Gastritis is a collective concept that combines different causes and methods of development of inflammation of the gastric mucosa. As a result of such inflammation, metabolic processes are disrupted in the cells lining the stomach from the inside; they change structurally and are no longer able to perform their functions.
Ultimately, the cells can degenerate into cells of other organs (for example, into cells of the small intestine), leading to the formation of erosions, ulcers, and various polyps - which may be a reason to consult an oncologist.
Gastritis of the stomach is widespread in the world: about 63% of the world's population suffers from this disease, and most of them do not even know about their disease. Only 10-15% of them consult a doctor, which is explained by the fact that chronic gastritis, unlike an acute disease, often has mild symptoms and rarely bothers a person.
Causes of gastritis of the stomach
At the present stage, gastritis is considered as a disease that can occur either under the influence of one main factor or due to their combination. Main reasons:
- the presence of a specific bacterium Helicobacter pylori in the gastric mucosa (85% of chronic gastritis);
- autoimmune mechanisms (the body considers stomach cells as foreign and produces specific proteins for them - immunoglobulins);
- disruption of food transit through the gastrointestinal tract;
- food allergies;
- excessive use of drugs that damage the gastric mucosa;
- disturbance of the rhythm of nutrition, poor quality food, abuse of excessively hot or cold food, gastronomic features of food unusual for humans;
- smoking;
- alcohol abuse;
- occupational hazards (heavy industry, etc.);
- internal factors (chronic foci of infection - sinusitis, carious teeth, etc.; metabolic disorders (overweight and obesity, gout); diseases of the endocrine system).
Despite the huge number of causes of gastritis, they are all divided into:
- primary (when inflammation of the gastric mucosa is considered exclusively as a disease of this organ)
- secondary (inflammation occurs due to the painful state of other organs and systems, against the background of severe intoxication of the body).
Acute gastritis
Among them are acute and chronic gastritis. Acute gastritis is caused by the action of a strong irritant, for example, when consuming contaminated food, chemicals, or as a complication of metabolic disorders in the body, as well as during a serious illness. It most often has a pronounced clinical picture and vivid symptoms.
Chronic gastritis
Chronic gastritis is a characteristic inflammation of the gastric mucosa, which occurs due to a huge number of reasons and is characterized by a long and asymptomatic course. Doctors distinguish in this group autoimmune inflammation of the gastric mucosa, inflammation of the stomach under the influence of a special bacterium - Helicobacter pylori, as well as special forms of gastritis, for example, with renal failure.
Diagnosis of gastritis
Along with the enormous successes in diagnosing this disease, understanding the causes of its development, and advances in the creation of drugs, the results of treatment of gastritis (especially chronic gastritis) leave much to be desired.
The course of the disease is undulating, the symptoms are often erased, the disease is often advanced, adherence to treatment of patients outside of exacerbation drops sharply, and adherence to diet and abandonment of bad habits when the attack of gastritis ends becomes burdensome.
Treatment of gastritis
Only a doctor should treat gastritis. You should not self-medicate: under the guise of relief, you can miss the development of formidable complications (stomach ulcers, obstruction, etc.). Acceptable treatment of gastritis at home, but under the systematic supervision of a doctor.
All treatment of gastritis is based on strict adherence to the rules of therapeutic nutrition (diet), a healthy lifestyle (quitting smoking and alcohol). It is doubtful to cure gastritis solely with diet (especially caused by H. pylori), but long-term remission is possible.
The diet has several basic principles:
- Meals should be nutritious, frequent, divided from 4 to 6 times a day. Dry food and overeating are excluded.
- Food should be gentle and not irritate the gastric mucosa (fatty meat and fish, dough products, vegetables and fruits high in fiber (peas, beans, etc.), chocolate, coffee, carbonated drinks, marinades, pickles, sour fruit juices are excluded ).
- The food should be dominated by vegetable fats and animal proteins, a reduced amount of carbohydrates (vegetable and milk soups, boiled low-fat fish and meat, scrambled eggs, noodles and crackers made from white flour, low-fat cottage cheese, vegetable purees, milk, weak tea, vinaigrette with vegetable oil).
Drug treatment of gastritis
In the process of such treatment, several main goals are achieved.
First, reducing the acidity of gastric juice, which in medical practice is achieved by prescribing 3 groups of drugs:
- Proton pump inhibitors (rabeprazole, omeprazole, etc.)
- Histamine blockers (famotidine, etc.)
- Antacids (Almagel, Hefal, etc.)
Second, normalization of motility in all parts of the gastrointestinal tract is achieved by taking prokinetics (Motilium, Cerucal).
Third, protect the cells of the gastric mucosa. For this purpose, mucus production enhancers (biogastron, etc.) and recovery stimulants (sea buckthorn oil, solcoseryl, etc.) are widely used. Modern medicine - synthetic analogues of prostaglandins (for example, misoprostol) - is effective, but too expensive.
Fourth, removal of H. pylori, if such a bacterium is present in the stomach.
For this purpose, treatment regimens are prescribed, consisting of 2 antibiotics, a proton pump inhibitor, and a bismuth drug.
Symptoms of gastritis
There are a large number of symptoms by which a person may suspect gastritis. Based on their combination, one can with a certain degree of confidence assume the acute or chronic nature of inflammation in the gastric mucosa.
Diagnosis of acute gastritis is not very difficult.
Firstly, a person can quite accurately indicate what causes a sharp deterioration in health (poor food, alcohol abuse, etc.).
Secondly, the symptoms of gastritis, which occurs in acute form, can be divided into two large groups:
- signs characteristic of inflammation of the stomach itself
- and signs of general intoxication (malaise) of the body.
The first group includes:
- sharp, cutting pain in the upper third of the abdomen or, conversely, unpleasant heaviness in the abdomen, alleviated after taking milk, a small amount of food or water, soda, taking antacids (Gefal, Almagel, etc.).
- Often, the first signs of acute gastritis begin with painful nausea, which can be replaced by repeated vomiting, which brings relief. It most often has an unpleasant sour-bile taste that remains in the mouth for a long time.
- often this is accompanied by heartburn- an unpleasant sensation of heat, strong warmth behind the sternum, which may intensify when lying on your side, but goes away somewhat while walking or standing.
Common symptoms that occur due to inflammation of the gastric mucosa are general weakness, lethargy, loss of mood and appetite, and a slight rise in body temperature.
Signs of gastritis
The signs of chronic gastritis are numerous, but, as a rule, they are erased and slightly expressed (in rare cases - chronic gastritis proceeds with a violent picture of the disease). Over the course of months, years or even decades, this disease may simply not bother you.
The most common symptoms with which “gastritis of the stomach” begins:
- an uncomfortable feeling of heaviness, pressure or fullness in the upper third of the abdomen, which is long-lasting and permanent;
- recurring heartburn;
- nausea ;
- unexpressed, aching without clear localization abdominal pain, which occurs after errors in eating (consumption of spicy, fatty, overcooked foods or alcohol; when eating quickly (hurriedly);
- belching air, eaten food (after which the pain decreases);
- decreased appetite;
- metallic taste in the mouth;
- bowel dysfunction;
- frequency of symptoms: autumn, spring - but with autoimmune gastritis, the symptoms are constantly expressed.
In cases where gastritis is complicated by the development of erosions or ulcers, characteristic cutting or sharp stabbing pains are added to this. In this case, you must immediately consult a doctor.
In advanced cases, when the gastric mucosa can no longer perform its functions (enzyme production, food digestion and partial absorption of nutrients), the general symptoms of “stomach gastritis” come to the fore: weakness, pallor, lack of satiety after eating, weight loss, fragility nails and hair (signs of insufficient digestion). At the same time, bleeding gums, bumps in the corners of the mouth may indicate vitamin deficiency, which develops with a long course of the disease. Often, chronic gastritis (especially atrophic) can cause the development of anemia.
It is worth noting that the above signs of gastritis are most clearly presented during an exacerbation, while during the period of remission (outside of an exacerbation) their expression is unclear and blurred.
Diet for gastritis
Therapeutic nutrition for diseases of the digestive system is of paramount importance. Treatment of gastritis solely with diet cannot cure the disease, but significantly alleviates the course of the disease and eliminates the symptoms. The main provisions of such nutrition are formulated as follows.
Firstly, nutrition for gastritis should be varied, complete in energy value and the composition of proteins, fats, and carbohydrates. Foods that are not typical for the region in which the patient lives are excluded from the diet. A minimum content of salt and spices (especially hot ones) is achieved in food. Dietary recipes include dishes prepared according to the principle of mechanical, chemical and thermal sparing (these are ground and mashed dishes, neither hot nor cold by the time of serving).
Secondly, nutrition for gastritis of the stomach must be carried out four to six times a day, regularly, at the same time. The evening meal should take place at least 2-3 hours before going to bed.
Thirdly, it is advisable to exclude eating on the go, overeating, and dry eating. The menu for gastritis should consist of 3, at least 2 dishes. Eating hot food at least 2 times a day. First - at least 1 time per day.
Fourthly, when planning your diet for the week, it is recommended to increase the proportion of vegetable fats in the menu by 15-20%, and animal proteins by 15%. It is believed that this combination of proteins and fats has pronounced restorative properties for the cells of the gastric mucosa. It is also worth sharply limiting, by about half, animal fats and carbohydrates.
Menu for gastritis
The diet for gastritis consists of avoiding cooking dishes that increase the secretion of gastric juice (mushroom, fish and meat soups and broths).
Vegetables and fruits with a high fiber content (legumes, turnips) are contraindicated for this disease.
In recipes, be careful to include a small amount of low-fat cottage cheese and non-acidic cheese.
You should be careful with fatty meats and fish.
Flour products, buns and pies are replaced with crackers.
Unripe fruits and berries with rough peels, various juices, strong tea and coffee, chocolate, carbonated water, canned food, pickles and spicy seasonings, smoked marinades are strictly contraindicated for gastritis.
What is possible?
Proper nutrition consists of the following:
- vegetable soups, cereals, milk soups
- Boiled meat and fish of low-fat varieties
- steamed meat and fish
- boiled porridge
- durum wheat noodles
- vegetable puree, mashed potatoes
- non-sour cottage cheese
- milk
- dairy products such as yoghurts and fermented baked milk
- alkaline mineral waters without gas
- non-acidic juices with pulp from fruits and berries
- weak tea
Dietary nutrition for gastritis with low acidity has some features. Firstly, instead of slimy vegetable soups, which are indicated for high acidity, it is recommended to drink a small amount of blackcurrant juice 1-2 times a day. Secondly, the diet for patients with gastritis in this case includes kefir and cottage cheese.
It is worth noting that during the non-exacerbation period, an important role is played not only by the quality of food preparation, but also by sufficient provision of the body with vitamins and minerals. At this stage, you can take multivitamins or baby food purees.
Gastritis in children
In children, the development of inflammation of the gastric mucosa occurs for the same reasons as in adults. There are acute and chronic, primary and secondary gastritis.
The most common age of development of the disease is 5-7 and 9-13 years. Before puberty, the frequency of occurrence in boys and girls is approximately the same, after which girls suffer more often.
Acute gastritis most often develops against the background of overeating, eating poor-quality food, or poisoning with spoiled foods. Often, the cause of gastritis is food with a high content of food allergens (large amounts of spices, exotic varieties of fish and meat, fruits).
Separately, gastritis is distinguished, which develops while taking certain medications that adversely affect the gastric mucosa (antipyretics, some antibiotics).
Gastritis can also develop against the background of a poorly tolerated childhood infection ( measles , rubella , flu and etc.).
Symptoms of gastritis in children
You should know that in young children, the fundamental symptoms of gastritis may not be expressed, masking as nonspecific signs of general malaise and intoxication.
Most often, at this age, parents are concerned about the development of nausea and vomiting in their child. In this state, children most often do not behave as actively as usual. They are lethargic, refuse to eat, or stop playing. You may notice increased production of saliva or, conversely, young children complain of constant dry mouth and often ask for a drink.
Parents may be alarmed by the child's low body temperature and frequent vomit, rumbling in the stomach, diarrhea.
In case of poisoning or severe gastritis, the child’s temperature may rise sharply, the pulse may increase, and consciousness may become confused. In such cases, the abdomen is swollen, there are no peristaltic sounds, or, conversely, rumbling and transfusion in the abdomen are clearly audible. In such cases, it is necessary to immediately take the child to the doctor to exclude an acute surgical disease (appendicitis, acute gastric ulcer and/or its complications).
Determining gastritis in older children does not cause great difficulties - the signs of gastritis are similar to those in adults.
Treatment of gastritis in children
Treatment of the disease in children has a number of features compared to adults.
The main task is to eliminate the cause of gastritis. They give smecta and activated carbon according to the age norm.
During the first 2 days, strict bed rest is indicated. The stomach is washed with a weak solution of soda and mineral water until the water is clear. The child is given frequent warm drinks over the next 12 hours.
In case of severe pain, you can give the child antispasmodics (for example, no-spa), a small amount of antacids (Almagel).
The diet for gastritis in children is as follows. After 1-2 days of fasting, you can give kefir, low-fat broth, jelly, porridge cooked in water - this diet is followed for the first 3-4 days. On days 5-7, it is allowed to give the child low-fat cottage cheese, white bread croutons, and soft-boiled eggs.
If the leading role of microorganisms in the development of gastritis (poisoning) is established, the leading role is occupied by the prescription of antibiotics. If worms are detected, use appropriate medications (acaris, etc.).
The tactics for managing chronic gastritis in children are similar to those in adults (see “Chronic gastritis”).
Acute gastritis
Acute gastritis is an inflammation of the gastric mucosa that occurs against the background of short-term exposure to strong irritants (acids, alkalis, various infections, etc.).
Most often, this condition develops suddenly, against the background of complete health. In such cases, a person can remember up to hours the moment the first symptoms appeared. Often he can independently associate his condition with a specific cause (eating errors, drinking alcohol, taking acid or alkali, etc.).
Acute gastritis in most cases has a severe course and is poorly tolerated by people.
It is necessary to distinguish between acute gastritis and exacerbation of gastritis, which has already entered the chronic stage. The symptoms of the two conditions are similar, but the treatment tactics in such cases are somewhat different.
Reasons for the development of gastritis:
- gastronomic excesses and errors in food (alcohol, excessively salty and peppery foods, smoked foods, marinades, etc.);
- intentional or accidental use of aggressive substances (acids, alkalis, etc.);
- overdose or long-term and systematic use of certain medications (steroid hormones, aspirin, etc.);
- secondary gastritis developing against the background of other diseases, injuries ( myocardial infarction, kidney failure, burn disease, etc.);
- intestinal infections (shigellosis, staphylococcal infection, etc.);
- Helicobarcter gastritis;
- psycho-emotional overload (stress ulcers and erosions).
Symptoms of acute gastritis
As a rule, the disease begins suddenly. There is heaviness in the stomach, nausea followed by vomiting, which brings relief. The second option for the onset of the disease may be a severe pain syndrome, starting with sharp, cutting pain in the upper and/or middle third of the abdomen. Joins vomit eaten food. The pain is excruciating, constant, weakens or temporarily disappears after taking a small amount of milk, antacids (Almagel, Hefal, etc.).
There is a sharp deterioration in general health: no appetite, mood disappears, weakness appears, lethargy, malaise.
Along with the pain, a slight fever appears. If gastritis is caused by intestinal microorganisms, the temperature may precede abdominal discomfort and reach significant numbers.
After a while it appears diarrhea, which may be accompanied by ongoing vomiting.
When consuming chemically active substances (acids, alkalis, etc.), the symptoms of inflammation of the gastric mucosa are accompanied by signs of a burn of the esophagus (severe heartburn, increased salivation), oral mucosa (loss of taste, drooling).
Treatment of acute gastritis
You should firmly know that acute gastritis is a disease that requires the participation of a doctor. Self-medication and untimely contact with a doctor can cause death, because... Under the mask of acute gastritis, a large number of emergency surgical situations can be hidden: from appendicitis to perforation of a stomach ulcer into the abdominal cavity! After providing first aid, contact a specialist.
Treatment of acute gastritis begins with removing the cause of the disease: gastric lavage with a sufficiently large amount of water or mineral water, taking adsorbents (polyphepam, activated carbon, etc.) are indicated.
If gastritis has developed due to the intake of aggressive liquids - acids, rinsing is carried out with a weak solution of boric acid or soda. If inflammation develops under the influence of alkalis, add citric acid to the solution. Then add a small amount of sea buckthorn oil or Vaseline to protect the mucous membrane from the irritant.
The patient is given plenty of warm, frequent drinks. In case of severe vomiting or diarrhea, a person needs to drink (even with force!) up to 8 liters of mineral water or special solutions containing electrolytes (Regidron, etc.).
The diet for acute gastritis consists of complete fasting for the first 1-2 days. Afterwards, with great caution, you can eat pureed rice or semolina porridges cooked in water. Weak tea is allowed.
After 3-4 days from the onset of the disease, add a small amount of low-fat (most often chicken) broth with white bread croutons, kefir, steamed omelet or soft-boiled eggs.
Starting from days 5-7, the diet is expanded, you can eat boiled meat, buckwheat porridge - “smear”, white bread (but more acceptable - crackers), low-fat cottage cheese.
By the end of the first week, you can eat everything, but with great caution. Salty, smoked, pepper and marinades should be avoided. Carbonated water, chocolate, milk, sour cream, mayonnaise are prohibited for the next 2-3 weeks. The diet after acute gastritis is not much different from that for chronic gastritis.
Chronic gastritis
This is a disease that is characterized by prolonged inflammation of the gastric mucosa with characteristic changes.
It should be noted that this diagnosis can only be made absolutely accurately using a microscope. When conducting a special study - fibrogastroduodenoscopy - an endoscopist takes several pieces of the gastric mucosa. When examining pieces of tissue under a microscope, this diagnosis is confirmed or refuted, the degree of atrophy, dysplasia, metaplasia of stomach cells is determined, and infection with a specific bacterium - Helicobacter pylori - is determined.
Chronic gastritis is widespread among the world's population. According to statistics, more than half of all people suffer from this disease.
Chronic inflammation of the gastric mucosa for reasons of development is divided into four main types:
- type “A” (gastritis of the body of the stomach) is based on autoimmune mechanisms, as a result of which antibodies are produced to the cells of the stomach.
- type “B” (antral gastritis) - it is believed that it is caused by the specific bacterium H. pylori, discovered at the beginning of the 21st century.
- type “C” develops under the influence of various chemicals, alcohol, and some medications.
- the next type develops as a result of prolonged exposure to contents from the duodenum (most often bile), which is thrown into the stomach as a result of insufficiency of the sphincter muscle sphincter.
- Some researchers classify as a separate group inflammation of the gastric mucosa that occurs after operations on this organ - post-resection gastritis.
In cases where the duodenal mucosa is involved in inflammation, the disease is called “gastroduodenitis.”
Another classification identifies two main types of gastritis, depending on which the doctor uses different treatment tactics.
This is chronic gastritis with and without the development of atrophy.
Atrophy is a condition in which the cells of the stomach change, lose the structure characteristic of this organ and cannot fully realize their functions (secretion of mucus, enzymes, hydrochloric acid). Such cells are no longer capable of absorbing useful substances (proteins, vitamins, small amounts of carbohydrates and fats broken down into amino acids).
Chronic gastritis is also distinguished with increased or decreased acidity of gastric juice (see “Gastritis with low acidity”, “Gastritis with high acidity”).
Symptoms of chronic gastritis.
The disease can have a clear picture only at the beginning of its development. In most cases, chronic gastritis develops gradually, unnoticed by a person. The signs of such gastritis are most often blurred, not clearly expressed - and a person may not even be aware of the presence of the disease for a long time.
Depending on the type of gastritis and the pH level of gastric juice, all symptoms can be divided into two large groups:
1. signs more characteristic of chronic gastritis with low acidity and atrophic gastritis (unexpressed dull, aching pain in the upper third of the abdomen; a feeling of discomfort, heaviness, bloating in the abdomen after eating; increased gas formation, rumbling in the abdomen and periodic loose stools or constipation, unpleasant bad breath).
2. signs more characteristic of chronic gastritis with increased acidity of gastric juice, erosive or superficial gastritis (severe “hungry” abdominal pain on an empty stomach or at night; sour belching; heartburn; pain in the upper third of the abdomen after a diet violation).
Treatment of chronic gastritis
The treatment tactics for this disease are complex: simultaneous prescription of medications and nutritional therapy (diet).
All medications used in treatment can be divided into four large groups:
- drugs that reduce gastric acidity
- drugs that normalize digestive processes in the gastrointestinal tract
- stimulators of gastric cell regeneration
- antibacterial drugs to eradicate (remove) H. pylori infection
More detailed treatment is discussed in the section “Treatment of gastritis”.
Nutrition for chronic gastritis is based on the principles of protecting (sparing) the gastric mucosa. This is achieved by steaming dishes, pureed soups and cereals, and limited consumption of fresh juices and fruits high in fiber. A diet for chronic gastritis requires frequent divided meals, preferably at the same time, a balance of proteins, fats and carbohydrates. Products must contain sufficient amounts of minerals and vitamins (see “Diet for gastritis”).
Atrophic gastritis
The most common form of chronic gastritis. It is found in approximately 70-75% of all those suffering from chronic inflammation of the gastric mucosa. Most often, elderly people or those who have been ill for a long time suffer.
Atrophy is a condition in which the cells of the stomach change, lose the structure characteristic of this organ and can no longer fully realize their functions (secretion of mucus, enzymes, hydrochloric acid). Such cells are not capable of absorbing useful substances (proteins, vitamins, small amounts of carbohydrates and fats broken down into amino acids).
The diagnosis of chronic gastritis with atrophic changes is made according to a typical clinical picture, very similar to that of gastritis with low acidity of gastric juice, and is confirmed by microscopic examination of pieces of mucous membrane taken during fibrogastroduodenoscopy.
Symptoms of atrophic gastritis
As already mentioned, this form of gastritis can be suspected by typical symptoms, also characteristic of gastritis with low acidity. In addition, low acidity is a constant companion to such inflammation of the gastric mucosa.
Most often, atrophic gastritis of the stomach can be suspected by symptoms of impaired digestion, passage of food through the gastrointestinal tract, and metabolic disorders.
It is characterized by a feeling of heaviness in the stomach after eating, discomfort in the upper third of the abdomen that is constant or worsens after errors in the diet, etc. (for more details, see “”).
Such people experience chronic anemia (decreased hemoglobin levels in the blood), poor skin and hair condition (dull, brittle hair, oily or dry skin, flaking). We are concerned about weakness and malaise, which can haunt a person for many months and years and cause him to turn to a huge number of specialists. This is often accompanied by weight loss while maintaining a normal diet.
Against the background of developing hypovitaminosis, pustular skin lesions and seizures in the corners of the lips appear. Immunity decreases, leading to frequent viral diseases.
Treatment of atrophic gastritis
The treatment tactics for such gastritis are the same as for gastritis with low acidity (see “Gastritis with low acidity”).
Enzyme preparations are prescribed to restore digestion. In advanced cases, the use of gastric juice is indicated.
Drugs that stimulate the restoration of stomach cells (solcoseryl, sea buckthorn oil, etc.) are actively prescribed.
Diet is of great importance for patients with atrophic gastritis. Its basic principles do not differ from nutritional therapy for other types of gastritis. The only exception is the consumption of slimy soups and cereals, which are replaced with fresh juice and low-fat broth.
Treatment of atrophic gastritis with folk remedies has no independent meaning and is used only in complex therapy. Propolis tinctures, honey, chamomile and sage decoctions are used (for more details, see “Treatment of Gastritis”).
It should be remembered that atrophic gastritis can become the basis for the development of precancerous conditions - and, thus, requires systematic medical supervision.
Gastritis with high acidity
This is an inflammation of the gastric mucosa, which is accompanied by an increase in the acidity of gastric juice.
This type of gastritis most often occurs in young people and has several causes for its development. Based on them, four forms of gastritis with high acidity are distinguished.
The development of gastritis type “A” (“fundal gastritis”) is based on autoimmune mechanisms, as a result of which antibodies are produced to the cells of the stomach.
Gastritis type "B" (antral gastritis) - is believed to be caused by a specific bacterium, H. pylori.
Type “C” gastritis develops under the influence of various chemicals, alcohol, and some medications. And reflux gastritis, which develops due to the reflux of the contents of the small intestine back into the stomach.
Symptoms and signs of gastritis with high acidity
It is believed that gastritis with high acidity is characterized by a wave-like course with periods of exacerbations (most often in autumn and spring) and remissions.
At the beginning, the pain is constant, aching, moderate, sometimes manifested in the form of pressure, heaviness in the pit of the stomach. Most often they are provoked by errors in food (overcooked, fatty and smoked foods).
A rare but characteristic symptom is “late” hunger pain, which occurs 6-7 hours after eating. The pain is so severe that it is similar to that of a stomach ulcer.
Often, problems with stool (constipation) appear.
Signs of gastritis with high acidity outside of exacerbation are most often not expressed. May be a minor concern heartburn , belching air or recently eaten food.
Treatment of gastritis with high acidity.
When treating gastritis of this type, several goals are simultaneously pursued.
Firstly, reduction of total acidity (this is achieved by prescribing special drugs from the group of proton pump inhibitors (PPIs) - omeprazole, rabeprazole, etc., histamine receptor blockers - famotidine, etc.; the use of antacids (Almagel, etc.).
Secondly, To normalize digestive processes, enzymatic preparations (festal, mezim, etc.) are prescribed.
Third, if gastritis is caused by H. pylori, then antibiotic therapy comes first. Currently, there are 2 main treatment regimens: 3-component or 4-component. The joint prescription of 2 antibiotics and an acid-reducing drug (PPI) is three mandatory components. Additional administration of bismuth preparations is typical for a 4-component regimen.
It must be remembered that the basis of any treatment for gastritis is diet and avoidance of alcohol and smoking. The food excludes dishes that stimulate secretion in the stomach (marinades, smoked meats, pickles, hot seasonings). Meals are frequent, split meals (from 4 to 6 times a day), preferably at the same time, gentle, steamed or with a minimum amount of fat and oil. Various vegetable or fish side dishes, lean meats (chicken, veal) are welcome; a special place is occupied by the consumption of soups, which should be included in the diet at least 2 times a day. The use of enveloping substances (flax seed decoction, white clay, antacids) is also recommended both during an exacerbation and outside of it.
During an exacerbation, treatment consists of complete cessation of smoking, alcohol, and fasting for 1-2 days. Antacids (Almagel, Hefal, etc.) and proton pump inhibitors are taken. It must be remembered that the symptoms of gastritis with high acidity during an exacerbation are similar to the signs of an acute ulcer of the stomach or small intestine. You must immediately stop self-medication and consult a doctor.
Gastritis with low acidity
This is an inflammation of the gastric mucosa, which is accompanied by a decrease in the acidity of gastric juice.
Such gastritis occurs in 20-25% of newly diagnosed cases of chronic gastritis, and reaches values of up to 60% in advanced forms of this disease. This is explained by the fact that during the transition of acute gastritis to chronic gastritis, in most cases, high acidity levels of the stomach contents are observed, but over time, the acidity values decrease.
Chronic gastritis with low acidity is typical for older people who have been suffering from inflammation of the gastric mucosa for a long time.
The reasons for the development of the disease are the same as for chronic gastritis with high acidity (there are 4 types: “A”; “B”; developing under the influence of various chemicals; reflux gastritis).
Symptoms of gastritis with low acidity
The release of hydrochloric acid by stomach cells is a necessary condition for the activation of a large number of enzymes of the digestive system. For example, pepsin, the main enzyme of gastric juice, which breaks down proteins in the lumen of the stomach, passes from an inactive form (pepsinogen) to an active one (pepsin itself) only at low pH. In addition, the acidic contents of the stomach are a direct regulator of the movement of the bolus of food into the lower gastrointestinal tract.
Thus, for gastritis with low acidity, symptoms associated with the quality of food digestion come to the fore, and very rarely, severe pain.
Patients suffering from this type of gastritis complain of a feeling of heaviness, fullness, and distension in the upper and middle third of the abdomen, especially after eating.
Treatment of gastritis with reduced activity.
The treatment achieves several goals.
- Firstly, restoring the activity of enzymes in the digestive system.
- Secondly, achieving proper regular functioning of all parts of the digestive tract.
- Thirdly, normalization of digestion.
- Fourthly, if H. pylori is detected, antibiotics are prescribed.
Due to the symptoms not being as pronounced as with gastritis with high acidity, the main focus is not on drug treatment, but on adherence to nutritional therapy (diet) and a healthy lifestyle (quitting smoking, drinking alcohol).
The diet corresponds to that for gastritis with high acidity, with minor exceptions: slimy vegetable soups and porridges are removed from the menu and a small amount of fermented milk products (kefir, non-acidic cheese), fresh berry juice with pulp are added (see “Diet for gastritis”) .
Enzymes (Pancreatin, Creon, Mezim, etc.) are prescribed to compensate for their insufficient activity, especially when the acidity of gastric juice is extremely low.
To regulate the functioning of the entire gastrointestinal tract, drugs that regulate digestion are prescribed - metoclopramide and domperidone (Motilium, Cerucal, etc.).
Antral gastritis
In modern classifications, this type of gastritis is called “type “B” gastritis. This gastritis is diagnosed based on the results of a biopsy and examination of stomach tissue under a microscope. The basis for its occurrence is considered to be the specific bacterium Helicobacter pylori.
Gastritis got its name because it is characterized by inflammatory changes in the part of the stomach called the “antrum”. Let us recall that the stomach is conventionally divided into 3 regions: the cardia (the uppermost part), the body (the middle part) and the antrum (the lower region at the junction of the stomach and the duodenum). It is in the antrum that the contents of the stomach are gradually alkalized and prepared for passage into the intestines.
Antral gastritis is especially studied because in 100% of cases of acute or chronic ulcers of the duodenum or stomach it is detected by microscopic examination. It is believed that antral gastritis is a direct factor in the formation of ulcers.
Three quarters of all antral gastritis occurs with increased acidity of gastric juice, the rest with normal acidity. A peculiarity of the symptoms of such inflammation of the gastric mucosa is that even at low pH values, a person most often does not feel the disease. He may only periodically be bothered by minor pain in the upper third of the abdomen and slight belching.
Treatment of antral gastritis
Treatment of gastritis with a predominant lesion of the antrum is carried out according to the general scheme (drugs that increase the pH of gastric juice, prokinetics, stimulators of gastric cell restoration, regulators of digestive activity and enzymes) (in more detail - “Treatment of gastritis”).
A special feature is that the treatment regimen includes aggressive antibacterial therapy aimed at removing Helicobacter pylori from the gastric mucosa. A 3-component combination of drugs (a proton pump inhibitor and two antibiotics) or a 4-component combination of drugs is prescribed (in this case, bismuth drugs are added). The course of therapy lasts from 10 to 14 days. Control fibrogastroduodenoscopy is performed 2, 4 and 8 weeks after treatment. Even after a positive result from the therapy, it is necessary to be systematically observed by the attending physician for early detection of relapse of the disease.
It is worth noting that the wording “superficial antral gastritis” implies inflammation of the gastric mucosa with a predominant localization in the antrum, which, according to the development mechanisms and characteristic microscopic picture, is the same as type B gastritis.
Erosive gastritis
Erosive gastritis is one of the most common types of gastritis, which is characterized by superficial damage to the gastric mucosa in the form of characteristic defects - erosions.
Erosion of the stomach or duodenum is currently the most common and at the same time the least studied lesions of the gastrointestinal tract. The mechanism of development of erosions, which are small (up to 3-4 mm) foci of necrosis of the mucous membrane in depth to a certain level (up to the so-called muscular lamina propria) and heal without scar formation, unlike ulcers, has not been fully elucidated.
Currently, depending on the structure, quantity and homogeneity, acute (the defect heals within 4-9 days) and chronic (healing over several months or years) erosions are distinguished.
According to the reasons for the development of gastric erosion, they are divided into:
- Primary, developing without concomitant diseases;
- secondary, which arise as a systemic lesion during severe injuries, burn disease, and stress.
Causes of gastric erosion
Currently, erosive gastritis of the stomach does not have a unified theory of occurrence. There are risk factors that increase the likelihood of developing erosive gastritis:
- Firstly, Helicobacter pylori infection. There is no direct evidence that this bacterium causes erosion. However, its eradication (removal) from the gastric mucosa sharply shortens the treatment time and increases the recovery rate of patients suffering from erosive gastritis.
- Secondly, the developing reflux of bile and bile acids with insufficiency of the sphincter between the stomach and duodenum, disruption of the movement of the food bolus into the underlying sections of the gastrointestinal tract, in approximately a third of cases, become the causes of erosion.
- Thirdly, a state of constant stress and nervous tension, which lead to an increase in the level of adrenaline, cortisol, thyroxine, are the direct causes of the development of erosive gastritis against the background of complete well-being.
- Fourthly, long-term use of anti-inflammatory drugs (aspirin, paracetamol, diclofenac, etc.) can cause erosive damage to the gastric mucosa.
Symptoms of erosive gastritis
There are no specific symptoms for erosive gastritis. Acute erosion can be suspected by sudden onset of heartburn, sour belching, and abdominal pain on an empty stomach. However, in 90% of cases, acute erosions go unnoticed.
Chronic erosions disturb a person with more pronounced pain in the upper third of the abdomen and digestive disorders. Belching, heartburn, heaviness in the abdomen and increased gas formation over the course of several months become signs by which erosion can be suspected. You may also experience dull or cramping pain in the upper third of the abdomen on an empty stomach, which can radiate to the spine. Unstable stool appears with a predominance of constipation.
At the first suspicion of the development of acute or exacerbation of chronic gastritis, you should immediately consult a doctor to exclude the development of erosive gastritis.
Treatment of erosive gastritis
Choosing tactics for treating erosions of the stomach or duodenum is not an easy task. Since the mechanisms of erosive gastritis are not yet fully understood, treatment is aimed at all possible links in the development of the disease. A doctor treats erosive gastritis. Avoid self-medication.
The primary task is to remove Helicobacter pylori from the gastric mucosa, for which three- and four-component regimens are used (see “Treatment of gastritis”).
Erosive gastritis: treatment with folk remedies
Treatment using traditional medicine recipes has no independent meaning. It is effective only in complex therapy with medications (see “Treatment of gastritis”).
Superficial gastritis
This form of gastritis was established solely thanks to the introduction of a special diagnostic method - fibroesophagogastroduodenoscopy (FEGDS). This diagnosis is made solely by microscopic examination of pieces of the gastric mucosa under a microscope. The characteristic changes that are detected in this case predominate with inactive gastritis or gastritis in the stage of long-term remission.
Its isolation became necessary due to the fact that this form of inflammation of the gastric mucosa is the first sign of the disease transitioning to the chronic stage and the eligibility for the diagnosis of “chronic gastritis”.
It is believed that with this type of inflammation of the gastric mucosa there are no significant disturbances in the structure of the cells, their functions are mostly preserved. However, increased secretion of mucus is already observed, and the production of hydrochloric acid and pepsinogen, the main enzyme of gastric juice, is slightly reduced. These changes are not yet pronounced and total, as with atrophic gastritis, but can further progress.
Symptoms of superficial gastritis
For this type of gastritis, typical symptoms (pain, discomfort in the upper third of the abdomen after eating or on an empty stomach, disruption of digestion and metabolism) are not typical. Superficial gastritis in the vast majority of cases is asymptomatic or only with minor manifestations. Most often, superficial gastritis becomes a finding during routine systematic examinations that are carried out in risk groups. They are workers in hazardous industries (heavy industry, chemical production, people with a family history of autoimmune diseases, etc.)
Treatment of superficial gastritis
If this type of gastritis is detected, no specific treatment is required. General strengthening therapy is prescribed, planned treatment of chronic foci of infection (carious teeth, chronic sinusitis, pustular skin lesions, etc.) is carried out, and the intake of multivitamin complexes and minerals is recommended. It is necessary to give up bad habits (smoking, drinking alcohol), moderate gastronomic excesses (overeating, excess spices, salt, smoked meats, marinades, carbonated water) in the daily menu. In general, the diet for superficial gastritis is looser than for other types of inflammation of the gastric mucosa (for more detail, see “Treatment of Gastritis”).
Drug treatment consists of a course of medications that stimulate the restoration of stomach cells and the treatment of concomitant diseases.
It should be remembered that at this stage of the development of the disease, the process of changes in the gastric mucosa is manageable - disciplined implementation of the doctor’s recommendations can protect against the transition of this type of gastritis to subsequent forms with the ensuing consequences.
Gastritis is a very unpleasant and dangerous disease, found in a third of adults aged 30 or more. Gastritis is an inflammatory process in the gastric mucosa, accompanied by disturbances in tissue regeneration and the basic functions of the stomach as part of the digestive system. The disease can be caused by many reasons, and in some cases, gastritis is only the “first call” of something more serious. It is very important to recognize the signs of the disease in time and treat it correctly. How to do this is described below.
There are two types of gastritis - acute and chronic. They are caused by approximately the same reasons, but differ in the time of development and action, as well as in the pain caused. Let us consider separately what causes their occurrence, what danger each form poses to humans and how they are recognized.
This form of the disease appears during short-term exposure to negative factors and is a reaction to them. Acute gastritis is characterized by severe, sometimes unbearable abdominal pain and general malaise. Depending on the cause of occurrence, the following subtypes of the disease are distinguished:
- Catarrhal gastritis occurs when pathogenic microorganisms enter the stomach along with spoiled food, or when uncontrolled taking a large number of medications or during an allergic reaction to certain foods. With this form of gastritis, there is a slight destruction of the upper layers of the mucous membrane, and inflammation and severe pain are a consequence of the body’s attempts to get rid of harmful substances (or microorganisms) and restore its integrity.
- Erosive gastritis appears from exposure to strong acids or alkalis that enter the stomach. Simply put, this is a chemical burn of its mucous membrane. The damage caused by acid or alkali is quite deep, and as a result, ulcers or scars appear on the stomach tissues.
- – develops due to blood poisoning. It is rare, but it is very dangerous and requires immediate treatment.
- occurs in situations when a foreign body (for example, spicy chicken or fish bone) enters the stomach, damaging the surface of the mucous membrane. Next, a purulent infection develops at the site of the wound, and this inflammation is called phlegmonous acute gastritis. If this form of the disease occurs, it requires immediate surgery and removal of the foreign body, otherwise gastritis will develop into inflammation of the abdominal cavity with a fatal outcome.
Now you know for what reasons acute gastritis can develop. If diagnosed in time and treated correctly, the disease lasts no more than a week.
IMPORTANT! It should be understood that an attack of gastritis lasts and is treated for up to 5-7 days, but the gastric mucosa takes much longer to recover, and if you do not provide it with all the conditions for this, there is a risk of the disease progressing from acute to chronic form.
Acute gastritis - signs and symptoms
Now let’s figure out what signs you can use to understand that you are experiencing acute gastritis. As in the case of the causes of occurrence, we will divide them into several subtypes.
- Catarrhal gastritis characterized by bloating and a feeling of heaviness, acute pain on an empty stomach or after eating food, vomiting with bile or a sour taste. Also, with this form of the disease, intestinal function is impaired, frequent constipation alternates with diarrhea. A person has a decreased appetite, headaches and malaise, tachycardia, dry mouth and a feeling of unpleasant taste, including on an empty stomach.
- Erosive gastritis can be identified by severe heartburn and a feeling of nausea, accompanied by pain that stops only after vomiting. Sometimes this form of the disease can be confused with an attack of an ulcer.
- develops quite quickly and is accompanied by high fever and extremely severe pain in the abdominal area. If these symptoms occur, the patient should be hospitalized immediately.
- can be identified by vomiting of blood and tissue particles and severe pain when touching or pressing on the abdomen. Unlike other forms of gastritis, with the phlegmonous form, not only the stomach, but also the chest may hurt, breathing problems, hoarseness in the voice and a bitter taste in the mouth.
IMPORTANT! Signs of acute gastritis appear quite quickly, like the disease itself, within 5-10 hours. The painful sensations are quite strong, so it is almost impossible not to notice them or not to give them due attention.
Video - Gastritis: causes of stomach pain
Chronic gastritis - causes and symptoms
This form of the disease is characterized by sluggish atrophy of the gastric mucosa and loss of the ability to produce gastric juice and its main component, hydrochloric acid, and as a result, the functioning of the human digestive system is disrupted.
One of the main causes of the disease is poor nutrition. If a person eats too much spicy, rough, too cold or too hot food, or eats only dry food, the gastric mucosa is injured and becomes vulnerable to pathogenic microorganisms, such as the bacterium Helicobacter pylori, or to aggressive and harmful substances.
Chronic gastritis can also be caused by improper treatment of its acute form or uncontrolled use of a large number of medications without consulting doctors for a long time.
ADVICE! If you think that you are likely to develop chronic gastritis, try to give up the abuse of tobacco and alcohol.
According to its signs, symptoms and progression, chronic gastritis is divided into several types, presented in the table below.
| Name | Process and consequences | Symptoms |
|---|---|---|
| Surface | Destruction of the upper layers of the gastric mucosa. The glands that secrete hydrochloric acid and gastric juice are not affected | Nausea, mild stomach pain, loss of appetite. Symptoms appear in autumn and spring |
| Atrophic | The disease destroys both the upper layers of the membrane and glands, tissues atrophy, dysfunction of the digestive systems and problems with digesting food | Heartburn, smell of rot or rotten eggs in the mouth, heaviness in the stomach, weight loss, periodic abdominal pain |
| With low acidity – hypoacid gastritis | Dysfunction of the digestive system, insufficient secretion of hydrochloric acid. Development of benign tumors, risk of developing cancer | Mild symptoms, frequent constipation, belching and decreased appetite. An additional sign is the absence of heartburn after eating a large amount of acidic foods. |
| With high acidity - hyperacid gastritis | Disturbance of the gastric mucosa, problems with digestion of food | Severe heartburn when eating small amounts of acidic foods. Pain in the stomach and epigastric region at night and on an empty stomach |
| Autoimmune gastritis | Destruction of mucosal tissue by cells of the immune system. Appears in thyroid disorders, Addison's disease and immune system disorders. Increased risk of development with frequent cases of acute gastritis and factors of unwanted heredity | Bloating and rumbling in the abdomen, flatulence, belching with the smell of rotten eggs, pain after eating. Drowsiness, weight loss, poor health, brittle hair and nails |
It should be understood that in the initial stages it is extremely difficult to recognize chronic gastritis by symptoms and signs, and detection of the disease requires diagnosis in medical institutions. There are two ways to identify gastritis:
Treatment of gastritis - prevention and diet
The main principle that is followed when curing gastritis is the elimination of factors that provoke inflammation of the gastric mucosa. And therefore, proper nutrition is as important as taking medications. In addition, a well-designed diet for acute gastritis will significantly reduce the risk of it becoming chronic.
Immediately when an acute form of the disease occurs, it is advisable to refuse to eat so as not to injure the gastric mucosa. Filtered water, Borjomi and not too strong tea are allowed. After treatment, you should switch to a gentle diet, with a small amount of food consumed and without sweets, fatty and spicy foods. Also, after acute gastritis, it is undesirable to drink alcohol, smoke or drink a lot of coffee.
IMPORTANT! If you need to take medications for other diseases, first consult your doctor and read the instructions for them.
As for the diet for the treatment and prevention of chronic gastritis, the list of undesirable foods is almost the same:
- alcohol;
- fatty foods and foods cooked in large amounts of oil;
- too spicy or too salty;
- mushrooms;
- rough food that burdens the stomach;
- grapes and grape juice;
- soda and sweets;
- sausage and smoked meats;
- seasonings;
- excessively hot food;
- completely cooled or very cold food.
- Boiled chicken, meat and fish with low fat content.
- Fish soup, chicken and meat broths.
- Grated vegetables and puree.
- Cottage cheese, cheese, kefir and other dairy products.
- Compotes and decoctions from rose hips.
- Mineral water - drink a glass half an hour before meals.
IMPORTANT! For the treatment or prevention of gastritis, it is important not only to eat the right food, but also to properly organize meals - at least 5-6 times a day, in small portions and at short intervals. The duration of the diet is from eight to twelve weeks. It will be useful to combine it with taking vitamin complexes, good rest and peace.
Treatment of gastritis
Medicines
It should be understood that taking medications is only effective in conjunction with a diet. Depending on the cause and extent of the disease, the patient should use the following medications:
- Antibiotics are needed in situations where gastritis is caused by the activity of microbes.
- Omeprazole - reduces the production of gastric juice and its main component, hydrochloric acid. Reducing acidity is necessary to relieve pain and protect damaged mucosal cells.
- Almagel and Gastal - create a layer on the surface of the mucous membrane that protects it from damage. These medications help relieve severe pain during attacks of gastritis. Requires frequent daily use.
- Sucralfate, Misoprostol and Pepto-Bismol - perform the same function as the drugs in the list above - form a barrier between the gastric juice and its walls, giving them the opportunity to recover.
- Medicines that suppress the immune system are used for autoimmune gastritis, protecting the mucous membrane from destruction by the body’s own immune system.
Before starting to take medications, be sure to undergo a diagnosis by biopsy and FGDS and consult with your doctor, and discuss with him the various nuances and features of combining drugs for gastritis with other medications.
Procedure for treating gastritis
So, what should you do if you suspect you have gastritis?
Timely detection of the disease and proper treatment will minimize possible consequences and significantly reduce the risk of further outbreaks and exacerbations of gastritis.
Video - How to treat gastritis with folk remedies
Gastritis is an inflammatory disease of the gastric mucosa, leading to its degenerative changes. Inflammatory processes of the stomach are different in origin and course, therefore in medicine gastritis can be considered both a primary, independent, independent disease, and a secondary one, which is caused by: intoxication, an infectious agent or other non-infectious diseases. The main characteristic symptoms of gastritis of the stomach are pain in the stomach both after eating and on an empty stomach, vomiting, constipation, nausea, diarrhea, heartburn.
According to statistics, more than 60% of the population suffers from various types of gastritis, among them, in 85% of cases, gastritis has a chronic course. The most dangerous form of inflammation of the gastric mucosa is atrophic gastritis, it is essentially a precancerous condition and is found in 60% of people after 50 years of age, in the population aged 30 to 50 years - in 30% of cases, in young people under 30 years of age in 5% of cases .
Types of gastritis
According to the nature of the course, gastritis is classified into:
- Acute gastritis
this form occurs as an acute inflammatory process; it develops rapidly, literally a few hours after provoking factors. Most often, acute gastritis is associated with intestinal infections or toxic infection due to ingestion of food that contains bacterial toxins, for example, staphylococcal toxins. Acute gastritis can also be caused by taking certain medications and chemicals that damage the mucous membrane - alcohol, alkaline and acidic solutions.
- Chronic gastritis
This is a constant, sluggish process of disruption of the stomach, accompanied by a structural change in the mucosa and its progressive atrophy. Typically, an acute disease becomes chronic with periods of remission and exacerbations. Some patients do not experience serious ailments or severe severe symptoms for a very long time, so chronic gastritis does not allow itself to be detected for a long time. Factors contributing to the development of the disease also include poor nutrition, intake of hot, spicy foods, food allergies, infections, metabolic disorders, smoking and alcohol.
What happens during gastritis in the human body? When pathogenic bacteria multiply or an aggressive environment enters the stomach, the body’s immune system, in response to the destruction of the mucous membrane, produces special substances that try to restore the integrity of the gastric mucosa, and externally such a fight is expressed by an inflammatory reaction, pain, loss of appetite, heartburn and other symptoms.
Diagnosis of gastritis
- The main method for diagnosing gastritis of the stomach is the fibrogastroduodenoendoscopy (FGDS) procedure. In this case, the condition of the gastric mucosa is examined using a probe; also, if necessary, a specialist can take a biopsy of the mucosa for a more accurate diagnosis.
- To diagnose Helicobacteriosis, a blood test is taken to determine antibodies to Helicobacter - immunoglobulins A, M and G.
- In case of chronic gastritis, it is advisable to do a stool test for occult blood.
Symptoms for various types of gastritis
The symptoms of this common disease have distinctive features depending on the type, nature, and duration of the inflammatory process.
However, all forms of gastritis are characterized by a number of identical symptoms:
- Nausea on an empty stomach and between meals
- Feeling of fullness in the stomach after eating
- Heartburn
- Decreased appetite
- Dull pain in the stomach that occurs periodically
Acute gastritis of the stomach
Symptoms of an acute process begin to appear 10-12 hours after the provoking agent enters the body or the occurrence of an irritating factor. According to some classifications, the following types of acute gastritis with their inherent symptoms are distinguished:
Banal gastritis or catarrhal simplex
most often occurs after food poisoning or as a result of long large breaks in food intake, irregular nutrition, dry food, allergies, rotavirus infections and Helicobacteriosis. With this type of gastritis, both the mucous membrane and the blood vessels in the stomach become inflamed, but the destruction of the mucous membrane is usually insignificant, since only the surface layer of the epithelium is damaged. And the body copes with such changes on its own. Symptoms of superficial acute gastritis:
- Bloating, heaviness in the stomach
- Pain in the stomach on an empty stomach and after eating
- Nausea and vomiting with mucus (sour taste and smell) and possibly bile (yellow-green color and bitter taste)
- Intestinal dysfunction - alternating constipation and diarrhea
- Decreased appetite, weakness, low blood pressure
- Heartburn, increased salivation, unpleasant taste or
- Headaches and dizziness,
Fibrinous
a purulent process in the stomach, which occurs quite rarely either when a foreign object enters the stomach, or as a complication during severe infections due to sepsis, or during poisoning with mercury or acids. It has all the symptoms of acute gastritis, but it also has distinctive features:
- Severe, unbearable pain in the stomach
- Heat
- Fibrinous gastritis requires urgent medical care, emergency surgery; if the patient is not helped in time, it is dangerous with peritonitis and can be fatal.
Erosive, focal, corrosive, necrotic or toxic-chemical gastritis
Corrosive or necrotizing toxic-chemical gastritis is a chemical multifocal burn of the gastric mucosa. Its development is provoked by the ingestion of heavy metal salts, concentrated acids, and alkalis into the stomach. In this case, both the superficial and deep layers of the mucosa are destroyed, the tissues of the submucosa of the stomach die, forming scars that can no longer secrete mucus and are provocateurs of the onset of gastric ulcer. The symptoms of this gastritis are as follows: 
- Paroxysmal vomiting with blood, tissue particles
- Severe pain behind the sternum, in the stomach
- Labored breathing
- The voice becomes hoarse and hoarse
- Unpleasant taste in the mouth
- Severe pain when pressing on the stomach
Erosive gastritis– damage to the stomach wall within the mucous membrane with the formation of surface defects called erosions. Which do not leave scars when healing. A common cause of erosive gastritis is the aggression of Helicobacter pylori. Since the microbe lives more often in the antrum. It is in the outlet section of the stomach that erosive changes are most often observed. The clinic of erosive gastritis is similar to that of peptic ulcer:
- fasting and early pain in the epigastrium of sucking
- hungry character
- heartburn, nausea, vomiting of eaten food, bringing relief
Signs of chronic gastritis
In 70% of cases, chronic gastritis is a secondary disease, that is, it appears as a complication or concomitant disease of diseases of the gastrointestinal tract, such as cholecystitis, pancreatitis, etc.
According to the type of disease, chronic gastritis is divided into 3 types:
- Type A is an autoimmune form of gastritis, when immune agents are directed against the gastric mucosa itself.
- Type B - Helicobacteriosis, when the mucous membrane is affected by the bacterium Helicobacter pylori.
- Type C - or reflux gastritis, when bile from the duodenum is thrown into the stomach.
The course of chronic gastritis is sometimes mild, patients do not feel significant discomfort and discomfort, and only periodically there are periods of relapses and exacerbations, which are not perceived by the person as a serious disease. However, with constant unfavorable factors in most people, trauma to the mucous membrane leads to the fact that it becomes susceptible to the destructive effects of Helicobacter. As a result of infection and injury with age, the destruction of the mucous membrane triggers autoimmune processes that contribute to the progression of disorders, causing ulcers and stomach cancer.
Classification of chronic gastritis and their symptoms
Superficial gastritis
This type of gastritis occurs with mild symptoms, since damage to the mucosa occurs only in the surface layer, without affecting the gastric glands. During periods of exacerbation of the disease, more often in spring and autumn, a person develops some signs of the disease, such as stomach pain, loss of appetite, and nausea.
Atrophic gastritis
With this type of disease, both the mucous membrane and the glands of the stomach, whose function is to produce gastric juice, are involved in the inflammatory process. Gradually, the glands die, atrophy, cease to perform their functions, and the process of breaking down food in a person is disrupted. And if atrophic gastritis affects most of the surface of the stomach, then the production of gastric juice decreases, accordingly, the process of breaking down and digesting food slows down and shortens, and the person weakens. Characteristic signs of atrophic gastritis:
- Belching that smells like rotten eggs
- Heaviness, sharp pain in the stomach
- Decreased appetite, weight loss
- Heartburn is constant
Reflux gastritis
This type of disease is caused by a disruption in the functioning of the biliary system (biliary) and duodenum (duodenal). Signs of reflux gastritis include:
- Chronic heartburn
- Vomiting bile
- Sudden weight loss
- Constant dull pain and heaviness in the stomach
Antral
This is a type of superficial gastritis with high acidity. This type of gastritis has no characteristic symptoms, so it can only be recognized with a specific diagnosis, but if a person experiences heartburn, heaviness and nausea when drinking apple juice or lemon, there is a high probability that this is increased stomach acidity:
- Heartburn from acidic foods
- Belching sour
- Constipation
- Heaviness after eating
- Night stomach pain, pain on an empty stomach
Hypertrophic
this is gastritis with low acidity, with the progression of which cysts appear on the walls of the mucous membrane; in fact, these are benign tumors that are dangerous due to their degeneration into malignant neoplasms. The diagnosis of gastritis with low acidity can only be established with fibrogastroduodenoendoscopy and examination of the composition of gastric contents. However, if a person really likes acidic foods and does not experience heartburn when consuming a significant amount, for example, lemons, the likelihood of low stomach acidity is high. Symptoms of hypertrophic gastritis include:
- Decreased appetite
- Frequent belching
- Constant taste in the mouth
- Constipation
Autoimmune
this gastritis occurs with diseases of the thyroid gland, Addison's disease and B12 deficiency anemia. Its signs include the following:
- Constipation, diarrhea
- Decreased appetite
- , bloating, rumbling
- Unpleasant taste in the mouth
- Belching with a putrid odor
- Feeling full after eating
- Dull pain and nausea 20 minutes after eating
- Anemia, dry, brittle nails and hair
- Drowsiness, weakness, irritability
Chronic gastritis type C is a chemical reactive reflux gastritis. Reflux gastritis is a chronic condition in which constant reflux of intestinal contents, including bile acids, lysolecithin, causes damage to the gastric mucosa and leads to the development of dystrophic and necrobiotic changes. True reflux gastritis develops in almost all patients after gastrectomy, pyloroplasty and partial gastrectomy.
In addition, similar changes in the mucous membrane are observed when taking non-steroidal anti-inflammatory drugs (NSAIDs), alcohol, iron and potassium supplements.
The epidemiology of this form of gastritis is due to a number of reasons: the frequency of gastric resection, the use of NSAIDs, the prevalence of alcoholism, etc.
Morphology of chronic gastritis type C
Type C gastritis is characterized by such distinctive morphological manifestations as hyperplasia of the pit epithelium, edema, necrobiosis and necrosis of epithelial cells, their vacuolization, absence of mucin in cell vacuoles, swelling and congestion of the lamina propria with an increase in the number of smooth muscle fibers without signs of pronounced and widespread inflammation. The dimples take on a corkscrew, tortuous appearance (foveal hyperplasia). Atrophy and metaplasia in chemical gastritis appears with long-term repeated damage to the mucous membrane.
Clinical picture of chronic gastritis type C
The severity of clinical manifestations of reflux gastritis does not always correspond to the degree of gastric damage observed during endoscopy and histological examination: Often, pronounced signs of severe antral atrophic reflux gastritis are asymptomatic.
Diagnosis of chronic gastritis type C
The diagnosis can be assumed based on the appearance of pain and a feeling of heaviness in the epigastrium during or immediately after eating, the development of nausea, vomiting, and heartburn. It is necessary to clarify the cause that caused reflux gastritis or chemical gastritis. This form of gastritis can be verified by a morphological examination of a biopsy of the gastric mucosa. With chemical gastritis, or reflux gastritis, the antrum of the stomach is predominantly affected, while the morphological signs of inflammation are minimally expressed.
Treatment of chronic gastritis type C
Drug treatment of reflux gastritis should be aimed at normalizing the motility of the digestive tract and binding bile acids. An effective drug that normalizes motility of the upper gastrointestinal tract is motilium. It increases the tone of the lower esophageal sphincter, stimulates the contractility of the stomach and accelerates its emptying, improves coordination between contractions of the antrum of the stomach and duodenum (antroduodenal coordination). Motilium is prescribed 1 tablet (10 mg) 3 times a day 15-20 minutes before meals.
To neutralize the damaging effect of bile acids on the gastric mucosa, cholestyramine is used (daily dose 6-10 g), which is best used with antacids (Maalox, phosphalugel), which themselves have adsorbing properties.
For bile reflux gastritis, ursodeoxycholic acid preparations of 250-500 mg at night for 6-8 weeks are successfully used. Ursodeoxycholic acid, being a non-toxic bile acid, being part of bile, prevents its damaging effect on the gastric mucosa.
In cases where duodenogastric reflux is a consequence of organic obstruction of the duodenum, the issue of surgical treatment must be addressed. In case of severe reflux gastritis that has developed in a patient after gastrectomy, pyloroplasty or partial gastrectomy, the question of surgical intervention is also raised (usually in these cases a Roux-en-Y operation is performed).
For NSAID-induced gastritis, it is advisable to discontinue nonsteroidal anti-inflammatory drugs; if discontinuation is impossible, use selective COX (cyclooxygenase) type 2 inhibitors (Mavalis or diclofenac). The drug of choice for the treatment of NSAID gastropathy is misoprostol, a synthetic analogue of prostagandin B, which is prescribed 200 mcg 3 times a day and at night.
Prevention of chronic gastritis type C
Unfortunately, there are no radical methods for primary prevention of chronic gastritis. Primary prevention of chronic gastritis, as well as prevention of its exacerbations, should be aimed at normalizing lifestyle, organizing a balanced diet, eliminating harmful effects on the stomach (NSAIDs, smoking, strong alcoholic drinks), and eliminating occupational hazards.
An important role is played by timely detection and systematic treatment of diseases that can cause gastritis. Much attention should be paid to the identification and effective treatment of acute gastritis, intestinal infections, helminthiases, chronic diseases of the liver, biliary tract, and pancreas.
A. Kalinin, etc.
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