In the process it goes clear violations progress in changing the structure of the stomach accompanied by serious functional disorders, which finds its expression in the secretory secretions and hydrochloric acid pepsin. Briefly describe the chronic gastritis can be both gastric mucosal inflammation. The disease is subject to 70% of the world population, and he with chronic gastritis has many subtypes, requiring treatment in case of relapse.
What it is?
Chronic gastritis - long inflammatory process of the stomach lining, causing a change in its structure. Accurate statistics on the prevalence of the disease does not exist.
Firstly, it is difficult to diagnose. Secondly, in most cases it proceeds without pronounced symptoms, and patients either do not seek medical care, or get to the hospital only as a result of complications - ulcer, peritonitis, cancer stomach.
Modern medicine as a cause of chronic gastritis indicates the bacterium Helicobacter pylori, which is located in the stomach and duodenum person.
These bacteria hit more than 70-80% of the adult population. Every year the number of cases is increasing among children. In developing countries, infection is higher than in developed countries. Most often, disease occurs in Asians and Latin America. The risk of its development is increasing every year and does not depend on gender.
The reasons that contribute to chronic gastritis, divided into exogenous (external) and endogenous (internal).
- consumption of alcoholic beverages;
- continued use of drugs;
- smoking on an empty stomach (nicotine activates the tone spazmiruet capillaries and vessels, which contributes to the circulatory deterioration in gastric tissues);
- diet disorder (a snack, insufficient rumination) addictions (eating spicy, oily, acidic food) use very hot and cold products;
- harmful production (under conditions in the presence of air pollutants and high dust).
Endogenous causes include:
- chronic inflammation of the lungs and upper respiratory tract;
- pulmonary insufficiency;
- endocrine diseases (diabetes, hypothyroidism, Disorder synthesis of corticosteroids);
- metabolic disease (gout, Lack of enzymes, insulin resistance);
- impaired immunity, which is characterized by the production of antibodies to the tissues of the body;
- cirrhosis of the liver, chronic pancreatitis, hepatitisThat contribute to the pathology of the gastric glands, change the environment and damage the mucous membranes.
Chronic gastritis is divided into:
|Autoimmune form (type A)||It is a rare pathology, characterized by the withering away of a large number of mucosal cells in all parts of the stomach. The cause of - disorders of the immune system. Defense cells perceive a normal healthy mucosa cells as foreign. Begin to produce specific antibodies that are active in the fight against them.|
|Bacterial form (type B)||Develops on the background of the defeat of the walls of the stomach bacterium Helicobacter. Infection becomes frequent cause of erosive gastritis.|
|Chemical form (type C)||Causes: casting of bile into the stomach, long-term use of NSAIDs, the operation at the intestine, congenital or acquired deficiency gatekeeper (valve 12 between the yolk and duodenal ulcer). Characterized by increased levels of histamine. As a consequence of enhanced alkalinity of the bile. Acting on the wall of the stomach, bile provokes inflammation, the formation of erosions, bleeding.|
|Mixed form gastritis (type A and B)||The acidity can be reduced or increased.|
Distinguish two forms of chronic gastritis: superficial and atrophic. On the surface affects the upper layers of the mucosa. In 98% of such species is not accompanied by pathological changes glands. Atrophic form - more severe. Characterized by severe effects - stomach wall becomes thinner, reducing the number of glands. All these processes lead to secretory failure.
The first signs
There are some common signs of chronic gastritis in adults. These include:
- aching, paroxysmal pain in the stomach after a meal;
- hunger pains at night;
- diarrhea alternating with constipation;
- flatulence, rumbling stomach;
- loss of appetite leading to weight loss;
- pale skin, sleep disturbance;
- eructation and heartburn (a sign of reduced acidity);
- lump in the throat, pain in the esophagus and burning;
- heaviness, bloating in the abdomen;
- nausea and vomiting after each meal or medication (a sign of reduced acidity).
Sometimes a person feels only pain and sometimes nausea. This means gastritis flowing secretly.
Symptoms of chronic gastritis
For a long time (especially in the beginning of the disease), chronic gastritis in adults occurs without visible symptoms. The development of the disease, there are usually periods of remission and exacerbation.
In periods of exacerbation may appear short-term bouts of pain, discomfort at the top of the stomach, a feeling of heaviness, nausea after food, heartburn, which alleges a violation of the natural "valve" function of the stomach and threw acidic stomach contents into esophagus. Can also be signs of disorders of digestion of food in the gut: episodes of diarrhea or constipation, bloating (flatulence), increased rumbling.
Symptoms of chronic atrophic gastritis:
- loss of appetite;
- unpleasant taste in the mouth;
- nausea after ingestion;
- constipation or diarrhea;
- bloating, rumbling in the abdomen, bloating;
- burping with unpleasant putrid odor;
- bloating, heaviness in the stomach after a meal;
- dull pain immediately after a meal or in 15-20 minutes;
- anemia, brittle and dry hair, nails bundle.
Often the above violations of the digestion process leads to weight loss, severe weakness, drowsiness, irritability person. As already mentioned, chronic gastritis, proceeds with periodic exacerbations and remissions. In virtually disappear during remission of the disease symptoms, but reappear in the period of acute illness.
Exacerbation of chronic gastritis may be seasonal (eg spring and autumn) and can be triggered by violation of diet, smoking, alcohol use, certain drugs.
Reduced or increased acidity
When the acidity of the stomach there is excessive production of hydrochloric acid. It not only digest food, but also irritates the mucous membrane. Lady insidious hyperacidity during the famine. Acid kills useful bacteria and leads to the formation of ulcers on the gastric surface.
Man feels the following symptoms:
- Unpleasant taste of acid in the mouth;
- Severe heartburn;
- Burning sensation in the stomach and the esophagus;
- Hunger pains that arise on an empty stomach and tested immediately after a meal.
Gastritis with high acidity can be found on other grounds:
- Irritability, depression;
- Drowsiness, fatigue;
- lowering blood pressure;
At low acidity It formed a little in the stomach hydrochloric acid. Its amount is not enough for full digestion. This leads to the fact that food is a lump in the bottom of the stomach and starts to rot.
As a result, the patient feels the following symptoms:
- Halitosis, taste rot;
- Nausea, which is present all day long;
- Bloating, flatulence, colic;
- The feeling of hardness in the stomach;
- Aching pain in the stomach after eating;
- Unpleasant eructation air immediately after meals;
- Poor appetite, small portions of food required for saturation;
- In advanced cases - vomiting undigested pieces of food.
These symptoms are associated symptoms of chronic gastritis. But they can also indicate a number of other diseases, so you should not put a diagnosis on their own, relying only on experience.
The correct diagnosis
Inspection, palpation, percussion, auscultation do not play a determining role in the recognition of the disease.
It occupies an important place to determine the state of acid functions. To this end, it is recommended for 1-2 days before studies stop taking drugs that affect the level of acidity in the stomach.
Lab tests may include:
- A study of the secretory function of the stomach.
- Feces analysis: possible presence of occult blood, as well as the undigested food residue with a reduced secretory activity of the stomach.
- Manometry: at reflux gastritis detect an increase in pressure in the duodenum to 200-240 mm water column (Norm - 80-130 mm water column).
- General blood and urine tests help detect signs of inflammation in the body during exacerbation chronic gastritis (remission assays will normally), hyperchromic anemia in chronic autoimmune gastritis.
- Identification of the microbe Helicobacter pylori. "The gold standard" is the histological examination of biopsy samples from their color in a specific pattern and subsequent microscopic examination. biological method (seeding microorganism on a nutrient medium) is also used.
- EGD and taking biopsies for histological examination. When you can not perform EGD can be carried out X-ray examination of the stomach with contrast barium, but it is less informative.
Differential diagnosis with gastric ulcer and duodenal ulcer, hernia of the diaphragm, esophagitis, tumors.
Treatment of chronic gastritis
Selecting the treatment regimen of chronic gastritis depending on the form of the disease. Usually, treatment is carried out at home, but with the development of complications in patients requiring hospitalization.
- Patients with low acidity of gastric juice prescribe drugs that stimulate the secretory activity.
- Patients with increased gastric secretion are shown antisecretory, antacid preparations (for relief heartburn) prokinetics.
In the acute phase of gastritis refrain from eating until then, until a self-healing of the stomach lining and the symptoms disappear; allowed to drink (tea, mineral water). Then gradually resume normal eating: first, compliance with sparing diet, then, When the mucous membrane of the stomach is completely restored by increasing the amount consumed products.
The basic principles of treatment of gastritis are: reduction or elimination of alcohol and caffeine, and spicy foods; stopping smoking and use of drugs, reducing dyspepsia and heartburn. It may require the appointment of vitamin preparations. In some cases, it shows the use of medicines.
Great importance in the treatment of gastritis is a health food. In the period of acute gastritis diet should be a fraction, 5-6 times a day. Diet prescribed by the physician, depending on the acidity of gastric juice. Appointed by physiotherapy, spa treatment.
In the treatment of chronic gastritis following groups of drugs used in adults:
- Enzyme preparations are necessary for the normalization of digestion. These include Mezim, Creon Pancreatin.
- Antacids are assigned to heartburn relief because they have the ability to bind the hydrochloric acid and reduce the activity of gastric enzymes. These include Almagell, Fosfalyugel, Gaviscon.
- Antibacterial drugs are prescribed in the identification of the patient in the stomach infection H. pylori. For their destruction can be used by different groups of antibiotics that are matched only by the doctor.
- Drugs that decrease the secretion of hydrochloric acid. These include blockers of H2-histamine receptors (Famotidine, Ranitidine) and proton pump inhibitors (Nexium, Omez).
- Drugs that stimulate gastric secretion (juice of plantain, Limontar), appointed in chronic gastritis with low gastric secretory function.
- Normalization of peristalsis and eliminating spasms achieved using antispasmodic drugs (No-spa, papaverine), and drugs - motor regulators (Trimedat).
- Vitamins included in therapy in those cases where a result of long-existing inflammation in the stomach has evolved beriberi and anemia. Typically, patients are assigned iron preparations (Sorbifer-durules, Ferlatum), vitamin B12 and folic acid.
- Formulations having gastroprotective effect, help to protect the gastric mucosa against aggressive hydrochloric acid and gastric juice. They have astringent and protective action. Products in this group are de-nol, Vikalin. Venter drug addition to the above effects, has antacid and antiulcer action.
The use of folk remedies for treatment of chronic gastritis is permissible, but before applying them to consult a doctor.
Diet in chronic gastritis
In the treatment of chronic gastritis patients shows light diet, which is taken into account in the preparation of component gastric acidity. The main goal of diet in chronic gastritis is maximal avoidance of thermal, mechanical, Chemical irritation of the stomach, reducing inflammation and stimulate healing processes of the mucous shell.
- During exacerbations of chronic gastritis be excluded reception is too hot and too cold food recommended cook steamed or boiled, fed in liquid state or puree. The diet can include lean meat and fish, eggs, cereals, broth hips. It is necessary to exclude the use of coffee, carbonated drinks, chocolate, raw fruits and vegetables, baked goods, dairy products, fatty, fried foods, spices.
- In the period of remission in patients with chronic gastritis acidity shows a fractional power. Excluded from the diet products which can stimulate the release of hydrochloric acid, such as meat broths, alcoholic drinks, tea, strong coffee. sharp, smoked, fatty, fried foods, canned food, some vegetables (onions, radishes, cabbage, sorrel) are also excluded.
Patients with chronic gastritis with low acidity in remission is not recommended to use products that are retained in the stomach for a long time (for example, flour, rice). You should also refrain from the use of sharp, spicy, smoked foods that irritate the stomach lining.
consequences of gastritis
Gastritis (except abscess gastritis) does not belong to the group of dangerous diseases. However, gastritis gives rise to dangerous complications:
- Gastric bleeding,
- Stomach ulcer and duodenal ulcers,
- Stomach cancer.
Gastritis influence on the organism as a whole is explained by the disorder of the digestive process. Patients with gastritis begin "to be afraid of food," lose weight, some large part of the food eaten out with vomiting after eating, or they suffer from heartburn. Against the background of gastritis often develop vitamin deficiencies, anemia.