Acute gastritis
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms of acute gastritis
- Features of the course of acute gastritis in children
- Diagnostics
- Treatment of acute gastritis
- Diet for acute gastritis
- Possible complications and consequences
- Forecast
- Prevention
Acute gastritis is an acute inflammation of the mucous membrane of the stomach wall. The disease affects people of all age categories, equally men and women. This is one of the most common gastroenterological pathologies.
Eating low-quality and / or irritating food to the stomach lining can cause acute gastritis.
Causes and risk factors
Acute gastritis is a polyetiological disease, that is, it occurs under the influence of several causal factors simultaneously. The reasons leading to the development of acute inflammation of the gastric mucosa are subdivided into exogenous (acting from the outside) and endogenous (certain disorders in the body itself).
The most common are:
- eating poor-quality and / or irritating products for the gastric mucosa;
- the use of strong alcohol (vodka, cognac, rum, etc.);
- Helicobacter pylori infection;
- taking certain medications (salicylates and other non-steroidal anti-inflammatory drugs, glucocorticoids, etc.).
In addition, acute gastritis can be caused by intoxication with salts and alkalis, radiation exposure (radiation gastritis), foreign bodies entering the stomach, food allergies, as well as some infectious diseases (measles, scarlet fever, viral hepatitis, etc.). In pregnant women, acute gastritis develops under the influence of toxicosis, poor nutrition.
Forms of the disease
Depending on the course of the pathological process and the nature of damage to the gastric mucosa, the following forms of acute gastritis are distinguished:
- catarrhal (banal, simple, superficial);
- fibrinous;
- corrosive (toxic-chemical, necrotic);
- phlegmonous (purulent).
The most common form of acute gastritis is catarrhal, which is characterized by an inflammatory process of the surface layer of the gastric mucosa. This form includes alimentary (food) and allergic gastritis.
With the fibrinous form of the disease, necrotic changes occur in the mucous membrane, as well as the formation of a mucous membrane on it, loosely connected to the underlying tissues and easily separating (croupous form). With deeper lesions, when the film is separated, numerous ulcers open on the surface of the mucous membrane (deep, diphtheria form). This type includes gastritis caused by poisoning with certain chemical compounds and severe infectious diseases.
Acute corrosive gastritis, in which the deeper layers of the gastric wall are involved in the pathological process, are divided into dry (coagulation) and wet (colliquation) necrosis. An acute corrosive form of the disease develops under the influence of aggressive chemicals on the stomach wall - acids, alkalis, heavy metal salts.
Phlegmonous acute gastritis occurs against a background of damage to the gastric mucosa due to trauma, treatment for a stomach tumor, and some severe infections. With this form of gastritis, purulent inflammation that occurs in the wall spreads along the gastric mucosa. For the phlegmonous form, there is a high risk of developing severe complications (for example, peritonitis).
Gastritis is classified according to the site of inflammation
Depending on the location of the inflammation:
- local (focal) acute gastritis - subdivided, depending on the location of the focus, into fundic, antral, pyloroantral and pyloroduodenal;
- diffuse - inflammation affects the entire gastric mucosa.
Symptoms of acute gastritis
The clinical picture of acute gastritis varies depending on the form of the disease. The first signs appear, as a rule, 6–12 hours after exposure to a damaging factor.
The main symptoms of acute gastritis are:
- pain and heaviness in the epigastrium;
- nausea;
- vomiting mixed with bile and mucus;
- decreased appetite;
- an unpleasant taste in the mouth;
- enhanced salivation.
With the development of acute gastritis after eating food contaminated with pathogens, the body temperature rises, repeated diarrhea, progressive weakness, signs of dehydration, and bad breath are characteristic.
Pain and heaviness in the epigastrium are the main symptoms of acute gastritis
Acute phlegmonous gastritis is manifested by fever, chills, vomiting (pus can be found in the vomit), severe cramping pains in the epigastric region. Tachycardia, weak filling of the pulse, sharp soreness of the abdomen on palpation are noted.
The clinical picture of acute corrosive gastritis is associated with the action of a chemical that damages the gastric mucosa. In addition to sharp pains in the epigastrium, there are burns on the lips and oral mucosa, hyperemia of the oral mucosa, difficulty swallowing, intense pain in the oral cavity, pharynx, esophagus. Vomiting does not bring relief, blood is found in the vomit, fragments of the mucous membrane of the wall of the digestive tube may be contained. Intense pain often causes shock.
In acute gastritis of allergic etiology, manifestations of allergies are added to dyspeptic disorders: rashes accompanied by itching, erythema, angioedema, etc.
Features of the course of acute gastritis in children
The development of acute gastritis in children is facilitated by a violation of the diet, an unbalanced diet, poor hygiene, excessive physical and / or psycho-emotional stress.
The main form of gastritis in children, often diagnosed in primary school and adolescence, is acute catarrhal gastritis. The main signs of acute gastritis in children:
- dyspeptic disorders;
- signs of body intoxication (weakness, fever, sleep disorders);
- pain in the epigastric region;
- decreased appetite;
- nausea, vomiting;
- violation of the functioning of the cardiovascular system;
- signs of dehydration (with frequent vomiting, severe diarrhea).
In children, acute gastritis can be caused by improper, unbalanced diet.
Dehydration is dangerous because the child may develop acute renal failure. In severe acute gastritis in children, general intoxication may develop, up to heart failure.
Diagnostics
Diagnosis of acute gastritis is based on data obtained during instrumental and laboratory examination, including:
- collection of anamnesis, complaints;
- objective examination;
- chemical and bacteriological analysis of biological fluids (vomit, feces, etc.);
- study of gastric secretion;
- general and biochemical blood test;
- general urine analysis;
- coprogram, analysis of feces for occult blood;
- X-ray examination using contrast;
- Ultrasound.
To detect Helicobacter pylori infection, an enzyme-linked immunosorbent assay, a polymerase chain reaction of blood and stool, and a breath urease test are performed.
In some cases, to clarify the diagnosis requires:
- gastroscopy;
- endoscopic biopsy;
- multislice spiral computed tomography;
- electrocardiography, etc.
An enzyme-linked immunosorbent assay helps to determine the infection with the bacteria Helicobacter pylori
Differential diagnostics with gastralgic form of myocardial infarction, food poisoning, acute appendicitis, cholecystitis, pancreatitis, gastric ulcer, mesenteric vascular thrombosis is carried out.
Treatment of acute gastritis
The treatment regimen for acute gastritis depends on factors such as the form and extent of the pathological process, as well as the general condition of the patient.
For acute catarrhal gastritis, gastric lavage with a tube and bowel cleansing may be required. Patients are shown diet, bed or semi-bed rest for several days. Drug therapy consists in the use of enveloping agents, enterosorbents, analgesics and antispasmodics. In acute gastritis of bacterial etiology, antibacterial drugs are prescribed.
Acute phlegmonous and corrosive gastritis requires surgical treatment
In the case of acute corrosive gastritis, the corrosive chemicals must be removed from the stomach. Patients are shown gastric lavage with a probe to clean wash water, relief of pain with non-narcotic or narcotic analgesic drugs and elimination of signs of acute vascular insufficiency. With severe dehydration of the body, patients undergo infusion therapy with isotonic electrolyte solutions. With perforation, cicatricial changes in the stomach, as well as esophageal stenosis, surgical intervention is indicated.
With the phlegmonous form of the disease, they also resort to surgical treatment. According to the indications, the following are performed: gastrotomy, drainage of a purulent focus, surgical removal (resection) of a part of the stomach, or gastrectomy.
Diet for acute gastritis
Diet for acute gastritis is an important component of treatment, as it contributes to the early recovery of the damaged gastric mucosa. In the first days after the onset of the disease, it is recommended to refrain from eating. The temperature of the liquid consumed during this period should be comfortable for the gastric mucosa, since taking too hot or cold liquid can aggravate irritation of the mucous membrane. For 2-3 days, liquid food can be introduced into the diet.
In the future, depending on the course of the disease and the acidity of the patient's stomach, dietary table No. 1 or No. 2 is shown.
Diet table number 1 is a physiologically complete diet in terms of the content of proteins, fats and carbohydrates. The intake of foods that irritate the gastric mucosa, strongly excite gastric secretion, are difficult to digest and remain in the stomach for a long time is limited. Food is cooked mainly in water or steam. Salt intake is limited.
In acute gastritis, dietary table No. 1 or No. 2 is shown
Diet table number 2 - the use of products that stimulate moderate secretion of the digestive tract is allowed. Dishes are used boiled, stewed, and baked. Foods that irritate the gastric mucosa and take a long time to digest are excluded from the diet.
At the stage of recovery, the diet for acute gastritis contributes to the normalization of the secretory and motor functions of the stomach with a full diet and excludes additional irritation of the gastric mucosa.
Possible complications and consequences
In the absence of adequate treatment, acute gastritis can become chronic. In addition, the disease can be complicated by the development of cardiovascular, renal and hepatic failure, gastrointestinal bleeding, and purulent-septic complications. Acute corrosive gastritis can cause perforation of the stomach wall and the penetration of stomach contents into nearby organs, the development of peritonitis, shock, cicatricial changes in the mucous membrane of the digestive tract, narrowing of the esophagus. Recovery of the mucous membrane after a chemical burn is not possible in all cases. Acute purulent gastritis can be complicated by pleurisy, pyothorax, sepsis, abdominal abscesses, mediastinitis, etc.
Forecast
With timely diagnosis and treatment of acute catarrhal gastritis, the prognosis of the disease is favorable.
Acute gastritis of infectious etiology can be dangerous for debilitated patients and elderly patients against the background of other internal diseases. The severity and duration of acute gastritis of endogenous etiology depend on the course of the main pathological process that caused it.
The most unfavorable prognosis for corrosive and phlegmonous forms of acute gastritis - mortality in these cases reaches 50%. A fatal outcome is possible in the first few days after the onset of the disease, in particular, due to the development of purulent peritonitis, sepsis, abdominal abscesses and shock.
Prevention
Prevention of acute gastritis is based on a number of measures:
- exclusion of low-quality products from the diet;
- timely treatment of diseases of internal organs;
- rejection of bad habits;
- the use of drugs strictly according to the doctor's prescription, in the prescribed dosage;
- compliance with the rules of personal hygiene;
- regular preventive examination by a gastroenterologist in case of a history of acute gastritis (even in the absence of symptoms).
In order to prevent the development of acute gastritis in children, it is recommended:
- organize proper nutrition, use only fresh, good-quality products when preparing meals for children;
- accustom children to the rules of personal hygiene;
- avoid psycho-emotional stress;
- undergo regular preventive examinations.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
