Anacid gastritis

Anacid gastritis is a chronic inflammatory disease of the stomach that occurs against a background of a sharp decrease in the concentration of hydrochloric acid in the composition of gastric juice. Some doctors call this disease "hypoacid", but there is no such term in the International Classification.

Another synonym - "atrophic gastritis" - is out of date, as studies of morphology have established the possibility of various lesions of the mucosa and deeper layers, not only atrophy. In ICD-10, the disease is included in the "Other gastritis" group and is coded K29.6.0.

The disease is excreted from gastritis by an initial chronic course. There is an opinion that the acute form is skipped, because it is either very fleeting, or has secretive symptoms.

Prevalence of the disease

There is no precise information on the prevalence of anatzid gastritis. According to medical statistics, all kinds of chronic gastritis account for about 90% of the stomach pathology in the adult population. More common is a hyperacid form. Some scientists suggest that increased acidity is the initial form of the anacid state.

Sex was not found in adults. Rare cases of illness in children indicate the primary lesion of girls, but by adolescence, the incidence is the same with young men. Anacid gastritis is a pathology of people of mature age who fully "tried" to violate all the principles of healthy eating and lifestyle (smoking, alcoholism, lack of exercise, lack of balanced food).

The role of hydrochloric acid in the process of digestion

Hydrochloric acid is an essential component of gastric juice. Without it, the process of digestion of food is disrupted. In the diagnosis, not the quantity, but the acidity index at the level of the basal (base) stomach is measured.

The unit of measurement is pH, the norm is considered fluctuations from 1.5 to 2 pH. In the initial period of gastritis, fluctuations are much greater. They are attributed to functional disturbances in the adequacy of acid production. Acidity drops significantly in the heat when a person consumes a lot of fluids. This is due to dilution of the concentration.

The enzyme system of the stomach is designed so that it works only in a sufficiently acidic medium (pepsin). When the food clot passes into the duodenum, neutralization occurs, the reaction changes to a slightly alkaline one.

In some people, sudden fluctuations in the pH level occur at different times of the day

Anatomically the stomach is divided into 2 areas:

• the base (the bottom and the body) - is called acid-forming, since there are lining and parietal cells that produce hydrochloric acid;
• antral - where the process of neutralization with mucus occurs.

Reduction of acidity is possible only with a decrease in the number of cells. The lack of hydrochloric acid causes disruption of the work of pancreatic and intestinal enzymes. Synthesis of pancreatic juice depends on the activation of cells against the background of normal secretory activity of the stomach:

• when the state of hyperacidity - the release of enzymes that break down proteins is disrupted, this can lead to the development of autoimmune processes, allergic reactions, increased sensitivity to food;
• reduced acidity - does not allow the development of biochemically active components responsible for the assimilation of minerals and vitamins, loss of iron, magnesium, zinc, calcium, vitamin B12, which contributes to the development of chronic anemia (anemia).

It should be noted the disinfecting property of hydrochloric acid. At a sufficient level, it disinfects the food. The disadvantage is the activation of the processes of putrefaction and fermentation, the multiplication of pathogenic pathogens that have got through the mouth.

Causes

A specific cause of oppression of the activity of gastric glandular cells is a genetic defect, which consists in suppressing the process of restoring the mucous layer. It is caused by some internal or external stimulus. This explanation is not sufficiently confirmed by research, but in practical activities it fully explains the hereditary predisposition in the family.

Another important reason is the absence of hyperacidity therapy. Excessive acid production leads to overexertion and death of gland cells in the gastric mucosa. First the acidity is normalized, then falls.

Infection with Helicobacter pylori causes a hyperacid gastritis, which first disturbs the restoration of the mucosa, and subsequently leads to atrophy of the epithelium and a decrease in acidity

The combination of these causes is possible in the presence of provoking factors. Significantly increased risk of hypoacid gastritis in humans:

• fond of spicy, fatty, roughly processed, fried, smoked food, sweets, fast food;
• constantly abusing alcoholic beverages;
• smokers;
• not supporting the diet (alternation of prolonged fasting and subsequent overeating, food intake dry);
• with broken chewing food due to lack of teeth and prosthetics;
• working with occupational hazards in the form of toxic fumes, gases, liquids;
• in stressful situations;
• not received a full-fledged treatment for acute gastritis, gastroenteritis;
• long-term use of drugs with irritant effects on the gastric mucosa (corticosteroids, non-hormonal anti-inflammatory drugs, aspirin and antipyretic drugs, cytostatics, some antibacterial drugs).

It should be borne in mind that anacid gastritis develops as a primary process against a background of general health, but it can become a consequence of other diseases - secondary. Such diseases include:

• neuroses;
• pathology of the thyroid gland;
• defeat of the digestive system (chronic pancreatitis, hepatitis, colitis, cholecystitis);
• presence of foci of infection in the form of chronic sinusitis, carious teeth, prostatitis in men, adnexitis in women;
• renal and hepatic impairment;
• rheumatism;
• gout;
• infection with parasites, helminths, fungi.

How does the disease develop?

In the mechanism of acid formation, the main role is played by disruption in the adaptation of acid production to incoming food. As a result of dysfunction of the glandular epithelium, the intake of enzymes, processing of food is delayed. Biochemical reactions that ensure the digestion process change qualitatively. There are clinical symptoms that indicate the pathology of the stomach.

A certain role is played by a decrease in the natural protection of glandular cells from the mucus-forming epithelium, this is facilitated by the ingestion of too coarse food, poisonous substances

At the same time, it is violated:

• cell repair process;
• the formation of protective mucus;
• often there is insufficient blood supply to the background of hypertension, diabetes.

An important feature of chronic hypoacid gastritis is:

• the primary defeat of the fundus, where the acid-producing glands are concentrated as much as possible;
• rapid transition of their stage of inflammation to atrophy;
• increased production of gastrin enzyme due to the accumulation of undigested food (the more pronounced atrophy, the higher the level of gastrin);
• Instead of new cells on the mucosa, connective tissue grows, which does not take any part in digestion;
• The epithelium of the stomach is partially replaced by the intestinal cell type.

According to the results of fibrogastroscopic research, three degrees of development of atrophic changes are distinguished:

• light - lost about a tenth of the parietal cells;
• average - atrophic surface is from 10 to 20% of the stomach;
• severe - changes affect more than 20% of the glandular epithelium.

Symptoms and course

Hypoacid gastritis can not appear for a long time any deviations. Initial signs are:

• feeling of overflow, heaviness in the epigastric zone after eating, even in the absence of excess;
• pains occur immediately after eating, localized in epigastrium, can be irradiated to hypochondria;
• eructation of rotten contents with an unpleasant odor;
• nausea;
• increased saliva in the mouth;
• metallic taste;
• rarely heartburn.

By the nature of pain, aching, dull, are facilitated by the challenge of vomiting

Secondary symptoms associated with damage to the intestines and other digestive organs include:

• alternation of diarrhea and constipation;
• swelling of the intestine (flatulence) because of the activation of the pathogenic flora, decay processes;
• loss and brittle hair;
• dry skin;
• increased fatigue, weakness;
• headache;
• propensity to lower blood pressure, palpitations;
• losing weight.

It is noteworthy that the pain syndrome in acid deficiency is not associated with spastic contraction of the stomach muscles, but with its overextension. Strengthens with overeating, the use of spicy dishes, sauces, fried foods. Secondary symptoms are caused by the formation of hypovitaminosis and anemia.

Exacerbations of gastritis with reduced acidity are observed in spring and autumn. They are provoked by alcohol intake, diet violation, treatment of respiratory infection. Long-term remission without clinical manifestations is possible.

Features of anacid gastritis in childhood

Children often have an acute form of gastritis, while the acidity is increased. If an anacid is found, the child should think about a secondary lesion and look for the cause.

Inflammation is more often limited to catarrhal character without atrophy of glandular cells. Timely treatment can normalize digestion. One of the main reasons is a violation of diet. This is confirmed by the maximum signs in the first years of schooling.

Uncontrolled use of carbonated drinks, chips, irritating the gastric mucosa, leads to gastritis

In addition, they matter:

• the growth of mental stress, stress;
• propensity to hypoacid state in children under the age of seven due to underdevelopment of gastric function;
• increased possibility of infection through the stomach;
• limited physical mobility of the child for various diseases.

The symptomatology is expressed by:

• in pain in the upper abdomen of varying intensity;
• loss of appetite;
• nausea;
• vomiting;
• stool disorder;
• intolerance to dairy dishes;
• losing weight;
• irritability.

The causes of gastritis in children can be:

• various chronic infections, helminthic invasion;
• lamblia in the gallbladder;
• allergy to food and medicine;
• disorders of the neuroendocrine character during adolescent development;
• liver and pancreas diseases.

Characteristics of different forms

Hypoacid gastritis occurs in different forms, which differ in severity of symptoms and morphological changes revealed in fibrogastroscopy.

Superficial gastritis

Decrease in the production of hydrochloric acid is poorly expressed. The wall of the stomach is somewhat thickened, the dystrophy is regarded as moderate. Increased mucus formation. Symptoms may be absent, detected by accident. A good effect is observed from the observance of diet, the use of folk remedies.

Erosive gastritis

Inflammation is hemorrhagic, accompanied by a marked circulatory disorder in the stomach, changes in blood vessels. It is often called:

• long-term drug therapy;
• abuse of alcoholic beverages;
• Crohn's disease;
• respiratory infection.

If the cause is unknown, gastritis is called idiopathic.

Acceptance of a large number of medications provokes the development of a pathological process

The gastric mucosa has increased bleeding due to vascular permeability. There are signs of bleeding in patients:

• black chair;
• vomiting "coffee grounds";
• dizziness;
• weakness;
• palpitation.

Antral gastritis

Most often has an autoimmune origin or is a consequence of parasitism of Helicobacter pylori. Atrophy is subjected to the pyloric section of the stomach. The connective tissue deforms the antral section, facilitating the passage of inflammation to the intestine. Exit from the stomach is narrowed due to edema of the tissue and scarring.

Hypertrophic gastritis

Against the backdrop of a lack of hydrochloric acid, the tissues of the mucous and even the muscle layer grow with the formation of single or multiple neoplasms. A lot of mucus is allocated. With an exacerbation, the patient develops diarrhea, nausea, and minor pain in the upper abdomen. The polypous form is characterized by a tendency to degeneration into a malignant tumor.

Complications

Anacid gastritis has severe consequences in the form of:

• disruption of the work of any digestive organs, most often the pancreas with the formation of chronic pancreatitis;
• development of malignant anemia due to lack of intake of vitamins in the body;
• ulcers and stomach cancer;
• a significant decrease in immunity;
• intolerance to certain foods.

How is the diagnosis carried out?

On clinical manifestations it is impossible to distinguish between hyper-and hypoacid gastritis. Therefore, the main importance is attached to the analysis and apparatus examination. Patients are assigned:

1. Esophagogastroduodenoscopy - the introduction of a probe with an optical device allows you to view the esophagus, all parts of the stomach and duodenum, to take a mucosal material for biopsy.
2. pH-metry is performed with fibrogastroscopy using a special probe or radio-capsule.

When examining biopsy specimens, not only Helicobacter pylori is detected, but also the degree of its spread along the mucous membrane.

The main method of diagnosing the form of gastritis, the presence of complications and cancer degeneration

If it is impossible to perform intragastric sounding, the acidity of the gastric juice is judged by the level of uropepsinogen in the daily urine, as well as by the concentration of serum gastrin (in case of insufficient acidification - increased, in cases of antral atrophic gastritis - sharply reduced). Morphological studies give a more complete analysis of the possibilities of the fundal glands, the degree of atrophic changes.

Infection with Helicobacter pylori is confirmed by the detection of specific antibodies in the blood of patients. In polyclinics, an X-ray method is used, which allows revealing polyposis growths, antrum deformities, tumors, and folding disorders. Ultrasound is a little informative way to detect stomach diseases, but helps to identify another pathology of the digestive system.

Treatment

The scheme of therapy is assigned individually depending on:

• from morphological changes in the mucosa;
• concomitant defeat of the whole digestive system;
• the degree of decrease in acidity.

Objectives of therapy:

• reduction of inflammatory phenomena;
• achievement of a long period of remission;
• slowing the process of atrophy;
• restoration of normal secretory activity of the stomach;
• ensuring proper digestion of food and assimilation of its components.

Dietary food

Great importance in therapy is given to diet and diet. It is recommended to take food in small volumes 6 times a day, necessarily warm and in a sufficiently crushed form. This allows you to relieve the stomach of unnecessary injury, reduce the load on the secreting cells.

Usually it is recommended table number 2. It involves the inclusion of products that stimulate acid function and appetite:

• boiled, steamed, mashed meat and fish dishes;
• porridge;
• vegetables;
• fruit;
• greenery.

Boiled fish is an excellent dish for a sick person's menu

It is necessary to exclude:

• spicy seasonings;
• fatty foods;
• cold and hot drinks;
• fresh pastry.

Medication Therapy

In order to compensate for acidity and enzymatic insufficiency, apply:

• Acidin-pepsin;
• natural gastric juice;
• Panzinorm;
• Pepsidil.

When combined with pancreatitis:

• Pancreatin;
• Festal;
• Pankurmen.

To reduce nausea and eliminate vomiting:

• Cerucal;
• Raglan.

From the group of phyto-drugs, the stimulating action has:

• Plantaglucid (from plantain),
• Romazulon (from chamomile flowers),
• Rotokan (chamomile, calendula, yarrow).

Ready phytopreparation can be purchased at the pharmacy.

To improve the blood supply to the mucosa are appointed:

• Methyluracil;
• Aloe extract in injections.

The patient needs courses of vitamin therapy. With a sharp weight loss, anabolic hormones are used (Retabolil). In the regimen of therapy necessarily include means for protecting the stomach.

De-Nol - one of the preparations based on bismuth compounds

To destroy Helicobacteria:

• bismuth subcitrate;
• Metronidazole;
• Omeprazole;
• antibiotics.

Physiotherapy methods are used only after examination and complete exclusion of precancerous conditions. Recommended:

• UHF procedures;
• magnetotherapy;
• diadynamic currents;
• electrophoresis with solutions of novocaine or calcium;
• applications of ozocerite and paraffin.

The prognosis of the disease depends on the patient's compliance with the requirements of the diet, stopping smoking and drinking alcohol, performing feasible gymnastics, applying spa treatment.