- Types and causes of gastritis
In the modern world, the diagnosis of “gastritis” has already become commonplace. The pharmaceutical industry is actively promoting non-prescription agents for the suppression of symptoms, the use of which makes it possible to postpone the visit to the doctor. But gastritis is a chronic disease that can gradually destabilize the work of the whole organism.
Types and causes of gastritis
The aggressive environment of the stomach constantly has a destructive effect on the epithelium of its walls. Normal rates of regeneration correspond to the degree of destruction, therefore, the functioning of the body does not suffer. Full update occurs every 2-6 days. Under the influence of a number of factors, restoration of the protective sheath slows down, which leads to disruption of its structure and inflammation – gastritis .
The nature of damage to the mucous depends on the type of irritant and the time of its impact. A single inflammatory reaction is defined as acute gastritis , a long maturing and recurring pathology – as chronic . Depending on the area of distribution, focal (point) or diffuse (widespread) tissue damage is diagnosed.
Chronic gastritis is a pathological gradual change in the structure and function of the tissues of the walls of the stomach, often leading to atrophy of the glands. As a result, the secretion of gastric juice, enzymes, hormones, the process of digesting food, its transportation to the duodenum is disturbed.
Several major causes of chronic irritation of the gastric mucosa:
- infections: Helicobacterpylori (most often), herpes, cytomegalovirus, fungi;
- a genetically determined formation of autoantibodies hostile to the body, the destructive action of which is directed to the covering cells of the gastric mucosa. As a result, their function is impaired – the production of hydrochloric acid and the enzyme responsible for the absorption of vitamin B12;
- aggressive influence of fluids produced by the duodenum. Their injection into the stomach is due to a failure of motor function – reflux;
- organ-saving operations.
External and internal factors can contribute to the development of gastritis. The first are:
- unhealthy diet: an excess of irritating food, irregular food intake (1-2 times a day);
- smoking and alcohol;
- long-term therapy with a number of medicines, for example: digitalis preparations, prednisone, salicylates.
Alcohol provokes enhanced desquamation of the cells lining the gastric mucosa, inhibits their recovery, and disrupts blood circulation. A single large dose can cause an acute attack of gastritis even in a healthy person. Long-term admission leads to atrophy of the mucous membrane.
- endocrine pathologies (Addison’s disease, diabetes);
- chronic infections, including nasopharynx;
- violation of metabolic processes (gout, obesity);
- diseases in which the supply of tissues with oxygen is disturbed (heart failure);
- self-poisoning of the body (auto-intoxication) due to the malfunction of certain organs (for example, renal failure).
Dysfunction of the mucous membrane over time entails a profound irreversible change in its structure.
Types of chronic form
Chronic gastritis by origin is classified into several types:
- A: autoimmune. Arises due to genetically determined failures in the immune system. The process can be triggered by primary damage to the mucous membranes (for example, spicy foods, alcohol).
- B: bacterial (antral) , associated with Helicobacterpylori spatogen, which usually lives in the lower part of the stomach. Although 80% of detected gastritis is associated with this particular infection, it is not known whether it is the root cause of the disease. The presence of a microorganism is also fixed in healthy people, but there are no pathological processes in the mucous membrane.
- C: chemically conditioned (reactive, toxic, reflux gastritis) . Able to develop after surgery, long-term use of alcohol, drugs with potassium and iron, nonsteroidal anti-inflammatory drugs. Toxic gastritis may be due to the peculiarities of working conditions: inhalation of acid vapors, coal, metal dust.
- Mixed type A and B.
- Idiopathic , the exact cause of which can not figure out.
There are also special, rarely developing forms of gastritis, which usually accompany various systemic diseases:
- granulomatous . It develops against the background of Crohn’s disease, gastric mycosis, and tuberculosis. On the walls of the mucous membrane are observed granulomas, ulcers, scars;
- lymphocytic . The walls of the stomach are infiltrated (saturated) with T-lymphocytes. It is provoked by Helicobacterpylori and gluten intolerance;
- eosinophilic . Tissue mucous impregnated with leukocyte cells. Characterized by systemic vasculitis, bronchial asthma, eczema. The cause of development is often food allergies;
- hyperplastic . The main causes of development: Helicobacterpylori activity, helminth infections, congenital defects of the anatomy of the stomach, impaired metabolic processes. As a result, increased cell division of the wall of the stomach thickens, folds, polyps, nodes that interfere with normal motility are formed. Instead of hydrochloric acid, a large amount of mucus is produced;
- radiation . Radiation therapy often causes necrotic lesions on the walls of the stomach. With a mild lesion, complete recovery is possible, with severe ulcers and fibrosis.
The pathological process can develop in the body of the stomach, its antral (lower) part, in the fundal section (above). If all areas are affected, pangastritis is diagnosed.
According to the nature of the lesion of the mucous membrane, there are several types of gastritis:
- superficial (only the upper layers of the tissue are inflamed). The initial stage of lesion of the mucous membrane, determined only by gastroscopy;
- erosive (ulceration of the walls). The erosive form is often accompanied by gastric bleeding, which is manifested by fecal colouration in black, anemia, and vomiting of black masses in the form of coffee grounds;
- atrophic . Cells whose task is the production of gastric juice and enzymes are gradually replaced by connective tissue.
The most dangerous complication of chronic gastritis is malignant tissue degeneration. Iron and folic acid deficiency anemia, polyhypovitamin deficiency (loosening of the gums, thickening of the tongue, stomatitis, hyperkeratosis of the skin over the joints) may develop. The accession of infection is fraught with hepatitis, cholecystitis, pancreatitis.
The chronic form may be asymptomatic (up to a certain stage) or with periodic exacerbations. The severity of clinical manifestations depends on the type and extent of tissue damage.
Symptoms characteristic of various types of chronic forms are summarized in the table below.
|Type of gastritis||Manifestations|
|Аутоиммунный||The severity, the feeling of overeating, even after small portions of food, belching with bitter sediment, heartburn. Appetite worsens, weight decreases.A gurgling, rumbling is periodically heard in the stomach. Diarrhea alternating with constipation . After eating, often dizziness, sweating, and general weakness. Gradually, the skin becomes dry and pale, vision is impaired, hair falls out, nails exfoliate|
|Antral||With a deep lesion of the mucous occurs heartburn, belching, periodic nausea, vomiting, background unpleasant taste. Frequent pains in the stomach : acute after eating, in a hungry condition.|
|Chemical||The aching pains in the stomach, aggravated after eating, not relieved by drugs to reduce acidity. Nausea, taste of bile, vomiting is possible. From nonspecific symptoms: bloating, anemia, impaired stool.|
|Special types||There are no specific symptoms. A typical pattern of gastritis is usually observed: indigestion, epigastric pain, belching, heartburn.|
Symptoms manifest Menetria disease – a complicated form of hyperplastic gastritis, in which the body and the bottom of the stomach cover the thick folds. The following features are characteristic:
- bloody vomiting;
- swelling of soft tissues;
- epigastric pain;
- persistent diarrhea.
Dangerous complications of this form are sepsis and thromboembolism. In 10% of cases, a malignant tumor develops in the affected tissues.
Chronic atrophic gastritis is also considered a precancerous condition of the mucous membrane. You can determine it by the following features:
- dense white coating on the tongue , in the corners of the lips are constant bullying;
- frequent belching, after which the bitter taste is preserved;
- epigastric background pain, significantly aggravated after eating;
- profuse salivation;
- unstable chair;
- heaviness in the stomach;
Hair loss, lamination and brittleness of nails, weight loss, pustules on the skin, pallor, bleeding gums – a set of symptoms that many take for beriberi. However, the same signs are accompanied by atrophy of the stomach.
Effect of gastric acidity on symptoms
Chronic gastritis on the background of normal or increased production of hydrochloric acid is most common in young men. Violation of the structure of the mucous membrane is superficial, sometimes found atrophic elements. In this form of pain is not a mandatory symptom, but may occur at night or a half to two hours after eating. Characterized by heartburn, sour belching, constipation, nausea.
Secretory insufficiency is more often diagnosed in the elderly and middle age. The walls of the mucous membrane are smoothed, lose their tone, the peristalsis is reduced. Gastritis in this case is manifested by heaviness after eating, belching along with pieces of food, a constant unpleasant aftertaste. On the part of the intestines are frequent excitement: a sense of transfusion of liquids, rumbling, flatulence.
Chronic atrophic form of gastritis with low acidity in 15% of cases can lead to oncology.
Acute gastritis is an inflammation of the gastric mucosa with severe symptoms. Often this condition is often triggered by a large amount of alcohol, intoxication, and severe stress.
Depending on the degree of damage to the gastric mucosa, several types of acute gastritis are distinguished.
|Form Name||State of the tissues of the stomach||The reasons||Symptoms|
|Catarrhal||Only the surface layer of the mucous membrane is affected, minor erosion is possible.||Food poisoning or allergies, overeating, medication, nervous strain, strong coffee, alcohol, spicy dishes, vinegar||Loss of appetite, unpleasant taste in the mouth, nausea, vomiting (first semi-digested food, then bile), pressure and distention in the stomach area turn into gradually increasing pain|
|Phlegmonous||Inflammatory purulent foci appear on the thickened walls of the stomach.||Bacteria: Staphylococcus, Proteus, Pneumococcus, E. coli||Severe chills, significant fever, pain of acute nature in the area of the stomach, and also left in the hypochondrium, nausea, vomiting with pus, repeated diarrhea, dryness of the tongue, the formation of a gray-yellow skin, frequent heartbeat|
|Necrotic (corrosive)||The death of the tissues of the esophagus, gastric walls. Ulcers are formed, often breaking through||Toxic effects of salts, acids, alkalis (poisoning by chemicals, low-quality alcohol)||Acute pain in the esophagus and stomach, profuse salivation, bloody vomiting, difficulty swallowing|
|Фибринозный||Erosive inflammatory foci appear on the walls, the surface of which is covered with fibrin protein. Necrotic mucosal change occurs.||Severe infections (scarlet fever, measles, diphtheria)||Dull pain in the stomach after eating, nausea, vomiting (it happens with blood), belching with a sharp taste, in some cases there is an increase in temperature.|
The most dangerous form is necrotic gastritis, requiring urgent hospitalization.
Video about the symptoms of gastritis:
Timely access to a gastroenterologist at the first signs of stomach discomfort will help prevent irreversible pathological changes in its walls. Visually and on the basis of the patient’s complaints, gastritis is not diagnosed. Urinalysis, blood and feces, as well as instrumental studies.
An important role is played by the assessment of the acid-forming function of the gastric walls and their condition. All necessary information can be obtained with the help of endoscopy: by means of a flexible thin conductor, the probe (4-5 mm) or the camera is lowered into the stomach through the oral cavity, juice is taken or the mucous membrane is examined under X-ray monitoring.
A reliable method of studying gastric secretion is intragastric pH-metry, in which special probes record the indicators directly in the organ itself.
If necessary, gastrobioptat (a piece of tissue of the stomach wall) is collected by means of endoscopic equipment for histological or cytological examination. For accurate results, you need several samples from different areas. Based on this material, not only the nature and depth of cell damage is detected, but also the presence and degree of contamination of the Helicobacterpylori mucosa. The presence of this infection is evidenced by the presence of urease in the biopsy specimen (rapid test). Staining (Gram, Giemsa) allows you to determine the prevalence of the colony. The strains of varying degrees of pathogenicity are isolated from the biopsy by the PCR method, and their sensitivity to antibiotics is determined for subsequent treatment.
A respiratory test (urease) is effective from non-invasive methods for diagnosing Helicobacterpylori, during which the spectrometer determines the amount and composition of the exhaled gas. Detect the presence of antigens for infection also by analyzing feces, and antibodies are detected during the serum immunoassay. The most accurate picture of infection shows the test system “GastroPanel”, with which you can also determine the degree of atrophy of the tissues of the stomach.
In order to diagnose the specific forms of gastritis (granular, hyperplastic), an x-ray is taken. With it, an ulcer, a tumor, an impaired motility and a tone of the stomach walls are detected. Ultrasound of the biliary tract, pancreas, and liver can help in the diagnosis.
To assess the digestive function, the stomach swallows a bag of dye tied with connective tissue (catgut). After some time, when the catgut is dissolved, urine or saliva (depending on the type of substance) should stain.
With regard to the diagnosis of acute gastritis, it is important history: information about the food consumed, drink, diet. In some cases, food, drinks, as well as feces and vomit undergo bacteriological and chemical research. Used as an x-ray of the stomach and study the quality of its secretion.
Food poisoning is often confused with the gastralgic form of acute myocardial infarction. The doctor must be notified of a history of strokes or hypertension.
The treatment regimen for gastritis is based on the results of diagnosis and depends on the general condition of the patient. First of all, therapy is aimed at relieving pain and stabilizing the patient’s condition.
In acute catarrhal form, it is necessary to clear the stomach by vomiting or washing. To do this, the patient is given to drink as much warm water or soda solution as possible (0.5%). If necessary, put a dropper. The first 1-2 days are recommended to refrain from eating, switch to drinking mode: strong warm tea in small portions, dogrose infusion, alkaline mineral water. Then mucous porridges and soups are gradually introduced. From medications can be used beladonna, bismuth (Den-Nol).
Antibiotics (cefalexin, levomycetin, ampicillin) are used to treat acute infectious gastritis. In case of toxic poisoning, the stomach is washed by adding toxin neutralizing substances.
Acute phlegmonous gastritis requires surgical intervention (gastrotomy, gastrectomy). In parallel, antibiotics and agents for maintaining the cardiovascular system are administered.
Therapy of the chronic form includes the selection of diets, drugs, as well as the fight against the factors that caused the pathology. During periods of exacerbations, it is important to spare the stomach, so food is taken many times (5-6 times), but in small portions. During remission, you must adhere to the basic rules of nutrition.
If the acidity is normal or increased, then products that stimulate its production are excluded:
- strong broths (on meat, fish, mushrooms);
- fried, smoked dishes, pickles, canned food;
- alcohol, coffee.
- boiled lean meat and fish;
- vegetable stew;
- jelly, mousses, weak tea.
To reduce secretory function in the presence of erosion, H2-receptor blockers are prescribed: omez, famotidine, ranitidine.
Smoking significantly increases the production of hydrochloric acid.
With low acidity, it is important to stimulate the secretory activity of the stomach and improve appetite. For this fit:
- lean meat and fish soups;
- rye dried bread;
- lean meat, fish;
- vegetable, fruit juices;
- dairy products;
- crumbly porridge.
Methyluracil, group B vitamins, solcoseryl are prescribed to improve the blood supply to the gastric walls. If Helicobacterpylori is detected, then the complex is prescribed: De-Nol, metronidazole, amoxicillin. Secretion is strengthened by tinctures of bitter wormwood and dandelion root, plantain juice. With reflux and weak motor skills Motilium, Raglan, Zerukal helps. The lack of enzymes is compensated by Mezim, Pancreatin, Panzinorm.
Video about the treatment of gastritis:
The main preventive measure against gastritis is the absence of bad habits and a balanced diet with a predominance of natural unrefined food. You should not take uncontrolled vitamins and other drugs. Motor activity and oxygen contribute to the rapid regeneration of damaged cells of the whole organism, including the epithelium of the stomach.
Any form of gastritis requires attention and adequate treatment. Not only the well-being of a person, but also the general state of his health depends on the work of the stomach. Modern diagnostic methods are less traumatic and accurate, so you should not postpone the visit to the doctor, ignoring the typical symptoms.