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Erosive gastritis

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What is erosive gastritis?

Erosive gastritis is a type of inflammation of the gastric mucosa acute and chronic origin, the distinguishing feature of which is the formation of small defects (erosions) on its surface.

This means that erosive gastritis:

  • Differs from simple gastritis by the presence of multiple plots with eroded mucosa on the background of its hyperemia (redness) and inflammation. Sometimes they can spread over the entire surface of the stomach;
  • May occur as acutely when injected into the gastric cavity of substandard food and toxic compounds, and can be chronic for when disruption of normal secretory and motor mechanisms of the digestive system;
  • Can be caused by H. pylori infection;
  • Prone to prolonged duration;
  • Treated more durable and more difficult in comparison with other types of gastritis;
  • Can cause gastric bleeding of any severity. This feature can be a real problem if bleeding occurs simultaneously from the entire eroded surface of the stomach.

Pathogenetic mechanisms of development of erosive gastritis can be:

  • Acute erosive gastritis damage of the mucosa occurs as a result of its direct contact with corrosive environments (poor quality food, acids, alkalis, chemicals, medications, etc.). Thus there is a kind of a burn that is accompanied by inflammation during its healing;
  • In the basis of chronic erosive gastritis are disturbed secretory processes. They may be associated with impaired nutrition, and internal failures of the body. Thus there is violation of microcirculation processes, blood circulation in the stomach and increased secretion of aggressive components of gastric juice. Naturally, ishemizirovanna the mucous membrane is unable to respond, leading to inflammation with subsequent ulceration and formation of erosions.

The symptoms of erosive gastritis

Suspect that is a form of erosive gastritis only on clinical signs and patient complaints extremely difficult. With the exception of those cases when the background confirmed gastritis is caused gastric bleeding. In such situations, the fact of the formation of erosions becomes apparent. All the other symptoms are typical for any kind of gastritis, and can only indirectly indicate its erosive of their strong intensity and durability.

To symptoms of erosive gastritis include:

  • Pain in the projection of the stomach (epigastric area of the upper abdomen). In erosive gastritis, it may not be intense, but widespread process for its relief may even require the introduction of strong analgesics;
  • Heartburn. The most typical for chronic erosive gastritis with impaired motor functions of the stomach and reflux of acidic gastric contents into lower esophagus;

  • Diarrhoeal disorders in the form of persistent heaviness in the stomach, sour and rotten burps, dryness and bitterness in the mouth, disorders of the chair;

  • The gain or pain occurs after meals or on an empty stomach, when in the cavity of the stomach is present only gastric juice, irritating pain receptors on the bottom of erosions.

Any suspected erosive gastritis should be confirmed or refuted through additional studies. For this purpose, a visual assessment of the gastric mucosa when fibrogastroduodenoscopy. This method allows us to assess the degree of structural changes caused by inflammation, to determine its prevalence and, if necessary, to biopsy. This is the fence of a fragment of mucosa along the edge of erosion for examination under a microscope.

To evaluate secretory activity of the stomach and acidity endoscopic examination produce relevant studies and measurements. Hyperacidity erosive gastritis with high acidity test for H. pylori infection that affects the volume of therapeutic interventions.


Erosive and hemorrhagic gastritis

Because of their persistent and long-term flow erosive gastritis often results in complications. Some of them are stomach bleeding from the eroded mucosa. Such gastritis is called erosive-hemorrhagic. The mechanism of their development is associated with the size, depth and localization of erosions. Superficialdefects in the anterior, posterior wall and fundus of the stomach bleeding is extremely rare. Most dangerous in this respect are extensive and multiple erosions extending to great depth. The most dangerous of their localization is the area of the lesser curvature in connection with the location in the area of large vessels and high intensity of the General circulation.

For the transition of erosive gastritis in erosive and hemorrhagic erosion should reach the depth of the vascular bed. Every person small vessels have different features of their branching structure and the level of pressure in them. So individuals with the same diagnosis have different degrees of risk of erosive and hemorrhagic gastritis. Increasingly, these patients with any form of hypertension and diseases of the blood coagulation system. Risk are patients taking anticoagulant drugs (aspirin and its analogs, warfarin, heparin), analgesics and non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen).

The transition symptoms of erosive gastritis in erosive and hemorrhagic bright enough. They all indicate the presence of stomach bleeding of varying severity.

To such signs carry:

  • Reduction pain intensity. This feature is the more pronounced, the more intense the bleeding. This phenomenon is related to the fact that erosion destroy sensitive receptors, which are blood vessels. Initially, therefore, the pain decreases, then there is bleeding;
  • Vomiting– a sign of erosive and hemorrhagic gastritis. Her character depends on the intensity of bleeding, diameter and number of bleeding vessels. If vomit is bloody content presented is evidence of active ongoing bleeding. The presence of vomit brown content is a Testament to prepodavaniya of blood from the vessels into the cavity of the stomach, or a slight bleeding;

  • Symptoms of anemia – reducing the amount of blood in the vascular space. Their severity depends on the amount of blood loss: pallor of the skin, dizziness, drop in blood pressure, acceleration of the pulse;

  • The dark color feces. Sometimes erosive and hemorrhagic gastritis is accompanied by so little bleeding that vomiting does not occur. But destroyed by acid, blood cells, into the intestine, cause dark color stool.

Treatment of erosive gastritis

Get rid of erosive gastritis should help such areas in its treatment:

  • Removing excess secretion of gastric juice. Achieved by the use of drugs with antisecretory mechanism of action. It can be either blockers of histamine receptors, or proton pump. From the first group are the most widely used famotidine, ranitidine, quamatel. From the second – omez, lansoprazole, controloc, Proxim;
  • Neutralization of aggressive hydrochloric acid. For these purposes, shown antacids: gaviscon, Maalox, Almagel, aluminium phosphate gel, Venter. They not only eliminate excessive acidity, but also form a protective film on the inflammatory mucosa and erosions. This contributes to their rapid healing;
  • Relief of digestive processes in the conditions of blocked gastric secretion. Used different generations of enzyme preparations: Kreon, Mezim, festal, panzinorm, mangrol;
  • The restoration of normal motility of the stomach and duodenum. In most cases of erosive and hemorrhagic gastritis occurs its violation. To eliminate this pathogenic component by using metoclopramide, cerucal, motylium, domperidone;
  • Hemostatic drugs. Used only in the case of erosive and hemorrhagic gastritis. Enter intramuscularly or intravenously is better: etamsilat, dicynone, menadione, and thioctic acid;
  • In the case of confirmation of Helicobacter gastritis erosive nature is shown taking anti-Helicobacter drugs: clarithromycin, metronidazole, Ornidazole, amoxicillin, de-Nol or ready combination of drugs (elobact neo, clatinol);
  • Treatment with alkaline mineral waters. Better to spend it in conditions of specialized health centers.

Topic: prevention of gastritis

Diet and menu with erosive gastritis

Acute and chronic erosive gastritis in the acute stage cannot be cured without the observance of certain dietary recommendations. They should stick to and for the prevention of disease. In the active stage of the inflammatory process is assigned a diet number 1. As it subsided, the patient gradually transferred to the fifth dietary table. Their General characteristics are as follows:

  • I do not eat, contributing to the increasegastric secretion and irritating the lining (spices, smoked, fried or fatty meals);
  • Products must be fresh, steamed or cooked;
  • The fractional and frequent meals. Preference is given to small portions;
  • Cooked food should be warm, preferably in liquid or pasty form. High and low temperatures are dangerous for inflamed and eroded mucosa.
  • With regard to the specific products and estimated menu, they should be:
  • Forbidden foods: fresh bread and scones from pastry flour, biscuits, chocolates, fatty foods of animal origin (pork, bacon, black pudding, homemade sausages with spices);
  • Permitted foods: stale white and black bread, biscuits, bran, potatoes mashed or in soup, various cereal of all cereals except wheat and barley, creamy and a small amount of vegetable oil, meat diet type (rabbit, chicken, fresh young beef), fish, dairy dishes.

Details about the diet: what can and can't eat for gastritis?


Estimated daily menus and the proper distribution of meals should look like this:

1st Breakfast

Dish of cottage cheese baked in the form, the drink of cocoa

2nd Breakfast

Weak sweet tea and nesdobnoe bread yesterday's baking with butter

Lunch

Any liquid dish based on meat stock, vegetables, steamed fish, fruit decoction or juice

Afternoon tea

Crackers or biscuit with jelly

Dinner

Roasted vegetables with pieces of meat, fruit decoction (wild rose)

Second dinner

Kefir, fermented baked milk or yogurt


orshenin Elena Ivanovna, doctor-gastroenterologist