Progressive morphological changes over time can become a cause of dysfunction body, which affects the patient's state of health and the quality of his life.
Depending on the extent of lesions and duration of exposure to irritants isolated acute and chronic.
What it is?
Gastritis - is inflammatory or degenerative inflammatory mucosal changes) - a long-flowing disease characterized dystrophic and inflammatory changes in the gastric mucosa, regeneration proceeds with infringement, also with atrophy of epithelial cells and the replacement of normal glands in the fibrous tissue.
Progression of the disease leads to a violation of the basic functions of the stomach, especially secretory.
Symptomatology of the disease occurs when damage to the stomach lining. Influenced by various factors:
- irregular food intake, hunger and overeating, haste while eating;
- poor mastication, often related to unhealthy tooth;
- substandard products, the abuse of fried, spicy, spicy, coarse food;
- Insufficient intake of protein and vitamins, making produces less gastric juice;
- regular consumption of alcohol, smoking;
- long-term use of drugs: antibiotics, aspirin, hormonal preparations;
- ailments of the digestive system, impaired motility, causing bile is in the stomach and causes inflammation of the mucous membrane;
- gastritis symptoms manifest themselves in the event of an imbalance of intestinal microflora, viruses, bacteria, streptococcus, staphylococcus, salmonella.
Chronic gastritis in adults occurs when poor quality or incomplete treatment of the acute form. Intestinal infections, inflammation of the tonsils or gall bladder, infection of Helicobacter pylori Helicobacter pylori support chronic. It develops in the conditions of production of harmful when ingested daily dust evaporating acids or alkalis, the harmful chemical compounds. Constant inflammation of the lining of the stomach is associated with a particular allergy.
The composition of gastric juice for digestion of protein foods include pepsin. If a failure occurs, pepsin affects the lining that contains protein causes inflammation, because the stomach starts to digest itself.
The role of infection with Helicobacter pylori gastritis development
In the second half of the XX century it has been revealed previously unknown factor, which now assign one of the first places in the etiology of chronic gastritis. Helicobacter pylori - a spiral gram-negative bacterium that infects various regions of the stomach and duodenum.
Many cases of gastric and duodenal ulcers, gastritis, duodenitis, and possibly some cases of lymphoma of the stomach and gastric cancer etiology are associated with infection by Helicobacter pylori. Successful experience with self-infection is one of the discoverers of the role of infection with Helicobacter pylori develop gastric diseases and duodenum - Barry Marshall and a group of volunteers served as conclusive proof of this theory. In 2005, Barry Marshall and his colleague Robin Warren for their discovery was awarded the Nobel Prize for Medicine.
However, the majority (90%) infected with Helicobacter pylori carriers show no symptoms of disease. Not every chronic gastritis is basically a bacterial cause.
There are several types of acute gastritis:
|Simple (catarrhal) gastritis||It develops as a result of ingestion of stale food contaminated with pathogenic microbes (food poisoning), when rotaviroze, allergy to some food or as a consequence of damage to the stomach lining certain medications. When catarrhal gastritis mucosa slightly destroyed (only the surface layer), and after the termination of the irritating factor is quickly restored.|
|erosive gastritis||develops after ingestion of certain concentrated acids or alkalis (chemical burn of the stomach lining). When corrosive gastritis destroyed not only the surface but also deeper layers of the gastric mucosa, so this form of the disease often gives rise to peptic ulcer or scar formation.|
|gastric abscess||it is a purulent inflammation of the stomach, which can develop as a result of contact with the stomach wall a foreign object (e.g., fish bone), followed by infection with pyogenic this area infection. A distinctive feature of this type of gastritis is a high fever and unbearable pain in the epigastric region. Gastric abscess requires immediate surgical intervention. Without medical care disease becomes peritonitis (inflammation of extensive abdominal organs), and ends with death.|
|fibrinous gastritis||very rare with sepsis (blood poisoning).|
In gastritis there are so many varieties. Briefly about every kind can be found below:
|With low acidity||insufficient concentration in the gastric acid secretion, because of which the conditions for weak incoming food fermentation. As a result, the stomach wall can be damaged by coarse pieces of food, and the body does not receive the proper amount of substances.|
|With increased acidity||increased concentration of gastric juice, forming a stable, sometimes wanton heartburn. Atypical saturation liquid enzyme stimulates the formation of multiple ulceration of the mucous.|
|atrophic||gradually leads to thinning of the stomach epithelium degeneration glands in simpler forms and reduce the quality of the work them. Without corrective therapy may cause cancer.|
|antral||developing against Helicobacter pylori infection culture, leading to modifications of the internal focal epithelium. The result is a life of bacteria scarring mucous formation and failure of gastric secretion.|
other classification of gastritis are used in occupational medicine, including the type of spread pathogenesis:
- Autoimmune gastritis (type A);
- Exogenous gastritis (type B), provoked by Helicobacter pylori;
- Mixed gastritis (type A + B);
- Gastritis (type C), provoked NSAIDs, chemical stimuli or bile;
- Special forms of gastritis;
- Gastritis in background reduction and increased secretion of hydrochloric acid;
- Other forms the functional and morphological manifestations of gastritis.
Their differentiation implies the use of sophisticated medical laboratory or instrumental methods of diagnosis in step. Therefore, the description of gastritis, having approximately the same clinical symptoms, but distinguished by the depth of the pathogenesis mechanisms for a wide range of readers is of no interest.
Let us dwell on the basic signs and symptoms of gastritis that can serve as the basis for human treatment in the hospital for help.
The symptoms of gastritis in adults
Characteristic symptoms of gastritis in adults depend on the form of the disease. Acute gastritis is characterized by the following features:
- nausea constant or intermittent, often it occurs immediately after a meal;
- abdominal pain: sharp paroxysmal or persistent painful. Often it depends on the meal: amplifies an empty stomach or after a certain time after a meal;
- repeated vomiting, stomach contents, first with a sour smell and taste, then clean with mucus, sometimes greenish or yellow and bitter taste (bile);
- heartburn - an unpleasant burning sensation in the chest, occurs after a meal;
- belching with a sour smell, after a meal or on an empty stomach;
- violation of the chair: constipation or diarrhea;
- excessive salivation - reaction to indigestion; Sometimes dry mouth (after multiple episodes of vomiting due to dehydration)
- by the whole body: severe weakness, dizziness, headache, sweating, increase in temperature, decrease in blood pressure, increase in heart rate - tachycardia.
Symptoms of chronic gastritis
In adults, chronic gastritis for a long time can occur without significant clinical manifestations. Symptoms often occur during exacerbations:
- frustration of a chair;
- appetite disorders.
Clinical manifestations depend on the acid-forming functions of the stomach.
High and low acidity
The most common symptoms of gastritis with reduced or zero acidity:
- constant bad taste in the mouth;
- heaviness in the stomach after a meal;
- burp "rotten eggs";
- nausea in the morning;
- problems with the regularity of bowel movements;
- stench from the mouth.
The most common symptoms of gastritis with high acidity, in addition to general symptoms (vomiting, nausea):
- long-term pain in the solar plexus, disappearing after meals;
- frequent diarrhea;
- heartburn after eating acidic foods;
- frequent urge to carminative mouth - eructation.
signs of worsening
Relapse of chronic gastritis is characterized by a variety of symptoms, most frequently encountered the following symptoms:
- Increased salivation, thirst, weakness;
- Manifestations dyspepsia (constipation, diarrhea);
- Dizziness, palpitations, headache;
- Nausea, vomiting semidigested morning meal with the characteristic sour taste, sometimes vomiting bile;
- Continuous or periodic pain in the solar plexus, which increases immediately after a meal, or vice versa, during prolonged starvation;
- Belching air burning in the sternum, heartburn, postprandial metallic taste in the mouth.
Symptoms of acute erosive (heavy) forms gastritis vomiting supplemented with blood clots, sometimes vomiting with the dark color of vomit. Gastric bleeding during bowel movements manifested feces black. Sometimes gastric bleeding may be determined only by laboratory methods. Massive internal bleeding of the skin appears pale and mucous membranes and can be easily determined by the color of the sclera eyes, dizziness, tinnitus.
Gastritis in adults (except abscess gastritis) does not belong to the group of dangerous diseases. However, gastritis gives rise to dangerous complications:
- Gastric bleeding,
- Gastric 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.
Stages diagnosis of chronic gastritis:
- Endoscopy with biopsy mandatory - to be confirmed the presence of Helicobacter pylori, the nature and localization changes of gastric mucosa, precancerous changes of the mucous membrane stomach. Biopsy taken at least five fragments (2 - of the antrum, 2 - from the stomach body 1 - the angle of the stomach).
- Clinical diagnostics - analyze patient complaints, medical history, examination of the patient data, expressed presumptive diagnosis is made and a rational plan instrumental examination.
- Laboratory diagnostics - blood count, blood chemistry, clinical urine analysis, clinical analysis of feces, fecal occult blood, detection of infection Helicobacter pylori.
- Respiratory Diagnostics - to be confirmed the presence of Helicobacter pylori. This method involves receiving patient of normal isotopic composition of urea and subsequent measurement of ammonia concentration by the gas analyzer.
- Intragastric pH-metry - determining the status of secretion and diagnosis of functional disorders of acid with gastrointestinal diseases.
- Ultrasound investigation of the liver, pancreas, gallbladder - to identify related diseases of the gastrointestinal tract.
- Manometry upper gastrointestinal tract with which the determined presence or absence of reflux gastritis (normal pressure in the duodenum 80-130 mm water. Art., in patients with reflux gastritis is increased to 200-240 mm of water. v.).
- Electrogastrogram - study motor-evacuation function of the gastrointestinal tract to determine duodenogastral reflux.
Establishing the clinical diagnosis is based on the definition of the type of chronic gastritis, assessing the degree of prevalence morphological signs of disease, the presence and severity of disorders function stomach.
Treatment of chronic gastritis
In 90% of cases of chronic gastritis in adults is caused by the bacterium Helicobacter pylori. Therefore, the first step is carried disease patient examination for the presence of the pathogen in the body. Also, no less important is the analysis of gastric juice, which will help you choose the best treatment.
The main stages of the treatment of chronic gastritis in adults are as follows:
- Carried H. pylori therapy. It is performed for 10 days on 3-component scheme: hydrogen pump blocker, amoxicillin, clarithromycin. If you are unable to achieve the effect, then one and a half months of treatment repeated already on 4-component scheme. In this case, means are added to the above de-nol.
- Select appropriate diet.
- At low acidity require enzyme replacement therapy. For this purpose, appoint polyenzyme funds - enzistal, festal, mezim, abomin.
- With increased acidity of drugs used to lower it. This reduces the pain and heartburn, accelerates the healing process.
- In combination with the drugs are allowed to use traditional medicine.
Current approaches to the treatment of chronic gastritis reduced incidence of the disease and significantly reduced the frequency of exacerbations. But, despite this, Helicobacter infection can easily be repeated. Therefore, for those who want to forget about the illness for a long time, care must be taken to eliminate the predisposing factors.
Treatment of acute gastritis in adults
Acute gastritis caused by receiving the concentrated chemicals are often accompanied by swelling of the larynx and kidney failure, requiring urgent medical intervention. Therefore, to treat such conditions at home is impossible. The main therapeutic measures conducted in acute gastritis include:
- Gastric lavage. To this end, the patient offered to drink a few glasses of water or a natural solution, and then by clicking on the root of the tongue, causing vomiting. This procedure is repeated as long as the vomitus will contain food particles.
- Full famine during the first day, taking only a weak tea, broth hips, chamomile or peppermint. One can also drink the mineral water without gas.
- Appointment then sparing diet - mucous pureed soups, omelets, souffles from low-fat varieties of meat or fish, jelly.
- Removal of nausea and vomiting, it is recommended to motilium or Reglan.
- Withdrawal pains and spasms elimination using platifillina and papaverine.
- In severe poisoning appointment of antibacterial therapy.
Gastritis allergic origin require the use of a food diary and keeping an elimination diet.
Folk remedies gastritis etc.
It is very important to consider what the acidity of the stomach - increased or decreased.
- If troubled with constipation anatsidnyh form of gastritis, you need to take laxatives based on buckthorn bark, rhubarb.
- If the acidity is increased, tedious before meals every day up to three times to drink 100 ml of juice from the potatoes.
- Autumn gastritis often can be exacerbated, in this case it is necessary to brew a fresh strawberry and blueberry, use of 100 ml before meals.
- If you have problems with appetite in the background of the disease herbalists recommend bitter - broths based dandelion, wormwood, yarrow. Good to add soothing herbs - Valerian, motherwort and those that trigger the stomach - licorice, calendula, plantain.
- At low acidity are advised to pay attention to such collection, it includes dandelion, sweet flag root, chamomile, calendula, St. John's wort, plantain.
- When acidity is recommended to such collection need to lime color, peppermint, sweet flag root, licorice, fennel, flax seeds for him.
Thus, gastritis should be treated at an early stage so that it eventually is not degenerated in ulcer or cancer.
Diet for gastritis what can and can not eat?
Power gastritis depends on the shape and course of the disease. In acute exacerbation of chronic gastritis and is a strict diet in remission of chronic gastritis diet can extend. In any type of gastritis categorically ruled out alcohol, smoking, fried, greasy, spicy food. Also can not starve in any case.
What can and can not eat depends on the type of gastritis, if the acidity of the stomach is increased, it is necessary to reduce and If gastritis occurs from the mucosal atrophy is necessary to stimulate the surviving glands.
Meals with low acidity of the stomach
Gastritis with low acidity and atrophic gastritis diet important point is to stimulate gastric secretion. Meals should be carried out at certain times (strict daily food intake normalizes the process of gastric juice). Food should cause a feeling of appetite, taking it should take place in a calm atmosphere, without haste. It is important to thoroughly chewing food on the one hand crushed food will not injure the gastric mucosa, on the other hand, while we chew, produced a large number of gastric juice and saliva, promotes the best mastering food.
Gastritis with low acidity should be excluded:
- salty, spicy dishes;
- mushrooms, rough stringy meat;
- foods fried in oil, baked dishes;
- cabbage, grapes and grape juice.
What can I eat for gastritis with low acidity:
- fish fillets from fish low-fat varieties;
- meat: rabbit, chicken as cooked meat, low-fat burgers, meatballs; broths, ear;
- sour cream, yogurt, cottage cheese, milk, cheese;
- vegetable puree, grated vegetable salad of potatoes, beets, carrots, onions, spinach;
- mineral water for 20-30 minutes before meals.
- fruit juices (except grape), fruit drinks, teas wild rose, blackcurrant;
Eating carried out at least 5 times a day. Clinical nutrition observe another 2-3 months after exacerbation. The patient should be in a quiet environment, with conditions for good rest and sleep. Recommended intake of vitamin and mineral preparations.
Meals at high acidity of the stomach
By following a diet for gastritis with high acidity is recommended to exclude:
- Products that stimulate the production of gastric juice: alcohol, soft drinks, wine, coffee, cabbage, rye bread, beans, sausages, smoked fish
- Products that damage the already inflamed gastric mucosa: mushrooms, fatty meats (lamb, pork, duck), radish, rye bread.
- Food in very hot or cold: hot food gastric mucosal damage, cold longer retained in the stomach and causes increased production of hydrochloric acid.
- Food fried in oil; fatty foods, fresh pastries.
- The maximum limit seasonings: salt, pepper, garlic, mustard.
What can have in this type of gastritis:
- Lean meat boiled: chicken, golubyatina, rabbit. Meat is recommended several times through a meat grinder or carefully and slowly chewed.
- Lean fish: cod, hake, salmon;
- Vegetable puree, grated vegetables: potatoes, carrots, beets, young peas;
- Fruit purees, jelly, stewed fruit: strawberries, raspberries, apples;
- Kashi, well tenderize in water (grits, oat, rice)
- Milk, fresh low-fat cottage cheese;
- Freshly prepared cabbage juice;
- Recommended intake of alkaline mineral waters (Borjomi): one glass an hour before a meal.
- It is necessary to pay special attention to the reception protein foods - proteins serve as a scaffold for the formation of new cells.
All food should be the minimum, and seasoned with salt. Food intake is carried out in small portions at regular intervals (5-6 times a day).
What can we drink?
Consider the common drinks:
- Milk - well absorbed and reduces the acidity of the stomach. However, do not use milk as a remedy - only as a supplement to solid food. The thing is that the milk, when liquid comes not long in the stomach, briefly reducing the acidity, it is increasingly stimulates the secretion of gastric juice.
- Weak tea - it is desirable to drink, when the tea cools down and becomes warm.
- Juices - it is desirable to eliminate the acidic juices: orange, grapefruit, apple, grape. Preference is to give the juices with pulp: peach, banana, apple, pear, tomato. Undesirable chilled juice drink better warm or room temperature.
- Kissel - partially neutralizes the acidity of gastric juice. However, it should not consume as medicine, only a part of the main meal.
- Mineral water - should give preference to alkaline waters mneralnym "Essentuki № 17", "Essentuki №4" and "Semigorsky", "Borjomi".
Is it possible to completely cure gastritis?
Gastritis cure can only be achieved if you follow a few simple rules:
- Fractional power - in small portions at least 4 times a day;
- Smoking exception;
- The timely administration of drugs;
- Exclusion of stress, physical or psihoemotsialnalnoy overload;
- The elimination of all types of alcohol;
- Rational mode of work and rest (sleep at least 7 hours a day and at night).
Also categorically any alcohol with gastritis (especially in acute exacerbation of chronic or use) is prohibited. Alcohol affects the gastric mucus, which protects the mucosal cells from the damaging effect of gastric juice. Consuming alcohol, you contribute more chemical damage to the stomach lining.