Diseases of the stomach

The current situation not only in Russia, but in the world also shows that more than 1/3 of the population suffers from digestive system diseases. Among them, stomach inflammatory diseases( gastritis) account for 80%.The study of Helicobacter pylori infection and the introduction of treatment with eradication techniques have a temporary effect, since most patients are repeatedly infected.

Surgical methods are widely used to radically get rid of tumors and ulcers, but the continued existence of a person is complicated by problems of functional organ inferiority, a long process of restorative therapy. Let's try to understand the peculiarities of the structure, connections, functioning and pathology of the stomach.

What is useful to know about the stomach

The stomach is anatomically an intermediate organ in the process of digestion, as it lies between the esophagus and the intestine( duodenum).Conditionally the organ is divided into parts:

• on the border with the esophagus( from above) the region of the cardia and the bottom;
• in the middle of the body;
• below antrum and pyloric department with sphincter.

Each department performs its functions. In medicine, division is important for determining the localization of pathological changes, developing optimal operational tactics. The inside of the body is lined with a mucous membrane. It consists of one layer of epithelial cells.

This causes significant sensitivity to any adverse effects and difficulties in trying to restore the gastric mucosa. The structure has pits. Here, the cells produce gastric juice containing hydrochloric acid, pepsin.

The muscular part of the wall consists of three layers. The fibers carry out contractions in the transverse, longitudinal and oblique directions. Due to this, the food after mixing into the stomach is well mixed, crushed to pieces of 2 mm in diameter, sufficient contact with the liquid part of the active substances is provided.

A significant number of nerve endings are located in all layers. They are represented by the branches of the parasympathetic system( sympathetic nodes of the spinal cord and the vagus nerve).

Thanks to such connections, immediately after ingestion of food, a signal is sent to the mouth for the production of digestive enzymes, muscles work in concert, pushing the food lump to the pyloric part. Sensitive painful endings in the mucosa are absent, so the sampling of the material for biopsy with fibrogastroscopy is a completely painless process.

Hydrochloric acid is essential for gastric function. The norm is measured in units of acidity( from 1.5 to 2 pH).It is produced by the lining cells. The level fluctuates within 24 hours. The reaction approaches the neutral at the border with the duodenum. Diluted with a large volume of fluid. Its role in disinfecting food and protecting mucous from bacteria is important.

The glandular cells produce the digestive enzyme pepsin and hormone informative substances( gastrin, serotonin, somatostatin).They ensure the regulation of the digestive process not only in the stomach. The secretion of secretion by the pancreas is stimulated by the signal.

What are the diseases of digestion on the list of diseases of the stomach?

There is no separate classification of stomach diseases. Statistics and clinicians adhere to each of their instructions. We will list the diseases of the stomach, the most common among children and adults. We offer to consider:

• gastritis - inflammation of the mucosa of various etiologies;
• peptic ulcer;
• neoplasm;
• motor function impairment;
• gastric descension;
• gastroesophageal reflux disease;
• polyposis.

To the rare pathology are the following types of functional disorders and stomach diseases:

• stomach ailments - complete suppression of gastric secretion;
• pilorospasm - reduction of the pyloric area, is more often observed in a child in infancy;
• pneumatosis - increased gas formation in the stomach with a feeling of pressure and a constant eructation;
• Menetries disease - characterized by hyperplasia of the mucosa with the formation of cysts and adenomas;
• Mallory-Weiss syndrome - mucosal ruptures pass from the esophagus to the cardiac area of ​​the stomach.

Treatment of the stomach with each disease requires a separate approach. In addition, it is worth considering when a patient complains that his stomach "does not work", implying diarrhea and constipation, he is right, because stomach diseases are not limited to one organ damage, but are the initial link of gastroenteritis, gastroduodenitis, bulbitis - bowel diseases, affect the operation of the gallbladder and pancreas. To restore the work of the stomach, you have to treat the entire digestive tract.

Facts only

The most dangerous form of gastritis is atrophic. They suffer up to 5% of young people, 30% of the adult population 30-50 years old, up to 70% of the elderly. This stomach disease has the greatest risk of transformation into a malignant tumor.

85% of the Russian population suffers from various types of chronic gastritis, while ¾ cases are combined with the defeat of other digestive organs.95% of those living in the Russian Federation are infected with Helicobacter pylori( compared to 60% in the USA), 9 species of this bacterium are known.

In different regions, between 5 and 10% of adults suffer from peptic ulcer disease, the disease is "younger" and is more prevalent among adolescents every year. In the overall incidence, it ranks second after myocardial ischemia.

The causes of the pathology of the stomach

Infection with Helicobacter pylori is not the only condition for the onset of symptoms of a stomach disease. It is known that in 30% of people surveyed the presence of a microorganism is not accompanied by any symptomatology for many years. Factors leading to pathology, are composed of various reasons.

The most important are related to malnutrition:

• infecting the population with unhealthy foods consisting of fast food, chips, semi-finished products, lack of sufficient vitamins in the diet due to ignoring fruits and vegetables;
• preference for spicy and fatty meat dishes;
• excessively hot or cold food temperature;
• lack of protein intake tears up the secretion of gastric juice;
• abuse of alcohol, beer;
• non-compliance with diet, long periods of hunger, poor-quality snacks, fashionable uncompensated diets.

Other reasons are:

• smoking, starting with adolescence;
• prolonged stressful situations, mental stress;
• uncontrolled use of drugs that have a negative effect on the gastric mucosa( from headache, aspirin, hormonal and non-steroidal anti-inflammatory drugs);
• defective products containing preservatives, dyes, stabilizers, causing allergic reactions;
• weighed down in the family.

labels. People with chronic illnesses are characterized by worse conditions:

• of the endocrine system;
• heart and respiratory system;
• with iron deficiency anemia;
• kidney pathology.

Poor functioning of the immune system caused by acute and chronic infectious diseases, the formation of foci of constant infection in carious teeth, nasopharyngeal tonsils, maxillary sinuses in men, appendages in women reflects gastric problems, since it creates a high risk of infection with Helicobacter pylori. Restoration of the gastric mucosa under such conditions is characterized by a low ability to regenerate tissues.

The main signs of stomach disease

Gastroenterologists group symptoms of stomach diseases in pathogenetic syndromes, depending on the secretory activity of the organ. These include pain syndrome and gastric dyspepsia, signs of bleeding. We will simultaneously consider diagnostic problems for stomach diseases with symptoms of hypo- and hyperacid conditions.

Hyperacid Syndrome

Increased production of hydrochloric acid and hyperactive pepsin usually increase gastric motility. The main role belongs to the vagus nerve, which stimulates the receptors of the lining cells on the mucous membrane, causes an increased isolation of histamine and gastrin.

There must be intense abdominal pains, which are spastic by the mechanism of origin. Supported spasm pyloric sphincter. Localized in the epigastrium, the hypochondrium on the right, irradiate into the back, have a paroxysmal character.

Typical are hungry and nocturnal seizures due to the continuing synthesis of hydrochloric acid without food intake. Late( 1.5-2 hours after meals) is explained by the need for a time period for digestion in the small intestine and absorption of hydrolysis products, which then stimulate gastric secretion.

Pains well stop:

• with drugs of antispasmodic action;
• with warm water bottle;
• measures that reduce acidity( food, antacids).

Symptoms of gastric dyspepsia include:

• belching with acidic contents;
• heartburn;
• nausea;
• constipation of a spastic character with "sheep" feces;
• vomiting, which brings relief from pain.

Patients can induce vomiting on their own if acidic contents accumulate in the stomach. This way the spasm of the gatekeeper is removed. Appetite is not broken.

Hypoacid syndrome

Pathology is caused by reduced gastric secretion and motor function. Observed with atrophic processes of the mucous membrane. The most common lesion:

• with peptic ulcer localized in the body and bottom of the stomach;
• chronic atrophic gastritis.

Atrophic changes affect not only the cells but also the receptor apparatus that reacts to the pressure in the stomach, so even a normal stretching of the wall with a small amount of food causes pain.

Patients experience pain immediately after a meal or 30-40 minutes later. They are non-intensive, have a stupid character in the form of a sense of heaviness, without a clear localization, do not irradiate. After 2-3 hours independently subsided, when food leaves the stomach. In the treatment of the stomach with hypoacid syndrome for pain relief prokinetics are effective( Motilium).

Symptoms of gastric dyspepsia are the same as in the hyperacid state, but a belch usually without acid, heartburn occurs due to reflux from the stomach into the esophagus. Characteristic decrease in appetite, weight loss. Significantly expressed intestinal indigestion( bloating, diarrhea, rumbling), which is caused by a sharp violation of the digestion of food.

Bleeding syndrome

Gastric bleeding is observed in peptic ulcer disease, tumors. It is detected by hidden blood in the feces or with severe symptoms with vomiting "coffee grounds", black liquid stool( melena).When bleeding from the esophagus, vomiting contains scarlet blood( there is no contact with acid), there is no previous nausea.

Blood in the stool should be differentiated from anal fissures, hemorrhoids, prolapse of the rectum. It is important to eat blueberries, blackberries, bird cherries, bismuth preparations. To clarify the source of bleeding can be done with recto-, colonoscopy, esophagogastroscopy.

How to treat the stomach with the available signs of bleeding should be addressed jointly by gastroenterologists and surgeons. Lack of intervention can lead to anemia and further complicates the ability to completely restore the stomach.

What if I need to set the type of gastric secretion?

For the diagnosis of gastric secretion disorders, the most accurate method is pH-metry. Fractional analysis of gastric juice is now recognized as not accurate, but also difficult for patients.

pH-metry is performed as an independent study or concomitantly with endoscopy. The most important is daily monitoring, it allows you to track fluctuations in secretion, evaluate the effectiveness of treatment measures. The technique is important in the diagnosis of gastroesophageal reflux disease.

For the detection of pathological changes, the degree of gastric lesion requires esophagogastroduodenoscopy. Carrying out an X-ray study with a barium suspension has not lost its significance to the present day.

A biopsy of the material is subjected to a cytology study, a special coloration is performed to identify tumor cells of the tumor type. Consider the features of the most frequent diseases of the stomach.

Features of diseases

Gastritis - inflammation of the gastric mucosa can occur in acute and chronic form. Acute damage occurs due to the action of bacteria and toxins( intestinal infection), direct damage in poisoning by chemicals, medicines. The most severe course is erosive gastritis caused by Helicobacter pylori. Cracks form on the mucous membrane.

By the form of the mucosa, the final diagnosis is made. A significant number of variants of chronic gastritis is characterized by periods of exacerbation and calm. Pain syndrome manifests itself depending on the secretion. The patient suffers from signs of dyspepsia. Atrophic gastritis is considered the most dangerous.

Peptic ulcer

Disease with recurrent chronic course. On the mucous membrane ulcers are formed, which cause pain, bleed. Without strengthening in the wall of the stomach, a defect results, leading to organ rupture( perforation), breakthrough into adjacent tissues( penetration of the ulcer), peritonitis, marked by bleeding. Pain more often occur on an empty stomach, have a cutting character. They become "daggers" during perforation into the abdominal cavity.

Stomach cancer

Malignant neoplasms of the stomach account for 40% of all oncopathology. Symptomatology can be divided into stages of the disease:

• first - the patient is concerned about fatigue, apathy, belching, weight loss, feeling of heaviness in the epigastric region;
• the second - there is a pronounced pain syndrome, nausea, vomiting with an admixture of blood, significant weight loss, fever;
• the third - intolerable pain, marked exhaustion, vomiting, aversion to food.

Motility slow

The disease is associated with a predominant lesion of the muscle layer, impaired innervation. As a result, the movement of the food lump in the intestine slows down. Overexertion causes pain. Stagnant food contributes to reflux in the esophagus. The process of digestion is disturbed. The disease can be a complication of diabetes mellitus, intestinal infections, surgical treatment.

Gastroptosis

Pathology refers to a violation of the localization of the stomach. The patient has a constant sense of heaviness. Expressed signs of dyspepsia. Acute pains are removed in a supine position. There is a frequent aversion to dairy products. Characteristic features of increased nervousness, sweating, tachycardia, "leaps" of blood pressure.

Gastric polyps

Polyposis is considered a sharp pathology of the stomach. It is more often formed as a result of a prolonged course of inflammation( gastritis).Symptoms are little pronounced. It is revealed with preventive fibrogastroscopic examination of people over 50 years old. Usually the doctor chooses the tactics of observation. If the polyp remains less than 10 mm in diameter and does not grow, then it should not be removed.

If the growth is detected, examine the biopsy and decide in what form it is better to remove the formation. The easiest is electrocoagulation under the control of an endoscope. In case of doubt about cancer degeneration, operative excision of part of the stomach is performed.

Gastroesophageal reflux disease

Pathology is a separate disease. Characterized by the reverse casting of food from the stomach into the esophagus. The patient complains of a worsening of well-being at night, with tilts.

Appears:

• intense heartburn with irradiation of burning sensation in the neck, in women it increases with sexual intercourse;
• belching sour with bitterness;
• excessive salivation;
• difficult swallowing( simultaneous inflammation of the esophagus);
• vomiting just eaten food;
• hiccup.

Principles of treatment of stomach diseases

Each disease has its own peculiarities in therapy, therefore, in order to cure the stomach, doctors should have a precise idea of ​​the nature of the pathological process, its spreading over the area, into the depth, with cancer to neighboring organs and in the form of separated metastases.

Common ways to maintain and strengthen the stomach are:

• refusal to smoke and drink alcohol;
• normalization of nutrition, a strict diet, depending on the stage of the disease;
• if necessary, a course of eradication( against helicobacteria) with convalescence control;
• reception of drugs depending on the level of acidity( blockers or stimulants);
• maintenance of motility( prokinetics);
• withdrawal of spasm and sufficient anesthesia;
• hemostatic therapies;
• compensatory introduction of vitamins;
• if necessary, enzyme therapy;
• physiotherapy in the absence of contraindications.

Treatment of peptic ulcer disease, tumors requires a timely decision on the feasibility of surgery, a combination of chemotherapy and radiation therapy. At a gastroptosis improvement of the condition comes at wearing of a special bandage, performance of exercise LFK.

How to relate to the advice of traditional medicine?

The recommendations of traditional medicine complement the basic treatment and never become the main "healing" link of therapy. You can not choose methods without consulting a doctor. The success of herbal therapy is related to the selection of herbal remedies, depending on the gastric secretion.

At a low level are shown: plantain, calendula, yarrow, cabbage juice, grated apple. To reduce acidity apply: sage, dog rose, ayr, mint, St. John's wort, honey, oat broth, flax seeds. Chamomile broth is useful for any lesion of the stomach.

Prevention

To prevent stomach problems, it is necessary: ​​

• adhere to proper nutrition, avoid long breaks, try to eat at one time, refuse from sharp and salty foods, do not abuse fatty and fried foods;
• better accustom yourself and relatives to cooked, stewed products;
• should not be overeating, drinking soda, fast food, chips;
• learn how to relieve stress;
• exercise, do not lie down on the sofa after eating;
• in the spring and autumn courses to drink herbal decoctions instead of coffee;
• undergo a regular examination;
• take into account its hereditary predisposition.

People who are attentive to their health know that you can not trust advertising. Any measures to prevent and diagnose digestive diseases should be coordinated with specialists.