Erosive atrophic gastritis is a type of chronic inflammation of the gastric mucosa, accompanied by the destruction of parietal cells, a decrease in the synthesis of hydrochloric acid, and the formation of erosions and ulcers. Atrophy has an autoimmune mechanism in which parietal cells are attacked by the body's own defense systems. An erosive lesion often results from infection with the bacterium Helicobacter pylori (HP). The disease has a combined etiology.
The appearance of the mucous membrane with erosive-atrophic gastritis
In the initial stages, it is asymptomatic. The accumulation of primary changes in the mucous membrane occurs. The process often develops in the fundus of the stomach. Under the influence of the immune system, glands die. The remaining are shortened, slimy, lose parietal cells.
As a result, the following changes occur:
- The production of hydrochloric acid is reduced.
- Tissue infiltration by lymphocytes, neutrophils.
- Cell differentiation is impaired.
- Areas of intestinal metaplasia are formed.
The mechanism of formation of changes does not differ from atrophic gastritis.
Epigastric severity after eating is one of the symptoms of the disease.
Due to the influence of pathogenic microflora that seed the mucous membrane, erosive defects occur. Their size at the beginning of the disease is small. Subsequently, the lesions can expand and deepen, an ulcer is formed. The number of defective areas is also increasing. In the area of their localization, chronic capillary bleeding is noted, which leads to the appearance of occult blood in the stool. All the signs mentioned above are detected during gastroscopy. A similar picture is observed with erosive gastritis without atrophy.
Subjective symptoms develop after a few months from the onset of the disease. Signs are nonspecific, blurry.
Patients complain of:
- severity in the epigastric region that occurs after eating,
- loss of appetite
A history of B12-deficiency anemia, thyrotoxicosis is often observed. If the patient develops vomiting, blood streaks are found in the discharge - “black clots” (the color of coffee grounds). With volume bleeding from ulcerations or with the initial accumulation of blood in the stomach, the entire volume of vomit is stained black.
The presence of coffee grounds vomit is not a defining sign of gastric bleeding. If the defect is located in the esophagus, it is possible for blood to drain into the stomach and convert it to hematin hydrochloride. With vomiting, the nature of the vomit will be the same as during gastric bleeding. Therefore, the source of bleeding is determined only by gastroscopy or appropriate radiographic techniques.
Despite the fact that the symptoms of the disease at its initial stages do not lead to a decrease in the patient's quality of life, therapy should be started as early as possible. Treatment of erosive atrophic gastritis is carried out with the help of medications, diet food. In some cases, invasive interventions are required to stop bleeding.
With atrophic erosive gastritis, drug therapy is carried out only with exacerbation. It is aimed at correcting the composition of gastric juice and eradicating Helicobacter pylori infection.
Acidin-pepsin - one of the drugs to compensate for gastric acid deficiency
To normalize the digestive function and replace the missing volume of hydrochloric acid using:
- natural gastric juice.
With a decrease in the secretory function of the pancreas, apply:
Elimination of HP is carried out using antibacterial agents:
To restore impaired trophic tissue prescribe:
- nicotinic acid.
With bleeding erosion, hemostatic drugs are used:
- aminocaproic acid.
The main invasive manipulation indicated for erosive atrophic gastritis is gastroscopy. The procedure is performed to assess the condition of the mucous membrane and stop capillary bleeding.
For the purpose of hemostasis, erosion is chipped with a solution of adrenaline with antibiotics, cauterized with silver nitrate. This allows you to achieve the desired effect without creating an additional systemic pharmacological load on the patient.
The diet for erosive-atrophic gastritis should be mechanically sparing in order to avoid damage to the mucous membrane and not provoke bleeding from erosion. At the same time, food should have a stimulating effect on the gastric glands in order to enhance the production of hydrochloric acid by the remaining parietal cells.
The patient’s diet includes:
- soups (meat, fish, vegetable),
- lean meat
Meal is produced in small portions, 5-6 times / day. After the onset of remission, the patient can eat on a par with healthy people, excluding indigestible (fat, cream) foods, alcohol.
Erosive-ulcerative gastritis is a progressive chronic disease of the stomach that increases the risk of developing malignant tumors. Without competent drug support, degenerative changes occur relatively quickly.
Treatment can significantly slow down the development of pathology, stop unpleasant symptoms, reduce cancer risk. Therefore, at the first signs of digestive upset, it is recommended to consult a doctor to make a diagnosis and determine the necessary therapeutic tactics.
There are many causes of external and internal nature that can provoke a disease. Often, the disorder is treated for a long time because many factors act simultaneously. In order to effectively and without complications cure gastritis when it occurs, you need to know about the factors that provoke the disease and try to avoid them:
- frequent consumption of too spicy and / or hot food,
- persistent stress, depression, or nervous breakdown,
- extensive body burns, head injuries of varying severity, large blood loss for a variety of reasons,
- prolonged use of any medication that can level the protective function of the mucosa,
- alcohol abuse
- diseases of the gastrointestinal tract, liver, kidneys,
- endocrine system diseases,
- intoxication with toxic substances, drugs,
- chronic diseases of the cardiovascular system,
- unbalanced work and rest
- harmful and dangerous living and / or working conditions,
- uncontrolled reproduction of microbes (for example, streptococci, herpes viruses, helicobacteria),
- various septic conditions
- malignant neoplasms in the stomach.
The specifics of the types of erosive gastritis and their symptoms
Symptoms of erosive gastritis and the treatment of this disease are directly related, since each subspecies of erosive gastritis has its own specificity, causes of development and therapy.
Depending on the provoking factors, erosive gastritis is divided into 2 types:
- Primary, which can be cured in a fairly short time. It occurs, as a rule, due to the stressful state of a person and adverse environmental conditions. Distributed among completely healthy people of middle age.
- Secondary, which is quickly difficult to cure, since it arises and develops against the background of any chronic disorders of the patient.
Types of erosive gastritis by the nature of the course:
- acute erosive gastritis,
- chronic erosive gastritis.
The most common types of erosive gastritis according to the development mechanism:
- antral gastritis,
- atrophic erosive gastritis,
- focal erosive gastritis.
The specifics of acute and chronic erosive disorder
Direct contact of the gastric mucosa with aggressive factors (for example, spicy food, medicine and other irritating substances) causes a burn. It is inflammation during the healing of this burn that causes all the symptoms of the disorder.
Symptoms of acute erosive gastritis:
- dull or sharp pain in the stomach that radiates to the chest and occurs after eating,
- stomach cramps
- frequent vomiting with a lot of mucus and blood,
- blood in the stool
- loose stools.
The basis of chronic gastritis is erosion of the mucous membrane of the inner lining of the stomach, resulting from circulatory disorders and the release of high concentration of gastric juice. Aggressive substances contained in the gastric fluid disrupt microcirculatory processes and ulcerate the walls of the stomach.
With erosive gastritis of a chronic stomach, the symptoms are mild, but some should be noted:
- severe flatulence
- feeling of nausea
- discomfort and heaviness in the abdomen,
- alternating constipation and diarrhea,
- loss of appetite.
Important! The totality of these symptoms cannot be ignored.
It is necessary to undergo a medical examination at the slightest suspicion.
If this is not done, then erosion of the mucosa can asymptomatically affect large areas of the stomach, which is treated at times more difficult.
Erosive antrum and focal gastritis
The erosive gastritis developing in the lower part of the stomach (antrum), the symptoms of which are caused by Helicobacter pylori, is called antrum.
Symptoms of erosive antral gastritis:
- pain in the epigastric region that occurs regardless of food intake,
- in the chronic stage causes severe pain on an empty stomach,
- severe heartburn
- nausea and vomiting - usually after eating,
- periodic sensations of dryness and bitterness in the mouth.
What is erosive gastritis of focal nature? Bulbit (an alternative name for the disease) is characterized by the simultaneous occurrence of foci of mucosal lesions in several places of the stomach. Wounds (defects, erosions) can affect both the distal (upper) part of the organ (actually the lower part of the esophagus), and any other part of it.
There are no deep ulcers with this type of gastritis, only the upper layers of the mucosa are damaged, erosive gastropathy is characteristic.
Symptoms of erosive focal gastritis are similar to those already described above.
Erosive subatrophic gastritis and its treatment
Do you still endure gastritis? It is not the effect that needs to be treated, but the cause, says Olga Kirovtseva.
Erosive atrophic gastritis is a pathological disease in which the gastric mucosa is affected. The mucous membrane can be affected both in one place, and simultaneously in several places.
At the initial stage of the disease, the wounds are small in size, while they are located on the outside of the stomach. With the development of the disease, the wound turns into a kind of erosion.
The main causes of the disease include poor nutrition, excessive consumption of alcohol and drugs. Atrophic gastritis with erosion can take several forms:
In acute manifestation of erosive atrophic gastritis, the patient experiences constant pain in the abdomen. Most often, pain intensifies after eating food. Vomiting and heartburn may also be present. In severe attacks, vomiting may contain some blood and gastric juice. Blood may also be present in the stool.
With a chronic manifestation of erosive atrophic gastritis, the patient experiences slight discomfort in the stomach. The stool constantly changes from constipation to loose stools, and vice versa after a while. The patient constantly feels heartburn and nausea.
Treatment of atrophic erosive gastritis
Having felt the first signs of the disease, the patient should urgently seek emergency medical care. To confirm the diagnosis, the doctor conducts a study. When the diagnosis of subatrophic erosive gastritis is confirmed, treatment is prescribed. Such a disease is the initial degree of an ulcer, which means that it must be treated concomitantly.
The elimination of erosive atrophic gastritis can be divided into several stages:
- First, the patient should undergo therapy aimed at the destruction of Helicobacter pylori. The doctor prescribes Levofloxacin, Tetracycline and Amoxicillin. In the event that the therapy was not completed to the end, the bacterium begins to recover, which means that the course of treatment will need to be taken first.
- Once the malicious environment is finished, you can proceed to the next recovery phase. To eliminate subtrophic erosive gastritis, it is necessary to regulate acidity. Most often, doctors prescribe acidic blockers and antacids. It is strictly forbidden to choose medicines on your own. You must follow the instructions of the gastroenterologist.
- Often, antacids have a bad effect on the digestive system, therefore, experts prescribe enzymes to their patients - Mezim, Festal or Digestal.
- The final stage of therapy is to restore the integrity of the stomach. In order to accelerate the process of mucosal regeneration, patients are prescribed Iberogast, which enhances the ingress of oxygen to the affected areas.
In the event that erosive atrophic gastritis was started, and the patient developed severe bleeding, the doctor sends him for surgery. Only surgery can eliminate bleeding.
Folk remedies for the disease
Erosive atrophic gastritis can be eliminated faster if drug treatment and folk remedies are combined. The most common remedy is sea buckthorn oil, which promotes wound healing. Such oil can be bought at any pharmacy or prepared independently. Sea-buckthorn oil is best consumed half an hour before a meal.
Also, in the fight against atrophic gastritis and erosion, decoctions from herbs will help. The most commonly used St. John's wort, valerian, birch leaf, hops and pharmacy chamomile. The grass must be shallow so that it can be brewed. Decoctions can be taken five times a day.
Erosive gastritis: symptoms, treatment, proper nutrition
What leads to the development of erosive gastritis? What varieties of it exist? What medications can a doctor prescribe?
Gastritis can be attributed to the most widespread diseases of the stomach, which is expressed in inflammation of its walls. At the same time, several forms of gastritis are distinguished, one of which is erosive gastritis. As the name implies, such gastritis is characterized by the appearance of erosion on the gastric mucosa.
There are two types of erosive gastritis:
Errors in nutrition, prolonged exposure to certain drugs (sulfonamides, salicylates, antibiotics, etc.), foodborne toxic infections can provoke the development of acute gastritis. Gastritis can also develop as a result of food allergies to certain foods (for example, mushrooms or strawberries).
Untreated gastritis can take a chronic form
Chronic gastritis is often the result of an incorrect or untreated acute illness. But most often, a chronic process in the gastric mucosa develops due to prolonged exposure to various exogenous factors, among which the following can be noted:
frequently recurring eating disorders,
eating coarse and spicy foods,
excessive passion for too hot food,
the habit of eating dry food,
frequent use of alcoholic beverages.
Also, chronic gastritis can develop due to prolonged and uncontrolled intake of certain medications that have an irritating effect on the gastric mucosa.
The relationship between the development of gastritis and the bacterium Helicobacter pylori was also identified. It was noted that this pathogen is involved not only in the development of gastritis, but also in peptic ulcer.
1. Atrophic gastritis.
It is characterized by thinning of the mucous membrane, as well as a decrease in the number of functioning cells. All this leads to the fact that less gastric juice is produced and, as a result, the acidity of the stomach decreases. The result is that food, due to the small amount of gastric juice, does not undergo the necessary processing here. Such changes in the mucosa appear, as a rule, after a long ongoing chronic process.
3. Autoimmune gastritis.
Refers to one of the forms of atrophic inflammation that occurs against the background of autoimmune disorders observed in the body. In this case, the immune system begins to fight with its own cells, producing antibodies (in this case, against the cells of the gastric mucosa, taking them for foreign). As a result of this, increased production of hydrochloric acid is noted. All this causes and supports the inflammatory process.
4. Allergic gastritis.
Most often found in people with a tendency to allergic reactions. The immediate cause is an allergen, which, when ingested, causes an inflammatory process of an allergic nature.
Gastritis - inflammation of the walls of the stomach
At the same time, the general condition of the patient changes - his skin and mucous membranes turn pale, a white-grayish coating is visible on the tongue. Both dry mouth and excessive salivation can be observed.
Symptoms of acute gastritis
Among the general clinical manifestations, the appearance of pain that occurs in the stomach and behind the sternum can be noted. However, it can be quite intense. The appearance of pain or intensification occurs, as a rule, after eating or after some time. Pain with erosive gastritis is associated with affecting the deeper layers of the mucous membrane, up to the muscle layer.
Often with erosive gastritis, vomiting also appears, and traces of blood and mucus are found in the vomit. Blood can also be present in feces, which as a result become almost black. In this case, the stool is most often liquid, and the presence of blood in it indicates internal bleeding.
Symptoms of Chronic Gastritis
Often, for this form, an almost asymptomatic course is characteristic. Sometimes patients may complain of flatulence, nausea, discomfort and heaviness in the stomach. Chronic gastritis can also manifest itself in unstable stools. This diagnosis is often associated with internal bleeding that has opened when the process goes into an acute stage. In this case, during an endoscopic examination, the doctor will be able to detect the presence of erosion on the gastric mucosa.
Given that among the main reasons for the development of erosive gastritis can be called errors in nutrition, then with its correction, it is worth starting the treatment of this disease. Therefore, it is worthwhile to consider dieting in more detail.
Nutrition for erosive gastritis
In this case, nutritional recommendations will vary depending on the severity of the process.
AT acute period. and also in the initial period of recovery, diet No. 1 is recommended. It implies the restriction of excitatory secretion products, as well as the exclusion of dishes that irritate the mucous membrane.
Nutrition depends on the type of gastritis.
Anonymous, Female, 44 years old
Erosive atrophic gastritis
Hello. My name is Nadezhda. In May of the year I was diagnosed with erosive gastritis. After unsuccessful treatment at home (I took de-nol, omez, clarbact, which I drank for only 3 days, because there was terrible nausea, bitterness). went to a hospital for a fee. She underwent a course of treatment. There was a microbe hilak pylori. At discharge, he was diagnosed with atrophic gastritis of the antrum and pancreatitis. I follow a diet for a year. In May, she began to feel sick again, growling in her stomach, belching after eating and in the morning on an empty stomach, heaviness in the stomach. Made, the diagnosis of erosion of 0.2 mm in the antrum. I am being treated by a therapist, because There are no gastroenterologists in the city. Doctor's prescription amoccillin 500mg. 2 Tab 2 p. On the day of 10 days, omez 1kap.2R. On the day, creon with food, and again clarithromycin 500 mg 1 tab. 2P. On the day that the doctor said that vseravno need to drink. In addition, in the morning I already take aloe with honey on an empty stomach, make brewed stomach tea, and plantaglucid. Analyzes, the doctor said, normally donated blood for biochemistry, feces for occult blood, blood from a finger with a formula, urine, blood for amylase ) True hemogabin 115 and chalestyrin 6.7. Questions: what caused erosion again. I follow a diet, though I am an emotional and emotional person. Can clarithromycin be replaced with another antibiotic? And it bothers me that I have atrophic gastritis in the antrum and erosion has formed there. Is this dangerous? Maybe it’s better to be treated again in a hospital? The therapist said that it is possible and successfully treated at home. Well, I drink only one antibiotic.
Hello, the cause of erosion can be an untreated Helicobacter pylori, taking certain drugs, the state of the nervous system, etc. It is impossible to prescribe the correct treatment without taking these factors into account, all the more it is inappropriate to take antibiotics (assuming that you are infected with Helicobacter pylori, the previously taken regimen is no longer effective, another treatment is selected). Your disease is treated on an outpatient basis, it is not necessary to go to a hospital. It is necessary to get a face-to-face consultation with a gastroenterologist.
The consultation is for reference only. Following the consultation, please consult a doctor.
Etiology and pathogenesis
The etiology and causes of this type of gastritis have not been reliably studied to date. Very often, this type of gastritis occurs against the background of a stressful situation for the body - postoperative complications, shock, burn disease, septic state.
Long-term alcohol consumption leads to the development of cirrhosis, as a result of which the pressure in the internal organs increases and their blood supply is disturbed. Diabetes mellitus, exacerbation of chronic diseases of the broncho - pulmonary system cause changes in the vessels of all organs and systems and provoke the development of erosion in the gastric mucosa.
Non-steroidal anti-inflammatory drugs have many side effects, among them the ability to cause damage to the gastric mucosa, manifested by erosive gastritis.
A certain role in the occurrence of this disease belongs to HP (Helicobacter pylori).
The pathogenesis of acute and chronic erosive gastritis is somewhat different.
In the first case, the aggressive action of acids, alkalis, alcohol-containing substances, drugs, as well as poor-quality foods containing pathogenic microorganisms and toxins produced by them is exerted on the mucous membrane. Most often, acute erosive gastritis develops in the antrum of the stomach.
The basis of the pathogenesis of exacerbation of chronic erosive gastritis is a malfunction in the secretory function of the stomach. Its cause is often a violation of the nature of nutrition, as well as immunological, humoral or endocrinological changes in the body. As a result, microcirculation processes change, which leads to secondary inflammation and the formation of erosion.
The main clinical symptoms of erosive gastritis differ from any form of gastritis only in severity and persistence:
- The pain symptom in the epigastric zone can be so intense that the administration of strong analgesics may be required.
- Heartburn is characteristic of gastritis with altered motility and reflux (reverse reflux) of acidic contents into the esophagus.
- Dryness, bitterness in the mouth, belching of rotten or sour, as well as heaviness in the stomach and disturbance of stool are very characteristic symptoms of exacerbation of chronic erosive gastritis.
- The relationship of pain with a meal is on an empty stomach or immediately after a meal. This is explained by the fact that acidic gastric juice irritates the receptors of erosive mucosa.
Chronic gastritis, especially untreated, usually lasts a long time and leads to very serious complications.
This is primarily gastric bleeding from an eroded mucosa.
Important here: area of erosive mucosa, its localization and depth.
The most dangerous location is the area of lesser curvature of the stomach due to the intensity of blood flow there and the location of large vessels. Also, the antrum section of the stomach is a dangerous section, since with complication of erosive gastritis-ulcer, cicatricial deformity of the antrum section occurs.
At risk are patients who take medications that reduce blood coagulation for a long time (warfarin and cardiomagnyl, for example), as well as patients suffering from hypertension and diseases of the blood coagulation system.
- Reduced pain symptom due to destruction of sensitive receptors.
- Vomiting, the intensity of which depends on the number of bleeding vessels, as well as their diameter.
- Anemia, the severity of which depends on the amount of blood loss.
- Blood elements destroyed by acid, getting into the intestine, stool the stool black.
- Signs of vitamin deficiency (dry skin, brittle nails and hair), a very characteristic symptom: a perversion of taste and smell.
Diagnosis and treatment
Diagnosis of chronic erosive gastritis is based on the conclusion of a gastroendoscopic examination, the results of a biopsy, which allows differentiating it from other diseases of the stomach, as well as testing for HP.
Treatment should be timely, a sufficiently long period continues, followed by endoscopic monitoring. This dynamic examination is necessary to control possible complications.
Therapy of chronic erosive gastritis is consonant with the treatment of gastric ulcer.
- Blockers of histamine receptors or proton pump. Kvamatel is a modern representative of the first group, and the second group is represented by the following: controls, omez, proxy.
- When confirming HP, as the etiological cause of erosive gastritis, anti-Helicobacter pylori drugs should be present in the treatment regimen: neo-pilobact, for example. The prerogative of prescribing drugs in the treatment of gastritis belongs to the doctor gastroenterologist. Self-medication is dangerous!
- In order to reduce the aggressive effect of hydrochloric acid, antacid preparations are connected to the treatment: maalox, almagel, venter, rennie. The protective film formed by them envelops the inflammatory mucosa and contribute to its rapid regeneration.
- In connection with the violation of the normal motility of the stomach and duodenum, motilium, cerucal, domperidone are added to the scheme.
- Panzinorm, pangrol, creon - modern enzyme preparations are necessary to improve digestion due to artificially created drug blockage of gastric secretion.
- Preparations with hemostatic effect are used only in the treatment of erosive hemorrhagic gastritis. Dicinon, vicasol, etamzilate are administered parenterally.
It is impossible not to mention the benefits and effectiveness of folk remedies used to treat erosive gastritis. Evidence-based medicine confirms the effectiveness of bee pollen, sea buckthorn oil, flax seeds, as well as carrot, potato and cabbage juice.
Their healing power is undeniable and convincing. Indeed, thanks to them, thousands of people got rid of the symptoms of exacerbation of erosive gastritis and returned health to their stomach.
Chronic erosive gastritis - features
Chronic erosive gastritis - it is also erosive, hemorrhagic - a fairly common disease.
With its development, focal lesions are formed on the mucous membrane of the stomach (focal - which means localized in a relatively small separate area). The walls of the blood vessels in the area captured by inflammation become extremely thin and permeable.
Characteristic gastropathy is usually found in the process of FGDS - fibrogastroduodenoscopic examination.
Typical causes of erosive gastritis
The disease can relate to both type A (autoimmune origin) and type B (bacterial origin, namely the action of bacteria Helicobacter pylori). Sometimes it provokes liver problems or kidney failure.
Sometimes erosion is formed after injuries (gastrointestinal surgery, internal burns). The cause of the ailment is often also an elementary neglect of one’s own health, namely, dry food, long breaks between meals, alcoholism.
Frequent excitement also plays a role. Note that people who tend to worry about trifles, generally very easily acquire a bouquet of various diseases.
Description of the disease
It is interesting that chronic erosive gastritis worries patients mainly in transitional seasons - from September to December and from May to June.
True, exacerbations in connection with violations of the diet are not predetermined by the time of the year.
Secretory function in chronic erosive gastritis is both increased and decreased. In some cases, it remains at the level of acceptable standards.
The most typical signs of the disease
- discomfort in the upper abdomen, especially after eating food harmful to the vulnerable stomach,
- weight loss associated with a loss of taste for food,
- nausea and sometimes vomiting
- heaviness in the stomach
- spitting up, burping,
- blood in the stool or vomiting.
The main danger that is usually associated with erosion in the stomach is the risk of internal bleeding. Blood can come out with stool, making it dark, or with vomit.
Hemorrhagic gastritis: treatment
The affected areas of the mucosa are gradually restored or, conversely, the inflammation is aggravated (if the recommendations of the attending physician are not followed). Conscientious treatment, begun at an early stage of erosive gastritis, gives a chance for an almost complete recovery.
The patient should sit on a special diet. It is recommended to refuse muffins, sweets, do not eat fried foods, preferring broths and dishes from grated components.
In the fight against the disease, first of all, medical methods of treatment are used - follow the link to see information about specific drugs for the treatment of hemorrhagic gastritis. Inhibitors are used - drugs that regulate the secretion of gastric juice and adjust its composition.
It is important to remember that with this disease, it is undesirable to take certain types of tablets designed to fight the flu or colds (even a seemingly harmless aspirin can cause pain in the stomach).
forms of gastritis chronic gastritis
- What does the coprogram show and how to donate it correctly?
- Infectious colitis: what causes it and how is it manifested?
- Transversitis - causes and manifestations of the disease
- NUC in children - causes, course features, treatment approach
- Diet for Crohn's disease and ulcerative colitis: basic requirements
How to treat focal atrophic gastritis
Focal atrophic gastritis is a common form of inflammation and damage to the gastric mucosa, most often it is chronic. It is believed that this type of gastritis is the most serious.
The peculiarity of gastritis is that there is a step-by-step replacement of the gastric mucosa by the connective. Because of this “rearrangement”, atrophy of the epithelium and degenerative disorders occur. Gastritis can spread so deeply that it involves the secretory glands (which are also depleted). These atrophied cells are again replaced by connective tissue cells. The process has a devastating effect on the production of gastric juice, which greatly slows down the performance of the stomach.
Sites of atrophy can be localized in completely different places of the organ, most often the process begins in the antrum (pyloric) section (at the border with the duodenum). With the above process, important functions are violated, such as:
- Motility of the stomach.
- Decrease in concentration of acidity of a food lump.
Causes of focal gastritis
Causes of focal gastritis of the stomach
Focal gastritis (like its other forms) depends on the influence of both internal and external stimuli. External factors, such as:
- Penetration and exposure to the gastric mucosa of the microbacterium Helicobacter pylori (Helicobacter pylori disease). Because of this pathogenic organism, antral and atrophic gastritis most often develops.
- Improperly prepared diet and diet, the use of harmful foods, overeating, abuse of very spicy foods. Due to the fact that a person does not observe proper nutrition, an erosive, erythematous and catarrhal type of destruction of the gastric mucosa can occur.
- Bad habits that develop into chronic addiction (alcoholic beverages, smoking, drugs) are the most common cause of atrophic and subatrophic gastritis.
- Prolonged and unbalanced use of medicines (without consulting a specialist - a gastroenterologist) - hormonal, pain medication, etc.
- Stressful and depressive states (most often occurring in women).
External causes that stimulate the occurrence of this ailment include:
- Failure of metabolic processes.
- Duodenogastric reflux (improper passage of the masses of the duodenum into the stomach).
Symptoms of atrophic focal gastritis
Symptoms of atrophic focal gastritis of the stomach
It often happens that people suffering from focal gastritis in the early stages do not notice this. With the progression of gastritis, classic symptoms are observed and the treatment of pathology should not be delayed. The most striking signs of gastritis of this form are:
- Slight or sharp pain.
- Lactose intolerance.
- Lack of appetite.
Such a phenomenon as a “polished tongue” can also be observed; it is as if all overlaid with a murky-white, thick coating.
How to treat atrophic focal gastritis?
Treatment of focal gastritis
In view of the fact that the degree of its danger depends on the form of gastritis, it is necessary to find out the diagnosis as soon as possible and conduct the necessary drug treatment of focal atrophic gastritis. First you need to find out the cause that caused gastritis and completely eliminate the influence of this harmful factor, for example, alcohol or a pathogenic microorganism. After this, a specific diet is prescribed, excluding fatty, fried, smoked, salty foods.
To specify the pathology, the patient must be tested. If the suspicion of infection with Helicobacter pylori is confirmed, the doctor must prescribe antibacterial agents that remove pathogenic microorganisms from the patient's body as soon as possible. The correct method will be to conduct a gastroscopy, which will allow you to know exactly at what stage the patient is on the path to recovery.
A number of medicines are also used, such as: “No-shpa” (from acute pain), “Cerucal” (from vomiting, nausea, loss of consciousness), “Mezim” (during the entire therapy), “Abomin” (to accelerate secretion juice), "Pariet" (antibiotic, to destroy the bacterial flora). An important advice of all specialists is that you should completely protect your body from stress and anxiety. Get rid of bad habits (alcohol, smoking).
Dietotherapy and traditional medicine
What you can not eat with gastritis
Proper nutrition and diet is the key to successful treatment and a speedy recovery, so it is so important to follow it and be responsible for your diet. Doctors have identified a list of products that are strictly prohibited for people with focal atrophic gastritis, these include:
- Spicy, fried, salty dishes.
- Fat meat.
- A fish.
- Butter products.
- Fruit in any form.
- Alcohol, coffee.
- Sour-milk food.
- Boiled vegetables.
- A little marshmallow, jam.
The main advice - you need to eat wisely, that is, do not overeat! All products must be prepared in a gentle way: steamed, boiled (with the lowest salt content). It is also advised that all products are in a frayed condition. It is not recommended to drink immediately after a meal, since the liquid destroys the necessary enzymes for the body, that is, the production of gastric juice may decrease - poor digestion of food.
Treatment of focal atrophic gastritis with folk remedies
Approximate menu for the day:
- First breakfast: hard-boiled egg, sweet tea, a small piece of black bread.
- Second breakfast: buckwheat porridge without salt, with unsweetened compote.
- Lunch: Rice soup, boiled meat (chicken), compote.
- Snack: mashed vegetables.
- Dinner: baked potatoes with a small amount of boiled carrots, tea, a small piece of marshmallows.
- Second dinner: a glass of kefir with a few pieces of biscuits.
Most people do not like going to doctors so much that only with acute pain or chronically triggered processes do they turn to a specialist. And more than half of these same patients resort to the use of folk remedies. The most common example of treatment for this disease is herbal decoction and tinctures, vegetable juices, oils, green apples, honey, propolis.
Sea buckthorn oil - taken on an empty stomach in the morning, is a regenerating agent. Juice from plants (plantain) - three teaspoons an hour before meals, is a healing drug. Juices from vegetables - restore the previous working capacity of the stomach. Decoctions of oats - affect the decrease in acidity of the stomach. Before resorting to using one of these recipes, consult a specialist! And it is important to remember that it is impossible to treat focal gastritis (severe forms) yourself!
Practitioners often encounter a diagnosis of atrophic gastritis in their work. Is this a disease of its own or the outcome of other inflammatory processes? How to diagnose and prescribe effective treatment?
What are the main drugs and herbs used in the treatment of this process? And how to evaluate the prognosis of atrophic gastritis, as well as the danger of the oncological process on the background of it?
The purpose of this article is an attempt to reasonably and in an accessible form to state the answers to all of the above questions.
According to the most common classification of chronic gastritis in the Russian gastroenterological school, they are divided as follows:
- Neatrophic (surface),
- Atrophic, which in turn are divided into: atrophic autoimmune and atrophic multifocal.
The prevalence of chronic atrophic gastritis in the human population is very high. At least one out of every three people suffers from this disease, however, the appeal for medical care among patients is unacceptably small - no more than 10-15%. Mild gastritis with mucosal atrophy at the initial stage of the process is often not accompanied by pain, which usually leads to earlier seeking medical help.
Chronic atrophic gastritis is a disease often caused by many causes and factors. Undoubtedly, the primary infection is HP (Helicobacter pylori), especially against the background of a latently occurring type 4 herpes virus infection (Epstein-Barra).
Autoimmune atrophic gastritis is much less common, the lion's share of patients is more than 50 years old, the percentage of children with autoimmune gastritis is 5-12%, very often Epstein-Bar virus DNA is detected in biopsy samples of the gastric mucosa in children, which indirectly indicates the role of the viral agent in the pathogenesis of this disease. The role of HP in the pathogenesis of autoimmune gastritis has not been reliably proven, but the role of chronic herpes virus type 4 infection is undeniable. This relationship is especially noted among children with autoimmune gastritis.
Atrophic autoimmune gastritis is a chronic and continuously progressive disease, accompanied by the destruction of the parietal cells of the stomach, leading to the development of pernicious anemia. Autoimmune atrophic gastritis is often combined with other autoimmune processes, that is, they are part of the so-called autoimmune polyglandular syndrome.
The atrophic process can spread only in any one part of the stomach, but it can affect all its parts. All three main cell populations, as well as selectively parietal (with autoimmune gastritis), can also be affected.
With atrophic gastritis, dyspepsia syndrome comes to the fore, due to severe functional insufficiency of the stomach, and with hyperacid gastritis, pain is usually predominant. However, pain in autoimmune gastritis in children occurs in about one in three children.
Dyspeptic symptom complex includes:
- heaviness and feeling of fullness in the epigastric zone,
- decreased appetite
- belching with air or rotten food,
- cocosmia (bad smell),
- vagus nature non-intense abdominal pain.
Due to the decrease in the bactericidal properties of gastric juice, there is an excess bacterial growth syndrome, it manifests itself in the following:
- Bloating with rumbling
- Unstable stool with a tendency to runny,
- Poor tolerance of dairy food.
The patient may lose weight.
Anemic syndrome often develops.
His reasons are as follows:
- There is a decrease in the production of Castle's internal factor - a decrease in the absorption of vitamin B 12,
- Violation of the conversion of ferric to ferrous leads to a violation of its absorption,
- Phenomena of dysbiosis lead to folic acid deficiency.
Correct diagnosis is the key to successful therapy.
Gastroscopy is the main leading method in the diagnosis of atrophic gastritis. This method of research reveals both sections of the mucosa with signs of atrophy, which has a pale gray color, and a decrease in the folding of the mucous membrane. There may also be the presence of varying in length and nature of intestinal metaplasia, which is a marker of precancerous condition. Metaplasia sites can be detected by chromatography.
Of the endoscopic research methods, a method of swallowing an endoscopic capsule has been available in recent years, thanks to which you can see images of the surface of the mucous membrane of the esophagus and stomach on a computer screen, evaluate the presence of erosion, metaplasia sites, etc. The disadvantage of this method is the inability to do a biopsy.
Qualitative morphological diagnosis also plays an important role in clarifying the diagnosis. So the “gold standard” of the presence of HP is the detection of microorganisms in biopsy specimens of the mucous membrane, including its erosive surfaces (the so-called “zones of interest”).
To diagnose atrophic gastritis, the cause of which is an autoimmune process, it is necessary to examine the blood for the presence of two types of antibodies (binding and blocking). Antibodies to parietal cells are a marker of autoimmune gastritis.
The effect of both types of antibodies on the gastrointestinal tract is pathological, since they disrupt the absorption of cobalamin.
Of the modern diagnostic methods, it is necessary to mention spiral computed tomography. Using it, thanks to the finest sections of tomographic images, it is possible to evaluate the wall of the gastric mucosa and pathological changes in it.
Principles of modern therapy
Treatment of atrophic gastritis is a complex process, but if it is chosen correctly, the patient’s quality of life does not suffer. Therefore, the success of the treatment process directly depends on the competence of the gastroenterologist.
An endoscopic examination of patients with autoimmune gastritis often reveals pathological (erosive or ulcerative) changes in the lower third of the esophagus. Medicines for atrophic gastritis include proton pump inhibitors (Pariet, Losek, Ultop, Omeprazole), they are combined with denol, and then after 2 weeks, halving the dose of omeprazole, connect nonabsorbable antacids to the treatment regimen (Phospholugel, Maalox). They must be taken one hour after eating for a month and a half, after the cancellation of omeprazole preparations, the course of taking antacids must be continued for at least 12-14 days.
Quite often, against the background of taking Omeprazole, HP reproduces, therefore, given the anti-Helicobacter action of denol, treatment with this drug should be carried out from 3 to 4 weeks.
Reception of Omeprazole and Denol within 2 weeks creates an acidity level (PH 4.0-6.0 units), favorable for the effective effect of antibacterial drugs on HP. The treatment regimen may be three or four component. However, if the patient has an exacerbation of chronic herpes virus infection caused by the Epstein-Barr virus, the use of amoxicillin is contraindicated in the eradication scheme, and antiviral drugs are added to the scheme.
If the patient also has reflux esophagitis, omeprazole preparations must be taken.
As with all chronic diseases of the gastrointestinal tract, dietary nutrition plays a decisive role in the success of treatment, as well as herbs for atrophic gastritis, which stimulate the production of hydrochloric acid by the gastrocytes (rosehip broth, for example).
The basis for the prevention of atrophic gastritis is unoriginal. It is, as always, trying to live healthy. Food should be varied, but you can not provoke the mucous membrane of the stomach by eating food stuffed with stabilizers and carcinogens. The correct and timely treatment of Helicobacter pylori infection is a proven prevention of atrophic gastritis and their complications.
A timely visit to a gastroenterologist will prevent the occurrence of many dangerous diseases of the gastrointestinal tract in the future.
Chronic gastritis and other forms of the disease
Gastritis is classified according to:
- developmental stages (acute, chronic),
- the severity of the disease (catarrhal, erosive),
- affected area of the gastric mucosa.
Acute gastritis is the most common form of the disease, in which a superficial or deep inflammatory process develops on the gastric mucosa. The period of development of the disease is usually short. Appropriate treatment or removal of side factors leads to rapid healing. Neglect can lead to a chronic form of the disease or serious complications.
Three types of acute gastritis are distinguished depending on the scale of the inflammatory process:
The simplest and most common type of gastritis. It is characterized by a slight lesion of the gastric mucosa with rapid development. For example, with poisoning for the development of gastritis, only a few hours are enough. And usually it disappears after a couple of days without special treatment.
More serious pathology. It is characterized by the appearance of ulcers (erosion) on the surface of the gastric mucosa. With different severity of the disease, the ulcers can be small or deep. Sometimes, with deeper erosion, bleeding may occur.
Quite a rare and extremely dangerous disease. It is characterized by a purulent inflammatory process and damage to the walls of the stomach. This type is specific for immunocompromised patients. Symptoms: fever, severe stomach pain, nausea and vomiting. Without proper treatment, it usually leads to death.
Chronic gastritis develops over a long time (several years) and causes irreversible processes - a violation of the structure and function of the stomach.
Atrophic gastritis is an advanced stage in the development of chronic gastritis. It leads to the degradation (destruction) of normal tissue of the walls of the stomach and its replacement with scar tissue. That is, the glands of the gastric mucosa that secrete gastric juice, with atrophic gastritis, are destroyed and replaced by connective tissue. As a result, the mucosa loses its ability to secretion of gastric juice, it becomes thinner and more sensitive to the aggressive effects of environmental factors.
Without treatment, against the background of atrophic gastritis, the cells of the gastric mucosa change their shape and can turn into cancer cells.
All types of gastritis can be considered as separate steps of the “evolutionary” process that develops in the absence of treatment. Acute gastritis turns into chronic, after which, after some time, chronic gastritis becomes atrophic, and atrophic gastritis can eventually cause cancerous degeneration of the stomach tissue.
For the correct diagnosis, a number of studies are necessary:
- biopsy analysis.
A differential diagnosis is made with other chronic diseases with similar symptoms, such as chronic pancreatitis, peptic ulcer, diaphragm hernia, esophagitis.
Erosive gastritis and atrophic: causes
Gastritis is considered one of the concomitant chronic diseases, such as cholecystitis, pancreatitis, etc. It is often perceived as a disease that occurs on its own, without any good reason.
There are many causes of gastritis. The most common: alcohol, caustic substances, prolonged use of drugs (for example, aspirin), irritating the mucous membranes, too cold or too hot food, coffee abuse, Helicobacter pylori infection and other infectious diseases, autoimmune stress diseases, etc.
Very often, erosive gastritis develops as a result of the transfer of bile from the duodenum into the stomach (biliary reflux), especially after some surgical interventions on the stomach that contribute to this process.
In addition, parasites and viruses that cause infectious gastritis can also be causes of gastritis.
Atrophic erosive gastritis
Atrophic gastritis with the formation of erosion has the following features:
- the development of the disease is possible in the presence of an autoimmune factor: the body itself produces cells that destroy healthy tissues of the stomach,
- the mucous membrane is very deeply affected
- the course of the disease is exacerbated by a deficiency of vitamin B.
The consequences of erosive atrophic gastritis:
- the mucous membrane of the stomach is thinning,
- decreases the number of cells capable of fully performing the function of the mucosa,
- not enough gastric juice is produced
- food consumed is not processed properly
- B-deficiency anemia develops.
Diagnostic measures to detect erosive disorder
No specialist will make a diagnosis based solely on symptoms.
A number of diagnostic measures are necessary to draw serious conclusions.
The attending physician (gastroenterologist) should:
- to collect detailed information about the development, symptoms of the disease and possible causes of its appearance, so that the patient’s medical history is complete,
- refer the patient for general and biochemical blood tests, feces for blood,
- appoint a bacteriological study of feces and vomit,
- to give the patient endoscopy to determine whether the patient has erosive gastropathy (the formation of defective erosion),
- do radiography (gastrography) to the patient.
After a full examination and diagnosis by a specialist, erosive gastritis of the stomach can be treated.
Treatment of the disease with medicines and folk remedies
The key to success in the treatment of gastritis with the formation of erosion is a comprehensive approach consisting of:
- the use of drugs
- the use of traditional medicine recipes,
- adherence to a special diet.
Although the symptoms and treatment are related, and different forms are treated with different drugs, in medicine there is a fundamental approach to the treatment of gastritis, regardless of its type.
So, drug treatment of erosive gastritis includes:
- means for eliminating excess production of gastric juice (for example, with Pariet - the active substance rabeprazole),
- neutralization of aggressive hydrochloric acid using antacids,
- drugs for the treatment, restoration and normalization of gastric and duodenal motility,
- digestive enzymes,
- medicines to stop the blood,
- Helicobacter pylori products
Important! The treatment regimen for erosive gastritis can be prescribed exclusively by a specialist (gastroenterologist or therapist).
Self-medication is dangerous to health!
The chances of curing erosive gastritis will be greater if, along with medicines, alternative recipes are used. Suitable for this:
- propolis tincture,
- sea buckthorn oil,
- egg whites
- decoction of mint, chamomile,
- rosehip and fennel tea.
How to treat erosive gastritis of the stomach in the acute stage at home? Reviews of the following recipes of traditional medicine claim that it is calendula-based products, as well as fresh potato juice, that are indispensable in the fight against gastritis in the acute phase:
- Drink raw potato juice 30 minutes before meals 3 times a day, 150-200 ml each. The course of admission is 30 days, but every 10 you need to take a break for 10 days too.
- Calendula broth. Pour 3-4 tsp. dried marigold flowers 300 ml of boiling water. After 12 hours, strain the broth and drink 80-100 ml on an empty stomach. Drink the remaining broth during the day in small portions.
Important! Even knowing how to cure the acute phase of erosive gastritis using folk remedies at home cannot guarantee a complete cure for the disease.
How to eat with erosive gastritis
How to treat erosive gastritis with a diet? There are several fundamentally important points regarding nutrition that must be observed:
- Refuse food that increases the production of gastric juice: sausages and meat products, smoked meats, fried, fatty, spicy, butter, chocolate.
- Use only boiled dishes and / or steamed.
- Pay attention to how much you eat. Servings should be small, and you need to consume food at least 7 times a day.
- Do not overeat, but do not starve, so as not to cause upset stomach and / or intestines.
- All consumed should be in the form of mashed potatoes or finely chopped.
- The temperature of the food should be medium - it is better to avoid cold and hot.
- The use of alcohol is strictly prohibited.
Recommended products for use:
- Yesterday’s wheat bread
- soups on vegetable broths,
- chicken and rabbit meat,
- boiled fish
- dairy products,
- porridge (except for pearl barley and millet),
- vegetables and soft fruits.
Important! Proper nutrition without treatment with medications and folk recipes will not give any result.
Forecast and preventive measures
Can gastritis be cured forever? It is possible under several conditions:
- The mucous has not yet undergone irreversible changes,
- If the patient has a “favorable” age: in adults, the disease is more complicated. The younger the person, the greater the chance of a full recovery.
- The patient is a responsible person who is ready to fully follow all the recommendations of the attending physician.
- There are no concomitant chronic diseases.
- The patient observes HLS.
Preventive measures include several important recommendations:
- keep track of how much, what and how you eat,
- consume the necessary amount of vitamins and other beneficial substances,
- observe the regime of work and rest,
- to refuse from bad habits,
- do not injure the digestive tract,
- timely treat any chronic pathology,
- avoid stress
- undergo periodic preventive examinations.
It is possible to cure gastritis forever, but it is a difficult and long way. And remember that it is always better to prevent a disease than to fight it.