Atrophic gastritis - symptoms, causes and treatment

Atrophic gastritis is a chronic form of gastritis, which leads to the disappearance of parietal cells of the stomach and, as a result, to a decrease in the secretion of hydrochloric acid, a deficiency of vitamin B12 and megaloblastic anemia.

This type of gastritis leads to the fact that the gastric mucosa is sharply thinned, and the glands atrophy. The onset of the disease is characterized by damage to the bottom of the stomach, then the production of hydrochloric acid and pepsinogen, the enzymes responsible for digestion, is disrupted. After this, the process is only aggravated, the stomach is injured by food ingested. The area of atrophy depends on the degree of trauma.

Atrophic gastritis is one of the most dangerous forms of chronic gastritis. If the time does not begin to implement complex treatment of atrophic gastritis, it can quickly grow into a stomach cancer.

Focal atrophic gastritis

This form is manifested by the formation of pathological inflammatory foci in the wall of the stomach with compensatory enhancement of the function of those parts of the organ that have not suffered.

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Light forms of focal gastritis are accompanied by a slight discomfort in the epigastric region, a burning sensation and pain after eating immediately. Nausea and a feeling of heaviness can appear not only after a plentiful meal, but even after a light breakfast.

If you ignore these symptoms, the disease progresses:

the patient loses his appetite,
to the initial symptoms is added heartburn,
pain syndrome increases
a person loses weight,
there is weakness and subfebrile temperature.

Often the course of focal gastritis is accompanied by an increase in the secretion of hydrochloric acid in the lumen of the stomach and an increase in total acidity, as in gastritis with high acidity.

Antral atrophic gastritis

Characterized by the development of atrophy in the antral part - the place where the stomach passes into the duodenum. In most cases, the lesion of the mucosa occurs first in this department, after which it begins to spread to the rest of the stomach. In this area, the cells responsible for the production of mucus are localized.

The main symptoms of gastritis of the antrum of the stomach, in which this department is deformed and narrowed, are as follows:

decreased appetite;
belching with an unpleasant aftertaste;
nausea;
heartburn after eating;
feeling of overfullness, heaviness, bloating in the stomach;
diarrhea (sometimes - constipation);
grumbling in the abdomen;
intense spasmodic pain in the stomach, arising after half an hour - an hour after eating;
general weakness;
irritability.

Atrophic changes in this department lead to an end to the production of mucus, which can trigger an increase acidity of the stomach, which in turn will eventually lead to the development of peptic ulcer. Scarring of ulcers causes narrowing of the pyloric section.

Causes

Why does atrophic gastritis occur, and what is it? At present, the reasons causing atrophic gastritis are not fully understood, but in spite of this specialists in the field Gastroenterology refers to the following list of putative factors that cause a pathological process:

When usedtoo sharp, spicy foods, too cold, poorly chewed and hot food.
Chemical substances- if you get into the stomach cavity or if you inhale alkali and acid vapors, a violent chemical reaction develops that damages the state of the gastric mucosa.
The presence of bad habits- Alcohol abuse, smoking, frequent use of carbonated drinks and coffee also leads to the development of the disease.
Medical preparations- prolonged use of drugs may adversely affect the mucosa.
Reflux is the process of casting the contents from the intestine into the stomach. As a result of this process, the mucous membrane is injured, which leads to the onset of atrophic gastritis.
Also the emergence of gastritis can becomeconsequence of bacterial infection or autoimmune processes in the body. In the first case, the disease manifests itself as a result of the multiplication of Helicobacter pylori bacteria. Initially, due to their vital activity, a superficial atrophic gastritis appears, then it passes into a more serious stage. The second case is characterized by a malfunction in the functioning of the immune system, when the body "eats" its own cells, which are perceived by the body as strangers.

Atrophic gastritis is dangerous because treatment no longer guarantees a full recovery and recovery. Gastroenterologists regard this form of gastritis as a precancerous condition. Atrophy of the mucous membrane and glands of internal secretion of the stomach seriously weakens the immune system as a whole.

The body begins to produce an insufficient amount of immunoglobulin, and antibodies that must fight with foreign microorganisms begin to "kill" their cells. Against this background, the patient develops an autoimmune disease.

Symptoms of atrophic gastritis

It is believed that in the first stages of a moderately expressed atrophic gastritis the clinic is worn out and has no specific symptoms. But in the further stages there is a symptomatology, forcing the doctor to think about the pathology of the stomach, and not another organ.

Common symptoms of atrophic gastritis in adults:

loss of appetite;
heaviness and rumbling in the abdomen after eating, bloating;
constant belching (air) with an unpleasant smell of rotten eggs;
then constipation, then diarrhea;
sometimes aching in the stomach after eating;
B12 deficiency and, or iron deficiency anemia;
polished language;
weakness sweating fast fatigue;
decrease in body weight in the late stages of the disease.

Sometimes there may be pain syndrome, when the feeling of discomfort arises in the form of dull aching pain, especially after eating. However, the distinctive feature of atrophic gastritis is that the pain may not be at all, or they can appear weakly, almost unnoticeably for a person and, as a rule, fleeting. Acute pain is absent in atrophic gastritis.

With the passage of time, due to a violation of absorption in the stomach and intestines of nutrients and vitamins, dry and pale skin may appear in patients, which is due to the developed anemia. Because of a lack of vitamin A, vision can be impaired, and a lack of ascorbic acid can cause increased bleeding gums, which will further exacerbate the manifestations of anemia.

Diagnostics

Diagnosis of atrophic gastritis is based on the analysis of clinical manifestations of the disease, endoscopic data, histological studies of coolant biopsy, on the evaluation of the functional activity of the stomach and the diagnosis of Helicobacter pylori infection.

Functional diagnostics of atrophic gastritis includes:

Measurement of the pH of the metry with which you can determine the secretory capacity of parietal cells;
study of the activity of gastric enzymes and the overall proteolytic activity of gastric juice;
diagnosis of motor function of the digestive tract, based on the results of gastroscopy.

The daily pH-metry is the "gold standard" for evaluating the secretory function of the stomach with atrophic gastritis. It is necessary to determine the tactics of patient treatment, prognosis and control of the effectiveness of therapy. On average, the daily pH ranges from 3 to 6.

A compulsory study with any form of gastritis is the determination of the presence on the mucosa of Helicobacter pylori bacteria. This study allows you to determine the cause of damage to the mucous membrane of the organ, since in most cases predisposing factor in the development of atrophic gastritis is a long-term infection Helicobacter.

Treatment of atrophic gastritis

In the case of atrophic gastritis, treatment is prescribed taking into account the stage of the course of the destructive process, the state of the secretory function, the general condition of the patient and taking into account the concomitant diseases:

Begin the treatment of atrophic gastritis in women and men withchanges in diet and diet. The diet is aimed at preventing the mechanical trauma of the gastric mucosa, so the food should be thoroughly crushed and taken warm. Fat varieties of meat and fish, meat broths, mushrooms, spices and foods that irritate the gastric shell must be excluded from the diet - sour, fried, spicy, pickled, smoked, pickles also cleaned. In addition, it is not recommended to drink carbonated drinks, coffee, alcohol, easily assimilated carbohydrates (chocolate, sweets, cakes, buns).
Destruction of Helicobacter pylori, if acid-fast bacteria have a significant effect on pathogenesis. Methods of eradication Helicobacter pylori are constantly being improved.
Substitution therapy. With a serious violation of the secretion of hydrochloric acid and pepsinogen, it is possible to use natural gastric juice - Abomin, Pepsidil, Acidin-pepsin. And also preparations of pancreatic enzymes - Mezim, Pankurmen, Creon, Pancreatin.
Pain relief. In cases of severe pain, cholinergic drugs may be used - Metacin, Platifillin, Gastrotsepin, and antispasmodics - Nosha, Galidor, Buskopan, Papaverin.
Stimulation of the muscles of the stomach. Medicines such as Cerucalum, Motilium may be prescribed to improve the motor function of the stomach.

All the above drugs are prescribed during the active phase of inflammation of the stomach with atrophy phenomena. During the period of remission, the main principle of treatment is replenishment of substances that are missing for full digestion.

Is it possible to cure an atrophic gastritis?

This disease can be cured, but only under medical supervision. Treatment of atrophic gastritis in women and men is prescribed exclusively taking into account the patient's general health, stage, condition of secretory function, accompanying problems and so on.

Diet

Atrophic gastritis symptoms Diet with atrophic gastritis is selected in accordance with the patient's age, his individual characteristics, stage of the disease and concomitant diseases. It is aimed at reducing the thermal, chemical and mechanical trauma of the stomach.

As a rule, with an exacerbation of the disease, diet No. 1 is prescribed - mechanically, thermally and chemically sparing: nutrition 5-6 times a day in small portions, mashed mashed rubbed soups, mashed broths, biscuits, jelly, porridges are used for food.

With decreasing signs of inflammation, dietary recommendations become less stringent, diet No. 2 is prescribed. Its goal is to restore the disturbed digestive functions and limit the load on the gastrointestinal tract while maintaining the nutritional value of the patient's diet.

Important conditions of this diet, which promote stimulation of gastric secretion, are strict adherence to the dietary regime, thorough chewing food and a calm environment during meals.

Forecast

The prognosis of the disease is worse in patients over the age of 50 years - at this age, metaplastic processes develop much faster and often lead to malignancy.

Of great importance for complete recovery is the early onset of treatment, as well as the degree of eradication of the infectious agent. If a second examination after the course of anti-Helicobacter therapy in the gastric contents of the microorganisms are determined, the course should be repeated.

Prevention

Physicians consider the timely treatment of helicobacter pylori as the main factor in the successful prevention of atrophic gastritis. All that is needed for this is to undergo a special course of treatment, which lasts on average from seven to fourteen days. Typically, patients prescribe three drugs, most of them antibiotics.

It is strictly forbidden to personally engage in choosing the right medication, as this can be fraught with complications. Only a professional doctor is competent in such matters.