Chronic gastritis - symptoms and treatment

Chronic gastritis Gastritis - inflammation of the mucous (inner) wall of the stomach. When the inflammation passes to the duodenum, so-called gastroduodenitis is formed.

There are two types of gastritis and gastroduodenitis: with reduced and increased acidity of gastric juice.

Chronic gastritis is a disease with a recurrent inflammatory process in the mucosa and submucosa of the stomach, accompanied by a violation of regeneration epithelium and the development of atrophy, which inevitably leads to the development of secretory insufficiency followed by a variety of digestive disorders.

Symptoms and treatment, as well as a description of the diet will be discussed in this material.

Causes

What it is? Among the main causes of the development of chronic gastritis specialiststhe following factors:

Receiving coarse food, marinades, smoked food, spices and spices. All this has a disastrous effect on the mucous membrane of the stomach and increases the secretion of hydrochloric acid.
Frequent use of overheated food and hot drinks (coffee, tea). All of the above causes irritation of the stomach, which has a thermal character.
instagram viewer
Continuous uncontrolled use of medicines that irritate the gastric mucosa (we are talking about salicylates, some antibiotics, sulfonamides and others).
Irregular intake of food, unduly quick chewing, habit is "dry".
Alcohol addiction. Alcoholic drinks have an extremely detrimental effect on the work of gastric spasogenesis, worsen the regeneration of epithelial cells of the mucous membrane, and causes blood circulation problems. Simultaneous reception of a considerable amount of alcohol can provoke an erosive gastritis.

Sometimes chronic gastritis is nothing but a result of the development of acute gastritis, however, most often it arises and develops under the influence of all sorts of factors.

Antral gastritis

Antral chronic gastritis is caused by the presence in the human body of the bacterium Helicobacter pylori. It negatively affects the glands in the stomach and damages its mucous membrane. In some cases, such processes are accompanied by violations of an autoimmune nature.

One form of the gastritis in question is of a dysteric-dystrophic character. This causes the inflammatory process in the mucosa and its scarring. It, in turn, leads to difficulty in the movement of food from the stomach to the duodenum. Anti-Helicobacter antibiotics, antacids, regenerating and anesthetics are necessarily included in the treatment.

Atrophic gastritis

Atrophic chronic gastritis - type A, in which the number of gastric glands decreases, the acid-forming function decreases. Atrophic gastritis is a precancerous condition.

It is manifested by the severity and dull pains in the stomach, nausea, heartburn, dyspepsia, anemia. Since 90% of gastric atrophy is associated with exposure to Helicobacter pylori, specific treatment usually involves eradication of the infection. Also, substitution and symptomatic therapy, sanatorium treatment and physiotherapy are prescribed.

Symptoms of chronic gastritis

In the case of chronic gastritis, symptoms in adults may differ depending on whether the disease leads to an increase or a decrease in the acidity of the gastric juice.

Patients with chronic gastritis with high acidity have such symptoms - abdominal pain, belching sour, heartburn, a feeling of heaviness in the stomach after eating, constipation.
For chronic gastritis with low acidity, burning pain after eating, nausea, vomiting, diarrhea, belching of the air, flatulence and rumbling in the abdomen are characteristic.

Among the common symptoms found in patients with chronic gastritis, the most common are irritability, weakness, fatigue. Sometimes there is a palpitation, pain in the heart, lowering blood pressure.

A prolonged course of gastritis can lead to a gradual weight loss, frequent occurrence of intestinal disorders, diarrhea, constipation. Extensive lesion of the gastric mucosa leads to the fact that the body ceases to fully absorb the nutrients obtained from food. As a result, a person develops anemia or anemia, associated with a lack of vitamin B12 in the body.

Against the background of the disease can be observed: a decrease in blood pressure, headaches, skin pallor, numbness of the limbs, disruption of the heart, dizziness, until the fainting condition. Depending on the form of the disease will directly depend on how to treat chronic gastritis, and what diet should be observed.

Symptoms of exacerbation of chronic gastritis

A patient suffering from gastritis should immediately seek medical help if they discover the following signs:

Pain in the upper half of the abdomen is prolonged, aching, intensifying after eating, in some cases ceasing after vomiting. Pain is associated with damage to the mucous (inner) shell of the stomach and stretching its walls with gastric contents.
Headache, weakness, palpitations, increased body temperature - signs of intoxication accompanying the inflammatory process of the gastric mucosa;
Dry mouth after vomiting;
Increased salivation;
Unpleasant taste in the mouth;
Weight loss;
Disorders of appetite;
Nausea or vomiting;
Diarrhea or constipation;
Blood in fecal masses (with erosive form of gastritis);
Heartburn;
Inflammation of the intestine;
Belching, etc.

The severity of these symptoms is individual for each patient. Pain, during an exacerbation of a chronic gastritis, can disturb the patient constantly or appears periodically. In some patients, it appears only on an empty stomach or before meals, and someone appears after some time after eating.

Prevention of exacerbations

To prevent exacerbations of chronic gastritis, it is necessary to adhere to therapeutic nutrition. It is recommended to eat food often, in fractional portions, to avoid overloading the stomach. It is also worth giving up smoking and drinking alcohol, as factors that affect the secretory function of the stomach.

In the period of well-being with increased or normal gastric secretion, one can take mineral water, oppressively acting on the gastric secretion: "Luzhanskaya", "Borjomi", "Slavyanovskaya", "Moscow".

Periodically, according to the doctor's recommendations, it is necessary to take such medications as vikalin, gastropharm, de-nol.

Diagnostics

Crucial to clarify the diagnosis is FGDS.

Diagnosis of chronic gastritis:

Study of the secretory function of the stomach.
Stool analysis: hidden blood may be present, as well as undigested food residues with reduced secretory activity of the stomach.
General analysis of blood and urine will help to detect signs of inflammation in the body with exacerbation of chronic gastritis (in remission analyzes will be normal), hyperchromic anemia with chronic autoimmune gastritis.
FGDS and taking biopsy samples for histological examination. If it is not possible to perform FGDS, it is possible to perform an X-ray examination of the stomach with barium contrast, but this is less informative.
Identification of the microbe Helicobacter pylori. The "gold standard" is the histological examination of biopsy specimens with their coloration according to certain schemes and the subsequent microscopic examination. A biological method is also used (seeding a microorganism on a nutrient medium).
Manometry: reflux gastritis reveals an increase in pressure in the duodenum to 200-240 mm of water. (in the norm - 80-130 mm of water.).

Differential diagnosis is carried out with peptic ulcer of the stomach and duodenum, hernia diaphragm, esophagitis, tumors.

Treatment of chronic gastritis

Treatment of the disease in adults includes a whole range of procedures, and therapy is selected individually for each patient, taking into account the type of gastritis detected, the stage of the disease and the presence of concomitant diseases. Usually patients are treated on an outpatient basis, but sometimes, with severe exacerbations and complications, hospitalization in a hospital may be required.

First of all, it is necessary to eliminate external factors, the impact of which led to the development of the disease, such as smoking, drinking alcohol, poor nutrition.

Therefore, chronic gastritis is based on diet therapy, and the diet is also selected depending on the type of violation of gastric secretion.

Medication

Chronic gastritis signs With gastritis caused by the microbial Helicobacter pylori, antimicrobial therapy is used. There are several standard treatment regimens for adult patients, including:

Antibiotics;
PPI (omez, nolpaz, pariet, emanera - substances used in the treatment of gastrointestinal diseases associated with the release of hydrochloric acid);
Preparations of bismuth (de-nol, ventrisol).

In the absence of Helicobacter pylori and increased secretory function of the stomach:

Drugs that reduce the acidity of gastric juice (Almagel, phosphalugel, gelusil-lac, maalox, etc.)
Medicines that protect (enveloping) the mucous membrane: sucralfate, bismuth dicitrate (also has antimicrobial effect in relation to Helicobacter pylori).

In the case of diagnosing reflux gastritis, the list of medications includes prokinetics. Their task is to normalize the motility of the gastrointestinal tract. Such drugs can also be included in the program of treatment of chronic autoimmune gastritis.

With this diagnosis, the patient is required not to reduce the acidity of the stomach, but, on the contrary, to stimulate the secretion of gastric secretion, which is helped by special medications. Enzyme preparations will help to improve digestion.

Diet for chronic gastritis

One of the main elements of treating the disease is diet. In the period of exacerbations of chronic gastritis it is impossible to do without sparing dietary nutrition. It is at this time that incorrect nutrition causes pain, intensifies the dyspeptic disorders inherent in this disease. It is necessary to reduce the likelihood of irritation of the inflamed walls of the stomach.

Depending on the nature of the secretory function of the stomach, an adult should adhere to one of two diets.

With gastritis withnormal or increased secretiongastric juice - diet №1a is prescribed (up to 7 days), then - diet №16 (up to 14 days), and for 3 months the diet №1 is stretched. When these diets are observed, the patient is given a liquid or a grinded diet, vitamins (ascorbic acid, riboflavin) are additionally administered. It is forbidden to drink alcohol, juices, coffee, strong tea, spicy fatty foods, canned food, beans, peas.
With chronic gastritis withinadequate gastric secretion- compliance with diet number 2 is shown. The food in this case is fractional, the food is taken in a well-ground and cooked form, and the intake of coffee, tea, juices, vegetable cooks, meat broths, meat and fish of low-fat varieties provides stimulation of the secretory function of the stomach. Due to insufficient production of gastric juice, foods that are rich in vegetable fiber are excluded from the diet, namely grapes, radishes, dates, as well as sharp, smoked and very salty dishes, cold drinks, dough products. Do not recommend whole milk, cream, porridge from buckwheat and pearl barley, beans, pickled vegetables, mushrooms, carbonated drinks.

When remission(significant weakening or disappearance of signs of the disease) dietary recommendations become less stringent:

Exclusion of spicy, fatty, fried, smoked food, canned food, carbonated drinks.
The food should be mashed, cooked steamed, boiled or stewed. Fresh fruits and vegetables are excluded. Of fruits, you can only bananas.
Food should be warm - 40-50 ° C. Cold and hot food is excluded.
The volume of liquid to be drunk must be at least 1.5 liters per day.
Any food should be thoroughly chewed.
You should not overeat and rush, snacks "on the go" and eating dry.
Alcohol and smoking are excluded.

Sanatorium treatment is indicated for patients with chronic gastritis outside the stage of exacerbation. It is held at the resorts of Arzni, Borjomi, Jermuk, Dorokhovo, Druskininkai, Essentuki, Zheleznovodsk, Krainka, Myrhorod, Pyatigorsk, Truskavets and others.