Gastritis with high acidity

Gastritis refers to all inflammatory diseases of the stomach. The process is localized on the mucosa, proceeds as acute inflammation or chronic. As a result of prolonged poorly treated gastritis, cells are destroyed, the organ stops participating in digestion. Hyperacid gastritis refers to pre-ulcer states of the stomach.

The disease has many varieties. The ability to examine the mucosa by means of fibrogastroscopy contributes to accurate diagnosis. There were classifications taking into account the species, localization of inflammation. However, for practical practitioners, the ability of the stomach to produce juice remains one of the basic fundamental distinctive principles.

The main constituent of gastric juice is hydrochloric acid. Depending on its level, gastritis with high acidity or with decreased acidity is excreted. We consider the relationship between inflammation and increased acidity, the clinical signs of these disorders.

Where is acid produced and what affects it?

The main secreting glandular cells are located in the body of the stomach. Among them there are "main"( 40%), which synthesize enzymes. The most important is pepsinogen. Others, obkladochnye( 12%), give off chloride salts and a substance called the internal factor of Castle. It ensures the absorption of vitamin B12 in the small intestine.

Chlorides are combined in the lumen of the glands with hydrogen ions, resulting in the formation of hydrochloric acid. The role of acid:

• to activate pepsinogen so that it turns into pepsin;
• maintain the optimal level of acidity( in the diagnosis it is called pH) for the functioning of enzyme systems of the stomach;
• provide initial chemical processing of food;
• using bactericidal action, protect the gastric mucosa from pathological microorganisms.

The glands of the lower part of the stomach( antral) produce an alkaline secret. It is designed to prevent acid from entering the duodenum.

The normal fluctuation of acidity during the day is ensured by the coordinated work of antrum and base glands

. To increase acidity, one of the conditions is necessary: ​​either a sharp increase in the production of gastric juice in the body or blocking of the process of alkalinization. Normally, the balance is controlled by the nervous and endocrine system( hypothalamus, pituitary gland).This explains the influence of stress and nervous tension on the secretion mechanism in the stomach.

One of the main hormones is gastrin. It is produced by the G cells of the antrum of the stomach, is capable of both stimulating and blocking digestion. In practice, its ability to activate the activity of the lining cells and increase acidity is important.

Others explain the mechanism of lesion of the antrum by stimulation of G cells, growth of secreted gastrin and subsequent stimulation of hydrochloric acid secretion in the unaffected fundus. Even with the inflammation of the fundus of the stomach, the decrease in acidity begins only when the process reaches the submucosal layer.

Reasons for

For the development of gastritis with high acidity, the following reasons are important:

• external( exogenous);
• internal( endogenous);
• is hereditarily-constitutional.

The external group includes:

• violation of the regime and quality of food, long breaks in food, hungry diets, overeating of heavy food, refined products( sweets), reducing the binding of excess hydrochloric acid in gastric juice;
• hard work, stress;
• taking medications with a negative effect on the stomach( derivatives of salicylic acid, nonsteroidal anti-inflammatory drugs, antibiotics, sulfonamides);
• deficiency in food substances, providing restoration of damaged cells of the gastric mucosa and glandular epithelium( vitamins, iron, protein, microelements).

Studies have shown that in territories with an unfavorable ecological situation, there are 3 times more gastric and duodenal pathologies. Among the internal factors, the mechanisms of:

• affect nervously reflex action on the gastric mucosa of other pathologically altered organs of the digestive system( liver, gall bladder, pancreas, intestine), which leads to a breakdown in the control of secretory activity and gastric motility;
• increased production of histamine;
• blood circulation microcirculation in the stomach zone up to a chronic thrombohemorrhagic syndrome.

This is possible with long-term smoking, alcoholism, endocrine diseases. As a separate reason, we will give opinions on the infection of Helicobacter pylori. Inflammation occurs even with normal acidity. Restorative processes are blocked, and around the bacterium, the enzyme urease creates a protective layer.

Helicobacter injected into the mucus layer, attached to the cells of the epithelium, moves inside the crypt and glands of the stomach. In this way the protective layer is destroyed and free access of hydrochloric acid to the tissues of

is opened. Some researchers do not recognize the leading role of Helicobacter pylori infection. Already more than 140 strains with different degrees of infectiousness and sensitivity to antibacterial agents have been isolated. Scientists believe that combinations of infectious agents are possible.

What are the known types of gastritis, accompanied by increased acidity?

One of the classifications suggests differentiating gastritis by type and type, depending on the causes, and include them in the diagnosis formulation. This applies to any inflammation of the stomach, regardless of acidity.

Fundamental( type A) - affects the body of the stomach, the bowl is caused by a genetic predisposition, the production of autoantibodies. Atrophy of the gland of the fundus, so there is no increase in acidity.

Antral( type B), bacterial - is caused by infection, including Helicobacter pylori, inflammation over-stimulates G cells, they increase the synthesis of gastrin. In response, the "healthy" foundation department produces an increased volume of hydrochloric acid, the acidity rises. At later stages, the cells of the stomach are depleted, the acidity falls.

Chemotoxic( type C) - is diagnosed if the provoking factors were drugs, alcohol, reception of toxic substances. It is divided into:

• reflux gastritis - is formed due to a violation of motor and inflammation of the gallbladder or duodenum, there is a throw into the stomach of bile acids, which is equivalent to a chemical burn of the mucosa;
• is a medicament.

Often there is a mixed form of the disease. In addition, distinguish between acute and chronic form. The acute form of the flow usually begins suddenly after exposure to the stomach of extremely strong irritants( infected foods, chemicals).

Chronic gastritis with high acidity is formed for a long time and is more associated with disruption of the processes of repair of damaged epithelium, redistribution of glands. Many authors agree that the increase in secretion is the first phase of development of a more frequent form - gastritis with reduced acidity and atrophy of the mucosa. Inflammation occurs with periods of exacerbation and remissions.

The acute form, according to the conclusion of fibrogastroscopy, is classified into four varieties:

• catarrhal or superficial - most characteristic of dietary errors;
• diphtheria or fibrosis - usually caused by chemicals;
• corrosive( toxic-chemical, necrotic) - severe inflammation due to the action of concentrated acids and alkalis, causes necrosis of the gastric mucosa;
• phlegmonous - melt the walls of the stomach, the pus spreads to all layers, is more often observed with a complicated course of cancer, ulcers, in persons with low immunity.

One of the classifications tries to combine the conclusion of fibrogastroscopy with the severity of atrophy processes

Depending on the localization of inflammation, the following are distinguished:

• pyloroduodenitis( lesion of the antral zone) of the stomach;
• foundation gastritis( of the body);
• pangastrit( captures the entire body).

What are the main symptoms?

Symptoms of gastritis with high acidity have common signs of all gastritis and their specific characteristics. They are "recognized" by doctors if the patient complains about:

• feeling of heaviness, raspiraniya in the stomach after 20-30 minutes after eating, pain blunt or aching nature, worse on an empty stomach, with a long break in food when the stomach is empty;
• belches acidic contents;
• heartburn - caused by a reverse casting of gastric juice in the lower part of the esophagus;
• predisposition to constipation;
• short-term colic along the bowel;
• nausea after eating;
• sometimes vomiting with acidic contents, improving overall health;
• changes in appetite - the decrease is due to fear of pain, and increase - by improving the condition when acid binds food.

Upon examination, the doctor discovers: a bright red tongue with a white or gray coating, a moderate tenderness in the epigastrium with a superficial form and expressed in the case of severe course, patients usually do not lose weight. Patients have an astheno-neurotic syndrome.

Patients are concerned about the constant bloating of the stomach

These are signs of a lesion of nervous regulation: emotional instability, laughter gives way to anxiety, crying, increased irritability, a tendency to lower blood pressure, bradycardia( pulse slackening), arrhythmias, sweating, the doctor sees in the skin with a blunt spatulathe appearance of red bands( red dermographism - a sign of impaired vascular tone).

What is the difference between chronic gastritis and acute disease?

Gastroenterologists at the current stage of diagnosis are not guided by the patient's complaints, data on the secretory function of the stomach and fluoroscopy. Objective signs of gastritis with high acidity are accurately characterized only after studying the biopsy of the mucous membrane.

Among the morphological changes, a reduced or preserved amount of glandular cells in the corresponding stomach, round-cell infiltration, epithelial degeneration, replacement of the gastric tissue with intestinal epithelium( metaplasia), and scar tissue should be identified.

Which examination is required?

In clinical analyzes, specific changes should not be expected, only confirmation of the presence of an inflammatory process in the body( small growth of leukocytes, ESR) is possible. Biochemical tests indicate concomitant lesions of the liver and pancreas.

If erosions appear on the gastric mucosa, bleeding can be detected by the reaction of feces to latent blood( Gregersen).To identify Helicobacter pylori: respiratory urease test, enzyme immunoassay, polymerase chain reaction method.

Bacteria can be seen when examining a material from a biopsy. Fibrogastroscopic way to examine the esophagus, all parts of the stomach and duodenum. In the diagnosis appears a kind of inflammation.pH-metry - is deciphered as a hyperacidity at an indicator less than 1,5.

There are several ways to measure the pH of gastric juice

Electrogastroenterography is shown to measure pressure fluctuations in the gastric cavity and the possibility of reflux from the duodenum. Auxiliary methods for diagnosing diseases of other abdominal organs with possible secondary inflammation of the stomach are ultrasound, computed tomography.

How to treat gastritis with increased acidity?

Treatment of gastritis with high acidity requires compliance with the main objectives:

• normalize acidity;
• to relieve the patient's stomach from Helicobacter pylori;
• conducting optimal anti-inflammatory therapy;
• restoration of cells' ability to regenerate;
• strengthening of immune defense.

In acute catarrhal form and mild exacerbation of chronic gastritis, patients can be treated on an outpatient basis. In the case of more complex species, prolonged course, hospitalization in the profile department is recommended. Smoking, drinking alcohol, carbonated water are strictly prohibited.

Diet

The treatment plan necessarily includes dietary nutrition. Food for patients should be prepared only for a couple or in a boiled, stewed. The methods of roasting are excluded. The feeding regime is increased to 5-6 times. This is necessary for the constant binding of hydrochloric acid. The total volume for each meal decreases.

The diet table №1 is appointed. The patient can not cook sharp, smoked, very salty foods. Excluded pickled vegetables, sour fruit and berry juices, sour-milk products, legumes, mushrooms, cabbage, onions and garlic, other spicy seasonings, cucumbers, radish.

You can not eat nuts, cream pies, sweets( jam), sour apples, lemon. Sweet fruits are allowed in fresh form and in juice( grapes, apples without skin, melon).All dishes should be well-cooked, as much as possible ground to create a discharge for the stomach.

Recommended boiled porridge( rice, buckwheat, oatmeal).Patients are helpful porridge with pumpkin and pumpkin juice. Perla, wheat and barley are forbidden. You can cook pasta. From the potatoes prepare liquid mashed potatoes, together they extinguish with carrots, zucchini.

Broccoli cabbage allowed.

Meat and fish soups should not be rich. It is forbidden to eat meat and fish, fatty pork. Recommended chicken, turkey without skin, beef in the form of meatballs, steam cutlets, slimy soups with boiled oats. With good tolerance, you can drink whole milk, coffee with milk, weak black and green tea, broth of wild rose.

It is recommended to use jelly from sweet berries, compotes, oat jelly. It is better to abstain from eating pears and plums. Pears have a fixing effect, draining weakens. They contain coarse fiber, which in the stage of inflammation is not useful for the stomach.

Creamy or olive oil is added to the second course, soup-mash, it is recommended to take an empty stomach. How long to keep a diet for acute gastritis, you need to decide with your doctor. Patients chroniclers will have to adhere to restrictions throughout their lives.

Treatment with medicines

Drugs of different groups are included in medicamentous treatment. For the treatment of acute gastritis, antispasmodics( No-shpu, Drotaverin, Papaverin) are used to reduce the pain syndrome. Prescribe antibiotics for obvious bacterial infection.

Antacids - a group of drugs that can neutralize the acid of gastric juice. They use combinations of salts of magnesium, aluminum, calcium, silicon( Maalox, Fosfalugel, Gastracid, Altacid, Palmagel, Topalcan, Gaviscon, Rutatsid, Gastal).

The effect does not occur immediately, but lasts a long time.

Proton pump blockers act directly on the mucosal glands that produce hydrochloric acid( Omega, Omeprazole, Rabeprazole).The blockers of H2-histamine receptors act through a decrease in tissue sensitivity to histamine( Ranitidine, Famotidine).They have an anti-inflammatory effect.

If the disease is associated with Helicobacter pylori infection, a course of treatment with antibiotics( Amoxicillin and Clarithromycin) is used in combination with Denol and Trichopol. Often patients need sedatives, normalization of sleep.

To enhance healing, physiotherapy methods are used:

• electrophoresis;
• applications of paraffin and ozocerite;
• magnetotherapy.

Popular advice

Among the popular recommendations on the use of herbal medicine most advice on the use of herbal decoctions and teas with mint leaves, chamomile flowers. Careful application of St. John's wort is required. Its unwanted carcinogenic properties are discovered.

Bee products can be used natural honey( a little add to porridge, tea, decoction).Tincture of propolis diluted with milk or warm water. It has a healing effect with inflammation of the stomach, negatively affects Helicobacteria.

The course of treatment with propolis is not more than a month, take one hour before meals.

Prognosis of cure and prevention measures.

. If the treatment is started on time and carried out in full accordance with the scheme, due courses, the forecast is quite favorable. If a patient refuses to part with bad habits, alcohol consumption, diet should be expected to transfer the disease to peptic ulcer of the stomach and duodenum.

For the purpose of prevention it is necessary: ​​

• to monitor the regularity of nutrition, to not allow any diets without consulting with the doctor;
• use coffee to cut to two cups a day;
• not drink soda water;
• diversify food with fruits and vegetables, refuse fast food;
• comply with personal hygiene requirements;
• take medication only in case of actual need.

How to treat hyperacid gastritis, tell the doctor at the reception. This species is not considered as dangerous as hypoacid. But complication in the absence of therapy becomes a peptic ulcer with all subsequent problems. Therefore, you should fully use the chance of recovery.