectomy is required. When cholelithiasis has such obvious complications, non-surgical treatment does not play a large role. There are patients who cannot or refuse surgery. In this case, depending on the type of gallstone, oral bile acid solubilizers may be used.

If gallstones are identified and treated appropriately, the complete dissolution rate of gallstones varies from 20 to 70%. However, since oral bile acid dissolution drugs only temporarily block the process of gallstone formation, recurrence is highly likely after treatment is discontinued. Therefore, even if diarrhea and gallstones have dissolved, regular follow-up is necessary.

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Health Checkup|Source: Getty Images Bank
Q. When diagnosed with high blood pressure, many people are afraid that they will have to take medicine for the rest of their lives.
Just because you start taking high blood pressure medications doesn’t mean you have to take them for the rest of your life. There are certainly cases in which the drug can be stopped if blood pressure is well controlled by not eating salty food and by controlling the weight. However, there are not many people who succeed in controlling their blood pressure only by controlling their lifestyle without taking blood pressure medications. Lowering blood pressure is sometimes not enough.

Also, even if blood pressure is measured high, blood pressure medication is not unconditionally used. Usually, if your blood pressure is not very high, you have enough time to adjust your lifestyle for about 3 months. If there is still no control, then medication is started. Conversely, if your blood pressure is controlled enough with lifestyle adjustment alone, you can of course watch without taking blood pressure medication. .

In addition, it can be dangerous to voluntarily stop the blood pressure medication, as there may be cases where the blood pressure rises again even if the drug is stopped. Even if you stop taking the medicine, blood pressure should be controlled continuously for the rest of your life, so it is recommended to consult with your doctor as much as possible.

Q. I was diagnosed with hyperlipidemia during a medical examination. Do I have to take the drug for the rest of my life?

Cholesterol levels are high and many people go to the hospital. This is called ‘dyslipidemia’ in a more precise way. Dyslipidemia refers to abnormal lipoprotein metabolism in the form of △high and low-density cholesterolemia, △hypertriglyceridemia, and △low high-density (HDL) cholesterolemia.

The causes of dyslipidemia can be divided into primary and secondary. Primary refers to primary hyperlipidemia caused by dietary problems, lack of exercise, and genetic factors. Secondary hyperlipidemia refers to hyperlipidemia that occurs temporarily when secondary changes occur due to underlying diseases such as hypothyroidism, chronic liver disease, and nephrotic syndrome, or when pregnant or taking medications.

The basis of dyslipidemia treatment is lifestyle improvement. Although it may vary depending on the risk of cardiovascular disease, drug therapy is generally administered when hyperlipidemia persists after 3 months of lifestyle changes. Lifestyle improvement plays an important role in treatment, so even if you have started drug treatment, you can reduce it or stop it if it is well controlled.

Lifestyle habits that dyslipidemia patients should follow include △Reducing caloric intake △Reducing saturated fatty acid and cholesterol intake △Increasing fiber intake △Exercise regularly △Losing weight △Stop smoking.

Some patients sometimes take a lot of health functional foods, but there are people who are reluctant to take blood pressure drugs or hyperlipidemia drugs. Is there any reason to avoid taking medications that can protect my health much more effectively than supplements? It would be nice if it could be controlled without taking medication, but I hope that patients will not be too reluctant to take the medication.

Help = Director Nam Jun-yeol (Seoul Him Internal Medicine Specialist)

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