What is gastritis?

Gastritis is called a group of stomach inflammatory diseases. As in all medical terms, this meaning is contained in one word. There is no gastritis of another organ, so it's wrong to say "stomach gastritis".

Pathology is accompanied by a violation of the function of digestion of food at the very beginning. This significantly complicates the work of other bodies, causing their overload. Timely treatment of gastritis can prevent gastric ulcer, bowel disease, the onset of a cancerous tumor.

Like any disease, gastritis can flow in acute and chronic form. Distinctive features depend on the causes of inflammation of the gastric mucosa, the level of acidity of gastric juice, the prevalence of the process according to the area of ​​the lesion, the degree of disruption of functions. Types of gastritis are diagnosed only with fibrogastroscopic examination. Identify what symptoms are specific to each form is almost impossible.

What causes inflammation of the stomach?

The causes of gastritis are most pronounced in acute inflammation, when the disease follows directly from their effect. The most common inflammation of the stomach is found:

• when food poisoning is of poor quality food containing pathological microorganisms;
• if infection with the bacterium Helicobacter pylori occurred( typical for gastritis with high acidity);
• as a result of viral diseases( influenza, ARVI);
• because of the consumption of a significant amount of alcohol;
• for accidental or willful poisoning by household chemicals( toxic dyes, solvents, detergents);
• from taking medicines that have a pronounced irritant effect on the gastric mucosa( any tablets for headache and heat containing Aspirin, non-steroid pain medications Ibuprofen, Ketoprofen, Diclofenac, Indomethacin);
• with a sharp decrease in immunity against the background of other serious diseases.

Paracetamol derivatives also irritate the stomach.

The causes of gastritis in chronic form are associated with untreated acute inflammation of the stomach, lack of measures against Helicobacter pylori, infection with parasites. To develop a chronic process, unfavorable factors must act for a long time.

These include various eating disorders:

• long breaks in eating, irregular eating, overeating;
• poor chewing due to a problem with the teeth, haste;
• no warmed-up food, dry food;
• abuse of alcoholic beverages, beer, soda water, strong tea and coffee;
• constant use of chips, fast food products.

Factors that disrupt innervation and provoke inflammation of the gastric mucosa may be: smoking - due to toxic effects of nicotine, frequent disturbances, hard work, stress, neuroses, depression.

Other causes arise:

• for untreated helminthic invasion;
• dumping of bile from the duodenum into the pyloric zone( gastroduodenal reflux);
• radiation irradiation and chemotherapy of tumors;
• for long-term work in conditions of industrial hazards( with metal and coal dust, heavy metal compounds, dyes, alkalis and acids);
• uncontrolled intake of irritant drugs;
• metabolic disorders with internal intoxication against a background of kidney disease, gout( urea and its derivatives are secreted through the gastric mucosa);
• of the transferred operation with removal of a part of the stomach in wounds, injuries;
• disruption of endocrine regulation;
• vitamin deficiency;
• state of hypoxia( lowering of oxygen level in the blood) on the background of cardiac decompensation.

The main mechanism of pain - stretching the gastric cavity of delayed food

What signs indicate gastritis?

Symptoms of gastritis in adults occur in acute form a few hours or earlier, with chronic - under the influence of agitation, eating disorders, diet, hypothermia. Signs for acute and exacerbation of chronic inflammation of the stomach are the same, patients are concerned:

• acute or moderate aching in the upper abdomen associated with food intake, gradually decreasing with the passage of contents into the intestine;
• dyspeptic syndrome, which manifests itself with nausea, vomiting with mucus, loss of appetite, heartburn, belching, flatulence( bloating).

Dyspepsia is caused by abnormal operation of the muscles of the stomach wall, sphincters. There is a reverse ejection of food, gas and acid into the esophagus( gastroesophageal reflux).Patients often show an unpleasant taste in the mouth, a smell. The tongue is constantly surrounded by a touch of white or dirty-yellow color.

Disturbs weakness, dizziness, weight loss, stools. The person becomes irritable, the character changes dramatically. If the inflammation of the gastric mucosa is caused by infection, the temperature may rise. This is a very common sign of stomach damage, a symptom of gastritis in the flu.

With atrophic chronic gastritis, a combination of sudden blanching, weakness, sweating after eating, and subsequent diarrhea are possible. In cases of severe acute gastritis, changes are possible that indicate the involvement of the cardiovascular system( pain in the heart, rhythm disturbances, fluctuations in blood pressure).

What kinds of acute gastritis are diagnosed on fibrogastroscopy?

A significant success in gastroenterology has been the widespread implementation of fibrogastroscopic examination with symptoms of gastric lesions. This is the only way to visually inspect the walls of the stomach and see how gastritis is manifested. Differences in the picture made it possible to distinguish the types of inflammation, correctly treat and prevent the transition to the chronic phase.

Catarrhal( simple gastritis, commonplace) - the most frequent consequence of food poisoning, usually occurs along with enteritis. It also accompanies malnutrition with overeating, prolonged hunger. The mucous membrane of the stomach is edematous due to a massive influx of leukocytes and tissue hyperemia, the folds are smoothed.

Biopsy finds areas of degenerative alteration of epithelial cells

Fibrinous( diphtheritic) gastritis - named after the characteristic type of fibrin films covering the mucous membrane. It looks like diphtheria films in the throat. It is formed by poisoning with sulemic acid, with infectious diseases.

Corrosive( necrotic, toxic-chemical) gastritis - is caused by concentrated acids and heavy metal salts that have entered the stomach. On the mucosa are found areas of necrosis.

Phlegmonous( purulent) gastritis - proceeds against the background of a stomach ulcer, a cancerous tumor, severe infections. It causes purulent melting of the wall, spreading along the inner layer. Clinically reveal signs of intoxication of the whole organism.

Types of chronic gastritis

The modern classification of chronic gastritis divides it into types, includes a predominant etiological and clinical principles.

• Type A - is caused by an autoimmune mechanism, antibodies are formed to cover cells, which cause inflammation in the mucous membrane of the body( body) of the stomach. Often accompanied by pernicious anemia.
• Type B - associated with bacterial infection Helicobacter pylori, localized in the antrum. It accounts for up to 90% of all cases.
• Type C - includes damage by chemical agents, also referred to as reflux. It differs from others in the presence of hemorrhages and cracks on the shell. May be accompanied by vomiting with blood, the appearance of latent blood in the stool. Deficient factors are bile acids with gastroduodenal reflux, drugs.

Mixed types of inflammation complement each other, for example, gastritis AB, AC, combining harm from drugs and alcohol with other factors

The state of epithelial cells distinguishes:

• atrophic gastritis - the epithelium disappears, the mucous becomes grayish, transparent, very thin, mucus and gastricjuice is not produced;
• hypertrophic - cells proliferate, the mucosa thickened, possibly the appearance of malignancy( partial replacement of the intestinal epithelium);
• polyposis - against the background of the picture of atrophy, the areas of hyperplasia( proliferation) are visible, possibly damage with gastric bleeding.

Many classifications have been proposed. Specialists in endoscopy conduct in-depth analysis on the type of changes, combined with the results of biopsy material. Clinicians insist on subdividing the disease at the stage( degree), which is logical to combine with the choice of gastric treatment for gastritis.

Which stages of gastritis are reflected in the diagnosis?

In the complete diagnosis, in addition to the form of gastritis, there should be a stage of the process. With this formulation, it becomes clear to any doctor the morphology of changes in the gastric mucosa, the symptoms of gastritis in adults can be assumed without questioning the patient.

I( initial, superficial) - is characterized by a moderate intensity of the inflammation process, without compromising the integrity of the shell and the function of the organ. Patient:

• decreased appetite;
• often shows fatigue;
• may be dizzy;
• dyspepsia is expressed in periodic nausea, diarrhea;
• in epigastrium there are short-term pains of spastic type.

Patients are prone to lowering blood pressure, increasing heart rate

II( chronic) - occurs when being late with treatment of gastritis, the patient's failure to follow the doctor's recommendations. In contrast to the first there is a violation of the secretion of gastric juice, the epithelial layer is partially destroyed.

Two forms of morphological changes in the mucous membrane are possible: erosive( erosion and shallow ulcers are formed on the surface) and diffuse( covers the entire shell, glandular apparatus).Symptomatic change:

• heartburn becomes permanent;
• in vomit there are impurities of blood;
• epigastric pain accompanies any meal;
• with diarrhea, too, is allocated blood.

The patient's condition deteriorates rapidly.

III( atrophic) stage of inflammation of the stomach is a sign of neglect of gastritis. Epithelial cells are replaced with connective tissue. The digestive function is completely absent. The intake of protein, micronutrients, and vitamins is disrupted. There are alternating exacerbations and remissions.

Patients complain of weight loss, bitterness in the mouth, persistent nausea, heartburn and belching, frequent rumbling in the abdomen, diarrhea, increasing weakness, dizziness, loss of appetite, heaviness in the upper abdomen.

IV( hypertrophic) - marked index of neglect of inflammation. In the mucosa, many small cysts and adenomas are formed, it sharply thickens. The stage is rare and the dynamics of the process is not sufficiently studied. Patients look very thin, pale, pain almost constant.

Diagnostic methods

The purpose of the diagnosis is to identify the morphological picture of changes and functional disorders. The following research methods are used for this. Fibrogastroscopy - allows you to visually determine the nature of the changes, identify precancerous structures on the mucosa, take a biopsy from five sites, clarify the presence of Helicobacter pylori.

The procedure for urease activity in the composition of exhaled air diagnoses the presence of helikobacteria

Laboratory tests of blood, urine, feces on Gregersen's reaction, biochemical tests - specify the stage of general body damage, protein loss, latent bleeding and anemia.pH-metry - accurate determination of the secretion of gastric juice, taking into account diurnal fluctuations, establishes the functional usefulness of the body for the digestive process.

Methods of electrogastroenterography and manometry - are to check the sufficiency of the motor activity of the stomach muscles for evacuation of the contents, are important in the diagnosis of gastroduodenal reflux. Ultrasound - helps to identify concomitant diseases of the liver, stones in the gallbladder and its dyskinesia, pancreatitis.

Complications of

Complications are more typical for a severe stage of inflammation of the stomach. They are expressed in the direct destruction of the mucosa and the involvement of neighboring organs:

• gastric bleeding( with erosive gastritis);
• hypovitaminosis, especially affects the patient's body deficiency of vitamins B12 and folic acid, iron, anemia develops;
• peritonitis is possible with reflammatory gastritis;
• dehydration( dehydration) accompanies frequent vomiting;
• loss of appetite leads to a breakdown in metabolism and exhaustion;
• transition to a peptic ulcer and the subsequent transformation of the epithelium into a malignant tumor;
• development of pancreatitis.

Methods of treatment of gastritis

To determine the correct diagnosis and advise what to do with gastritis depending on the form, the stage of the process can only be a specialist. You can not start treatment yourself, because there are features known to doctors.

With acute gastritis

Treatment of acute inflammation of the stomach is associated with a causative factor. If food poisoning occurs, then the stomach is washed, saline solutions are recommended inside, enterosorbents are prescribed to remove toxins. Pain is removed with antispasmodics.

The catarrhal form allows to wash the stomach with warm water with drinking soda, for anesthetizing take enveloping agents( Almagel A, bismuth preparations), diet and bed rest should be observed for several days. The bacterial form is treated with broad-spectrum antibiotics. In case of chemical damage, it is necessary to call a doctor for help.

Toxic substances, acids and alkalis must be removed from the stomach very carefully, by washing the probe to clean water and no odor. Use warm milk, egg white, vegetable oil. It is strictly forbidden to add to the solution a "quenching" substance with the opposite effect.

When an attempt is made to rinse the burned surface of acid mucosa with alkali, a violent reaction occurs with the release of gas, it can rupture the stomach, cause bleeding, peritonitis

. Specialists use a solution of magnesia, aluminum hydroxide. In gastritis caused by alkalis, it is advised to use lemon juice, a weak solution of acetic acid. Pain is removed with narcotic drugs, strong analgesics.

For chronic gastritis

Treatment of patients with chronic inflammation of the stomach provides for a change in the regimen( elimination of stressful situations, smoking cessation), dietary intake and medications, depending on the type of acidity, intake of mineral waters and physiotherapy procedures.

Medicines for high acidity

If the acidity level is normal or increased, antacids( antacids), enveloping and adsorbing preparations are recommended. To remove heartburn and burping, it is not recommended to use baking soda, especially for the elderly.

Calcium carbonate, magnesium oxide, bismuth nitrate are much safer. They also have an astringent property. Against the background of constipation, magnesium preparations are more recommended, with diarrhea - calcium.

Hydrochloric acid is well bound and magnesium trisilicate, aluminum hydroxide or aluminum phosphate( included in Almagel, Almagel A, Fosfalugel) are recovered. They are appointed after meals. With pain, medications with anticholinergic action( Gastrotsepin, Metacin, Platifillin) are effective.

With weakened motor function of the stomach apply Cerucal, and with strengthened - No-shpu, Halidor. The erosive form is treated with Denol, Antepsin, Venter. These drugs increase the stability of the mucous membrane. Be sure to conduct a course of destruction of Helicobacter pylori with a combination of Denol, Metronidazole and Amoxicillin.

Medications with reduced acidity

Secretory deficiency requires compensation of gastric juice, stimulation of its production. For this purpose:

• preparations from plantain( juice and Plantaglucid) are suitable;
• ready-made gastric juice;
• Acidinpepsin and Betazid;
• enzymatic agents Pepsidil, Abomin.

Recommended enzyme preparations, such as Pancreatin, Digestal, Festal, Pansinorm, Mezim-forte, Pankurmen. They delay the defeat of the pancreas and intestines. To improve the supply of mucous courses, use an extract of aloe, Pentoxyl, Methyluracil.

Sometimes, with severe weight loss, anabolic hormones are prescribed( Retabolil, Nerobol)

The value of proper nutrition

The diet and following a clear schedule of food intake are no less important in treatment than medications. And with a superficial form, generally speaking, one can do without them.

With acute gastritis

For 1-2 days a hunger is prescribed with a drink of warm alkaline mineral water without gas, broth of wild rose. Then add low-fat broth, liquid porridge, jelly, kefir. From the fourth day you can eat fruit jelly, meat steamed meatballs and meatballs, soft-boiled eggs, white crackers. A week later, go to the diet table number 1.It is necessary to eat a little, 5-6 times a day. Strongly contraindicated all fatty, fried and irritating foods.

In case of chronic gastritis

The same principles of gastric sparing are observed, the multiplicity of nutrition. The safety of the secretory function is taken into account. With normal or increased acidity, dietary table # 1 is recommended, which excludes from the diet all products that stimulate the release of hydrochloric acid( rich broths, canned food, fried foods, condiments, pickles, coffee, alcohol and soda water, black bread).

It is advised to include in the diet boiled meat and fish, soft-boiled eggs, cereals, dried white bread, dried biscuits, milk soup, boiled vegetables stewed, mashed potatoes. Fruit jellies, compotes, baked apples, cocoa with milk are allowed.

In case of secretory insufficiency, a dietary table №2 is appointed. It includes dishes and products that stimulate the secretion of gastric juice: low-fat soups, boiled meat and fish, parsley and dill, soaked herring, black caviar, dried rye bread, vegetables in boiled and stewed, porridges on water or milk, faint cheese andham, fresh juices, apples.

If gastritis is accompanied by diarrhea, then diet No. 4 is recommended, with concomitant pancreatitis - table number 5.The most stringent requirements should be observed when exacerbating and after 2 months. These dietary rules, patient-chroniclers will have to adhere to all life.

Kasha must be included in the diet

Use of folk remedies

All physicians recommend phytotherapy during the absence of an exacerbation. But you need to know exactly the effect of herbs on acidity, so as not to disturb the balance with medications. By the same principle, you can choose in the pharmacy ready-made herbs.

With secretory deficiency are effective: mint, wormwood herb, root of aira, juice of plantain. With normal and increased acidity - flowers of lime, chamomile, calendula. An excellent result gives sanatorium-resort treatment with mineral waters, mud applications.

Patients-chroniclers are recommended to undergo annual supportive care courses. Before the trip, you need to check the tests and fill out a doctor's card with your doctor. Contraindication is the suspicion of bleeding, ulcers, neoplasm. In choosing one can not rely on health.