Chronic gastritis
The content of the article:
- Causes and risk factors
- Forms of the disease
- Chronic gastritis symptoms
- Features of the course of the disease in children
- Diagnostics
-
Chronic gastritis treatment
Penzital
- Diet for chronic gastritis
- Possible complications and consequences
- Forecast
- Prevention
Chronic gastritis is a chronic disease characterized by inflammatory and dystrophic changes in the gastric mucosa. Chronic gastritis is one of the most common pathologies of the digestive tract. The disease is found in all age groups. According to various sources, chronic gastritis is diagnosed in 50-80% of the adult population, but occurs in isolation in about 10-15% of patients. More often gastritis is combined with other pathologies of the gastrointestinal tract. For chronic gastritis, a recurrent course is characteristic.
Types and signs of gastritis
Causes and risk factors
One of the main reasons for the development of gastritis is infection with the microorganism Helicobacter pylori. Infection with this bacterium is more common in children and young people. Infection occurs through contact and household means (through personal hygiene items, dishes, with kisses, meals, etc.). However, the carriage of Helicobacter does not necessarily lead to gastritis; for its development, predisposing factors are necessary, which can be both endogenous and exogenous.
Risk factors for developing chronic gastritis include:
- improperly selected and / or untimely treatment of acute gastritis;
- hereditary predisposition;
- diseases of the internal organs;
- hormonal disorders;
- metabolic disorders;
- helminthic invasions;
- infectious diseases;
- decreased immunity;
- surgical interventions;
- exposure to the gastric mucosa of a number of chemicals;
- irregular and / or irrational nutrition;
- food allergies;
- lack of vitamins;
- the presence of bad habits (especially alcohol abuse, prolonged smoking);
- professional harm;
- exposure to the body of ionizing radiation;
- stressful situations.
In children, chronic gastritis can develop against the background of improper nutrition.
The development of chronic gastritis in children usually occurs against the background of a violation of the diet (irregular food intake, monotonous diet, insufficient chewing of food, etc.).
Forms of the disease
Gastritis can occur as an independent disease (primary gastritis), and develop against the background of other diseases (secondary gastritis).
Depending on the etiological factors, chronic gastritis is divided into:
- autoimmune (type A);
- bacterial (type B);
- chemical toxic (type C);
- mixed;
- additional types (medicinal, alcoholic, etc.).
Depending on the localization, there are:
- pangastritis;
- gastritis of the antrum of the stomach (antrum);
- gastritis of the body of the stomach;
- gastritis of the fundic stomach (fundic).
Depending on the functional sign, chronic gastritis can be:
- with normal secretion;
- with increased secretion;
- with secretory insufficiency.
According to the Houston classification system (1996), chronic gastritis is divided into:
- non-atrophic;
- atrophic autoimmune;
- atrophic multifactorial;
- chemical;
- radiation;
- lymphocytic;
- granulomatous;
- eosinophilic;
- giant hypertrophic (Menetrie's disease);
- other infectious gastritis.
Depending on the signs of disease activity, active (exacerbation) chronic gastritis and inactive (remission) are distinguished.
According to the severity, chronic gastritis is divided into mild, moderate and severe.
In addition, the disease is classified by morphological types into superficial and atrophic chronic gastritis.
Chronic gastritis symptoms
A wave-like course with periods of exacerbations of chronic gastritis and remission is characteristic.
The disease may not attract the attention of the patient for a long time, manifesting itself with such nonspecific symptoms as fatigue, flatulence, minor violations of the motor-evacuation function of the intestine.
Symptoms of the disease differ depending on the secretory activity of the stomach.
Symptoms of chronic low-acid gastritis are bad breath, bleeding gums, belching with a rotten egg-like odor, morning sickness, bloating, decreased appetite, feeling of heaviness after eating, and irregular bowel movements. Also, after eating, there may be pain in the upper abdomen.
Bad breath - a symptom of gastritis with low acidity
In chronic gastritis with high acidity, the patient complains of prolonged pain in the solar plexus region, which usually subside after eating. In addition, there is a bitter taste in the mouth, heartburn, sour belching, a feeling of pressure in the epigastrium, frequent diarrhea or constipation, and headaches on an empty stomach.
With an atrophic autoimmune form (type A gastritis) of chronic gastritis, patients have heartburn, bitter belching, a feeling of heaviness in the abdomen, decreased appetite, weight loss, pallor and dryness of the skin. Patients with this form of gastritis gradually develop B 12 deficiency anemia.
The clinical picture in non-atrophic chronic (superficial, type B gastritis, antral) gastritis may resemble the symptoms of peptic ulcer disease. Patients complain of epigastric pain at night and on an empty stomach, heartburn, belching with acidic stomach contents, nausea, and vomiting. The course of this form of chronic gastritis is also asymptomatic.
With chemical chronic gastritis (type C gastritis), an asymptomatic course is also often observed. In other cases, patients complain of heartburn, pain in the epigastric region, a feeling of heaviness after eating, nausea and vomiting.
Nausea, vomiting, heartburn occur with chemical chronic gastritis (type C)
With atrophic multifactorial chronic gastritis (mixed type), patients experience discomfort and pain in the epigastric region, bloating, nausea, vomiting, loss of appetite, diarrhea or constipation.
Features of the course of the disease in children
Chronic gastritis in children is usually combined with other diseases of the gastrointestinal tract. The clinical picture of the disease depends on the violation of certain functions of the stomach.
Children often experience pain in the epigastric region, which can be intense, paroxysmal, occur on an empty stomach and disappear after eating, appear 30-60 minutes after eating, with overeating, physical exertion. In addition, dyspeptic disorders are typical: heartburn, belching, loss of appetite, nausea, vomiting, and constipation.
Diagnostics
To diagnose chronic gastritis, anamnesis and patient complaints are collected, an objective examination, endoscopic diagnostics, as well as laboratory tests of the patient's blood and gastric juice.
When collecting anamnesis, attention is focused on the patient's food preferences and diet, the presence of bad habits, as well as on the lifestyle.
On examination, attention is drawn to the pallor of the skin, coated tongue, and bad breath. The abdominal wall in the epigastric region is painful on palpation.
Endoscopic examination allows to determine the localization of the inflammatory process and its severity.
In the general analysis of blood, signs of anemia, leukocytosis are determined. In the analysis of feces, undigested food debris can be detected, and a fecal occult blood test can also be positive.
To determine infection with Helicobacter pylori, a bacteriological study is carried out (growing on selective media), a rapid urease test, a breath test, and polymerase chain reaction studies.
Endoscopic examination helps to determine the severity and localization of inflammation in chronic gastritis
To study the acid-forming function of the stomach, intragastric pH-metry, a simple histamine test, are performed.
In some cases, they resort to double-contrast fluoroscopy of the stomach, which makes it possible to study the microrelief of the gastric mucosa.
To clarify the diagnosis (as well as to exclude malignancy), a biopsy of the gastric mucosa is sometimes performed.
Differential diagnosis is required with diseases of the esophagus, functional dyspepsia, gastric ulcer, malignant neoplasms of the stomach.
Chronic gastritis treatment
The choice of treatment regimen for chronic gastritis depends on the form of the disease. Usually, treatment is carried out on an outpatient basis, however, if complications develop, patients require hospitalization.
Patients with increased gastric secretion are shown antisecretory, antacid drugs (to relieve heartburn), prokinetics.
Patients with low acidity of gastric juice are prescribed drugs that stimulate secretory activity.
When Helicobacter pylori is detected, antibacterial drugs are used.
In order to improve digestion, enzyme preparations are prescribed, to normalize peristalsis and eliminate spasms - antispasmodics. To stimulate the motor function of the stomach, motor regulators are used, which also have an antiemetic effect. In addition, patients with chronic gastritis are shown gastroprotectors, which have an astringent and enveloping effect.
With the development of anemia, iron preparations, folic acid, vitamin B 12 are prescribed.
Treatment of chronic gastritis with medication
During the period of remission, physiotherapy is indicated: EHF-therapy, electrophoresis, phonophoresis, balneotherapy.
Penzital
Penzital is one of the medicines used in the treatment of chronic gastritis. It is based on pancreatin, an extract of pancreatic enzymes, which normalizes digestive processes by regulating the functions of the pancreas. The action of pancreatin is to break down fats, carbohydrates and proteins from food into simple substances that are easily absorbed. Penzital differs from other drugs of a similar composition and action by the absence of bile components in the composition, which, additionally stimulating the secretion of the pancreas, are an additional burden for it, therefore the drug is suitable for patients with liver and biliary tract diseases.
Penzital
Penzital is effective for gross errors in the diet, it helps digestion when overeating, eating heavy, spicy, fatty and unusual foods. It is prescribed in preparation for an ultrasound or X-ray of the abdominal organs, and also helps to maintain digestive function in the following conditions:
- inactivity and immobilization;
- problems with chewing in elderly patients;
- condition after resection of the stomach and small intestine.
Penzital is indicated for dyspepsia, flatulence, chronic pancreatitis, cystic fibrosis, diarrhea of non-infectious origin.
Available in tablets in packs of 20 and 80 pcs. It is taken orally 1-2 tablets 3 times a day immediately after a meal or during it.
Before you start taking Penzital, it is recommended to consult with your doctor.
Diet for chronic gastritis
In the treatment of chronic gastritis, patients are shown a gentle diet, in the preparation of which the acidity of the gastric juice is taken into account. The main goal of the diet for chronic gastritis is to maximally avoid thermal, mechanical, chemical irritation of the stomach, reduce inflammation and stimulate the healing processes of the mucous membrane.
During exacerbations of chronic gastritis, it is necessary to exclude the intake of too hot and too cold food, it is recommended to steam or boil food, serve in a liquid or puree state. The diet can include lean meat and fish, eggs, cereals, rosehip broth. It is necessary to exclude the use of coffee, carbonated drinks, chocolate, raw vegetables and fruits, flour products, dairy products, fatty, fried foods, spices.
In the period of remission of chronic gastritis, patients with high acidity are shown fractional nutrition. Foods that can stimulate the production of hydrochloric acid, such as broths, alcoholic beverages, tea, strong coffee, are excluded from the diet. Also excluded are spicy, smoked, fatty, fried foods, canned food, some vegetables (onions, radishes, cabbage, sorrel).
In chronic gastritis, a gentle diet is indicated.
Patients with chronic gastritis with low acidity during the period of remission are not recommended to eat foods that linger in the stomach for a long time (for example, flour products, rice). You should also refrain from eating spicy, spicy, smoked foods that irritate the gastric mucosa.
Possible complications and consequences
Chronic gastritis can be complicated by the following conditions:
- gastric bleeding;
- stomach ulcer;
- irritable bowel syndrome;
- hypovitaminosis;
- anemia;
- peritonitis;
- sepsis;
- anorexia;
- malignant neoplasms.
In addition, chronic gastritis can contribute to the development of diseases of the pancreas, gallbladder.
Forecast
With adequate treatment and dispensary observation, chronic gastritis does not lead to a significant deterioration in the patient's quality of life. With atrophic changes in the gastric mucosa, the prognosis of the disease is less favorable.
Patients with chronic gastritis are shown regular examinations by a gastroenterologist at intervals of twice a year. Patients at risk of malignancy are shown regular endoscopic examination.
Prevention
In order to prevent chronic gastritis, as well as to prevent relapses, it is recommended:
- timely treatment of diseases that can provoke the development of chronic gastritis;
- timely consultations with a doctor if you suspect a pathology;
- balanced diet;
- regular physical activity;
- getting enough night sleep;
- rejection of bad habits;
- avoidance of stressful situations.
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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!
