Gastritis - inflammation of the mucous (inner) membrane of the stomach wall. When inflammation passes to the duodenum, the so-called gastroduodenitis is formed.
There are two types of gastritis and gastroduodenitis: with low and high acidity of gastric juice.
Chronic gastritis is a disease with recurrent inflammatory process in the mucous and submucous membranes of the stomach, accompanied by a violation of the regeneration of the epithelium and the development of atrophy, which inevitably leads to the development of secretory insufficiency with subsequent multiple digestive disorders.
Symptoms and treatment, as well as a description of the diet will be discussed in this material.
What it is? Among the main reasons for the development of chronic gastritis experts identify the following factors:
- Eating coarse food, marinades, smoked food, spices and hot spices. All this has a detrimental effect on the gastric mucosa and enhances the secretion of hydrochloric acid.
- Frequent use of overheated foods and hot drinks (coffee, tea). All of the above causes thermal irritation of the stomach.
- Long-term uncontrolled use of medications that irritate the stomach mucosa (we are talking about salicylates, some antibiotics, sulfonamides, and others).
- Irregular food intake, excessively fast chewing, the habit of eating dry.
- Alcohol addiction. Alcoholic beverages extremely adversely affect the work of gastric spysis, worsen the regeneration of mucosal epithelial cells, and cause problems with blood circulation. The simultaneous intake of a considerable amount of alcohol can provoke erosive gastritis.
Sometimes chronic gastritis is nothing but the result of the development of acute gastritis, however, most often it occurs and develops under the influence of various factors.
Antral chronic gastritis is caused by the presence of the bacterium Helicobacter pylori in the human body. It adversely affects the glands in the stomach and damages its mucous membrane. In some cases, such processes are accompanied by disorders of an autoimmune nature.
One of the forms of gastritis in question has a denorative-dystrophic character. This causes the inflammatory process in the mucosa and its scarring. It, in turn, leads to obstruction of the movement of food from the stomach into the duodenum. Antihelicobacter antibiotics, antacids, regenerating and anesthetic drugs are necessarily included in the treatment.
Atrophic chronic gastritis - type A, in which the number of gastric glands decreases, the acid-forming function decreases. Atrophic gastritis is a precancerous condition.
Manifested by heaviness and dull pain in the stomach, nausea, heartburn, dyspeptic symptoms, anemia. Since 90% of gastric atrophies are associated with Helicobacter pylori, specific treatment usually involves the eradication of the infection. Substitution and symptomatic therapy, sanatorium treatment and physiotherapy are also prescribed.
Symptoms of chronic gastritis
In the case of chronic gastritis, the symptoms in adults may differ depending on whether the disease leads to an increase or decrease in the acidity of the gastric juice.
- Patients with chronic gastritis with increased acidity have such symptoms - abdominal pain, belching sour, heartburn, feeling of heaviness in the stomach after eating, constipation.
- Chronic gastritis with low acidity is characterized by burning pains after eating, nausea, vomiting, diarrhea, belching, flatulence and rumbling in the abdomen.
Among the common symptoms found in patients with chronic gastritis, irritability, weakness, and fatigue are most common. Sometimes there is a heartbeat, pain in the area of the heart, blood pressure decreases.
A long course of gastritis can lead to a gradual weight loss, frequent occurrence of intestinal disorders, diarrhea, constipation. Extensive damage to the gastric mucosa leads to the fact that the body ceases to fully absorb the nutrients obtained from food. As a result, a person develops anemia or anemia associated with a lack of vitamin B12 in the body.
On the background of the disease can be observed: reduction in blood pressure, headaches, pallor of the skin, numbness of the extremities, disruption of the heart, dizziness, up to fainting. Depending on the form of the disease will directly depend on how to treat chronic gastritis, and what diet should be followed.
Symptoms of exacerbation of chronic gastritis
A patient suffering from gastritis should immediately seek medical help in identifying the following symptoms:
- Pain in the upper abdomen - long, aching, aggravated after a meal, in some cases, subsides after vomiting. The pain is associated with damage to the mucous (inner) lining of the stomach and with its walls stretching to gastric contents.
- Headache, weakness, palpitations, fever - signs of intoxication, accompanying the inflammatory process of the gastric mucosa;
- Dry mouth after bouts of vomiting;
- Increased salivation;
- Unpleasant taste in the mouth;
- Weight loss;
- Appetite disturbances;
- Nausea or vomiting;
- Diarrhea or constipation;
- Blood in the feces (with erosive gastritis);
- Belching, etc.
The severity of these symptoms is individual for each patient. Pain, in the period of exacerbation of chronic gastritis, may disturb the patient constantly or appear periodically. In some patients, it appears only on an empty stomach or before meals, and for someone it appears some time after eating.
To prevent the exacerbation of chronic gastritis, it is necessary to adhere to therapeutic nutrition. It is recommended to eat food often, in divided portions, to avoid overloading the stomach. It is also worth quitting smoking and drinking alcohol as factors affecting the secretory function of the stomach.
During the period of well-being, with increased or normal gastric secretion, it is possible to take courses of mineral waters, which inhibit gastric secretion: "Luzhanskaya", "Borjomi", "Slavyanovskaya", "Moskovskaya".
Periodically, according to the recommendations of the doctor, it is necessary to take drugs such as vikalin, gastrofarm, de-nol.
FGDS is crucial for clarifying the diagnosis.
Diagnosis of chronic gastritis:
- The study of the secretory function of the stomach.
- Analysis of feces: possible presence of hidden blood, as well as undigested food residues with reduced secretory activity of the stomach.
- A general blood and urine test will help detect signs of inflammation in the body during exacerbation of chronic gastritis (tests will be normal in remission), hyperchromic anemia in chronic autoimmune gastritis.
- EGD and biopsy specimens for histological examination. If it is impossible to perform FGDs, an X-ray examination of the stomach with barium contrast can be performed, but this is less informative.
- Detection of Helicobacter pylori microbe. The "gold standard" is a histological examination of biopsy specimens with their color according to certain patterns and subsequent microscopic examination. A biological method is also used (sowing a microorganism on a nutrient medium).
- Manometry: with reflux gastritis, an increase in pressure in the duodenum up to 200-240 mm water column is detected. (in normal - 80-130 mm water column).
Differential diagnosis is performed with gastric ulcer and duodenal ulcer, diaphragmatic hernia, esophagitis, tumors.
Treatment of chronic gastritis
Treatment of the disease in adults includes a whole range of procedures, and therapy is selected individually for each patient, taking into account the type of gastritis, the stage of the disease and the presence of associated diseases. Patients are usually treated on an outpatient basis, but sometimes, for severe exacerbations and the occurrence of complications, hospitalization may be required.
First of all, it is necessary to eliminate external factors, the impact of which has led to the development of the disease, such as smoking, drinking alcohol, poor nutrition.
Therefore, in chronic gastritis, diet therapy is the basis of treatment, and the diet is also selected depending on the type of impaired gastric secretion.
In case of gastritis caused by the microbe Helicobacter pylori, antimicrobial therapy is used. There are several standard treatment regimens for adult patients, including:
- IPP (omez, nolpaz, pariet, emaner - substances used in the treatment of gastrointestinal diseases associated with the release of hydrochloric acid);
- Bismuth preparations (de-nol, ventrisol).
In the absence of Helicobacter pylori and increased gastric secretory function:
- The drugs that lower the acidity of gastric juice (almagel, phosphalugel, gelusil varnish, maalox, etc.)
- Drugs that protect (envelop) the mucous membrane: sucralfate, bismuth dicitrate (also has an antimicrobial action against Helicobacter pylori).
In the case of diagnosing reflux gastritis, prokinetics are included in the list of medications. Their task is to normalize the motility of the gastrointestinal tract. Such drugs may also be included in the treatment program for chronic gastritis of the autoimmune type.
With this diagnosis, the patient is required not to reduce the acidity of the stomach, but rather to stimulate the secretion of gastric secretion, in which special medications help. Enhance digestion will help enzyme preparations.
Diet for chronic gastritis
One of the main elements of the treatment of the disease is diet. In the period of exacerbations of chronic gastritis it is impossible to do without a sparing diet. It was at this time that malnutrition causes pain, aggravates dyspeptic disorders characteristic of this disease. It is necessary to reduce the likelihood of irritation of the inflamed stomach walls.
Depending on the nature of the secretory function of the stomach, an adult should follow one of two diets.
- In case of gastritis with normal or increased secretion of gastric juice, diet No. 1a is prescribed (up to 7 days), then diet No. 16 (up to 14 days), and diet No. 1 is stretched for 3 months. If these diets are observed, the patient is given food in a liquid or shabby form, and vitamins (ascorbic acid, riboflavin) are also added. Alcohol, juice, coffee, strong tea, spicy fatty foods, canned food, beans, peas are prohibited.
- In chronic gastritis with insufficient gastric secretion - compliance with diet number 2 is shown. Nutrition in this case is fractional, the food is taken in a well crushed and boiled form, and the intake of coffee, tea, juices, vegetable Navar, meat broths, meat and fish of low-fat varieties stimulates the secretory function of the stomach. Due to insufficient production of gastric juice, foods that are rich in fiber, namely grapes, radishes, dates, as well as spicy, smoked and very salty foods, cold drinks, and pastries are excluded from the diet. Whole milk, cream, buckwheat and barley cereal, legumes, pickled vegetables, mushrooms, carbonated drinks are not recommended.
When remission (significant weakening or disappearance of signs of the disease) dietary recommendations become less stringent:
- The exception is spicy, fatty, fried, smoked food, canned food, carbonated drinks.
- Food should be grated, steamed, boiled or stewed. Excludes fresh fruits and vegetables. From fruit can only bananas.
- Food should be warm - 40-50 ° C. Cold and hot food is excluded.
- The amount of fluid you drink should be at least 1.5 liters per day.
- Any products should be chewed thoroughly.
- You can not allow overeating and haste, snacking "on the go" and eating dry meal.
- Alcohol and smoking are excluded.
Sanatorium-resort treatment is indicated for patients with chronic gastritis outside the acute stage. It is held in the resorts of Arzni, Borjomi, Jermuk, Dorokhovo, Druskininkai, Yessentuki, Zheleznovodsk, Krainka, Mirgorod, Pyatigorsk, Truskavets and others.