(2) Prevention of Gastric Cancer

Gastric cancer prevention advocates "three-level" prevention. Primary prevention starts with addressing the causative factors of gastric cancer, strengthening public education on gastric cancer prevention, correcting unhealthy lifestyle habits, especially dietary habits. Avoid mechanical damage to the upper gastrointestinal mucosa; do not eat moldy food, eat less smoked, salted, fried, and baked foods to reduce exposure to carcinogens; maintain an optimistic and cheerful mood, quit smoking and drinking, keep the immune and nervous systems in good condition. It is recommended to eat more fresh vegetables and fruits, drink more fresh milk, and regularly drink tea, especially green tea, which helps prevent gastric cancer. Secondary prevention advocates "three earlys": early detection, early diagnosis, and early treatment. For people at high risk of gastric cancer, such as those with chronic atrophic gastritis, intestinal metaplasia, gastric ulcers, gastric polyps, postoperative residual stomach, or pernicious anemia, especially those with a family history of gastric cancer or long-term unhealed stomach diseases over 40 years old, regular check-ups are recommended; where conditions permit, those with precancerous lesions (intestinal metaplasia and atypical hyperplasia) should be monitored via X-ray, fiber gastroscopy, and mucosal biopsy, and once diagnosed, strive for surgical treatment as soon as possible. Tertiary prevention means strengthening comprehensive treatment for mid- and late-stage gastric cancer to improve survival rates, and for advanced cases, alleviating pain and improving quality of life. Integrating traditional Chinese and Western medicine in the prevention and treatment of gastric cancer has broad prospects.

Chapter 6: Gastric Ptosis

Section 1: Overview

Gastric ptosis refers to the vertical descent of the stomach body, with the lowest point of the greater curvature arc dropping below the line connecting the iliac crests, even entering the pelvis—a pathological condition. Clinically, patients may present with upper abdominal discomfort, easy fullness and bloating, a feeling of heaviness, belching, nausea, and constipation. It is most common among young and middle-aged adults aged 20–40, with females more affected than males. The causes of gastric ptosis can be divided into congenital and acquired factors. Congenital gastric ptosis occurs when the internal organs in the abdominal cavity are inherently lacking strong ligament support and fixation—meaning the ligaments suspending the visceral organs are very loose. In addition to gastric ptosis, such patients often have ptosis of other internal organs, such as renal ptosis and uterine ptosis. These patients typically have a fishhook-shaped stomach, with relaxed and weak stomach muscles, resulting in very low gastric tension (i.e., pulling force), so after a full meal, the stomach is often pulled downward. Acquired gastric ptosis is mainly caused by excessive thinness and relaxation of intra-abdominal ligaments; frequent overeating or exercise after meals can also trigger it. Mild gastric ptosis can be adapted to and compensated by the body, so no subjective symptoms appear—only discovered incidentally during a physical exam; more severe gastric ptosis can obstruct food passage into the intestines, slow gastric emptying, leading to symptoms like bloating, belching, and even vomiting. Because food stays in the stomach too long and ferments, harmful substances produced can irritate the stomach lining and cause gastritis. Additionally, there is the so-called "maternal type" physique, often referring to women who have given birth multiple times, resulting in abdominal wall laxity, decreased abdominal pressure, and visceral ptosis. However, this situation has significantly decreased today due to family planning policies.

Section 2: Diagnosis

Most patients with gastric ptosis have congenital deficiencies, weak constitutions, or long-term dietary imbalances, emotional distress, and excessive labor leading to weight loss; additionally, chronic wasting diseases can also be complicated by gastric ptosis.